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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We performed a retrospective clinicopathological review of 124 patients with epithelial downgrowth seen over a 30-year-period at the Massachusetts Eye and Ear Infirmary. The purpose of this study was to determine predisposing factors in the development of epithelial downgrowth, diagnostic symptoms and signs, and the results of various types of treatments. The incidence of this condition after cataract surgery was 0.12%, decreasing to 0.08% over the latter decade. 82% of postsurgical patients with epithelial downgrowth presented to the ophthalmologist within one year following surgery, commonly complaining of decreasing visual acuity, red eye, and pain. The most common presenting signs of epithelial downgrowth were retrocorneal membrane, which was seen in 45% of patients, glaucoma in 43%, corneal oedema in 21%, and a positive Seidel test in 23%. We found that a variety of conditions predispose to epithelial downgrowth but that no one factor was present in all cases. Damage to the underlying endothelium, corneal stromal vascularisation, and stromal downgrowth appeared to be important events not emphasised in prior studies. The angle was partially or totally closed in 87% of enucleation specimens. Patients treated surgically underwent fewer enucleations than those treated medically or not treated.
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PMID:Epithelial downgrowth: a 30-year clinicopathological review. 292 Jan 56

In March 1985, a Health Care Financing Administration regulation went into effect requiring that cataract removal without exceptional circumstances be done in outpatient settings. In this paper, we study implications of that mandate by comparing the cost and quality outcomes of cataract removal in outpatient and inpatient settings both before and after the regulation went into effect. After controlling for population and physician differences for both study periods, we found by chi square significantly fewer infections, suture adjustments, and pain requiring medication among outpatients than inpatients. Log-linear regression, however, found that the only significant predictor was inpatient or outpatient, and only for infection (p = .02), with an odds ratio of 7.55 (95% confidence interval; .92-61.60). We also found lower Medicare payments for outpatients in both study periods. For the preregulation study groups, inpatient care was 34.8% more costly than outpatient care; the cost differential dropped to 32.5% for the postregulation study groups.
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PMID:Cost and quality effects of outpatient cataract removal. 297 23

A six year randomised trial was conducted among 5139 apparently healthy male doctors to see whether 500 mg aspirin daily would reduce the incidence of and mortality from stroke, myocardial infarction, or other vascular conditions. Though total mortality was 10% lower in the treated than control group, this difference was not statistically significant and chiefly involved diseases other than stroke or myocardial infarction. Likewise, there was no significant difference in the incidence of non-fatal myocardial infarction or stroke--indeed, disabling strokes were somewhat commoner among those allocated aspirin. The lower confidence limit for the effect of aspirin on non-fatal stroke or myocardial infarction, however, was a substantial 25% reduction. Migraine and certain types of musculoskeletal pain were reported significantly less often in the treated than control group, but as the control group was not given a placebo the relevance of these findings was difficult to assess. There was no apparent reduction in the incidence of cataract in the treated group. The lack of any apparent reduction in disabling stroke or vascular death contrasts with the established value of antiplatelet treatment after occlusive vascular disease.
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PMID:Randomised trial of prophylactic daily aspirin in British male doctors. 312 82

Complicated retinal detachments (RDs) were successfully managed in 150 eyes of 170 consecutive patients by one surgeon (JLF) using silicone oil in conjunction with modern pars plana vitrectomy. Long-term postoperative complications were observed between 6 months and 5 years of follow-up. Cataracts developed in all phakic eyes and all corneas with oil-endothelial touch showed band keratopathy within 6 months. Recurrent detachments were noted in 22% of eyes during silicone oil tamponade and occurred in 13% of eyes after the oil had been removed. Other complications associated with the use of oil for vitreous surgery included pupillary block glaucoma (3%), closure of the inferior iridectomy (14%), fibrous epiretinal and subretinal proliferations (15%), pain (5%), and subconjunctival deposits of oil (3%). Without exception, within a period of 1 year the intraocular silicone oil showed some degree of emulsification, suggesting that the physicochemical characteristics of the oil injected may be an important variable in long-term complications.
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PMID:Complications associated with the use of silicone oil in 150 eyes after retina-vitreous surgery. 317 36

A 78-year-old woman underwent recession-resection surgery for longstanding exotropia. A scleral perforation occurred at the time of surgery and was treated with transscleral retinocryopexy. Three days after surgery the patient experienced light perception vision, pain, and hypopyon. She underwent a trans pars plana vitrectomy with intravitreal and periocular antibiotics. Three months after vitrectomy, visual acuity returned to the preoperative level of 20/50. Six months after vitrectomy she underwent an uneventful cataract extraction with posterior chamber lens implant. Visual acuity 5 months after cataract surgery was 20/20.
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PMID:Endophthalmitis after strabismus surgery with a good visual result. 325 55

Bacterial endophthalmitis is a postoperative complication of intraocular lens implantation. A review of 30 cases showed that 77% occurred within seven days of initial cataract surgery and that all cases occurred within 32 days. Common presenting symptoms and signs included pain localized to the involved eye, decreased visual acuity, conjunctival injection, anterior chamber inflammation, hypopyon, and absent or poor red reflex. Diagnosis of an infectious etiology was made by aqueous and vitreous sampling for gram stain and culture. The commonest bacterial agents were coagulase-negative staphylococci and Staphylococcus aureus, but a wide variety of gram-negative and -positive organisms were also isolated. On the basis of this series and review of the literature, optimal treatment includes prompt diagnosis by culture and gram stain of vitreous fluid, frequent application of topical antibiotics, and administration of intraocular antibiotics. Intravenous antibiotics and vitrectomy may improve the visual outcome. Removal of the intraocular lens is unnecessary for bacteriologic cure and is not associated with improved visual outcome.
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PMID:Endophthalmitis following intraocular lens implantation: report of 30 cases and review of the literature. 351 84

A boy aged 3 years had a Worst Medallion intraocular lens with loops made of nylon 6 implanted in his right eye after aspiration of traumatic cataract. Post-operatively, the eye was irritated and showed increased tendency to secondary membrane formation. The patient was lost to follow-up 3 months post-operatively. He returned 5 years later because of 4 days of pain and redness in his right eye. On examination, the optic part of the intraocular lens was seen to lie free in the anterior chamber. The loops were broken near their insertions in the lens body. The distal ends of the broken loops could not be detected in the pupillary region. No traces of the iris fixation suture were to be seen. The lens was removed and subjected to scanning electron microscopy which revealed extensive biodegradative changes in the 3 loop stumps, the 4th being totally dissolved. The young age of the patient and the chronic inflammation may have had an accelerating effect on the nylon degradation. We conclude that children with eyes implanted with nylon-loop lenses should stay under regular ophthalmological control.
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PMID:Dislocated intraocular lens after biodegradation of fixation loops. A case report. 352 4

In this double-blind study, retrobulbar block for cataract surgery was produced in 43 patients with etidocaine 1% and in 37 patients with a mixture of equal volume of lidocaine 2% and bupivacaine 0.75% (final concentrations of 1% and 0.375%, respectively). While a greater proportion of etidocaine-treated patients needed supplemental drug for block, the times of onset of sensory and motor block were not different for the two groups. Compared to treatment with etidocaine, patients treated with the mixture had a slower recovery of motor function. While the proportion of patients reporting postoperative pain was about the same in each group, both the onset of pain and the use of analgesic agents occurred earlier in the group treated with etidocaine. Thus retrobulbar blocks produced by the combination of lidocaine and bupivacaine occurred as rapidly as those produced by etidocaine but had a longer duration.
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PMID:A comparison of retrobulbar block produced by etidocaine 1% and by a mixture of lidocaine 2% and bupivacaine 0.75%. 357 62

Visualized cyclodialysis was carried out in 16 consecutive cases of operation-demanding glaucoma, where trabeculectomy was considered inexpedient. In 9 cases simultaneous cataract extraction was carried out. At follow-up 2-34 months (median = 15) post-operatively, the IOP had decreased from a median value of 32 mmHg (range 21-44) to a median value of 17 mmHg (range 7-28) in 15 out of 16 eyes. The 16th eye had to be eviscerated because of pain before and after an inefficient cyclodialysis. Five eyes were reoperated upon. Essential complications were 2 cases of central visual field impairment and 1 case of arteriovenous occlusion after cyclodialysis revision. We find visualized cyclodialysis a useful procedure for aphakic glaucoma as well as for re-operations. Frequent post-operative examinations are necessary for 1-2 months post-operatively.
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PMID:Visualized cyclodialysis--an additional option in glaucoma surgery. 372 51

Six diabetic patients (five women and one man, 63 to 79 years old) developed pseudophakic pupillary block with angle-closure glaucoma two days to one year after undergoing extracapsular cataract extraction. None of the six had had a peripheral iridectomy during the procedure. Symptoms included pain and visual loss. Corneal edema and intraocular pressures as high as 80 mm Hg were also present. Laser iridotomies decreased the intraocular pressure in three cases but failed in a fourth. In one case corneal edema prevented laser treatment but a surgical peripheral iridectomy was successful. One eye with central retinal vein occlusion was treated with panretinal photocoagulation and trabeculectomy.
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PMID:Pseudophakic pupillary block with angle-closure glaucoma in diabetic patients. 375 97


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