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

A patient had a corneal transplant with removal of an anterior chamber lens. As part of the procedure, an exchange posterior chamber lens was inserted and sutured transsclerally into the ciliary sulcus with two subconjunctival 10-0 polypropylene (Prolene) sutures. One month later the patient experienced a sudden decrease in vision and severe eye pain. Streptococcus viridans was cultured from the vitreous tap and the eye eventually was lost from this endophthalmitis. The infecting organism appeared to gain access to the eye through one of the Prolene sutures that had eroded through the conjunctiva and become exteriorized. This report presents a case in which an eroding 10-0 Prolene suture used for transscleral posterior chamber lens fixation was the probable mechanism causing endophthalmitis. This complication represents an avoidable risk unique to this type of intraocular lens fixation.
J Cataract Refract Surg 1990 Nov
PMID:Suture-wick endophthalmitis with sutured posterior chamber intraocular lenses. 225 14

1031 British optometrists completed a questionnaire to give information on their rates of referral and notification to the medical profession. Data were collected in relation to the conditions concerned, the age and sex of the patient, and the spectacle correction. Major causes of referral were cataract, glaucoma, fundus changes, headaches/migraine/eye pain and lowered visual acuity; 6.5% of all patients seen were referred to their general medical practitioner notified, and of this group it was estimated that 25-30% could have managed with reading glasses which comprised spherical lenses of equal power. If such glasses could be self-selected, without reference to a medical practitioner or optometrist, a significant number of people would not benefit from the health screening aspects of the eye examination.
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PMID:Referrals and notifications by British optometrists. 326 10

Acanthamoeba keratitis occurs mainly in contact lens users. We experienced a patient with Acanthamoeba keratitis after operation for cataract. A 70-year-old male, who suffered from suppurative keratitis with impairment of visual acuity and eye pain in the left eye after the operation, was admitted to our hospital. After admission he received treatment with oral and topical antibiotics without any improvement. Neither bacterial or fungal pathogens was detected from corenal skrappings. Blue stained Acanthamoeba cysts were detected with the Parker ink KOH preparation from punctured fluid of the anterior chamber of the eye. Acanthamoeba cysts were also cultured on a nonnurient agar plate with Escherichia coli. Then he was treated with oral and topical miconazole and topical fluconazole. His visual acuity did not improve because of the lag of appropriate treatment. Therefore, attention must be paid for the existence of Acanthamoeba keratitis after ophthalmologic operations.
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PMID:[A case of Acanthamoeba keratitis after operation for cataract]. 749 19

Intraocular pressure elevation after the use of viscoelastic agents in uncomplicated cataract surgery has been well documented in adults. However, pediatric patients are thought to clear residual viscoelastic agents from the anterior chamber more easily than adults, presumably because of healthier trabecular meshwork. (1) We report on a series of 4 eyes of 4 children with previously normal intraocular pressure who underwent cataract extraction with primary (3 patients) or secondary (1 patient) intraocular lens implantation with Healon GV, which was complicated by marked postoperative intraocular pressure elevation (greater than 30 mm Hg). The patients, aged 5 to 14 years, had an intraocular pressure ranging from 34 to 50 mm Hg with Tonopen or applanation tonometry 1 day, postoperatively associated with nausea, eye pain, and microcystic corneal edema. Viscoelastic material was not entirely removed during surgery. Each of these cases occurred after a change in our preferred viscoelastic agent from one with less viscosity to Healon GV. Medical management controlled the elevated intraocular pressure in all cases without affecting the visual outcome. However, 1 patient with intractable nausea and vomiting required hospitalization for rehydration. With meticulous removal of all viscoelastic material at the completion of surgery, we have not documented any additional cases of postoperative pressure elevation.
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PMID:Postoperative intraocular pressure elevation after the use of Healon GV in pediatric cataract surgery. 1067 75

A 72-year-old man with long-standing bilateral glaucoma became refractory to levobunolol ophthalmic solution therapy after many years. Brimonidine was prescribed, but the patient developed a hypersensitivity several months later that was treated with loteprednol ophthalmic suspension. Bimatoprost was initiated 2 weeks later. Within an hour of the first dose of bimatoprost, the patient reported eye pain and photophobia that remained unresolved the following day. Examination revealed acute bilateral nongranulomatous anterior uveitis that was effectively treated with loteprednol. While observations in human and animal models suggest an association between certain prostaglandin-like agents and intraocular inflammation, this report is one of the first to suggest a link between bimatoprost and intraocular inflammatory reaction.
J Cataract Refract Surg 2003 Nov
PMID:Bilateral nongranulomatous anterior uveitis associated with bimatoprost. 1467 Apr 42

Macugen (pegaptanib sodium), manufactured by Eyetech Pharmaceuticals, Inc., and Pfizer, Inc., is the first treatment approved by the U.S. Food and Drug Administration for all forms of wet macular degeneration. Although the cause of wet macular degeneration is not known, it is believed that vascular endothelial growth factor (VEGF) induces angiogenesis, resulting in a neovascular process, the hallmark of wet macular degeneration. Macugen is a VEGF antagonist. In two controlled, double-blinded identical studies, Macugen 0.3 mg was shown to slow the progression of wet macular degeneration. Using strict aseptic technique, Macugen 0.3 mg is administered via intravitreal injection every six weeks for one to two years. Serious adverse reactions include endophthalmitis, retinal detachment, and iatrogenic traumatic cataract. Macugen is administered after a topical anesthetic, a subconjuctival block, or a combination of both is used to numb the injection site on the temporal sclera. Post-procedure patients may initially complain of transient vision loss, burning, pressure, eye pain, or "floaters". At time of discharge, patients should be informed of the signs and symptoms of infection and instructed in the administration of antibiotic drops and in proper follow-up care. Most patients are seen for follow up one week after injection and again in five weeks for additional treatment.
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PMID:Macugen treatment for wet age-related macular degeneration. 1681 67

Phacomorphic glaucoma is a lens-induced secondary angle closure glaucoma that may occur as a result of mature cataract formation. A patient with markedly asymmetric cataract and anterior chamber depth was referred after the development of significant eye pain and elevated intraocular pressure that did not respond to topical antiglaucoma medications. The presence of an asymmetric mature lens, angle closure, and intraocular pressure elevation in the affected eye led to the diagnosis of phacomorphic glaucoma. Because the patient was systemically ill, physically frail, and had poor vision in the affected eye since birth, secondary to strabismic amblyopia, initial therapy was medically directed toward pain management. Cycloplegia, corticosteroids, and aqueous suppressants successfully ameliorated the patient's intraocular pressure and adequately controlled pain. However, progression to phacolysis and subsequent failure of pain management necessitated referral for lens extraction. The diagnosis and mechanism of phacomorphic glaucoma is discussed along with a review of current treatment modalities.
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PMID:Phacomorphic glaucoma: case and review. 1715 40

Age-related macular degeneration (AMD) is one of the most common causes of severe vision loss in the western world. Both animal and human studies have established that vascular endothelial growth factor (VEGF) plays an important role in the pathogenesis of this process. Ranibizumab (Lucentis(TM) Genentech, South San Francisco, CA) is a monoclonal antibody fragment (Fab) directed toward all isoforms of VEGF-A that was specifically designed to target wet AMD. The human antibody fragment is produced by an E. coli expression system and has a molecular weight of 48kD allowing for excellent retinal penetration. The most common ocular complaints of patients receiving ranibizumab injections in randomized clinical trials were transient conjunctival hemorrhage, vitreous floaters, intraocular inflammation, increased intraocular pressure and eye pain. The rates of serious adverse events such as retinal detachment, cataract and endophthalmitis were similar to those that have been reported with other intravitreal injections and patients should always be treated under strict aseptic conditions to reduce this risk. There were no significant non-ocular events found during any study so far and the risk of thromboembolic events was less than 4% and not different than sham. The MARINA, ANCHOR and PIER studies validated the safety and efficacy of ranibizumab amongst a large population with different choroidal neovascular membrane lesion types against sham or standard of care treatment. These studies recommended monthly intravitreal ranibizumab for patients. However, the PIER study reported that an alternative dosing of every three months is acceptable but less effective than monthly injections.
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PMID:Role of ranibizumab in management of macular degeneration. 1795 97

To report acute onset lens particle glaucoma associated with a spontaneous anterior capsular dehiscence. A 66-year-old man presented with spontaneous anterior lens capsule dehiscence with an acute onset of right eye pain that was associated with white particles in the anterior chamber angle and intraocular pressure (IOP) of 55 mmHg. No trauma or other inflammatory antecedents were reported. A hypermature cataract was observed at slit lamp exam. After medical treatment without IOP control, we performed extracapsular cataract extraction and anterior vitrectomy. Anterior chamber aspirate confirmed the presence of macrophages. The postoperative IOP at one month was 16 mmHg OD without medication. Spontaneous dehiscence of the anterior lens capsule in a patient with a hypermature cataract may release lens cortical material, resulting in lens particle glaucoma. Prompt surgical removal of the lens material usually controls the high IOP, and the need for additional glaucoma surgery is not common.
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PMID:Spontaneous anterior lens capsular dehiscence causing lens particle glaucoma. 1956 12

We present the case of a patient who experienced recurrent episodes of blurry vision and eye pain after uneventful cataract extraction and in-the-bag intraocular lens (IOL) implantation. Examination revealed a microhyphema and signs of pigment dispersion. Iris transillumination was seen overlying areas where the IOL optic was not covered by the anterior capsule. Anterior segment optical coherence tomography confirmed iris indentation by the IOL optic, which was alleviated by performing laser peripheral iridotomy. This case shows that IOLs in the capsular bag can erode the posterior surface of the iris and that an adequately sized capsulorhexis should be performed to ensure anterior capsule coverage. Laser peripheral iridotomy should be considered when significant posterior iris bowing is observed.
J Cataract Refract Surg 2009 Aug
PMID:Pigment dispersion and recurrent hyphema associated with in-the-bag lens implantation. 1963 Nov 36


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