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

Central corneal perforations have traditionally been managed by conjunctival flaps, tissue adhesives, soft contact lenses, corneal patches and other conservative measures for the immediate preservation of the eye. An alternative method of treatment is immediate penetrating keratoplasty. We present the result of immediate keratoplasty for 25 eyes referred with acute central corneal perforations, 20 of herpetic origin and 5 with a chemical burn or dry eye syndrome. In all cases, the eye was successfully preserved. Twelve of 20 grafts (60%) for herpetic perforation went on to eventual clear grafts as opposed to 1 of 5 grafts (20%) in the dry eye or chemically burned patients. Significant complications encountered included cataract formation, secondary glaucoma and persistent epithelial defects; however, these should not preclude eventual restoration of good visual acuity. Penetrating keratoplasty in acutely inflamed and perforated eyes used to lead to angle closure and secondary glaucoma in a considerable number of cases, sometimes progressing to total disaster. We have shown that if enough corticosteroids are given immediately postoperatively, the risk for angle closure is not significant.
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PMID:Penetrating keratoplasty in acute herpetic corneal performations. 77 41

We report the etiological profile and management with simple patch, tarsorrhaphies, conjunctival flaps, tissue adhesive, or penetrating keratoplasty of 104 chronic corneal perforations in a North India population. Chronic corneal perforations were observed in infective keratitis, degenerative keratolysis, neurotrophic keratitis, chemical burns, dry eyes, collagen vascular diseases, and following cataract extraction. A two-stage tissue adhesive application and adhesive-assisted debridement of epithelial lining at the cornea surface of perforation were important factors in healing. Although penetrating keratoplasties brought comparable anatomical and functional success in these cases, in developing countries, where facilities for keratoplasty and availability of corneal donor is poor, detection and management of small perforations in diseased cornea with tissue adhesive is recommended.
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PMID:Chronic corneal perforations. 151 36

A study was performed on 60 patients, of whom 20 had the dry eye syndrome, 20 had had cataract surgery and 20 belonged to a control group. Twenty percent of the dry eye group and 45% of the post-cataract surgery group had cells with so-called bar-shaped nuclear chromatin (bar-chromatin cells) with a morphology basically akin to those of Anitschkow nuclear changes found in cardiac tissue. Bar-chromatin cells were found in scrapings from different parts of the conjunctiva, mostly in intermediate squamous cells and rarely in goblet cells. However, these nuclear changes were infrequent in the control group. Since the bar-chromatin cells were much more frequent in patients with diseased eyes, we concluded that the findings were possibly of a regenerative nature.
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PMID:Presence of bar-shaped nuclear chromatin in cell samples from the conjunctiva. 154

The authors report on 64 of the first 65 patients treated with iodine 125. The mean follow-up was 64.9 months. After treatment, 29 patients (45.3%) retained visual acuity of 20/100 or better, and 18 patients (28.1%) retained visual acuity within two lines of visual acuity before irradiation. Eleven patients (17.2%) died of metastasis, and 5 patients (7.8%) had local recurrence. Cataract developed in 29 (45.3%) patients; keratitis developed in only 2 (3.1%) patients, and dry eye developed in none. Neovascular glaucoma developed in 7 (10.9%) patients, and 15 (23.4%) patients had radiation retinopathy. Eleven patients (17.2%) required enucleation for either tumor growth or neovascular glaucoma. These results show the increasing number of radiation complications seen with long-term observation and the frequently seen adverse visual outcome.
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PMID:Long-term results of iodine 125 irradiation of uveal melanoma. 159 24

Collagen shields have been studied in the enhancement of the initial healing of epithelial defects, as an adjunct in the treatment of dry eye, and as a reservoir and delivery system for topical ocular medications. The authors used collagen shields to collect information on the numbers and types of free cells populating the normal and postoperative ocular surface. In addition, correlative microscopic techniques were used to study details of the mechanisms responsible for the dissolution of the shields when applied to the human eye. Collagen shields were applied as a bandage lens on the eyes of patients who underwent extracapsular cataract extraction (n = 10) or penetrating keratoplasty (n = 10) and on normal volunteers (n = 10). The shields were collected at the 1-day postoperative examination and fixed in aldehyde mixtures. Specimens then were processed for correlative light (LM), transmission (TEM), and scanning (SEM) microscopy. Cell accumulation was shown by SEM on both anterior and posterior shield surfaces. Cell adherence occurred primarily on the posterior shield periphery for approximately 2 mm, with the central zone relatively clean. Both LM and TEM evaluation revealed cell counts ranging from 0.066 cells/10(4) microns2 (standard deviation, +/- 0.256) in healthy eyes compared with shields placed on postoperative eyes (194.25 +/- 7.32 cells/10(4) microns2). Various correlative microscopy techniques revealed that most cells were polymorphonuclear leukocytes with a low number of other hematogenous (lymphocytes and monocytes) and exfoliated epithelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Collagen shields as a vehicle for collecting and studying migratory cells on human corneas. 174 Mar 59

Forty-one patients who had undergone bone marrow transplantation were examined. Nineteen (63%) of the 30 who had received fractionated total body irradiation (TBI) had cataracts in comparison with only 1 (9%) of the 11 non-irradiated patients. No significant differences in steroid therapy were demonstrated between these groups of patients. Dry eyes were observed in eight irradiated patients, seven of whom had preceding graft-versus-host disease. Superficial punctate staining of the bulbar conjunctiva was observed in 25 (83%) of the irradiated group and, in milder form, in five (45%) of the non-irradiated group. Our data suggest that the incidence of cataract following fractionated TBI is influenced not only by the total dose of radiation but also by its rate of administration (defined by midline tissue dose rate and fractionation schedule). In addition dry eyes and conjunctival staining may be exacerbated by TBI, though other aspects of conditioning may also be implicated.
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PMID:Ocular complications of bone marrow transplantation. 195 11

The intraoperative and postoperative complications of cataract surgery that affect the cornea vary in etiology and severity. Principal complications include epithelial disruption, infections, sterile corneal ulceration, stromal melt, mechanical or toxic injury of the endothelium, vitreous touch, stripped Descemet's membrane, and epithelial and fibrous downgrowth. Meticulous cataract surgery with careful attention to protecting the cornea can prevent most serious corneal complications. Certain clinical situations warrant special note; patients with rheumatoid arthritis and dry eyes require extra lubrication to the epithelium to prevent disruption during surgery; patients with low endothelial cell counts benefit from the least possible surgical trauma to minimize cell loss; surgical clean-up of vitreous from the anterior segment remains an important principle; clinically significant Descemet's membrane tears or areas of stripping should be repaired at the time of cataract surgery. The clinical judgment and skills of the cataract surgeon should be equal to the type of cataract operation performed.
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PMID:Corneal complications of cataract surgery. 204 52

We report the occurrence of sterile corneal ulceration in 11 eyes of eight patients with collagen vascular diseases and dry eyes after cataract extraction with intraocular lens implantation. Keratolysis occurred after both extracapsular and intracapsular cataract extraction and appeared unrelated to the type of intraocular lens. Despite aggressive lubrication and other medical treatment, including systemic immunosuppressive agents, penetrating keratoplasty was often required. Although all eyes were saved, visual outcome was usually poor. The histopathologic finding of polymorphonuclear leukocytes localized near the areas of corneal dissolution provides evidence for the role of polymorphonuclear leukocyte-derived collagenase as a contributing factor in the pathogenesis of sterile corneal ulceration in these patients.
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PMID:Sterile corneal ulceration after cataract extraction in patients with collagen vascular disease. 207 56

Epikeratophakia continues to be an extremely attractive option for younger children with unilateral aphakia who are noncompliant users of contact lenses but who are young enough to benefit from amblyopia therapy. The epikeratophakia procedure is much safer than IOL implantation. The epikeratophakia tissue lens is especially useful for children with traumatic aphakia and corneal lacerations because the lens can strengthen and smooth the cornea as well as correct the aphakia. This allows much quicker rehabilitation than could be accomplished with contact lenses. The epikeratophakia procedure may be combined with a cataract extraction and should be in those children with acquired cataracts who demonstrate contact lens noncompliance in an office trial of contact lens insertion before operation. Epikeratophakia should be used with caution in neonates and young infants because of the rapid growth of the eye. Extended-wear contact lenses are a safer option for these children, and epikeratophakia can be performed as a secondary procedure if and when problems with contact lens compliance arise. Surface ocular problems such as uncontrolled dry eyes or severe blepharitis will continue to be incompatible with the survival of epikeratophakia tissue lenses. Children who are treated with high doses of radiation for orbital tumors such as rhabdomyosarcomas invariably develop radiation cataracts, which can occur before the onset of radiation keratitis. These children do not do well with epikeratophakia tissue lenses. Likewise, children with severe metabolic disturbances who are not healthy or gaining weight have a diminished chance of graft healing, as do children with poor vision in whom oculodigital autostimulation produces persistent epithelial defects, which prevent survival of the tissue lens.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Update on epikeratophakia in children. 264 36

A sterile corneal ulcer was observed in four cataract patients (two with intraocular lenses) during the early postoperative period. All patients had a history of rheumatoid arthritis and were on systemic antiinflammatory agents. The two patients treated medically exhibited a short recovery phase with complete healing over several days and no recurrence. Aggressive treatment of the dry eye syndrome with artificial tears, bandage lenses, punctal occlusion, tarsorrhaphy, and antibiotics resulted in immediate improvement. In this report, variabilities in corneal ulceration are stressed while emphasis is given to the role of dry eyes and exposure as the principal common factor. A discussion of risk factors, presentation, treatment, pathogenesis, and prevention is provided.
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PMID:Corneal ulceration following cataract surgery in patients with rheumatoid arthritis. 407 77


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