The frequency of secondary cataract after extracapsular cataract extraction

A complication of extracapsular cataract extraction is posterior capsule opacification (secondary cataract). In this study we found that 26.0% of patients operated for cataract with extracapsular technique were treated for secondary cataract. The average postoperative time to treatment with Nd-YAG-lasercapsulotomy was 15.2 months with a follow-up time of 34 months.     

Late iris abscess after cataract extraction

A 73-year-old woman underwent an uneventful intracapsular lens extraction. Two years later, an iris abscess, hypopyon, strong flare, corneal edema, and elevated intraocular pressure developed. Visual acuity diminished from 6/6 (20/20) with aphakic correction to hand movements. Gram-positive cocci sensitive to erythromycin and chloramphenicol were cultured from the anterior chamber. The hypopyon and the iris abscess reabsorbed because we administrated erythromycin at the beginning of the illness. Final visual acuity was 6/6 (20/20) and only a small hole remained in the iris at the site of the abscess. She was in good health four years later.     

Progression of diabetic retinopathy after cataract extraction

A prospective study of the effect of cataract extraction with intraocular lens implantation on the course of diabetic retinopathy (DR) in 44 patients (59 eyes) was carried out. It showed that in the 1-3 years following surgery, there was progression of DR (including development of newly formed retinopathy) in 35% of the patients (28.8% of eyes). Progression was more marked in patients with pre-operative bilateral DR compared to those without bilateral DR (77% and 16% respectively). Insulin dependence did not play a role in progression. Final visual acuity was better in patients without pre-operative DR, as well as in eyes without progressive retinopathy.     

The correction of diplopia after cataract extraction

The records of 12 patients with persistent diplopia after cataract extraction were reviewed. All patients were corrected surgically using an adjustable-suture technique. After strabismus surgery, the diplopia in nine of the 12 patients resolved without adjunctive therapy. Three patients had occasional diplopia postoperatively. Prismatic correction postoperatively was unwarranted in two patients because diplopia occurred on rare occasions, but the third required postsurgical prismatic correction with improvement.     

Cystoid macular edema occurring 13 years after cataract extraction

Thirteen years after cataract extraction, a patient complained of diminished visual acuity. In the interim visual acuity was 6/6 (20/20), or 6/7.5 (20/25+2). Fluorescein angiography demonstrated cystoid macular edema. Except for vitreous adherence to the inner surface of the cataract wound, no ocular cause for the macular edema was apparent.     

Combined cataract extraction and thermal sclerostomy versus combined cataract extraction and trabeculectomy

We performed either a combined cataract extraction and trabeculectomy or a combined cataract extraction and thermal sclerostomy on 43 eyes. All eyes had chronic open angle glaucoma or chronic angle closure glaucoma, or a combination of the two. In our cataract/trabeculectomy group, 74% had improvement in visual acuity, 91% had normalized intraocular pressure without anti-glaucoma medications, 31% had transient postoperative hyphemas. In our cataract/thermal sclerostomy group, 61% had improvement in visual acuity, 61% had normalization of intraocular pressures without antiglaucoma medications, 17% had transient postoperative hyphemas. We could not correlate any of the complications of surgery with poor intraocular pressure results in either groups. The mechanism for the higher success rate with a combined cataract extraction and trabeculectomy as compared with a combined cataract extraction and thermal sclerostomy was not obvious after analyzing these patients.     

Results and complications after extracapsular cataract extraction in eyes with pseudoexfoliation syndrome

Postoperative results and complications in 136 eyes with pseudoexfoliation syndrome were compared to 744 eyes without pseudoexfoliation syndrome in a consecutive study. The patients were followed for 4 months postoperatively. Excluding cases with glaucoma, 81.4% of the pseudoexfoliation eyes and 83.0% of the eyes without pseudoexfoliation achieved a corrected visual acuity of 5/8.5 or better. IOL malposition was rare in both groups (1.5% in the pseudoexfoliation group and 1.6% in the group without pseudoexfoliation). IOP elevation the first day postoperatively occurred most often in the pseudoexfoliation eyes. In the pseudoexfoliation eyes, postoperative iritis and cellular precipitates were demonstrated in 16.2% and 11.0%, respectively, compared to 3.8% and 3.2% in the eyes without pseudoexfoliation (p < 0.001). The frequency of an inflammatory reaction was highly correlated to small pupil size during operation in both groups.     

Bulging iris-lens in cataract extraction

The basic cause of iris-lens diaphragm bulging during cataract extraction is thought to be increased choroidal venous congestive pressure. This is shown to be controlled by hyperventilation under general anesthesia.     

Long-term intraocular pressure control after cataract extraction with trabeculectomy: phacoemulsification versus extracapsular technique

Mutations of the p53 gene are associated with a number of non-lymphoid cancers of the dog. The present study investigates the p53 gene status within canine patients treated for primary and secondary lymphoma. Three out of eight patients exhibited p53 gene mutations. These included one patient with a germ line mutation and two patients with de novo p53 mutations associated with the secondary lymphoma. Allelic loss of the p53 gene was also observed within primary and secondary tumours of the three canine patients. The results indicate that germ line p53 mutations exist in dogs and may be involved in the known predisposition of some breeds to cancer. The presence of therapy-related p53 point mutations was found to be associated with chemoresistant secondary lymphomas. A causative role for DNA-damaging chemotherapy in de novo mutation of the p53 gene is discussed. Characterization of p53 inactivation in canine tumorigenesis may provide a valuable clinical model for assessing the efficacy and optimal therapeutic regimens of anti-cancer agents.     

Management of persistent filtering cicatrix following cataract extraction

We used a safe and simple surgical technique in the management of persistent filtering cicatrices after cataract extraction. The edematous, friable filtering cicatrix was excised entirely and a healthy fornix-based conjunctival flap was sutured over the fistula. Invariably, the fistula was very small, usually only large enough to admit a 27-gauge needle. Of the 27 eyes treated with this technique, there were two failures, but no other complications.     

The efficacy of using enzymes in treating toxic-allergic reactions after cataract extraction with intraocular lens implantation

In experimental study of antiulcerative activity of dibunol on various models of gastric ulcers in rats the drug caused a marked antiulcerative effect in all of them, reduced the incidence of ulcer formation, and shortened the time of ulcer healing. In a model of "acetic" ulcer dibunol oil solution led to quick normalization of lipid peroxidation in the gastric mucosa, which was evidence of high antioxidant activity in cases of ulcer lesions.     

Late hypotony after cataract extraction due to a scleral fistula: a technique for surgical correction

We report a case of hematomyelia which led to sudden onset complete paraplegia in a 74-year-old man. Hematomyelia revealed a spinal dural arteriovenous fistula at level T8-T9. Spinal hemorrhage was observed in contact with a round-shaped aneurysmal like ectasia which undoubtedly ruptured. Treatment was embolization. Spinal atrophy followed and MRI one year after embolisation visualized the involution of the pathological vessels. We discuss the pathophysiology of this hemorrhagic accident and specific anomalies of the drainage veins in these malformations.