Cases reported "Contracture"

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11/53. Complete anterior capsule contraction after phacoemulsification with acrylic intraocular lens and endocapsular ring implantation.

    A 69-year-old man with pseudoexfoliation syndrome and bilateral cataract had phacoemulsification with continuous curvilinear capsulorhexis and implantation of a morcher endocapsular ring and AcrySof acrylic intraocular lens (IOL) (Alcon). Two months later, the patient had vision loss in the left eye with a visual acuity of 20/500. He presented with anterior capsule fibrosis in both eyes, with complete occlusion of the capsule opening in the left eye and mild occlusion in the right eye. After a neodymium:YAG laser anterior capsulotomy in the left eye, visual acuity was 20/20. This case shows that endocapsular ring implantation does not prevent anterior capsule contraction syndrome but can prevent IOL decentration.
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ranking = 1
keywords = capsular, ocular
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12/53. Total encapsulation and asymmetric deformation of an intraocular lens.

    We report a case of marked anterior capsule contraction after uneventful cataract surgery in an 82-year-old women. The patient had implantation of a single-piece foldable acrylic intraocular lens (IOL) after phacoemulsification through a 3.0 mm superior corneal incision. Between 1 month and 5.5 months after surgery, significant anterior capsule contraction ensued with total encapsulation of the lens. The resultant fibrotic reaction, which had a localized tangential component, caused an asymmetric deformation and mild IOL displacement. The patient was treated on separate occasions with a neodymium:YAG laser anterior capsulotomy and surgical capsulotomy to release tension on the lens and clear the visual axis.
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ranking = 0.00091714540034318
keywords = ocular
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13/53. Refractive changes produced by capsule contraction after piggyback acrylic intraocular lens implantation.

    I describe a case of anterior capsule contraction after implantation of piggyback acrylic intraocular lenses (IOLs). Treatment by neodymium:YAG capsulotomy resulted in anterior chamber deepening despite a myopic shift. With acrylic IOLs, refractive changes may be due to optical deformation rather than axial shifts.
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ranking = 0.00091714540034318
keywords = ocular
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14/53. Arthroscopic release of a posttraumatic flexion contracture in the elbow: a case report and review of the literature.

    Open arthrotomy has been the standard of treatment for posttraumatic flexion contractures of the elbow. Utilizing standard arthroscopic techniques combined with electrocautery, anterior capsulotomy was performed without complication. Immediate improvement in extension was demonstrated. Multiple cadaveric dissections evidenced the safety of the approach as the humeral capsular attachment is isolated from the neurovascular structures by the brachialis muscle. This technique serves to underscore the utility of elbow arthroscopy in patients with dysfunction previously only amenable to open joint procedures.
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ranking = 0.16651380909994
keywords = capsular
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15/53. Capsular peeling in anterior capsule contraction syndrome: surgical approach and histopathological aspects.

    We present 4 cases of anterior capsule contraction syndrome in which progressive shrinkage of the anterior capsulorhexis developed after uneventful phacoemulsification. Three eyes were pseudophakic, and 1 eye remained aphakic. The newly formed membrane was surgically peeled from the anterior capsule, restoring the capsular bag.
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ranking = 0.16651380909994
keywords = capsular
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16/53. Choroidal effusion and hypotony caused by severe anterior lens capsule contraction following cataract surgery.

    PURPOSE: The case report describes a case of severe anterior capsular contraction associated with choroidal effusion. CASE REPORT: An 81 year old female with primary open angle glaucoma underwent routine phacoemulsification cataract surgery. Eight weeks following surgery the anterior capsule opening had reduced to 3 mm in size. intraocular pressure was found to be 4 mmHg and B scan ultrasound revealed a large choroidal effusion. Anterior capsulotomy with Nd:YAG laser was performed. At review, two weeks later, the choroidal effusion had resolved and visual acuity had recovered. DISCUSSION: The Nd:YAG laser radial relaxing capsulotomies helped relieve the capsular contraction and associated traction on the ciliary body.
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ranking = 5.3980791704448
keywords = anterior capsular, capsular, ocular
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17/53. Surgical management of severe cocontraction, globe retraction, and pseudo-ptosis in Duane syndrome.

    BACKGROUND: Correction of severe cocontraction and pseudo-ptosis present unique surgical challenges in patients with Duane syndrome. methods: We report four Duane syndrome patients with esotropia in primary position, poor abduction, and severe cocontraction causing limitation to adduction, globe retraction, and pseudo-ptosis. All were treated with partial tendon transposition of the vertical rectus muscles augmented with Foster fixation sutures and surgical weakening of the ipsilateral lateral rectus muscle. One patient had a large recession of the lateral rectus muscle, and in three patients, the lateral rectus muscle was inactivated by removing from the globe and attaching its insertion to the lateral orbital wall. RESULTS: Postoperatively, all patients were aligned within eight prisms diopters of orthotropia, had no face turn, and improved adduction and abduction. The two patients who had restriction to abduction on intraoperative forced ductions also had residual esotropia in primary position and underwent recession of the ipsilateral medial rectus muscle as a second procedure. Postoperative binocular single visual field was enlarged by 56 to 500% in the three patients who were tested preoperatively and postoperatively. Globe retraction and cocontraction were markedly relieved. Palpebral fissure widened 1.0 and 6.0 mm in two patients who had preoperative and postoperative measurements. CONCLUSION: In Duane syndrome patients, severe cocontraction, globe retraction, and limitation to adduction may improve if the lateral rectus muscle is maximally recessed or its insertion is inactivated from the globe. Partial transposition of the vertical rectus muscles augmented with Foster sutures improved the angle of esotropia in primary position and abduction. Medial rectus muscle recession is indicated when the passive forced duction test reveals moderate-to-severe restriction to abduction.
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ranking = 0.00018342908006864
keywords = ocular
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18/53. Ocular findings of Beals syndrome.

    BACKGROUND: In this report of two Okinawan patients with Beals syndrome and accompanying ocular complications, the symptoms of Beals syndrome and marfan syndrome are compared. The etiology of these two syndromes is considered in relation to fibrillin. CASES: Case 1 was a 5-year-old boy who showed blue sclera and bilateral enlargement of optic disc cupping. Case 2 was a 24-year-old man who had partial coloboma of the lens, mild cataract, and bilateral glaucomatous disc cupping. OBSERVATIONS: Beals syndrome was diagnosed in these two patients based on the initial examination. In further investigations, while the patients were being observed without treatment, the intra ocular pressure of both patients remained within normal range. Funduscopy showed that the cup-to-disc ratio was 0.8 bilaterally in both patients. Case 1 was followed up for 6 years with no changes. Ultrasound biomicroscopy examination in case 2 revealed hypoplasia of the ciliary body, leading to a diagnosis of glaucoma. This patient remains under observation. CONCLUSIONS: Two cases of Beals syndrome with ocular complications including glaucomatous optic disc cupping are reported. Ophthalmic examinations are recommended to identify the ocular complications of Beals syndrome. Further studies are needed to elucidate the relation between fibrillin abnormality and ocular complications in Beals syndrome.
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ranking = 0.00091714540034318
keywords = ocular
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19/53. Inferior oblique overaction/contracture following retrobulbar anesthesia for cataract extraction with a positive Bielschowsky head Tilt test to the contralateral shoulder. A report of one case.

    BACKGROUND AND PURPOSE: This is a report of a patient with diplopia, hypertropia, extorsion and a positive Bielschowsky head Tilt Test following retrobulbar anesthesia, due to an inferior oblique muscle overaction-contracture. CASE REPORT: Oculomotor and sensorimotor examinations and ocular motility recordings and Bielschowsky head Tilt Test demonstrated overaction characteristics overpowering the contracture characteristics of the involved inferior oblique muscle. RESULTS: Weakening of the overacting inferior oblique eliminated the vertical and torsional deviations and the forced head tilt difference upon tilting the head to either shoulder. It also normalized ocular motility and resulted in a symptom-free patient. CONCLUSION: Oblique muscle dysfunction with vertical and torsional deviations and a positive Bielschowsky head Tilt Test can result from retrobulbar anesthesia.
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ranking = 0.00036685816013727
keywords = ocular
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20/53. Recurrent posterior capsular opacification and capsulorhexis contracture after cataract surgery in myotonic dystrophy.

    Cataracts are well known to be associated with myotonic dystrophy. Less well known are the phenomena of recurrent posterior capsule opacification and capsulorhexis contracture post cataract surgery. Two cases are described herein of postoperative capsular complications requiring multiple capsulotomies in patients with myotonic dystrophy. It is proposed that a common aetiology may underlie both posterior capsule opacification and capsulorhexis contracture in myotonic dystrophy cases.
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ranking = 0.83256904549971
keywords = capsular
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