Cases reported "Corneal Edema"

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1/10. phacoemulsification in spherophakia with corneal touch.

    A phacoemulsification procedure with implantation of a foldable acrylic intraocular lens in a 31-year-old man with spherophakia is described. The procedure was necessitated by anterior dislocation of the spherophakic lens, with corneal endothelial contact and development of central corneal edema. With a careful approach, the procedure was uneventful and the outcome successful. Modern small-incision cataract surgery techniques are of great benefit in this type of complicated case.
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ranking = 1
keywords = phacoemulsification
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2/10. Late spontaneous resolution of a massive detachment of Descemet's membrane after phacoemulsification.

    We report the spontaneous resolution of a massive detachment of Descemet's membrane 10 months after uneventful phacoemulsification. diagnosis of the detachment was delayed because of severe corneal edema; thus, surgery was not performed. We propose that this complication of severe corneal edema after cataract surgery be considered and, given its excellent outcome, we recommend surgical treatment.
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ranking = 5
keywords = phacoemulsification
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3/10. Toxic anterior segment syndrome and possible association with ointment in the anterior chamber following cataract surgery.

    PURPOSE: To report clinical and laboratory findings of 8 cases of toxic anterior segment syndrome (TASS) related to an oily substance in the anterior chamber of patients following cataract surgery with intraocular lens (IOL) implantation. SETTING: John Moran eye Center, University of utah, Salt Lake City, utah, USA. methods: Eight patients had uneventful phacoemulsification by the same surgeon via clear corneal incisions with implantation of the same 3-piece silicone IOL design. Postoperative medications included antibiotic/steroid ointment and pilocarpine gel; each eye was firmly patched at the end of the procedure. On the first postoperative day, some patients presented with diffuse corneal edema, increased intraocular pressure, and an oily film-like material within the anterior chamber coating the corneal endothelium. The others presented with an oily bubble floating inside the anterior chamber, which was later seen coating the IOL. Additional surgical procedures required included penetrating keratoplasty, IOL explantation, and trabeculectomy. Two corneal buttons were analyzed histopathologically. Two explanted IOLs had gross and light microscopic analyses (as well as surface analyses of 1 of them), and 4 other explanted IOLs had gas chromatography-mass spectrometry. RESULTS: Pathological examination of the corneas showed variable thinning of the epithelium with edema. The stroma was diffusely thickened and the endothelial cell layer was absent. Evaluation of the explanted IOLs confirmed the presence of an oily substance coating large areas of their anterior and posterior optic surfaces. gas chromatography-mass spectrometry of the lens extracts identified a mixed chain hydrocarbon compound that was also found in the gas chromatography-mass spectrometry analyses of the ointment used postoperatively. CONCLUSIONS: The results indicate that the ointment gained access to the eye, causing the postoperative complications described. These cases highlight the importance of appropriate wound construction and integrity, as well as the risks of tight eye patching following placement of ointment.
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ranking = 1
keywords = phacoemulsification
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4/10. Severe toxic effect of methylene blue 1% on iris epithelium and corneal endothelium.

    PURPOSE: To report a case of corneal endothelial decompensation and iris pigment dispersion following the inadvertent use of methylene blue 1% for capsular staining during cataract surgery. DESIGN: Case report. methods: During an otherwise routine phacoemulsification cataract surgery, inadvertent anterior capsule staining with methylene blue 1% instead of trypan blue 0.025% was performed. Copious irrigation of the anterior chamber with balanced salt solution was initiated upon identification of the wrong dye. The operation was completed with minimal ultrasound energy without complications. RESULTS: iris discoloration and severe corneal edema developed in the early postoperative period, resulting in severe visual loss. The patient developed bullous keratopathy and underwent penetrating keratoplasty 16 months later. CONCLUSIONS: In vivo intracameral injection of methylene blue 1% induces extreme cytotoxicity, primarily on the corneal endothelium and iris epithelium.
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ranking = 1
keywords = phacoemulsification
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5/10. Iatrogenic descemetorhexis as a complication of phacoemulsification.

    During clear corneal temporal phacoemulsification, an accidental iatrogenic descemetorhexis occurred. The entire cornea was hazy and edematous on the first postoperative day. By the 1-month postoperative review, the cornea had become clear with visible descemetorhexis margins; best corrected visual acuity was 20/25, and the pachymetry was 556 microm. The patient remained stable at the 2-years postoperative follow-up, and specular microscopy done at this time showed a cell density of 1301 cells/mm2 with evidence of pleomorphism and polymegethism. This is the first report of iatrogenic descemetorhexis in which the cornea had become clear and nonedematous by as early as 1 month postoperatively. This case highlights that a healthy endothelium can maintain corneal deturgescence despite a low endothelial cell count. Corneal thickness increases only when the number of endothelial cells has gone below a physiologic lower limit.
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ranking = 5
keywords = phacoemulsification
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6/10. Presumed herpetic endotheliitis following phacoemulsification surgery.

    The authors present an observational case series. Three cases of presumed herpetic endotheliitis presented as cases of pseudophakic bullous keratopathy many years after successful phacoemulsification surgery. All patients had reduction of vision in the involved eye, corneal oedema and secondary glaucoma. The patients were treated with medical therapy consisting of topical corticosteroids, antiviral and antiglaucoma drugs. Resolution of corneal oedema, control of glaucoma and restoration of visual acuity were achieved in all cases. Specular microscopy performed thereafter demonstrated relatively normal endothelial cell counts. The authors conclude that pseudophakic bullous keratopathy occurring after phacoemulsification surgery may be caused by herpetic endotheliitis.
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ranking = 6
keywords = phacoemulsification
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7/10. Outbreak of toxic anterior segment syndrome associated with glutaraldehyde after cataract surgery.

    PURPOSE: To present clinical findings of a cluster of cases of toxic anterior segment syndrome (TASS) after uneventful phacoemulsification cataract surgery. SETTING: Department of ophthalmology, Akdeniz University, Antalya, turkey. methods: Six eyes of 6 patients developed TASS after uneventful phacoemulsification cataract surgery with implantation of a 3-piece acrylic IOL performed by 2 ophthalmologists on the same day. Clinical findings included corneal edema, Descemet's membrane folds, anterior chamber reaction, fibrin formation, and irregular, dilated, and unreactive pupils. RESULTS: Glutaraldehyde 2% solution was used inadvertently by the operating room staff who cleaned and sterilized reusable ocular instruments before autoclaving. None of the affected corneas improved. Additional surgical procedures were required and included penetrating keratoplasty, trabeculectomy, and glaucoma tube implantation. CONCLUSIONS: Glutaraldehyde in concentrations generally used for cold sterilization is highly toxic to the corneal endothelium. The operating room staff involved in sterilizing instruments should be well educated about and careful to follow the protocols to properly clean and sterilize reusable ocular instruments.
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ranking = 2
keywords = phacoemulsification
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8/10. Spontaneous resolution of corneal oedema following Descemet's detachment.

    We report a case of spontaneous resolution of corneal oedema in the presence of a large persistent Descemet's detachment in a 71-year-old woman. Detachment of Descemet's membrane occurred during phacoemulsification surgery and produced significant corneal oedema. The patient declined surgical repair. Six months later the corneal oedema resolved and in vivo confocal microscopy showed endothelial cells on the posterior stroma in the region of the detachment. Endothelial cell hypertrophy, migration and redistribution were thought to be responsible for reversal of the corneal oedema. Experimental evidence and clinical studies raise the possibility that limited endothelial cell proliferation may occur.
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ranking = 1
keywords = phacoemulsification
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9/10. Clinical findings in Brown-McLean syndrome.

    The Brown-McLean syndrome is a clinical condition with corneal edema involving the peripheral 2 to 3 mm of the cornea. The edema typically starts inferiorly and progresses circumferentially, but spares the central portion of the cornea. Additionally, the edema is associated with a punctate orange-brown pigmentation on the endothelium underlying the edematous areas. Central cornea guttata is frequently seen. This condition occurs most frequently after intracapsular cataract extraction, but may also occur after extracapsular cataract extraction and phacoemulsification, or pars plana lensectomy and vitrectomy. Surgical complications and multiple intraocular procedures are frequently observed in these patients. Less frequently, the Brown-McLean syndrome can occur in eyes that have not had surgery. We studied the clinical characteristics of 43 affected eyes of 32 patients. New findings included Brown-McLean syndrome occurring in two eyes of a phakic patient with intermittent angle-closure glaucoma. Two eyes developed Brown-McLean syndrome after phacoemulsification and one eye developed peripheral edema after pars plana vitrectomy and lensectomy. Additionally, severe, infectious keratitis occurred after rupture of peripheral bullae in two eyes. patients with this condition should be examined periodically and educated regarding the early clinical signs of corneal ulceration.
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ranking = 2
keywords = phacoemulsification
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10/10. Complications of retained nuclear fragments in the anterior chamber after phacoemulsification with posterior chamber lens implant.

    PURPOSE: We report two cases in which retained nuclear fragments in the anterior chamber after phacoemulsification and posterior chamber lens implant resulted in intraocular complications. methods: case reports. RESULTS: In two eyes of two patients, retained nuclear fragments resulted in minimal anterior chamber reaction but substantial corneal edema and reduced visual acuity. Topical anti-inflammatory medications did not alter the postoperative course. Improvement occurred only when the nuclear fragments were surgically removed. CONCLUSIONS: Retained nuclear fragments in the anterior chamber can cause corneal edema and reduced vision that may be reversed by removing the fragments.
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ranking = 5
keywords = phacoemulsification
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