Cases reported "Corneal Opacity"

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1/5. Combined phacoemulsification and penetrating keratoplasty.

    To highlight indications, technique, and advantages of closed-chamber phacoemulsification and intraocular lens (IOL) implantation during penetrating keratoplasty for corneal opacities. case reports of 2 patients who underwent combined phacoemulsification, IOL implantation and penetrating keratoplasty. The technique described allowed controlled capsulorrhexis, cataract removal and in-the-bag IOL implantation. Complications due to increased posterior pressure during open-sky extracapsular cataract were not encountered. The surgical technique described in this report can only be used in selected patients undergoing combined corneal transplant and cataract surgery. In this group of patients, however, the technique offers many intra- and postoperative advantages.
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2/5. phacoemulsification in eyes with corneal opacification.

    We describe a technique in which transcorneal illumination with a fiber-optic light probe is used to safely perform phacoemulsification in cataractous eyes with dense corneal opacification. The technique was used in 3 eyes of 3 patients. No surgical complications occurred, and all eyes had improved visual acuity. Indications and further refinement of the technique and instrumentation are discussed.
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keywords = phacoemulsification
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3/5. Endoillumination-assisted cataract surgery in a patient with corneal opacity.

    We present a technique to better visualize cataracts through corneal opacity. A 70-year-old Japanese woman with retinal detachment, cataract, and corneal opacity in the left eye was treated with phacoemulsification, 3-port vitrectomy, and intraocular lens implantation. To circumvent the difficulty of performing continuous curvilinear capsulorhexis (CCC) and subsequent cataract surgery through a hazy cornea, we used an endoilluminator as a light source outside the cornea for CCC and inside the anterior chamber for phacoemulsification. As a result, CCC and subsequent cataract surgery were successfully and easily performed despite potentially troublesome corneal opacity. The use of an endoilluminator can be an effective supportive measure for cataract surgery in patients with corneal opacity.
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keywords = phacoemulsification
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4/5. Combined surgery with deep lamellar keratoplasty.

    The opportunity to perform two or more ophthalmic operations simultaneously has increased in recent years. In keratoplasty too, the simultaneous operation consisting of cataract extraction and IOL insertion (triple procedure) has become common. Penetrating keratoplasty (PKP) and planned extracapsular cataract extraction (PECCE) or vitrectomy is today often done simultaneously. However, phacoemulsification and aspiration (PEA) or 3 ports vitrectomy has to be performed on patients with corneal opacity due to some corneal diseases. In such cases, we performed the PEA or vitrectomy coupled with deep lamellar keratoplasty (DLK), successfully applied to closed eye surgery with corneal opacity. Simultaneous surgery using DLK, free of postoperative endothelial type of rejection, and PEA, enabling cataract extraction by a small incision, is a surgical technique making use of the advantage of the two types of operation. We performed the DLK PEA IOL on 17 cases. In the other hand, simultaneous surgery consisting of DLK and vitrectomy may be taken into consideration. The use of DLK will make it possible to perform surgery on urgent vitreoretinal diseases with corneal opacity and cataract. We performed the DLK 3 ports vitrectomy on 3 cases. The current study describes the advantages and disadvantages of these types of operation.
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keywords = phacoemulsification
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5/5. Corneal opacification occurring after phacoemulsification and phacofragmentation.

    Four patients developed progressive corneal opacification five to eight months after ultrasonic cataract extraction. Transmission electron microscopy was performed in all patients. Scanning electron microscopy, performed in only one patient, showed radiating folds of Descemet's membrane with pits on its posterior surface as well as focal traumatic disruption probably caused by probe contact. Bullous keratopathy was present in one patient. Two other patients had folds of Descemet's membrane and a thin retrocorneal fibrous layer. All four tumor specimens showed secondary epithelial and stromal changes. The common denominator was the total or partial absence of endothelium or marked alterations of its remnants.
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keywords = phacoemulsification
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