Cases reported "Eye Diseases"

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1/8. Intraocular lens implantation in a child with monocular cataract and anterior persistent hyperplastic primary vitreous.

    A 3-year-old girl had phacoemulsification during which the presence of anterior persistent hyperplastic primary vitreous (PHPV) was discovered. Visual rehabilitation comprised contact lens use for 1 year. However, visual acuity deteriorated gradually because of secondary cataract formation. In a second surgery 1 year after the first, the posterior capsule was incised, followed by an anterior vitrectomy and intraocular lens implantation. At the last follow-up 6 months after the second surgery, there was no evidence of ocular complications and best corrected visual acuity was 0.6.
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ranking = 1
keywords = phacoemulsification
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2/8. Erroneous automated refraction in a case of asteroid hyalosis.

    To our knowledge, this is the first report of asteroid hyalosis giving rise to spurious automated refraction readings. A patient with asteroid hyalosis had uneventful phacoemulsification with intraocular lens implantation. Using a Nikon autorefractor, the postoperative refraction was 13.0 diopters (D); retinoscopy revealed that it should be 1.0 D. Asteroid hyalosis changes the optical quality of the vitreous and can cause an incorrect reading from automated equipment such as autorefractors and A-scan ultrasound scanners. In patients with asteroid hyalosis, results from autorefractors should be viewed in conjunction with clinical findings.
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ranking = 1
keywords = phacoemulsification
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3/8. Zonular dialysis and vitreous loss with a J-shaped hydrodissection cannula during phacoemulsification.

    We report a complication that occurred during clear corneal phacoemulsification. When saline was injected during hydrodissection with a 27-gauge J-shaped cannula attached to a 2.0 mL luer-lock polypropylene syringe, the cannula dislodged and slipped behind the iris, hooking to the lens equator. Although the cannula was carefully removed, 3 clock hours of zonular dialysis were observed between the 4 o'clock and 7 o'clock meridians. After phacoemulsification, lens aspiration, and in-the-bag intraocular lens implantation, vitreous was noted inferiorly and the anterior vitrectomy was completed.
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ranking = 6
keywords = phacoemulsification
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4/8. vitrectomy-phacoemulsification-vitrectomy for the management of aqueous misdirection syndromes in phakic eyes.

    OBJECTIVE: To describe vitrectomy-phacoemulsification-vitrectomy, a sequential 3-step surgical approach, in the management of malignant glaucoma/aqueous misdirection syndromes in phakic eyes. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Five eyes (4 angle-closure glaucoma and 1 open-angle glaucoma) of 5 patients with mean age of 66 years (range, 56-78). Four patients presented with aqueous misdirection syndrome and 1 patient presented for cataract extraction, having previously had malignant glaucoma in the fellow eye after phacoemulsification surgery. INTERVENTION: The operation performed had three steps: vitrectomy, phacoemulsification, and vitrectomy. Step 1: Preliminary vitrectomy involved limited core vitrectomy to "debulk" the vitreous and soften the eye. Step 2: phacoemulsification was performed in a standard manner. Step 3: Residual vitrectomy, zonulohyaloidectomy and peripheral iridectomy (if not already present) were performed to create a free communication between the posterior and anterior segments. MAIN OUTCOME MEASURES: intraocular pressure, visual acuity, biomicroscopic anterior chamber depth, and complications. RESULTS: The time interval between the onset of malignant glaucoma and surgery ranged from 2 weeks to 3 months. All 4 patients with aqueous misdirection syndrome had relief of the aqueous misdirection postoperatively with anterior chamber deepening. Intraocular pressures on day 1 ranged from 6 to 28 mmHg (mean 15.6, mmHg), and at the last visit ranged from 8 to 30 mmHg (mean, 20.4 mmHg). One eye developed an early choroidal serosanguinous effusion requiring drainage. CONCLUSIONS: The vitrectomy-phacoemulsification-vitrectomy approach was effective in this pilot series in the management of aqueous misdirection syndromes and malignant glaucoma in phakic eyes.
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ranking = 8
keywords = phacoemulsification
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5/8. Pupillary block following Nd:YAG laser capsulotomy.

    A patient who developed opacification of the posterior lens capsule three years after phacoemulsification was treated with a Nd:YAG laser capsulotomy. Five hours later he developed pupillary block, elevated intraocular pressure, and transient loss of vision. To our knowledge, this major complication following Nd:YAG laser surgery has not previously been reported.
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ranking = 1
keywords = phacoemulsification
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6/8. Corneoscleral block excision of postoperative anterior chamber cysts.

    PURPOSE: To describe the clinical presentation, surgical treatment and histopathology of three cases of cystic epithelial ingrowth occurring after cataract surgery. methods: Three patients developed anterior chamber cysts, two with an associated conjunctival bleb and fistula, following extracapsular cataract and phacoemulsification surgery. The technique of block excision and corneoscleral graft was used in the three patients. RESULTS: There was no evidence of recurrence twenty-six, twenty-three and seven months postoperatively. Visual acuities were 20/30, 20/20-2 and 20/25-2, with mild astigmatism and well controlled intraocular pressure. Histopathology illustrated that conjunctival and corneal epithelium invaded the anterior chamber through a wound defect. CONCLUSION: At this time, block excision with a corneoscleral graft may be the most definitive surgical treatment of cystic epithelial ingrowth.
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ranking = 1
keywords = phacoemulsification
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7/8. Asteroid hyalosis and vision loss after posterior capsulotomy.

    We describe the case of a 77-year-old man with asteroid hyalosis who had phacoemulsification and implantation of a plate-haptic intraocular lens (IOL). Intraoperatively, a tear occurred in the anterior capsule, and vision loss occurred 3 months after a neodymium:YAG posterior capsulotomy. Because of the asteroid hyalosis, a posteriorly dislocated IOL, which occurred after the capsulotomy, was difficult to diagnose. Careful retinoscopy established the aphakic condition of the eye, and the B-scan ultrasonography indicated the IOL's location.
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ranking = 1
keywords = phacoemulsification
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8/8. Unusual presentation of phacoanaphylaxis following phacoemulsification.

    A case of phacoanaphylaxis following phacoemulsification is presented. The unusual features of the disease included the markedly delayed onset and the clinical appearance of the hypopyon. Emphasis is placed on the cytologic examination of anterior chamber aspirate in such cases.
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ranking = 5
keywords = phacoemulsification
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