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1/27. Clinical course of phacoemulsification wound burns.

    PURPOSE: To present 3 cases illustrating the outcomes of phacoemulsification corneal wound burns. SETTING: A university referral center. methods: This was a retrospective case series. RESULTS: Three patients developed corneal wound burns during phacoemulsification of cataract. All eyes developed from 7.00 to 15.00 diopters of astigmatism in the axis of the incision. In 2 eyes, the astigmatism decreased over several months. The third had permanent high astigmatism and corneal edema requiring corneal transplantation. CONCLUSIONS: Corneal wound burns occurring during phacoemulsification can have serious effects on the cornea, including corneal edema and severe astigmatism. In the milder cases, the astigmatism decreases spontaneously over several months.
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keywords = phacoemulsification
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2/27. Intraoperative ocular damage caused by a cannula.

    We report a case in which posterior capsule rupture, vitreous loss, and vitreous hemorrhage were caused by a dislodged, flying cannula during phacoemulsification. We modified our surgical practice since the occurrence of this unusual complication and use Luer-lock syringes during surgery. This measure should prevent the recurrence of this complication.
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ranking = 0.14285714285714
keywords = phacoemulsification
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3/27. Severe iridodialysis from phacoemulsification tip suction.

    During cataract surgery, the iris of an 83-year-old woman was strongly sucked into the phacoemulsification tip twice, resulting in severe iridodialysis. The dehisced iris was sutured to the sclera using double-armed 10-0 polypropylene on a long curved needle. Intensive suction of the iris by the phacoemulsification tip can lead to severe iridodialysis. Machine setting parameters, particularly flow rate, should be lowered after the first iris suction to avoid further iris damage.
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ranking = 0.85714285714286
keywords = phacoemulsification
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4/27. 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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ranking = 0.85714285714286
keywords = phacoemulsification
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5/27. Superior oblique damage from the traction suture at cataract surgery.

    A 41-year-old woman underwent uneventful phacoemulsification and posterior chamber lens implantation in the right eye. Approximately a month later similar surgery was performed in the left eye. The surgery was performed with the patient under retro-bulbar anesthesia with a combination of bupivacaine (Marcaine) 0.75% and lidocaine (Xylocaine) 4% administered through a lower lid injection. Immediately after the patch was removed, the patient was aware of constant vertical diplopia. Over the ensuing 6 months the symptom worsened. Orbital computed tomography showed no abnormalities.
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ranking = 0.14285714285714
keywords = phacoemulsification
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6/27. Intraoperative choroidal hemorrhage in the Osler-Rendu-Weber syndrome.

    PURPOSE: To describe a patient with Osler-Rendu-Weber syndrome who developed a nonsimultaneous intraoperative choroidal hemorrhage in each eye. METHOD: Interventional case report. A 65-year-old Caucasian woman with Osler-Rendu-Weber syndrome developed a choroidal hemorrhage in the left eye during vitrectomy for a complicated retinal detachment with a poor visual outcome. Fifteen years later, she developed a macula on retinal detachment in the right eye, which also had a dense cataract. Immediately after uncomplicated phacoemulsification and intraocular lens implantation, under monitored anesthesia care and retrobulbar block, and without valsalva stress, ophthalmoscopy demonstrated a choroidal hemorrhage. A planned scleral buckle was replaced by pneumatic retinopexy. RESULTS: Seven months postoperatively, the retina remained attached with resolution of the choroidal hemorrhage. visual acuity was 20/30.CONCLUSION: Choroidal hemorrhage may occur more commonly in individuals with Osler-Rendu-Weber syndrome. Recognition of this possible association and institution of appropriate intraoperative precautions may facilitate a good visual outcome.
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ranking = 0.14285714285714
keywords = phacoemulsification
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7/27. Vitreoretinal management of posteriorly dislocated plate haptic silicone intraocular lenses.

    PURPOSE: To report the vitreoretinal management of posteriorly dislocated plate haptic silicone intraocular lenses (PHSIOLs) and to present a surgical algorithm for this problem. methods: A retrospective analysis of 12 cases of immediate and delayed posterior dislocation of a PHSIOL after phacoemulsification was performed. RESULTS: The ages of the patients ranged from 26 years to 82 years (mean, 68 years); six of the patients were male. Delayed posterior dislocation of the PHSIOL occurred in 7 eyes (after Nd:YAG laser capsulotomy in 4 cases), while intraoperative dislocation occurred in 5 eyes. Defects of the anterior capsulorhexis rim or posterior capsule were present in nine eyes. The mean time from PHSIOL dislocation to definitive treatment was 4.8 months (range, 0.25-13 months). All patients underwent pars plana vitrectomy and implant exchange or repositioning. The dislocated PHSIOL was removed through the transpupillary route in 8 cases, while it was segmented and delivered through the pars plana in 3. Two patients underwent implant repositioning in the ciliary sulcus, although subsequent redislocation in one case required transpupillary removal and exchange. The mean follow-up period was 6.5 months (range, 2-18 months), with a final best corrected visual acuity of 6/12 or better in 10 eyes. CONCLUSIONS: Delayed and immediate dislocation of PHSIOL can occur in eyes with a defect in capsular integrity. The implant may be repositioned or exchanged following vitrectomy with either transpupillary or pars plana removal, resulting in generally excellent postoperative visual acuity and minimal complications.
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ranking = 0.14285714285714
keywords = phacoemulsification
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8/27. Expulsive hemorrhage before phacoemulsification.

    A 65-year-old white man who was scheduled for cataract extraction experienced a sudden increase in intraocular pressure (IOP) with flattening of the anterior chamber immediately after the anterior capsule incision. The eye was sutured, and because no decrease in pressure was noted, surgery was postponed. The presence of the cataract prevented ophthalmoscopic examination. Echographic examination revealed a hemorrhagic choroidal detachment with involvement of the ciliary body. The patient was examined regularly until the choroidal detachment disappeared 4 weeks later. He then had uneventful phacoemulsification and intraocular lens implantation.
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ranking = 0.71428571428571
keywords = phacoemulsification
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9/27. Intraoperative capsular block syndrome masquerading as expulsive hemorrhage.

    PURPOSE: To describe the clinical features of two cases of intraoperative capsular block syndrome (CBS) mimicking expulsive hemorrhage. SETTING: The eye Institute at Tan Tock Seng Hospital, National Healthcare Group, singapore. methods: Two case reports. RESULTS: Two patients underwent phacoemulsification under retrobulbar anesthesia and developed severe globe hardening, shallow anterior chamber (AC) and uveal prolapse intraoperatively after hydrodissection. The AC spontaneously deepened in one patient and the operation was converted to extracapsular cataract surgery on suspicion of CBS with posterior capsule rupture, which was confirmed after nucleus expression; anterior vitrectomy was done and an anterior chamber lens implanted. At the eight post-operative month, his best-corrected visual acuity was 6/24 secondary to an epiretinal membrane in the macula. CBS, however, was not recognized in the other patient and caused posterior lens dislocation during attempted phacoemulsification. This patient underwent vitrectomy, removal of the lens nucleus and insertion of a posterior chamber intraocular lens in the sulcus the next day. His best-corrected visual acuity was 6/9 at the tenth postoperative month. CONCLUSIONS: Intraoperative CBS may mimic expulsive hemorrhage. early diagnosis of this condition and proper management optimizes the visual outcome.
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ranking = 0.28571428571429
keywords = phacoemulsification
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10/27. Acute suprachoroidal hemorrhage during clear corneal phacoemulsification using topical and intracameral anesthesia.

    Shallowing of the anterior chamber and hardening of the eye occurred just before commencement of irrigation/aspiration of cortex in an 80-year-old man having temporal clear corneal cataract surgery under topical and intracameral anesthesia. Nucleus removal had been completed and was uneventful. Intraoperative fundus examination with the indirect ophthalmoscope disclosed a choroidal hemorrhage. The wound was immediately closed with sutures, and intravenous mannitol was administered. The hemorrhage remained localized. The red reflex remained unchanged at all times, and there was no prolapse of intraocular contents. A high index of suspicion is critical to the early diagnosis and management of choroidal hemorrhage.
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ranking = 0.57142857142857
keywords = phacoemulsification
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