Cases reported "Lens Diseases"

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1/22. Capsular block syndrome with external blockage of the capsular opening by a ciliary sulcus fixated posterior chamber lens.

    PURPOSE: To report capsular block syndrome with external blockage of the capsular opening by a posterior chamber lens fixated in the ciliary sulcus. METHOD: Case report. RESULTS: In an 89-year-old man who had undergone cataract surgery, a posterior chamber lens was accidentally fixated in the ciliary sulcus after continuous curvilinear capsulohhexis and phacoemulsification/aspiration. The next day, capsular block syndrome was noted along the posterior chamber lens optic, which was blocking the capsular opening from the outside. CONCLUSION: In all previously reported eyes with capsular block syndrome, the posterior chamber lens had been placed inside the lens capsule to block the continuous curvilinear capsulorhexis opening from the inside.
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ranking = 1
keywords = phacoemulsification
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2/22. ciliary body detachment caused by capsule contraction.

    A 74-year-old woman developed capsule contraction associated with hypotony and choroidal effusion 18 months after uneventful phacoemulsification with 3-piece poly(methyl methacrylate) intraocular lens implantation. Ultrasound biomicroscopy revealed ciliary body detachment and stretched zonules. A radial neodymium: YAG anterior capsulotomy was performed, resulting in the resolution of the ciliary body detachment and choroidal effusion as well as in normal intraocular pressure over 4 days.
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ranking = 1
keywords = phacoemulsification
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3/22. Massive anterior capsule shrinkage after plate-haptic silicone lens implantation in uveitis.

    Two patients, both with bilateral uveitis, had synechiolysis, continuous curvilinear capsulorhexis (CCC), phacoemulsification, and in-the-bag implantation of a foldable single-piece plate-haptic silicone intraocular lens (IOL) in 1 eye. Several weeks postoperatively, massive anterior capsule shrinkage with obstruction of the visual axis occurred in both patients. Surgical revision was performed in both eyes. Both patients had CCC and phacoemulsification and confirmed in-the-bag acrylic IOL implantation in the second eye months after surgery in the first eye. Follow-up examinations showed no significant shrinkage of the anterior capsule opening in any eye. In patients with uveitis, intraoperative lens epithelial cell removal, creation of a large CCC, and careful selection of IOL style and material may prevent occlusion of the anterior capsule opening.
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ranking = 2
keywords = phacoemulsification
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4/22. Management of atypical epicapsular star.

    An 18-year-old woman had brown pigment deposits on the central anterior capsule of the lens associated with poor visual acuity and significant anisometropia. Surgical removal of the deposits, phacoemulsification, and intraocular lens implantation resulted in visual improvement. Epicapsular stars are formed by the confluence of multiple fine pigmentary deposits. Although they cause amblyopia, this does not appear to be dense. Surgical removal of these central deposits may improve vision, even if the patient presents as an adult.
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ranking = 1
keywords = phacoemulsification
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5/22. Double-ring and double-layer sign of the anterior lens capsule during cataract surgery.

    BACKGROUND: Splitting of the lens capsule with a double-ring contour during continuous curvilinear capsulorrhexis has not often been reported. CASE: An 86-year-old woman underwent phacoemulsification cataract extraction with intraocular lens implantation in the right eye. Preoperatively, the anterior lens capsule appeared normal. OBSERVATIONS: A double-ring sign was observed during capsulorrhexis. During intraocular lens implantation, the capsule developed radial tears, and a double layer of the capsule was noted. The patient's postoperative course was uneventful. CONCLUSIONS: The findings in our patient may be uncommon and may differ from but resemble true exfoliation.
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ranking = 1
keywords = phacoemulsification
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6/22. 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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7/22. Lensectomy in the management of glaucoma in spherophakia.

    A 42-year-old woman presented with uncontrolled glaucoma despite patent peripheral iridotomies after a previous episode of acute angle-closure glaucoma. Spherophakia was diagnosed by anterior segment findings, refraction, A-scan biometry, and ultrasound biomicroscopy. Continuous curvilinear capsulorhexis, phacoemulsification, and infusion/aspiration were performed in the right eye. Attempted intraocular lens (IOL) implantation failed, and the eye was left aphakic. Six months later, the intraocular pressure (IOP) was normal without glaucoma therapy and visual acuity was 6/6 with a contact lens. The patient then had phacoemulsification in the left eye, removal of the capsular bag, anterior vitrectomy, and insertion of an anterior chamber IOL. Four months after surgery, the uncorrected visual acuity was 6/9 and the IOP was normal without glaucoma therapy.
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ranking = 2
keywords = phacoemulsification
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8/22. Capsular block syndrome associated with horizontal jerk nystagmus.

    A 78-year-old cataract patient with horizontal jerk nystagmus had phacoemulsification and intraocular lens (IOL) implantation in the capsular bag with continuous curvilinear capsulorhexis. One week postoperatively, the posterior capsule ballooned posteriorly, the anterior capsule opening was sealed to the IOL optic, and a transparent liquefied substance accumulated between the lens optic and the posterior capsule. The best corrected visual acuity was 0.6 with a myopic shift compared with the refraction after the first day. A neodymium:YAG laser posterior capsulotomy was performed, and the capsular block syndrome (CBS) resolved. The results confirm the experimental model proposed by Zacharias suggesting that saccadic eye movements contribute to CBS under certain anatomic conditions.
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ranking = 1
keywords = phacoemulsification
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9/22. Capsular block syndrome in a case with excessive cortical remnants.

    Ten days after cataract extraction with phacoemulsification and in-the-bag acrylic intraocular lens implantation, capsular block syndrome developed in the right eye of a 62-year-old man. Aspiration of the swollen cortical remnants resulted in resolution of the capsular block.
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ranking = 1
keywords = phacoemulsification
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10/22. phacoemulsification and intraocular lens implantation in an Alport's syndrome patient with bilateral anterior and posterior lenticonus.

    We report a case of intraocular lens (IOL) implantation with a continuous curvilinear capsulorhexis and phacoemulsification in a 30-year-old man manifesting anterior and posterior lenticonus. The surgery was uneventful and on follow-up, the IOL was well centered in the bag.
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ranking = 1
keywords = phacoemulsification
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