Cases reported "Ocular Hypertension"

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1/5. Pigment dispersion with elevated intraocular pressure after AcrySof intraocular lens implantation in the ciliary sulcus.

    A 45-year-old white woman had phacoemulsification with intraocular lens (IOL) implantation. The surgery was routine except for a linear tear in the posterior capsule; there was no disruption of the anterior vitreous face. After residual soft lens matter was removed, an AcrySof IOL was placed in the ciliary sulcus. One month postoperatively, the patient presented with an intraocular pressure (IOP) of 30 mm Hg and signs of pigment dispersion with 360 degrees of heavy pigmentation of the trabecular meshwork and iris transillumination defects. intraocular pressure was controlled with a topical beta-blocker. The optic disc appearance and visual field remained normal, but the uniocular hyperpigmentation of the trabecular meshwork was still present. We hypothesize that the sharp square edge of the AcrySof IOL increases the risk of a chafing effect on the posterior iris pigment and advocate that this IOL be placed in the capsular bag and ideally have 360 degrees of protective overlapping of the anterior capsule over the edge of the optic.
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ranking = 1
keywords = phacoemulsification
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2/5. Transient intraocular pressure elevation after trabeculotomy and its occurrence with phacoemulsification and intraocular lens implantation.

    PURPOSE: To elucidate the characterization of intraocular pressure (IOP) spike after trabeculotomy, and after the combined procedure of phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. methods: Included in this study were 39 patients (53 eyes) with primary open-angle glaucoma with IOPs uncontrolled even with anti-glaucoma medication. We conducted a retrospective study for the following two groups: patients who underwent trabeculotomy alone (25 eyes) and patients undergoing trabeculotomy combined with PEA and implantation of an IOL (28 eyes). RESULTS: In 7 (28%) of the 25 eyes after trabeculotomy alone and 7 (25%) of the 28 eyes after the combined procedure, transient IOP elevation was found postoperatively. The incidence of hyphema-related IOP spike was significantly higher in eyes after trabeculotomy alone (16%) than after the combined procedure (0%). After removal of the blood present in the anterior chamber in eyes with hyphema-related IOP spikes, the IOP levels were well controlled. CONCLUSIONS: hyphema-related IOP spike is one of the common complications in eyes after trabeculotomy alone, and the combined procedure decreases the incidence of this complication. It is thought that removal of prolonged massive hyphema is effective as treatment for hyphema-related IOP spike.
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ranking = 5
keywords = phacoemulsification
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3/5. Removal of a capsular tension ring from the anterior chamber angle.

    A 75-year-old woman presented with unexplained ocular hypertension 4 weeks after phacoemulsification. Steroid response was diagnosed initially until a misplaced capsular tension ring (CTR) was identified in the drainage angle. We describe the technique used to successfully remove the CTR from the drainage angle with minimal trauma. This case illustrates the importance of the initial surgical technique used for CTR insertion and emphasizes the role of gonioscopy in such a case.
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ranking = 1
keywords = phacoemulsification
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4/5. Marked intraocular pressure rise following Nd:YAG laser capsulotomy.

    A Nd:YAG laser was used to perform a posterior capsulotomy on a patient one and a half years after phacoemulsification. Within 24 hours the intraocular pressure had increased to 67 mm Hg despite pre-treatment with timolol and acetazolamide. intraocular pressure eventually returned to pre-capsulotomy levels after several days. A mechanism is postulated for the particularly high pressures encountered in this case.
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ranking = 1
keywords = phacoemulsification
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5/5. Choroidal ischemia after extracapsular cataract extraction by phacoemulsification.

    Three patients developed apparent choroidal ischemia after phacoemulsification. The outer half of the posterior retina appeared white after operation, with confluent lesions in the posterior pole and splotchy white areas in the midperiphery. The separate lesions appeared similar in pattern to the lobular division of the choriocapillaris, and the retinal vessels were not involved. The white lesions resolved in two to three weeks, leaving alterations in the pigment epithelium. Vision was transiently reduced in each eye but returned to a nearly normal level in two of three affected eyes, although paracentral scotomas persisted. In each case of phacoemulsification, the posterior lens capsule was either damaged or was removed. In all three cases, an investigational type of irrigating solution (BSS Plus) containing balanced salt, glutathione, and other constituents was used. Controlled ocular compression was performed before operation using a pneumatic device in two cases. However, the cause of retinal and choroidal damage now described was probably excessively elevated intraocular pressure during the operation.
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ranking = 6
keywords = phacoemulsification
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