Cases reported "Recurrence"

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1/11. Postoperative inflammation in a patient with multiple sclerosis.

    We report a 51-year old white woman with a history of relapsing episodes of multiple sclerosis (MS) who developed acute anterior uveitis 11 days after having uneventful phacoemulsification with posterior chamber intraocular lens implantation. Topical corticosteroids relieved the pain and inflammation within hours. A week after the episode of anterior uveitis, the patient had a severe systemic relapse of MS. Acute inflammation in MS patients during the postoperative period may be noninfectious and could be a prodrome for a relapse of MS.
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ranking = 1
keywords = phacoemulsification
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2/11. Recurrent methicillin-resistant staphylococcus aureus wound ulcer after clear-cornea cataract surgery.

    PURPOSE: To present a case of recurrent, methicillin-resistant staphylococcus aureus (MRSA) wound ulcer after clear-cornea cataract surgery. methods: Case report. RESULTS: An 82-year-old man underwent an uncomplicated phacoemulsification procedure with posterior-chamber intraocular lens (PCIOL) implantation. Two weeks after surgery, a corneal ulcer was present at the wound site. Corneal tissue sample cultures produced methicillin-resistant staphylococcus aureus. The ulcer responded to high-dose vancomycin but recurred twice as vancomycin was tapered. Lamellar keratectomy with conjunctival flap was performed at 6 months after surgery, with no additional ulcer recurrence. CONCLUSIONS: wound infection after clear-cornea cataract surgery occurs infrequently. Management of these infections, however, can provide challenging clinical decisions.
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ranking = 1
keywords = phacoemulsification
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3/11. Late recurrent uveitis after phacoemulsification.

    It is now assumed that recurrent late onset uveitis after phacoemulsification with intraocular lens (IOL) is due to indolent infection. Fifteen such cases were observed after uncomplicated phacoemulsification with-in-the-bag IOL implant. These cases were considered noninfective and treated medically with good visual recovery.
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ranking = 6
keywords = phacoemulsification
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4/11. Recurrent enterococcus faecalis endophthalmitis after phacoemulsification.

    We present the first reported case of late recurrence of postoperative enterococcus faecalis endophthalmitis after cataract surgery in a 45-year-old diabetic man. culture-positive E faecalis endophthalmitis was diagnosed 2 days after uneventful phacoemulsification. Early vitrectomy with intravitreal and subconjunctival vancomycin and amikacin and topical vancomycin resulted in apparently complete clinical resolution after 4 months and a best corrected visual acuity of 20/25. Recurrent endophthalmitis with hypopyon occurred 7 months postoperatively and resolved with intravitreal vancomycin and topical prednisolone acetate 1%. However, the patient had a similar relapse at 9 months that resulted in deterioration of visual acuity to no light perception despite a repeat vitrectomy, intraocular lens explantation, capsular bag removal, and intravitreal antibiotics. The late recurrences could have been the result of persistent sequestration of the organism in the capsular bag.
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ranking = 5
keywords = phacoemulsification
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5/11. Pigmented-membrane formation on acrylic intraocular lenses after phacoemulsification.

    PURPOSE: To report the formation of pigmented membranes on acrylic intraocular lenses (IOLs) after phacoemulsification and to determine the clinical characteristics of these pigmented membranes. DESIGN: Observational case series. methods: Four eyes of three patients were found to have pigmented membranes on their acrylic IOLs (Sensar AR40). Their medical records were reviewed. RESULTS: The pigmented membranes were observed at 4- to 9-month intervals after phacoemulsification. Their best-corrected Snellen visual acuity (BCVA) decreased by more than 2 lines, ranging from 20/63 to 20/40. After Nd:YAG laser treatment, BCVA improved 2 to 4 lines. At 5- to 12-week intervals after Nd:YAG laser treatment, recurrences of the pigmented membranes were observed with decreased BCVA. CONCLUSIONS: We have observed visually significant, recurrent, pigmented membrane formation in eyes implanted with Sensar AR40 acrylic IOLs. To the best of our knowledge, pigmented membranes on acrylic IOLs have not been described previously.
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ranking = 6
keywords = phacoemulsification
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6/11. mycobacterium chelonae-Mycobacterium abscessus complex clear corneal wound infection with recurrent hypopyon and perforation after phacoemulsification and intraocular lens implantation.

    We report a clear corneal wound infection occurring in a 74-year-old man caused by a member of the mycobacterium chelonae-Mycobacterium abscessus complex, presenting as crystalline keratopathy with recurrent hypopyon. This led to perforation after phacoemulsification with posterior chamber intraocular lens implantation. Only after corneal biopsy of the incision was the causative organism isolated and found to be sensitive to clarithromycin and ciprofloxacin. Despite aggressive therapy, a full-thickness corneal perforation developed, requiring emergent cyanoacrylate glue to preserve ocular integrity. Both the difficulty and delays in obtaining a correct diagnosis led to severe ocular morbidity. Infectious lamellar keratitis limited to the clear cornea phacoemulsification incision is rare, but some unusual organisms such as atypical mycobacteria may be encountered.
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ranking = 6
keywords = phacoemulsification
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7/11. Postoperative endophthalmitis caused by sphingomonas paucimobilis.

    We present a case in which a new organism, sphingomonas paucimobilis, caused endophthalmitis after phacoemulsification in a 73-year-old woman. The case shows a recurrent acute endophthalmitis with complete resolution only after vitrectomy. This organism has not been described as a cause of endophthalmitis and was resistant to initial medical management. We also describe an interaction between this organism and a co-infective organism that may account for the unusual clinical course.
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ranking = 1
keywords = phacoemulsification
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8/11. Reduced vision secondary to pigmented cellular membranes on silicone intraocular lenses.

    PURPOSE: Visually significant, pigmented cellular membranes may form on intraocular lenses after implantation. We studied a series of patients to determine the onset, visual significance, treatment, and recurrent nature of these pigmented membranes in patients who underwent surgery with silicone lens implantation. methods: In nine eyes (eight patients) with visually significant pigmented cellular membranes on their Allergan Medical Optics (Irvine, california) silicone intraocular lenses (model SI18NGB or SI26NB), eight underwent combined phacoemulsification, intraocular lens implantation, and trabeculectomy; one underwent phacoemulsification and lens implantation only. We reviewed medical records to identify preoperative, operative, and postoperative similarities and differences in care. Clinical examinations and slit-lamp photographs, over an average of 21.3 /- 7.2 months (range, 11 to 31 months), documented the effects of different treatment modalities. RESULTS: The patients sought treatment ten to 20 weeks (mean, 15 weeks) postoperatively. Except for the cellular membranes, each eye was without evidence of inflammation or cystoid macular edema. Subjective complaints decreased, and best-corrected Snellen visual acuity improved with topical corticosteroid therapy alone. Pretreatment best-corrected visual acuities ranged from 20/40 to 20/400 (mean, 20/70 using Snellen fractions) and improved two to eight (mean, five) Snellen lines, to a range of 20/20 to 20/50 (mean, 20/25). All nine eyes had recurrence of the membranes after treatment terminated and required a maintenance regimen of corticosteroid eyedrops. CONCLUSION: The pigmented cellular membranes observed on these silicone lenses were visually significant to each patient. The membranes resolved and visual acuity improved with topical corticosteroid treatment alone but recurred in all patients on cessation of treatment.
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ranking = 2
keywords = phacoemulsification
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9/11. Pseudophakic candida parapsilosis endophthalmitis with a consecutive keratitis.

    We describe a case of candida parapsilosis endophthalmitis with a consecutive keratitis after phacoemulsification and posterior chamber intraocular lens implantation in an otherwise healthy eye. Despite aggressive medical and surgical management during a 2-year period, multiple episodes recurred, with the development of an intracapsular plaque and an infectious nidus on the corneal endothelium 6 months after the initial presentation. After subtotal removal of the culture-positive capsule, intravitreal and topical amphotericin b, and oral fluconazole, the inflammation improved. However, the corneal endothelial plaque persisted with recurrent inflammation 2 months later, prompting debridement of the culture-positive plaque and further removal of the culture-negative capsular remnants and lens implant. The infection was quiescent for the subsequent 12-month period until recurrent intraocular inflammation developed with enlargement of the endothelial plaque. culture of this plaque was again positive for C. parapsilosis. After debridement and intraocular and topical amphotericin b, the eye has now been quiescent for 13 months. This case demonstrates the development of a secondary keratitis in an eye affected by pseudophakic C. parapsilosis endophthalmitis, with the posterior cornea serving as a sanctuary site for the fungus despite aggressive management leading to recurrent infection 1 year after the clinical disease appeared to be quiescent.
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ranking = 1
keywords = phacoemulsification
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10/11. Transscleral suture fixation of a subluxated posterior chamber lens within the capsular bag.

    A 48-year-old man with cataract had uncomplicated phacoemulsification and implantation of a posterior chamber intraocular lens (IOL) into the continuous capsulorhexis. Three years later, part of the capsular bag and a haptic subluxated into the anterior chamber. At the time of repositioning surgery, partial zonular dehiscence and iridocapsular synechias were found. The IOL was repositioned behind the iris; however, subluxation of the lens recurred 1 year later. The IOL and capsular bag were successfully sutured to the sclera by introducing a double-armed polypropylene suture through a limbal stab incision.
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ranking = 1
keywords = phacoemulsification
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