Cases reported "Rupture, Spontaneous"

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1/4. Late spontaneous resolution of a massive detachment of Descemet's membrane after phacoemulsification.

    We report the spontaneous resolution of a massive detachment of Descemet's membrane 10 months after uneventful phacoemulsification. diagnosis of the detachment was delayed because of severe corneal edema; thus, surgery was not performed. We propose that this complication of severe corneal edema after cataract surgery be considered and, given its excellent outcome, we recommend surgical treatment.
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ranking = 1
keywords = phacoemulsification
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2/4. 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 = 1
keywords = phacoemulsification
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3/4. Orbital varix rupture during cataract surgery.

    We report a case of orbital varix rupture during cataract surgery with retrobulbar anesthesia. No remarkable changes were observed 10 minutes after retrobulbar anesthesia was administered, but a rise in intraocular and intraorbital pressure was noted about 10 minutes after phacoemulsification began. The eyelid could not be closed at the end of surgery because of severe proptosis. Follow-up by magnetic resonance imaging and color Doppler imaging revealed orbital hemorrhage and varix. Based on the time of its appearance, the hemorrhage was thought to be the result of venous congestion caused by anesthetic agent in the muscle cone. Although intermittent exophthalmos is a symptom of orbital varix, silent orbital varix should be considered when selecting the method of anesthesia for ocular surgery.
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ranking = 0.2
keywords = phacoemulsification
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4/4. 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 = 1.2
keywords = phacoemulsification
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