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1.
Combined cataract surgery and vitrectomy for recurrent retinal detachment   总被引:4,自引:0,他引:4  
PURPOSE: To report our experience with combined cataract surgery, posterior chamber intraocular lens implantation, and pars plana vitrectomy in the management of recurrent retinal detachment (RD) and visually significant cataract. METHODS: Retrospective chart review of patients with cataract and recurrent RD who underwent combined cataract extraction, posterior chamber intraocular lens implantation, and pars plana vitrectomy between January 1991 and September 1998 at the Bascom Palmer Eye Institute. Sixteen eyes were included. All eyes had visually significant cataract and had undergone primary repair of the RD with encircling scleral buckle; eight eyes also had undergone pars plana vitrectomy during the primary repair. The technique of cataract extraction included phacoemulsification (10 eyes), extracapsular cataract extraction (5 eyes), and pars plana lensectomy (1 eye). All eyes underwent pars plana vitrectomy, membrane peeling, fluid-air exchange, endolaser treatment, and placement of a retinal tamponade. Perfluoropropane (C3F8) gas was used in 14 eyes, and silicone oil was placed in two eyes. RESULTS: The postoperative follow-up interval ranged from 4 to 64 months (mean, 16 months). Preoperative visual acuity ranged from 20/60 to hand motions and was better than 20/200 in 3 (19%) eyes. Postoperatively, 9 (56%) eyes improved to better than 20/200. Anatomic success was achieved after the initial reoperation in 13 (81 %) eyes. With further surgery, the overall success rate was 94%. CONCLUSIONS: Combined cataract surgery, posterior chamber intraocular lens implantation, and pars plana vitrectomy in selected patients with cataract and recurrent RD was successful in improving visual acuity and achieving retinal reattachment in most of these reoperated patients.  相似文献   

2.
PURPOSE: To assess differences in conjunctival bacterial flora between patients undergoing glaucoma and cataract surgery. PATIENTS AND METHODS: A prospective study comparing conjunctival bacterial cultures obtained from 339 patients undergoing either cataract (n = 258) or glaucoma (n = 81) surgery. All cultures were acquired during the preoperative visit, approximately three to seven days prior to surgery. The culture samples were inoculated onto blood and chocolate agar, as well as blood culture broth media. All bacterial isolates were identified and statistical analyses were performed to determine if there were differences in flora between the eyes undergoing cataract versus glaucoma surgery. RESULTS: Two hundred fifteen of 258 eyes (83%) undergoing cataract surgery were found to have positive bacterial growth, compared with 62 of 81 eyes (77%) of those undergoing glaucoma surgery (P = 0.2246). Coagulase-negative Staphylococci, the most common bacterial isolate, was cultured from 167 eyes (65%) in the cataract group and 42 (52%) in the glaucoma group (P = 0.0514). Among all bacterial isolates, only Corynebacterium species was found to be statistically different between the two patient groups with 92 (36%) and 11 (14%) eyes testing positive in the cataract and glaucoma groups, respectively (P = 0.0003). CONCLUSIONS: There was no statistically significant difference in the proportion of conjunctival culture samples testing positive for bacterial growth in eyes undergoing glaucoma surgery compared with those undergoing cataract surgery. Glaucoma medications, or their preservatives, do not appear to significantly alter conjunctival flora. Techniques used for endophthalmitis prophylaxis prior to cataract surgery are likely appropriate for glaucoma surgery as well.  相似文献   

3.
AIMS: To review the current management and outcomes of retinal detachment following cataract surgery in childhood. METHODS: A retrospective review of 59 eyes of 52 patients. RESULTS: In 37% of patients, the fellow eye was blind (<3/60). The macula was detached at presentation in 81% of eyes. The detachment was obscured by residual lens matter, or a miotic pupil in 67% of eyes that had cataract surgery before 1970, but in only 30% of eyes operated after 1970. The retina was reattached with one operation in 59% of eyes, and final reattachment was achieved in 81%. No retina was reattached by scleral buckling alone. Visual outcomes were slightly better in eyes that had retinal detachment repair after 1 January 1998. Nine patients were blind in both eyes at the latest follow-up. CONCLUSIONS: Retinal detachment following childhood cataract surgery remains a serious condition. There has been some improvement in the prognosis due to a combination of advances in childhood cataract surgery as well as to improvements in the management of retinal detachment. Early recognition and prompt surgery, using an internal approach, may prevent blindness in most cases.  相似文献   

4.
目的:探讨糖尿病患者白内障超声乳化摘除联合囊袋内人工晶状体植入术后的疗效及并发症。方法:对61例(81眼)糖尿病白内障患者施行超声乳化摘除联合囊袋内人工晶状体植入术治疗。结果:术后视力≥0.5者占85.19%,视力≥0.3者占88.89%,并发症主要包括;晶状体后囊破裂5眼,占6%,角膜纹状混浊16眼,占19%,前房纤维素性渗出6眼,占7%,后囊混浊10眼,占12%,糖尿病视网膜病变13眼,占16  相似文献   

5.
目的 探讨白内障超声乳化人工晶状体植入术后影响视力的因素。方法 对94例118眼进行术后1月至1年随访观察。结果 矫正视力1.0以上者38眼(32%)。0.5以上96眼(81%),主要影响视力的因素;角膜水肿及失代偿、后发性白内障、前段葡萄膜炎及脉络膜脱离。结论 超声乳化是一种较好的手术方法、术中操作损伤小、减少了并发症,对提高视力有极其重要的作用。  相似文献   

6.
Pars plana vitrectomy for epiretinal membrane associated with sarcoidosis   总被引:2,自引:0,他引:2  
PURPOSE: To examine retrospectively the visual outcomes in patients undergoing vitrectomy for epiretinal membranes secondary to sarcoid uveitis. METHODS: Eleven consecutive patients (11 eyes) with epiretinal membrane and uveitis associated with sarcoidosis underwent pars plana vitrectomy. RESULTS: Nine eyes (82%) gained two or more lines of Snellen visual acuity at 1-12 months after surgery. However, 4 of these 9 eyes lost two or more lines of Snellen visual acuity by the final visit. Overall, 5 eyes (45%) had attained at least two Snellen lines of visual acuity improvement, 5 eyes (45%) were unchanged, and 1 eye (10%) had worsened by two lines at the final visit. Nine eyes (81%) achieved visual acuity of 20/40 or better by the final visit. Slit-lamp biomicroscopy and fluorescein angiography showed that cystoid macular edema had resolved in 4 of 7 eyes postoperatively; vitritis improved in all cases. Postoperative complications included cataract formation, glaucoma, and membrane recurrence. Subsequent surgeries consisted of cataract extraction in 2 eyes and membrane peeling in 1 eye. CONCLUSIONS: Pars plana vitrectomy appears to have a beneficial effect on restoring vision in eyes with epiretinal membrane and uveitis associated with sarcoidosis, but final visual acuity was limited by the development of cataract and membrane recurrence.  相似文献   

7.
目的:观察青光眼白内障小切口非乳化白内障囊外摘除+后房型人工晶状体植入+小梁切除术(简称三联手术)的疗效。方法:对56例62眼青光眼合并白内障患者施行三联手术并观察其术后疗效(包括矫正视力,眼压,滤过泡及并发症等)。术后随访2~36(平均22)mo。结果:术后矫正视力0.02~0.25者12眼(19%),视力在0.3~1.0者50眼(81%),术后眼压控制者60眼(97%),仅2眼眼压为21.87与22.15mmHg,但可通过局部药物控制。术后7d54眼(87%)呈扁平的功能性滤过泡,6眼呈泡状滤过泡,2眼滤过泡不明显。术后并发症主要为角膜水肿29眼(47%),前房渗出9眼(15%)与浅前房6眼(10%)。结论:青光眼合并白内障的三联手术是一种适宜在基层医院推广的安全有效且并发症较少的术式。  相似文献   

8.
目的 探讨和分析白内障囊外摘除(ECCE)和超声乳化吸除术(PHACO)的白内障复明手术的手术效果.方法 2000年3月至2008年12月对408例(408只眼)行白内障手术.其中ECCE组92例(92只眼),PHACO组316例(316只眼).比较两组手术效果和手术并发症,将结果进行统计学分析.结果 ECCE组脱盲率为88.04%(81只眼),脱残率为56.52%(52只眼);PHACO组脱盲率为93.35%(295只眼),脱残率为76.27%(241只眼).两组比较差异有统计学意义(X~2=6.31,P<0.05)结论白内障超声乳化吸除联合人工晶状体植入术后可获得良好的复明效果.  相似文献   

9.
小瞳孔白内障超声乳化术探讨   总被引:1,自引:1,他引:0  
目的:探讨小瞳孔状态下白内障超声乳化术的手术技巧。方法:临床确诊的小瞳孔白内障患者60例68眼,术中不切开瞳孔缘,采用"T"型调位钩牵引扩张瞳孔,原位进行超声乳化手术。结果:术后55眼(81%)瞳孔圆形,直径3~4mm;13眼(19%)瞳孔欠规整,直径4~5mm,其中9眼(13%)虹膜不同程度损伤;术后视力均提高,裸眼视力≥0.8者20眼(29%),0.5~0.8者25眼(37%),0.3~0.5者15眼(22%),0.1~0.3者8眼(12%);无严重并发症发生。结论:利用"T"型调位钩牵引扩张瞳孔,小瞳孔白内障的超声乳化手术可顺利进行。  相似文献   

10.
Contrast sensitivity and glare sensitivity are often abnormal in cataract patients. However, despite significant subjective complaints, relatively good visual acuities often are obtained with high-contrast optotypes. Using Variable-Contrast Visual Acuity Charts (VCVAC), we measured visual acuities of 40 eyes of 24 normal subjects (visual acuity greater than or equal to 1.0) aged 41 to 72 years, and 40 eyes of 28 cataract patients (visual acuity greater than or equal to 0.6) aged 44 to 81 years. The VCVAC consists of 4 different charts (1-4). The contrast is 90% in charts 1 and 4, 15% in chart 2 and 2.5% in chart 3. Chart 4 is the reverse polarity of chart 1. The decrease of visual acuity compared with the high-contrast chart (chart 1) was larger in the cataract group with both in the 15% contrast (0.52 vs. 0.71 octave) and the 2.5% contrast (1.21 vs. 1.75 octaves). In cataract group, 23/40 eyes (57.5%) showed better visual acuity with chart 4 than that of chart 1. In addition to high-contrast optotypes, acuity measurements using intermediate- to low-contrast optotypes, combined with the reverse polarity chart, seem effective in analyzing the visual disabilities caused by early cataract.  相似文献   

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