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Complications in Vitreoretinal Surgery
Published in Pradeep Venkatesh, Handbook of Vitreoretinal Surgery, 2023
Fibrinoid anterior chamber reaction is another serious complication that is commonly seen after diabetic vitreous surgery. It is seen in the early postoperative period and may mimic endophthalmitis. Eyes without prior laser, nephropathy, excessive tissue manipulation, and combined phacoemulsification surgery are some risk factors for its occurrence. The condition can be treated by increasing the frequency of topical steroids, intravitreal steroid injection, and systemic steroids. Some patients in whom silicone oil has been used as vitreous substitute tend to develop appreciable anterior chamber inflammation on day 2 or 3 after the surgery. This could be accompanied by the development a translucent pupillary membrane. Prompt treatment with frequent corticosteroid drops, cycloplegics, and a short course of oral corticosteroids usually results in retraction of the pupillary membrane and resolution of the complication.
The Special Sense Organs and Their Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Treatment for cataracts varies from frequent changes in eyeglasses to compensate for gradual vision loss, to surgery in which the lens is removed and replaced with an artificial lens. Removal of the entire lens is termed an intracapsular extraction, while extracapsular extraction denotes retention of the posterior portion of the lens capsule. Phacoemulsification is a technique utilizing ultrasonic vibration to disintegrate the lens for aspiration. A combination of the artificial lens and bifocal glasses or contact lenses is used to restore focusing ability. Refractive errors and unilateral aphakia (absence of the crystalline lens) can also be treated with corneal contact leases.
Answers
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
A cataract is an opacity of the lens. Cataracts are the leading cause of blindness in the world. In the UK, they are more associated with the elderly population; however, cataracts can be congenital usually due to maternal infection, e.g. rubella. Patients with developing cataract usually complain of gradual visual disturbances, such as having trouble reading the paper or not recognising faces. Other symptoms are seeing ‘haloes’ when the sun is in their eyes. Phacoemulsification involves breaking up the affected lens with ultrasound then aspirating it through a cannula. A replacement artificial lens is then inserted. The posterior capsule is left ‘untouched’ at surgery to make surgery safer; however, it is the source of the commonest complication; opacification, which is treated with laser therapy.
Cataract Surgery Numbers in U.S. Ophthalmology Residency Programs: An ACGME Case Log Analysis
Published in Ophthalmic Epidemiology, 2022
Brittany C. Tsou, Hursuong Vongsachang, Boonkit Purt, Divya Srikumaran, Grant A. Justin, Fasika A. Woreta
Phacoemulsification is the most common technique for cataract surgery in the United States (U.S.). While in the past, U.S. residency programs had trained residents in manual ECCE followed by gradual introduction to phacoemulsification, programs have moved to phacoemulsification as it is now the preferred technique for cataract surgery in the U.S.3 According to a 2002 survey of ophthalmology program residency directors, all residents learned the phacoemulsification technique.4 However, recently trained residents in the U.S. are not as familiar with alternative surgical techniques such as manual ECCE and SICS. For instance, a survey in 2010 of graduating ophthalmology residents showed that the majority had performed fewer than two manual ECCE cases and about a quarter had never performed a planned ECCE.3 Another survey of ophthalmology chiefs in the U.S. Veterans Health Administration facilities showed that only about a quarter of VA facilities taught residents manual ECCE technique.5 This trend toward phacoemulsification and away from other techniques such as manual ECCE and SICS has currently been observed in the U.S. and several European countries, and it may also happen in other countries in the future.
Preoperative Management of MGD with Vectored Thermal Pulsation before Cataract Surgery: A Prospective, Controlled Clinical Trial
Published in Seminars in Ophthalmology, 2021
Yinying Zhao, Junhua Li, Keyun Xue, Jialu Xie, Gongpei Xie, Siyi Gu, Yune Zhao
Phacoemulsification is one of the most common and successful surgical procedures to treat cataracts; however, many patients complain of ocular symptoms despite excellent visual acuity after the procedure. Several studies have suggested that cataract surgery may play a significant role in the development of MGD.1 Cochener B et al.2 reported a high prevalence of the disease, even in asymptomatic patients. It has also been found that symptoms of self-reported dryness in patients continued to increase and did not return to normal levels, even 3 months after a cataract surgery.3 Similarly, it has been observed that postoperative inflammation, tissue edema, and the use of eye drops following a phacoemulsification surgery have been found to result in a decrease in tear film stability.4 Generally, in order to prevent early postoperative intraocular infection, patients are instructed not to wipe or clean their eyelids. This may also be a contributing factor that leads to MGD and a decrease in tear film stability.
Short-Term Changes in Retinal Vasculature and Layer Thickness after Phacoemulsification Surgery
Published in Current Eye Research, 2020
Yifan Zhou, Minwen Zhou, Yulan Wang, Shenyu Ben, Min Gao, Siqi Zhang, Haiyun Liu, Xiaodong Sun
Phacoemulsification surgery is the most extensively performed intraocular surgery for aged patients with cataract, which was once considered as merely a simple anterior segment ocular surgery, and is generally associated with good visual outcomes. However, visual-threatening postoperative complications (mainly fundus diseases) like pseudophakic cystoid macular edema, progression of the diabetic retinopathy, and even onset of age-related macular degeneration (AMD)1–5 have come to our attention. One has to realize that the short-time phacoemulsification surgery can also cause long-term fundus changes.6–8 Hilton et al. first found pulsatile ocular blood flow to be improved after cataract surgery, which according to their suggestion, might be beneficial for eyes.9 Later, using optical coherence tomography (OCT), changes of postoperative macular thickness were observed.8,10–12 Increase in macular retinal thickness and volume compared to preoperative level was regarded as an indication to the rupture of the blood–retinal barrier (BRB) after the surgery.10 Recent studies also demonstrated that postoperative choroid thickness increased during follow-up, which may be related to the late onset of AMD.6,7,13,14