Prevalence, surgical management, and complication rate in patients unable to lie flat for cataract surgery

2013 ◽  
Vol 39 (7) ◽  
pp. 1120-1122 ◽  
Author(s):  
Anas Injarie ◽  
Gerald P. Clancy ◽  
Tom Eke
Keyword(s):  
Cataract Surgery ◽  
Surgical Management ◽  
Complication Rate

Aqueous misdirection syndrome masking as myopic surprise following phacoemulsification surgery

2021 ◽  
Vol 14 (12) ◽  
pp. e242777
Author(s):  
Chung Shen Chean ◽  
Duminda Gabadage ◽  
Subhanjan Mukherji
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
Early Diagnosis ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Surgical Management ◽  
Clinical Presentation ◽  
Optic Nerve Damage ◽  
Shallow Anterior Chamber ◽  
Aqueous Misdirection

Aqueous misdirection syndrome is a rare but serious condition that can present after routine phacoemulsification surgery. This report examines a case of myopic surprise following an uncomplicated left eye (LE) phacoemulsification surgery. The patient had previous bilateral peripheral iridotomies for narrow anterior chamber angles. Repeat biometry measurement of the pseudophakic LE did not show shallow anterior chamber, and intraocular pressure (IOP) was normal at initial presentation. However, approximately 3 years postoperatively, LE IOP was raised. Surgical management was considered as medical and laser procedures did not stop deterioration. Clinical presentation of aqueous misdirection syndrome may be subtle and can occur weeks to years after routine uncomplicated phacoemulsification surgery. Myopic surprise may be the only initial presenting sign. Patients who are at risk of aqueous misdirection syndrome should be followed up closely after cataract surgery with accurate gonioscopic assessments for early diagnosis and treatment to prevent optic nerve damage.

Innovative alternatives in the surgical management of glaucoma with cataract surgery

2017 ◽  
Vol 12 (5) ◽  
pp. 403-419 ◽  
Author(s):  
Tsontcho Ianchulev ◽  
Iqbal I. K. Ahmed ◽  
Robert L. Stamper ◽  
David F. Chang ◽  
Thomas W. Samuelson ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Surgical Management

scholarly journals Surgical Management of Proximal Fifth Metatarsal Fractures in Elite Athletes: A Systematic Review

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110376
Author(s):  
J. Brett Goodloe ◽  
William M. Cregar ◽  
Alexander Caughman ◽  
Evan P. Bailey ◽  
William R. Barfield ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Management ◽  
Complication Rate ◽  
Elite Athletes ◽  
Return To Play ◽  
Treatment Modalities ◽  
Iliac Crest Bone Graft ◽  
Complication Rates ◽  
Exclusion Criteria ◽  
Metatarsal Fractures

Background: As a result of the high physical demand in sport, elite athletes are particularly prone to fifth metatarsal fractures. These injuries are typically managed surgically to avoid high rates of delayed union and allow for quicker return to play (RTP). Purpose: To review studies showing clinical and radiographic outcomes, RTP rates, and complication rates after different surgical treatment modalities for fifth metatarsal fractures exclusively in elite-level athletes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search was conducted within the PubMed, Scopus, and Cochrane databases from January 2000 to January 2020. Inclusion criteria consisted of clinical outcome studies after operative management of fifth metatarsal fractures in elite athletes. Exclusion criteria consisted of nonoperative management, high school or recreational-level athletic participation, nonclinical studies, expert opinions, and case series with <5 patients. Results: A total of 12 studies met inclusion and exclusion criteria, comprising 280 fifth metatarsal fractures treated surgically. Intramedullary screw fixation was the most common fixation construct (47.9%), and some form of intraoperative adjunctive treatment (calcaneal autograft, iliac crest bone graft, bone marrow aspirate concentrate, demineralized bone matrix) was used in 67% of cases. Radiographic union was achieved in 96.7% of fractures regardless of surgical construct used. The overall mean time to union was 9.19 weeks, with RTP at a mean of 11.15 weeks. The overall reported complication rate was 22.5%, with varying severity of complications. Refracture rates were comparable between the different surgical constructs used, and the overall refracture rate was 8.6%. Conclusion: Elite athletes appeared to have a high rate of union and reliably returned to the same level of competition after surgical management of fifth metatarsal fractures, irrespective of surgical construct used. Despite this, the overall complication rate was >20%. Specific recommendations for optimal surgical management could not be made based on the heterogeneity of the included studies.

Surgical management of urolithiasis in octogenarians

2019 ◽  
Vol 12 (5) ◽  
pp. 347-352
Author(s):  
Danielle Whiting ◽  
Irem Arican ◽  
Khaled Farrag ◽  
Faqar Anjum ◽  
Seshadri Sriprasad ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Length Of Stay ◽  
Surgical Management ◽  
Complication Rate ◽  
Case Series ◽  
Unknown Origin ◽  
Stent Insertion ◽  
Stone Size ◽  
Level Of Evidence ◽  
Emergency Procedures

Objective: The objective of this study was to report the outcomes of octogenarians undergoing surgical treatment for urolithiasis. Materials and methods: We performed a retrospective review of patients aged over 80 years who underwent surgical management for urolithiasis over 8.5 years. Data was collected for patient demographics, procedure, stone size, position, composition and clearance, urine cultures, complications and length of stay. Results: Sixty patients had 111 surgical procedures: 89 elective procedures (80.2%) and 22 emergency procedures (19.8%). Median age was 83 years (81–85), ASA grade 3 and stone size 8 mm (6–10). Clinical presentation was varied, with only 17 patients (28.3%) presenting with ureteric colic/flank pain. Ureterorenoscopy was performed in 74 procedures (66.7%). A ureteric stent was left in 91 procedures (82.0%). The median length of stay for the emergency patients was 6 nights (3–9.5 nights) and for the elective patients was 1 night (1–3 nights). The complication rate varied depending on the primary procedure performed. The overall complication rate was 19.8%: three (2.7%) Clavien I (urinary retention); 11 (9.9%) Clavien II (blood transfusion/urinary tract infection/urosepsis); two (1.8%) Clavien IIIb (stent insertion/bleeding); three (2.7%) Clavien IV (urosepsis) and three (2.7%) Clavien V (two patients urosepsis and one patient pneumonia). The stone-free rate was 68.3%. Conclusion: Octogenarian patients with urolithiasis have a variable presentation, and in patients with sepsis of unknown origin urolithiasis should be considered. We demonstrate that surgical treatment, in particular ureterorenoscopy, can be safely and effectively performed in octogenarians with appropriate surgical planning. Level of evidence: 4 Case series

scholarly journals Current Medical and Surgical Management of Retained Lens Fragments After Cataract Extraction

2014 ◽  
Vol 07 (02) ◽  
pp. 95
Author(s):  
Shlomit Schaal ◽  
Brooke LW Nesmith ◽  
Mark A Ihnen ◽  
Motasem Al-Latayfeh ◽  
◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Surgical Management ◽  
Anterior Segment ◽  
Corneal Edema ◽  
Cataract Extraction ◽  
Pubmed Database ◽  
Close Cooperation ◽  
Contemporary Management ◽  
Management Recommendations ◽  
Lens Material

Purpose:To review current literature understanding and modern clinical guidelines, and to provide contemporary management recommendations regarding the medical and surgical management of retained lens fragments (RLF) after cataract surgery.Methods:Literature review for articles published in the PubMed database between 1948 and 2014 with the following keywords: retained lens fragments, retained lens material, dropped nuclear fragments, dislocated lens.Results:RLF is a complication of cataract surgery, with incidence reported between 0.18 % and 1.1 %, which can result in severe inflammatory reaction, leading to significant vision-threatening complications, including cystoid macular edema, glaucoma, uveitis, and corneal edema. Management of RLF can be either medical or surgical, depending upon the severity of inflammation and symptoms. Proper timing of either medical or surgical management is crucial in preventing visual loss.Conclusion:RLF is a well-known complication of modern cataract surgery that should be managed promptly medically or surgically. Close cooperation between the anterior segment and posterior segment surgeon is crucial for optimal results.

Surgical management challenges and clinical results of bimanual micro-incision phacoemulsification cataract surgery in children with congenital cataract

1970 ◽  
Vol 3 (1) ◽  
pp. 3-8
Author(s):  
M Amon
Keyword(s):  
Cataract Surgery ◽  
Surgical Management ◽  
Congenital Cataract ◽  
Clinical Results ◽  
Posterior Capsular Opacification ◽  
Surgical Removal ◽  
Promising Alternative ◽  
Age Related ◽  
Phacoemulsification Cataract Surgery

Introduction: Small incisions in cataract surgery have shown to reduce tissue damage, postoperative inflammation and pain. Objective: To describe in detail the surgical management challenges and clinical results of bimanual micro-incision phacoemulsification cataract surgery in children with congenital cataract. Materials and methods: In 22 eyes of 14 children aged from 11 months to 17 years with congenital cataract, micro-incision cataract surgery with lensectomy, bimanual aspiration or phacoemulsification and implantation of an intraocular lens (SN60WF, Alcon®) was performed under general anesthesia. The visual equivalent obtained with age-related methods, the slit-lamp examination, and refractive outcome were documented in the medical records and were analyzed retrospectively. The patients fulfilled at least 3 months of follow up. Results: In all operated eyes, micro-incision cataract surgery could be performed without serious intra-operative complications. Lensectomy was safely combined with a primary posterior capsulorhexis and anterior vitrectomy in 17 of 22 eyes. Corneal incision length ranged between 2.2 mm and 2.6 mm (mean: 2.3 ± 0.2 mm). No cases of postoperative hypotony and increased inflammation were observed. One eye required surgical removal of the after-cataract 7 months after surgery. Laser capsulotomy for posterior capsular opacification had to be performed in 2 (9 %) eyes. In all other eyes (19/22), visual axis remained clear during follow-up.Conclusion: Micro-incision cataract surgery is a promising alternative to conventional pediatric cataract surgery, since the technique showed to be comparably safe and effective. Longer follow-up examinations will now be performed.Key words: congenital cataract; bimanual micro-incision phacoemulsificationDOI: 10.3126/nepjoph.v3i1.4270Nepal J Ophthalmol 2011;3(5):3-8

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