Review of Surgical Management of Small Pupils in Cataract Surgery

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.

Download Full-text

Innovative alternatives in the surgical management of glaucoma with cataract surgery

Expert Review of Ophthalmology ◽

10.1080/17469899.2017.1362335 ◽

2017 ◽

Vol 12 (5) ◽

pp. 403-419 ◽

Cited By ~ 1

Author(s):

Tsontcho Ianchulev ◽

Iqbal I. K. Ahmed ◽

Robert L. Stamper ◽

David F. Chang ◽

Thomas W. Samuelson ◽

...

Keyword(s):

Cataract Surgery ◽

Surgical Management

Download Full-text

Review of Surgical Management of Small Pupils in Cataract Surgery

Techniques in Ophthalmology ◽

10.1097/ito.0b013e3181f1a0df ◽

2010 ◽

Vol 8 (3) ◽

pp. 104-118 ◽

Cited By ~ 2

Author(s):

Boris Malyugin

Keyword(s):

Cataract Surgery ◽

Surgical Management

Download Full-text

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

US Ophthalmic Review ◽

10.17925/usor.2014.07.02.95 ◽

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.

Download Full-text

Surgical Management of Positive Vitreous Pressure (PVP) During Cataract Surgery

Trocar Surgery for Cataract Surgeons ◽

10.1007/978-3-030-36093-1_11 ◽

2020 ◽

pp. 49-52

Author(s):

Ulrich Spandau

Keyword(s):

Cataract Surgery ◽

Surgical Management

Download Full-text

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

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v3i1.4270 ◽

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

Download Full-text

Conquering the White Cataract

US Ophthalmic Review ◽

10.17925/usor.2018.11.1.24 ◽

2018 ◽

Vol 11 (1) ◽

pp. 24

Author(s):

Kate Xie ◽

Marjan Farid ◽

◽

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Surgical Management ◽

Complex Cases

We review clinical pearls in the evaluation and surgical management of white cataracts. Femtosecond laser-assisted cataract surgery is a newer technology that can aid in capsulorhexis creation, however the surgeon should be aware of the risk of incomplete capsulotomy creation in intumescent white cataracts. The surgeon should be fully prepared and anticipate challenges at every step of cataract surgery in these complex cases.

Download Full-text