scholarly journals A Rare Case of Lens-Induced Uveitis with Proliferative Vitreoretinopathy and Massive Encapsulation of Fallen Nuclear Material

2020 ◽  
Vol 11 (2) ◽  
pp. 436-441
Author(s):  
Saki Inoue ◽  
Hisanori Imai ◽  
Akira Tetsumoto ◽  
Keiko Otsuka ◽  
Makoto Nakamura
Keyword(s):  
Cataract Surgery ◽  
Proliferative Vitreoretinopathy ◽  
Rare Case ◽  
Vision Loss ◽  
Nuclear Material ◽  
Oral Steroid ◽  
Vitreous Opacity ◽  
Complicated Cataract ◽  
Pars Plana ◽  
The Right

We experienced a rare case of lens-induced uveitis (LIU) with severe proliferative vitreoretinopathy (PVR) diagnosed upon finding lens nuclear material encapsulated by intravitreal proliferative tissue. A 60-year-old man was referred to our hospital for the treatment of vision loss caused by unexplained uveitis in the right eye (OD). Seven months previously, a complicated cataract surgery that required unplanned anterior vitrectomy and transscleral suture of intraocular lens was performed on that eye at another clinic. Severe inflammation with dense vitreous opacity occurred in the OD postoperatively. Although topical and oral administration of steroids reduced the inflammation 7 months after the surgery, PVR with tractional retinal detachment was developed in the OD. Pars plana vitrectomy (PPV) was performed for the treatment and diagnosis. PPV revealed the presence of lens nuclear fragments within the vitreous, which was approximately 60% the ordinary nucleus size and was encapsulated by intravitreal proliferative tissue. The nuclear fragments were extracted from a superior corneoscleral flap. Intraocular inflammation was reduced with postoperative topical and oral steroid treatments and the retina remained reattached 1 year after the PPV. In conclusion, uveitis with an episode of a complicated cataract surgery may suggest LIU.

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

scholarly journals Valsalva Retinopathy Associated with Sexual Activity

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Khalid Al Rubaie ◽  
J. Fernando Arevalo
Keyword(s):  
Visual Acuity ◽  
Sexual Activity ◽  
Vision Loss ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Sudden Loss ◽  
Initial Visual Acuity ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

A 54-year-old healthy male presented complaining of sudden loss of vision in the right eye. Initial visual acuity was counting fingers. The patient’s acute vision loss developed after sexual activity. Color fundus photos and fluorescein angiography were performed showing a large subinternal limiting membrane hemorrhage in the macular area. A 23-gauge sutureless pars plana vitrectomy with brilliant blue assisted internal limiting membrane peeling was performed with best-corrected visual acuity recovery to 20/50 at 6 months of followup.

Endophthalmitis after dropless (Tri-Moxi injection) cataract surgery

2019 ◽  
Vol 30 (5) ◽  
pp. NP29-NP31 ◽  
Author(s):  
Caleb Ng ◽  
Kakarla V Chalam
Keyword(s):  
Cataract Surgery ◽  
Staphylococcus Epidermidis ◽  
Vision Loss ◽  
Hand Motion ◽  
Corrected Visual Acuity ◽  
Case Summary ◽  
Keratic Precipitates ◽  
Vitreous Sample ◽  
Severe Vision Loss ◽  
Pars Plana

Introduction: A case of endophthalmitis after dropless cataract surgery with intravitreal Tri-Moxi associated with severe vision loss. Case summary: An 82-year-old male developed severe vision loss in the left eye 24 days after dropless cataract surgery with intravitreal Tri-Moxi injection. Best corrected visual acuity was hand motion in the left eye. Intraocular pressure was 13, with inferior keratic precipitates, 4 + cell with 1 mm layered hypopyon, and a plaque on the posterior capsule that blocked direct exam of the posterior segment. Ultrasonography revealed extensive vitritis without retinal or choroidal detachments. Conclusion: Endophthalmitis resolved and vision improved after management with vitreous tap, intravitreal and fortified topical antibiotics, and subsequent prompt pars plana vitrectomy. Vitreous sample grew fluoroquinolone-resistant staphylococcus epidermidis.

scholarly journals Iridotrabecular and Iridocorneal Contact Changes after Cataract Surgery and Endothelial Keratoplasty in Bilateral Iridoschisis

2021 ◽  
pp. 198-203
Author(s):  
Takashi Omoto ◽  
Chisato Agata ◽  
Reina Akiyama ◽  
Kohdai Kitamoto ◽  
Tetsuya Toyono ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Surgical Procedures ◽  
Vision Loss ◽  
Anterior Segment ◽  
Corneal Oedema ◽  
Endothelial Keratoplasty ◽  
Laser Iridotomy ◽  
Before And After ◽  
The Right ◽  
Endothelial Decompensation

We report a case of bilateral iridoschisis with corneal oedema and a quantitative evaluation of the changes in iridotrabecular and iridocorneal contact before and after cataract surgery and after Descemet stripping automated endothelial keratoplasty (DSAEK). A 76-year-old woman with iridoschisis and cataracts, previously managed with laser iridotomy, experienced progressive vision loss. The preoperative iridotrabecular contact (ITC) index measured by anterior segment optical coherence tomography was 23.6% in the right eye and 24.4% in the left eye. Preoperative corneal oedema in the right eye was more severe than that in the left eye. Cataract surgery, followed by DSAEK, was performed in the right eye and subsequently in the left eye. Her visual acuity improved postoperatively, and the corneal oedema of both eyes was treated successfully. Moreover, the ITC index improved in both eyes, to 4.7 and 6.9% after cataract surgery and to 0 and 0% after DSAEK in the right and left eyes, respectively. Staged cataract surgery and DSAEK were effective for endothelial decompensation caused by iridoschisis. Additionally, we confirm that iridotrabecular and iridocorneal contacts improved after both surgical procedures not only after cataract surgery but also after DSAEK. This case report showed the clinical usefulness of the ITC index in the detection of changes after different surgical procedures.

25-Gauge Pars Plana Vitrectomy for Retained Lens Fragments in Complicated Cataract Surgery

2015 ◽  
Vol 234 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Andrea Scupola ◽  
Edoardo Abed ◽  
Maria Grazia Sammarco ◽  
Gabriela Grimaldi ◽  
Paola Sasso ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Nuclear Material ◽  
Early Vitrectomy ◽  
Complicated Cataract ◽  
Duration Of Surgery ◽  
Pars Plana ◽  
The Mean ◽  
Group B ◽  
Lens Material

Purpose: To verify the efficacy of 25-gauge pars plana vitrectomy (PPV) for the management of posteriorly dislocated lens material after complicated cataract extraction and to determine in what patients this approach offers the optimal benefit in terms of efficacy and safety, considering the amount of retained nuclear material and the duration of surgery. Methods: Forty eyes of 40 patients with retained lens fragments undergoing early (within 1 week) or late (within >1 week) 25-gauge PPV were retrospectively reviewed. The amount of dislocated nuclear material was graded by the surgeon intraoperatively, and the patients were divided into two groups according to the nuclear grading: group A (≤50% dropped nucleus) and group B (>50% dropped nucleus). The presence of brunescent nuclear pieces was considered. The outcomes measured included best-corrected visual acuity (BCVA) and postoperative complications such as retinal detachment, cystoid macular edema (CME) and postoperative ocular hypertension or hypotonia. Results: The patients had a mean age of 78 years. The mean preoperative logarithm of the minimum angle of resolution (logMAR) BCVA was 0.57 ± 0.24 (20/80). A significant positive correlation was found between nuclear material grade and PPV duration (R2 = 0.81, p < 0.0001). None of the patients had dislocation of brunescent nuclear pieces. On postoperative day 1, the mean postoperative intraocular pressure was 16.75 ± 2.7 mm Hg, with no case of ocular hypotonia. At 6 months of follow-up, the mean logMAR BCVA improved to 0.23 ± 0.3 (20/32). Retinal detachment developed in 4 patients (10%), occurring only in patients of group B (p < 0.002). Four patients with late PPV developed postoperative CME, with no case of CME among patients with early vitrectomy (p = 0.014). Conclusion: Removal of dislocated lens fragments after complicated cataract surgery can be effectively managed with 25-gauge PPV, although it appears to be most efficient for cases with a limited amount of dislocated lens material. In consideration of the higher rate of retinal detachment observed in cases of prolonged PPV time, the expected duration of surgery should be taken into account when choosing the best surgical approach. Visual outcomes are not affected by the timing of PPV, whereas early vitrectomy seems to prevent the onset of inflammatory macular edema.

scholarly journals Management of a Case of Dropped Nucleus following Small Incision Cataract Surgery in a Patient with Thoracic Kyphoscoliosis and Review of Literature

2017 ◽  
Vol 2 (1) ◽  
pp. 21-23
Author(s):  
Deeksha Katoch ◽  
Sabia Handa ◽  
Banashree Mandal
Keyword(s):  
Cataract Surgery ◽  
Pars Plana Vitrectomy ◽  
Case Reports ◽  
Vitreoretinal Surgery ◽  
Review Of Literature ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Complicated Cataract ◽  
Pars Plana Lensectomy ◽  
Pars Plana

ABSTRACT A curved spine accompanied by restricted neck motion poses a challenge for an ophthalmic surgeon, especially a vitreoretinal surgeon, who needs the patient’s eyes in a horizontal position to operate with the microscope. Literature is sparse with case reports of thoracic kyphoscoliosis for vitreoretinal surgery, although many reports are available for cataract surgery. We report a case of thoracic kyphoscoliosis and ankylosing spondylitis with dropped nucleus into the vitreous cavity following a complicated cataract surgery posted for pars plana vitrectomy, pars plana lensectomy, and phacofragmentation under general anesthesia and review the current literature of such case. How to cite this article Mandal B, Katoch D, Handa S. Management of a Case of Dropped Nucleus following Small Incision Cataract Surgery in a Patient with Thoracic Kyphoscoliosis and Review of Literature. Res Inno in Anesth 2017;2(1):21-23.

scholarly journals Three Cases of Intraoperative Acute Fluid Misdirection Syndrome during Cataract Surgery

2021 ◽  
Vol 62 (8) ◽  
pp. 1141-1147
Author(s):  
Hyun Young Park ◽  
Ji Hyun Kim
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Intraoperative Complications ◽  
Pseudoexfoliation Syndrome ◽  
Normal Limits ◽  
Osmotic Agent ◽  
Pars Plana ◽  
The Right ◽  
End Stage ◽  
Capsular Bag

Purpose: We report the management of three cases of intraoperative acute fluid misdirection syndrome during cataract surgery.Case summary: Cataract surgery was performed in one eye of an 82-year-old woman with pseudoexfoliation syndrome, one eye of an 80-year-old man with end-stage glaucoma, and both eyes of a 72-year-old man with pseudoexfoliation syndrome. In the first two cases, the capsular bag space decreased during cortex aspiration and after removal of the cortex, respectively. After intravenous mannitol and intake of oral acetazolamide, the intraocular lens was successfully inserted in the first two cases on the same day. In the third case, after first removing the nucleus and cortex of the right eye, the capsular bag space decreased and an intraocular lens was carefully inserted. No intraoperative complications were seen during the left eye operation. One month after the operation, the best-corrected visual acuity had improved and the intraocular pressure was within normal limits for all three cases.Conclusions: A relatively shallow chamber, pseudoexfoliation, zonular laxity, and use of high molecular weight ophthalmic viscosurgical devices may cause acute fluid misdirection syndrome during cataract surgery. Pars plana vitrectomy may be required. However, intravenous high osmotic agent treatment should be attempted first, followed by intraocular lens insertion on the same day.

Effects of Kakkon-to and Sairei-to on Aqueous Flare Elevation after Complicated Cataract Surgery

2002 ◽  
Vol 30 (02n03) ◽  
pp. 347-353 ◽  
Author(s):  
Nariko Ikeda ◽  
Seiji Hayasaka ◽  
Yasunori Nagaki ◽  
Yoriko Hayasaka ◽  
Chiharu Kadoi ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Herbal Medicines ◽  
Intraocular Lens Implantation ◽  
Aqueous Flare ◽  
Complicated Cataract ◽  
Lens Implantation ◽  
Before And After ◽  
The Right

We evaluate prospectively the effects of traditional herbal medicines on elevation of aqueous flare after complicated cataract surgery. Twenty-seven patients with bilateral complicated cataract undergoing phacoemulsification with intraocular lens implantation were studied. The patients received no herbal medicine when the right eyes underwent cataract surgery. Fifteen patients were given Kakkon-to (Ge-Gen-Tang in Chinese) granules (7.5 g daily) and 12 patients were given Sairei-to (Cai-Ling-Tang in Chinese) granules (9.0 g daily), for 3 days before surgery, the day of surgery, and for 7 days after surgery when the left eyes underwent cataract surgery. Diclofenac eyedrops were instilled in all patients. Aqueous flare was measured before and after surgery. The differences in preoperative flare intensities between groups treated with Kakkon-to and Sairei-to were not significant. In the untreated right eyes of the Kakkon-to and Sairei-to groups, the flare was 99.1 and 89.6 photon counts/msec, respectively, on day 1, and then gradually decreased. The flare intensities on days 1, 3, and 5 in the Kakkon-to treated left eyes were significantly lower than in those of the untreated right eyes (Fig. 1). The flare intensities in the Sairei-to treated left eyes were the same as those in the untreated right eyes. Kakkon-to contributed to a reduction of aqueous flare elevation after surgery for complicated cataract.

scholarly journals Rare case of endogenous Klebsiella endophthalmitis associated with emphysematous prostatitis in a patient with diabetes, cirrhosis and COVID-19

2021 ◽  
Vol 14 (4) ◽  
pp. e240425
Author(s):  
Alexander B Crane ◽  
Monica C Abreu Diaz ◽  
Yi Jiang ◽  
Kathleen Mangunay Pergament
Keyword(s):  
Pars Plana Vitrectomy ◽  
Rare Case ◽  
Vision Loss ◽  
Urine Culture ◽  
Suprapubic Catheter ◽  
Prostatic Abscess ◽  
Intravenous Antibiotics ◽  
Pars Plana ◽  
Scleral Icterus

A 35-year-old Hispanic man presented with fever, chills, dysuria, diarrhoea, scleral icterus, tachycardia and tachypnea. He was found to be COVID-19 positive, CT of the pelvis revealed prostatic abscess, and urine culture grew Klebsiella pneumoniae. Additionally, he was found to have diabetes and cirrhosis. During treatment, the patient developed vision loss, and was diagnosed with endogenous Klebsiella endophthalmitis. The patient was treated with intravenous antibiotics, pars plana vitrectomy, intravitreal antibiotics and cystoscopy/suprapubic catheter placement. On follow-up, the patient has had the suprapubic catheter removed, and successfully passed a voiding trial, but suffers permanent vision loss in both eyes.

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