scholarly journals Intraoperative and postoperative complications of phacoemulsification in cataract eyes with pseudoexfoliation syndrome

2017 ◽  
Vol 145 (3-4) ◽  
pp. 124-128
Author(s):  
Aleksandar Veselinovic ◽  
Marija Cvetanovic ◽  
Zoran Milosevic ◽  
Dragan Veselinovic
Keyword(s):  
Postoperative Complications ◽  
Pupil Diameter ◽  
Intraoperative Complications ◽  
Corneal Edema ◽  
Significant Rise ◽  
Pseudoexfoliation Syndrome ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Age Related ◽  
Systemic Disorder

Introduction/Objective. Pseudoexfoliation syndrome (PEX) is an age-related systemic disorder characterized by deposition of fibrillary white flaky material mainly on the lens capsule, corneal endothelium, zonules, ciliary body, iris, and pupillary margin. Zonular weakness progressively increases along with the hardness of the lens, patient?s age, and the presence of glaucoma. The objective of the study is to compare the intraoperative and postoperative complications of phacoemulsification in cataract eyes with PEX with cataract eyes without PEX. Methods. The study enrolled 300 eyes with consequently operated senile cataract and PEX and 300 consequently operated eyes with cataract without PEX who underwent phacoemulsification performed by one experienced surgeon (single-surgeon series). A complete ophthalmological examination of all patients was performed preoperatively, as well as on the first, seventh, and 180th day postoperatively. Results. Significant statistical differences between the observed groups were the following: patients with PXF were older (74.2 ? 8; range 56?82 years vs. 68.1 ? 9.6; range 56?79 years), had smaller pupil diameter, and higher intraocular pressure (IOP) preoperatively (16.1 ? 4.1 vs. 13.8 ? 3.7 mmHg). There were no differences between the groups regarding intraoperative complications. Early postoperative complications were a significant rise of IOP (33 vs. six patients; p < 0.001), more frequent postoperative corneal edema (36 vs. 21 patients; p < 0.036), and anterior chamber inflammation (17 vs. seven patients; p < 0.037) in the PEX group, comparing to the control group. The significant late postoperative complication was elevated IOP (24 vs. five patients; p < 0.0002) in patients with PEX. Conclusion. In the hands of an experienced and careful surgeon, phacoemulsification is a safe and beneficial surgery to treat cataract with associated pseudoexfoliation. The greatest problem a surgeon faces is a narrow pupil and zonule instability, and difficulty in recognizing eyes that are particularly at risks, such as those having glaucoma and phacodonesis.

Cataract

2012 ◽  
Author(s):  
Georgia Cleary ◽  
David Spalton
Keyword(s):  
Postoperative Complications ◽  
Cataract Surgery ◽  
Congenital Cataract ◽  
Intraoperative Complications ◽  
Intraocular Lenses ◽  
Posterior Capsular Opacification ◽  
Clinical Knowledge ◽  
Practical Skills ◽  
Age Related ◽  
Nd:Yag Laser Capsulotomy

The chapter begins by discussing lens anatomy and embryology, before covering the key areas of clinical knowledge, namely acquired cataract, clinical evaluation of acquired cataract, treatment for acquired cataract, intraoperative complications of cataract surgery, infectious postoperative complications of cataract surgery, non-infectious postoperative complications of cataract surgery, congenital cataract, management of congenital cataract, and lens dislocation. Practical skills are then covered, including biometry, local anaesthesia, operating microscope and phacodynamics, intraocular lenses, and Nd:YAG laser capsulotomy. The chapter concludes with three case-based discussions, on age-related cataract, postoperative endophthalmitis, and posterior capsular opacification.

scholarly journals An Ophthalmic Changes in Patients with Chronic Obstructive Pulmonary Disease: Case-Control Study

2019 ◽  
pp. 108-114
Author(s):  
Carlos Teixeira Brandt ◽  
Milena Amorim De Souza ◽  
Diego Nery Benevides Gadelha ◽  
Maria Cecília Santos Cavalcanti Melo ◽  
Rita de Cássia Santa Cruz
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Strong Association ◽  
Control Group ◽  
Chronic Obstructive ◽  
Ophthalmological Examination ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients ◽  
Disease Case

Purpose: To evaluate the prevalence of ophthalmological changes in patients with Chronic Obstructive Pulmonary Disease (COPD) cared for at the Pneumology and Ophthalmology Departments at Medical School Unifacisa-Campina Grande-Paraiba-Brazil.Materials and Methods: Twenty-two smoker patients with COPD (study group) and 22 healthy controls that underwent routine ophthalmological examination (control group) were enrolled in the investigation. They were homogeneous regarding age, gender, presence of Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM). They were examined for the presence of cataract and Age Related Macular Disease (AMD).Results: The prevalence of ophthalmologic changes was significantly different in the two groups. Eight (36.4%)patients presented with cataract requiring surgical intervention, while one (4.5%) person in the control group had cataract (p = 0.0212). Regarding AMD, 10 (45.5%) smoker COPD patients had this disease, whereas in the control group, one (4.5%) person had this disease (p = 0.0039).Conclusion: From the results one can conclude that there is strong association between smokers diagnosed with COPD with cataract and AMD patients, reinforcing the need for a protocol for referral of these patients to the ophthalmologist.

Slit Lamp profile of Pseudoexfoliation eyes

2021 ◽  
Vol 12 (3) ◽  
pp. 66-69
Author(s):  
Shilpi Kapoor ◽  
Arjit Kapoor ◽  
Dinesh Gupta
Keyword(s):  
Intraoperative Complications ◽  
Pseudoexfoliation Syndrome ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Pupillary Dilatation ◽  
Medical College ◽  
Age Related ◽  
Department Of Ophthalmology ◽  
D 12 ◽  
Operative Assessment

Background: Pseudoexfoliation syndrome is an age-related systemic microfibrillopathy, caused by progressive accumulation and gradual deposition of extracellular grey and white material over various tissues. It is associated with many intraocular abnormalities like poor pupillary dilatation, zonular dehiscence, glaucoma etc. Hence it is important to do detailed slit lamp examination with dilated pupil to detect the pseudoexfoliative deposits in eye, especially in elderly to prevent unforeseen complications. Aims and Objective: To study pattern of distribution of pseudoexfoliative material in eyes with pseudoexfoliation syndrome and to study the dilatation profile of pupil in such eyes. Materials and Methods: This observational study was conducted on patients with pseudoexfoliation syndrome who attended OPD in the Upgraded Department of Ophthalmology, Government Medical College, Jammu from 1st April 2018 for a period of 6 months. The clearance was taken from ethical committee for the study in reference. Informed consent was taken from all the patients enrolled in the study. Results: Pupillary margin was found to be the most common site for deposition of pex material i.e. 51 (75%) patients followed by anterior surface of lens in 32(47.05%) patients. Patients had simultaneous deposition of pex material over various parts of the eye. 64 (94.12%) patients had pex material deposited on pupil or lens. Only 1(1.47%) patient had pex deposits over cornea. 56 (82.35%) patients attained good to moderate dilatation of pupil with 0.8% tropicamide e/d. 12(17.65%) patients had pupillary dilatation of ≤4mm hence poor dilatation. Conclusion: Pseudoexfoliation presents challenges that must be adequately addressed with detailed slit lamp examination. Cases may go undetected due to failure to dilate the pupil or to examine with slit lamp after dilatation. Adequate pre-operative assessment should especially be done before cataract surgery with the aim to identify problems like the possibility of fragile zonules and inadequate mydriasis which could increase intraoperative complications arising from undue manipulations.

scholarly journals Pseudoexfoliation syndrome and episcleral venous pressure

2017 ◽  
Vol 16 (1) ◽  
pp. 32-37
Author(s):  
V. V. Potemkin ◽  
E. V. Ageeva
Keyword(s):  
Matched Control ◽  
Important Determinant ◽  
Venous Pressure ◽  
Main Group ◽  
Pseudoexfoliation Syndrome ◽  
Control Group ◽  
Episcleral Venous Pressure ◽  
Age Related ◽  
Temporal Quadrant ◽  
And Control

Introduction. Pseudoexfoliation syndrome (PEX) is a relatively widespread generalized age-related disease, in which abnormal fibrillar extracellular material is produced and accumulates in many tissues including vessels. Glaucoma occurs more commonly in eyes with PEX than in those without it. Episcleral venous pressure (EVP) is an important determinant of intraocular pressure (IOP). It seems reasonable to evaluate episcleral venous pressure in patients with PEX. Purpose. To evaluate episcleral venous pressure in patients with PEX. Methods. 540 eyes of 270 patients were enrolled in the prospective study. We evaluated episcleral venous pressure. Results. EVP in total vein compression in lower-nasal quadrant (mmHg) in main group(with PEX) was 14.0±3.29, in control group No. 1 (non PEX, adults) - 14.38±3.77, in control group No. 2 (non PEX, young) - 10.91±2.34. EVP in total vein compression in lower-temporal quadrant (mmHg) in main group was 15.1±3.31, in control group No. 1 - 15.76±3.45, in control group No. 2 - 11.00±2.16. Difference in episcleral venous pressure between main group and age-matched control group No. 1 was not significant, and between main group and control group No. 2 was significant. Conclusion. EVP level is not influenced by PEX, but is influenced by age.

scholarly journals “Cold” polypectomy for colorectal polyps: prospective randomized trial

2021 ◽  
Vol 20 (2) ◽  
pp. 65-73
Author(s):  
O. S. Toporkova ◽  
V. V. Veselov ◽  
Yu. E. Vaganov ◽  
M. A. Nagudov ◽  
O. A. Majnovskaya ◽  
...  
Keyword(s):  
Risk Factor ◽  
Postoperative Complications ◽  
Randomized Trial ◽  
Intraoperative Complications ◽  
Univariate Analysis ◽  
Operation Time ◽  
Colorectal Polyps ◽  
Prospective Randomized Trial ◽  
Control Group ◽  
Number Of Patients

Background: endoscopic electroexcision is the standard technique for the removal of colorectal polyps. However, it is associated with the postoperative morbidity. In order to reduce the incidence of complications, “cold” excision seems to be an alternative option.Aim: to improve the results of endoscopic treatment for patients with colorectal polyps.Patients and methods: from September 2019 to September 2020, 160 patients ≥ 18 years old (80 in each group), who underwent endoscopic removal of colorectal polyps ≤ 10 mm in size by cold excision (132 lesions) and traditional polypectomy (129 lesions), were included in a prospective randomized trial. All removed specimens were studied histologically with an assessment of the resection margins (R0/R1). The analysis of the postoperative complications after endoscopic polypectomy and the incidence of Rx resection after removal of polyps by both techniques was done.Results: the compared groups were homogenous in the number of patients, gender, age, and comobridities. There were no significant differences in the number of removed polyps, their site and the type according to endoscopic classifications. The operation time was significantly higher in the conventional polypectomy group compared with the “cold” one (p = 0.0001). There were no significant differences in the intraoperative complications rate between the two groups (p = 0.06). There were no postoperative complications in the “cold” group. In the control group postoperative complications occurred after 12 out of 129 polyps removal (p = 0.001). The univariate analysis showed that a risk factor for the development of postoperative complications after conventional polypectomy is the lack of submucosal lifting (OR: 15.3, 95% CI: 1.9-125.6, p = 0.01). Histopathology of the removed specimens showed that in both groups most of the procedures were considered as R0 resections (54% in the main group, 56.4% in the control group, p = 0.8). The polyp size ≤ 4 mm identified as a risk factor for R1, Rx resection (OR: 2.4, 95% CI: 1.3–4.7, p = 0.007).Conclusion: “cold” polypectomy is an effective and safe method and may be recommended as an alternative technique for the removal of non-pedunculated colorectal polyps ≤ 10 mm.

scholarly journals CHANGES AND DYNAMICS OF INTRAOPERATIVE AND POSTOPERATIVE COMPLICATIONS AFTER APPLYING VARIOUS TECHNIQUES OF SURGICAL TREATMENT OF CATARACT

2019 ◽  
Vol 19 (2) ◽  
pp. 74-77
Author(s):  
I. S. Steblovskaya ◽  
I. M. Bezkorovayna
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Negative Impact ◽  
Anterior Segment ◽  
Corneal Edema ◽  
Age Related ◽  
Operative Complications ◽  
The Uk ◽  
Iol Dislocation ◽  
Post Operative Complications

Transition to the small incision surgery and the practice of cataract phacoemulsification and femtosecond-guided cataract phacoemulsification have contributed to the reduction of postoperative complications, however, despite this, there are some potentially dangerous sight problems that include infective endophthalmitis, toxic syndrome of the eye anterior segment, intraoperative suprachoroidoid hemorrhage, cystic macular edema, retinal detachment, persistent corneal edema and IOL dislocation. According to the study conducted in the UK, the overall frequency of complications following phacoemulsification was 8.7%. Complications that arise at any stage of the surgical intervention and after it have a negative impact on the immediate and remote functional outcomes of the treatment. Thus, the improvement of surgical treatment of age-related cataracts by studying the features and mechanisms of the development of postoperative edema in the central retinal zone, as well as the development of new methods for predicting this complication, is an urgent problem of ophthalmology. The aim of this study was to determine and differentiate the frequency and dynamics of intraoperative, early and late post-operative complications in various techniques of surgical treatment of age-related cataracts. Materials and methods. 558 patients (558 eyes) with cataracts participated in the examination and treatment. The first group consisted of 298 patients (298 eyes) who underwent standard phacoemulsification, and the second group involved 260 patients (260 eyes) who were performed on femtosecond-guided cataract phacoemulsification. The examination was carried out on the 1 day, and in 1, 3 6 and 12 months after cataract surgery. The use of femtosecond laser can reduce the rate of intraoperative, as well as early and late post-operative complications after the cataract removal.

scholarly journals Beta-Catenin in Pseudoexfoliation Syndrome

2020 ◽  
Vol 10 (18) ◽  
pp. 6199
Author(s):  
Joanna Stafiej ◽  
Marta Hałas-Wiśniewska ◽  
Magdalena Izdebska ◽  
Maciej Gagat ◽  
Alina Grzanka ◽  
...  
Keyword(s):  
Anterior Segment ◽  
Ultrastructural Level ◽  
Cell Junctions ◽  
Pseudoexfoliation Syndrome ◽  
Elastic Fibers ◽  
Control Group ◽  
Beta Catenin ◽  
Systemic Diseases ◽  
Cancer Metastases ◽  
Age Related

To find whether it is possible that beta-catenin, associated with the development of serious systemic diseases, as well as the neoplastic process, plays a role in the development of pseudoexfoliation syndrome (PEX). If so, identifying PEX, an age-related, vision-threatening disorder of elastic fibers, which is manifested in eyes by the accumulation of an abnormal fibrillar material on the tissues of the anterior segment, with its poorly understood pathogenesis, may be an early indicator of other systemic diseases. The specimens of anterior lens capsules were obtained during routine cataract surgeries from patients with PEX (study group) and those without it (control group). Patients with previously diagnosed renal, cardiac or neoplasm diseases were excluded. In order to determine the localization of β-catenin at the ultrastructural level, the post-embedding colloidal gold (AU) method was used. For the analysis of the presence of proteins involved in cell–cell junctions, including β-catenin, fluorescence staining was performed. An enhanced accumulation of AU in the area of cell junctions in the PEX group was observed in comparison to control patients. A statistically significant increase in the level of β-catenin expression in lens epithelial cells (LECs) for the PEX group (MFI = 808.98) in comparison to the control patients (MFI = 731.6) was also noted. Our study presented the increase in the β-catenin in LECs of PEX group in comparison to control patients. It might be possible for PEX, due to it being easily recognizable, to be the first indicator of serious kidney or cardiac diseases, as well as cancer metastases. Further studies are needed in order to confirm this hypothesis.

THE INFLUENCE OF PSEUDOEXFOLIATION SYNDROME ON CENTRAL RETINA IN ELDERLY PATIENTS

2021 ◽  
pp. 258-263
Author(s):  
В.В. Потемкин ◽  
С.Ю. Астахов ◽  
Ван Сяоюань ◽  
А.Р. Потемкина ◽  
Л.К. Аникина ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Retinal Thickness ◽  
Age Related Macular Degeneration ◽  
Central Retinal Thickness ◽  
Pseudoexfoliation Syndrome ◽  
Control Group ◽  
Saint Petersburg ◽  
Age Related ◽  
Significant Difference ◽  
The Mean

Цель работы - оценка влияния пседовэксфолиативного синдрома (ПЭС) на толщину центральной зоны сетчатки по данным оптической когерентной томографии (ОКТ) и на стадию возрастной макулярной дегенерации (ВМД) в соответствии с критериями AREDS у лиц старшей возрастной группы, проживающих в Санкт-Петербурге. Были обследованы 25 пациентов (30 глаз) пожилого возраста с ПЭС и 25 пациентов (29 глаз) пожилого возраста контрольной группы, не имеющих признаков ПЭС. Сравнение между группами проводили по следующим признакам: толщина сетчатки в фовеа и средняя толщина сетчатки в парафовеа по данным ОКТ-исследования, а также стадия ВМД в соответствии критериям AREDS. Толщина сетчатки в фовеа и средняя толщина сетчатки в парафовеа не имела статистически значимой разницы для двух групп (p>0,05). Также между двумя группами не было обнаружено разницы в стадии ВМД, установленной в соответствии с критериями AREDS (p>0,05). Показано, что наличие ПЭС не влияет на толщину центральной зоны сетчатки и на стадию ВМД у лиц пожилого возраста, проживающих в Санкт-Петербурге. Это позволяет предположить отсутствие прямой связи между этими двумя ассоциированными с возрастом заболеваниями, а выявленные в ряде работ признаки истончения макулярной зоны сетчатки рассматривать как признак возрастных изменений. Purpose: to evaluate the effect of pseudoexfoliation syndrome (PXF) on the stage of age-related macular degeneration (AMD) and central retinal thickness, measured by optical coherence tomography (OCT) in elderly patients living in Saint-Petersburg. 25 elderly patients (30 eyes) with PXF and 25 age-matched patients (29 eyes) without PXF (control group) were included in the study. Retinal thickness in fovea and parafovea as well as AMD stage were compared in the groups. Thickness of fovea and parafovea was measured with OCT, the stage of AMD was graded according AREDS criteria. The mean fovea and parafovea thickness in PXS group were not significantly different compared with control group (p>0,05). There was no significant difference between two groups in the stage of AMD, graded according AREDS criteria (p>0,05). The effect of PXS on central retinal thickness and the stage of AMD was not found in Saint-Petersburg elderly population.

scholarly journals Endothelial Cell Markers in Patients with Pseudoexfoliation Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Joanna Stafiej ◽  
Grażyna Malukiewicz ◽  
Hanna Lesiewska-Junk ◽  
Danuta Rość ◽  
Karolina Kaźmierczak
Keyword(s):  
Endothelial Cell ◽  
Blood Plasma ◽  
Venous Blood ◽  
Pseudoexfoliation Syndrome ◽  
Antihypertensive Drug Therapy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Cell Markers ◽  
In Blood Plasma

The aim of the study was the assessment of the von Willebrand antigen (vWF Ag), E-selectin, and P-selectin concentration in blood plasma of patients with pseudoexfoliation syndrome (PEX). The group studied comprised 30 patients with PEX, aged from 50 to 86 years (mean 73, SD 8 years). Patients with cardiovascular and cerebrovascular diseases, diabetes mellitus, infectious disease, cancer, renal or liver insufficiency, connective tissue disease, current smoking, and hormone, antiplatelet, hypolipidemic, antioxidant, or antihypertensive drug therapy were excluded from the study. Each subject underwent a complete ophthalmological examination. Venous blood samples from the cubital vein were taken into sodium citrate solution. VWF Ag, sP-selectin, and sE-selectin concentration were determined by a commercially available enzyme-linked immunosorbent assay (MedSystems, Diagnostica Stago/Roche, R&D). Concentrations of vWF Ag, soluble E-selectin, and soluble P-selectin in blood plasma in the study group were compared with the levels in blood plasma in the control group. No significant differences were found between the groups. Our results indicate that there might be no correlation between PEX and such endothelial cell markers as vWF Ag, sP-selectin, and sE-selectin concentrations. Since the study size is limited, further investigations to confirm that there is no association between endothelial dysfunction in PEX and risk of future cardiovascular disease are necessary.

scholarly journals The Complications of Cataract Surgery in Patients with Pseudoexfoliation

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Tatjana Sarenac Vulovic ◽  
Dusan Todorovic ◽  
Nenad Petrovic ◽  
Svetlana Jovanovic
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Tear Film ◽  
Corneal Edema ◽  
Crystalline Lens ◽  
Mean Value ◽  
Control Group ◽  
Film Instability ◽  
Age Related ◽  
Anterior Lens Capsule

Abstract The senile cataract represents the blurring of the crystalline lens after the age of 65. It occurs due to metabolic changes in the crystalline lens which occur over the years. The only effective way to treat cataract is the surgical one. Pseudoexfoliation is an age related systemic disorder. PEX represents the accumulation fibrillar material in the extracellular matrix of the tissue. The most known ocular manifestation of the PEX are the collection at iris pupillary margin and anterior lens capsule. This accumulation is associated with many intraoperative and postoperative complications in patients scheduled for cataract surgery. The aim of the study was to investigate the prevalence of the surgical complications during phacoemulsfication in patients with PEX. The study included 91 patients scheduled for cataract surgery divided into two groups (PEX group 46, control group 45 patients). Poor intraoperative midryasis, zonular dehiscence, postoperative corneal edema, anterior chamber inflammation, elevated intraocular pressure and tear film instability had particularly higher rate of occurring in PEX group comparing to the control group (p<0.001). The highest mean value of intraocular pressure was observed in PEX group on the first postoperative day 25.6 ± 1.1 mmHg, while the best corrected visual acuity was measured in control group 0.71 ± 1.2 one month after phacoemulsification. Cataract surgery in patients with PEX carries great risk, but with adequate preoperative planning, the awareness of the potential complications, can provide safe and routine phacoemulification in these patients.

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