Cataract following electric shock - Case report

Ocular trauma is the under-recognized cause of unilateral blindness particularly in developing nations.The growing demand on generated electricity has also led to increase in electricity related occupational trauma. We report a case of bilateral cataract in a 22 years professional electrician. He survived a high voltage electric shock and sustained burn injury on the right side of his head. Ocular examination revealed typical anterior as well as posterior subcapsular cataract in right eye and visually insignificant early anterior subcapsular vacuoles in the left eye. There was a significant difference in lenticular opacification density in between these two eyes. Uneventful phacoemulsification and foldable posterior chamber intraocular lens implantation was performed in the right eye and the sufferer was rehabilitated with normal best corrected visual acuity. The possibility of ocular complications and importance of ocular screening is emphasized in the survivors of electrical injury. The lenticular opacities can be successfully managed with surgery, however the final visual acuity depends on damage to other vital ocular structures. The clinical features, pathogenic mechanism of these opacities and review of the literatures are discussed.

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Small Incision Cataract Surgery (SICS) with Posterior Chamber Intraocular Lens (PCIOL) Implantation is the Preferred Method of Community-Based Cataract Surgery: Study of 100 Cases

TAJ Journal of Teachers Association ◽

10.3329/taj.v22i1.5037 ◽

1970 ◽

Vol 22 (1) ◽

pp. 132-135

Author(s):

AKM Shahidur Rahman Tarafder ◽

M Anwarul Kader ◽

SM Rezaul Karim

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Posterior Chamber ◽

Extracapsular Cataract Extraction ◽

Small Incision Cataract Surgery ◽

Small Incision ◽

Corrected Visual Acuity ◽

Department Of Ophthalmology ◽

Posterior Chamber Intraocular Lens

To study "small incision cataract surgery (SICS)" for the rehabilitation of cataract visually impaired and blind patients, a retrospective study of 100 cases of cataract patients with small incision cataract surgery (SICS) with posterior chamber intraocular lens (PCIOL) implantation were done at Rajshahi Medical College Hospital. All cases were selected having corrected visual acuity less than 6/60 who were admitted at the Department of Ophthalmology for cataract surgery from March, 2006 to February, 2008. Age group of the patient range from 40 to 85 years. Age related senile cataract were selected any complicated cataract was excluded from the study. All these patients underwent SICS with 5.5 mm optic polymethylmethacrylate (PMMA) non-foldable posterior chamber intraocular lens (PCIOL) were implanted by irrigation vectis. Intra operative complication were present in 8% cases among them 3 cases (3%) required to conversion to Conventional Extracapsular Cataract Extraction (ECCE). 2 cases (2%) had small posterior capsular rent (PCR), 1 case (1%) irido dialysis & 2 cases (2%) hyphaema occurred. Postoperative complications were found in 38 cases (38%) among them transient corneal oedema occurred in 18 cases (18%) iritis occurred in 13 cases (13%), decentering of intraocular lens (IOL) occurred in 2 cases, corrected visual acuity after 6 weeks of operation were 6/12 or better in 97 cases (97% cases achieved functional vision). Induced astigmatism ± 0.50 D to ± 1.00 D occurred in 94 cases (94%) and ± 1.500 to 2.50D in 6 cases (6%). So, SICS may be the choice of surgery in respect of visual outcome with the limited facilities and surgeons. DOI: 10.3329/taj.v22i1.5037 TAJ 2009; 22(1): 132-135

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Management of bilateral microspherophakia with secondary angle closure glaucoma

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i1.13174 ◽

2015 ◽

Vol 7 (1) ◽

pp. 69-73

Author(s):

K PS Malik ◽

R Goel ◽

K Jain ◽

S Nagpal ◽

S Singh

Keyword(s):

Visual Acuity ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Posterior Chamber ◽

Middle Aged ◽

Aged Patients ◽

Posterior Chamber Intraocular Lens ◽

Shallow Anterior Chamber ◽

The Right

Background: Microspherophakia is characterized by lenticular myopia, late development of lens dislocation, shallow anterior chamber and angle-closure glaucoma. If it is associated with angle closure glaucoma, the management can be challenging.Objective: To report the management of a case of bilateral secondary angle closure glaucoma with isolated microspherophakia and right subluxated lens in a middle aged lady. Case: A 47-year-old female presented with bilateral secondary angle closure glaucoma with isolated microspherophakia, right subluxated lens and left operated trabeculectomy. The patient`s best corrected log mar visual acuity improved from 1.0 to 0.2 and intraocular pressure (IOP) decreased from 24.9mm of Hg to lower teens following lensectomy with scleral ¿xation of posterior chamber intraocular lens in the right eye. The left eye IOP remained in mid teens without medication in two year follow up. Conclusion: This case demonstrates that microspherophakia should be ruled out even in middle aged patients presenting as angle closure glaucoma. The possibility of thickened cornea must be kept in mind requiring an IOP correction. Lensectomy with scleral ¿xation of posterior chamber IOL provides a satisfactory recovery of visual acuity and IOP control. Though in this patient, the lens was held in position by posterior synechiae in the left eye, future stability of zonules needs to be monitored.

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Capsular Bag Distension Syndrome Following Phacoemulsification with Implantation of Intraocular Lens

Medicine & Health ◽

10.17576/mh.2020.1502.27 ◽

2020 ◽

Vol 15 (2) ◽

pp. 306-312

Author(s):

Safinaz Mohd Khialdin ◽

Keyword(s):

Intraocular Lens ◽

Rare Complication ◽

Posterior Chamber ◽

Poor Vision ◽

Post Surgery ◽

Corrected Visual Acuity ◽

Posterior Chamber Intraocular Lens ◽

The Right ◽

Capsular Bag

Capsular bag distension syndrome is a rare complication following phacoemulsification with posterior chamber intraocular lens implantation. We describe the case of a middle-age male, who developed early onset capsular bag distension syndrome of the right eye after phacoemulsification with implantation of plate haptic posterior chamber intraocular lens (Zeiss CT ASPHINA 509MP). There was persistent poor vision during follow up at 1 week and 5 weeks post-surgery with a myopic shift of 2.5 diopters sphere (DS). The intraocular pressure was only elevated at 2 hours post-operative and was normal during the subsequent followup. Distension of capsular bag was confirmed with the IOP Master 700 which showed abnormal separation of posterior capsule from the intraocular lens. He was diagnosed with capsular bag distension syndrome secondary to retention of viscoelastic. Right eye removal of retained viscoelastic was performed and the capsular bag distension syndrome resolved successfully with best corrected visual acuity at 6/6. Hence, complete clearance of viscoelastic during phacoemulsification with plate haptic intraocular lens is important in order to prevent capsular bag distension syndrome.

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Agreement analysis comparing iPad LCVA and Sloan testing in multiple sclerosis patients

Multiple Sclerosis Journal ◽

10.1177/1352458517713667 ◽

2017 ◽

Vol 24 (8) ◽

pp. 1126-1130 ◽

Cited By ~ 4

Author(s):

Neda Sattarnezhad ◽

Samantha Farrow ◽

Dorlan Kimbrough ◽

Bonnie Glanz ◽

Brian Healy ◽

...

Keyword(s):

Multiple Sclerosis ◽

Visual Acuity ◽

T Test ◽

Computerized Testing ◽

Low Contrast ◽

Significant Difference ◽

Increased Sensitivity ◽

The Right ◽

Multiple Sclerosis Patients ◽

Paired T Test

Background: Visual symptoms are common in multiple sclerosis (MS). Low-contrast visual acuity (LCVA) testing using Sloan charts has demonstrated increased sensitivity for visual deficits compared to high-contrast acuity testing. Computerized testing of visual acuity may facilitate use in the clinic setting. Objectives: To evaluate the agreement between an iPad-based and Sloan testing of LCVA in a cohort of MS patients. Methods: A total of 38 patients with relapsing-remitting MS were enrolled after providing informed written consent at Partners MS Center, Brigham and Women’s hospital. Monocular LCVA was measured using retroilluminated Sloan chart and iPad-based LogMAR chart. Number of correct letters and agreement between two measurements were assessed for each eye using Bland–Altman analysis and paired t-test. Results: For both eyes, there was no significant difference in number correct between the two measurements using a paired t-test, and there was high correlation between two measurements (oculus dextrus (OD) r = 0.89, p < 0.001; oculus sinister (OS) r = 0.78, p < 0.001). The limits of agreement were −7.9 to +8.5 letters for the right eye and −10.9 to +11.2 letters for the left eye. Conclusion: An iPad-based LCVA test shows good agreement with Sloan testing in MS patients.

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Intra-ocular lens opacification in the anterior chamber leading to loss of vision in an adolescent

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v6i1.10780 ◽

2014 ◽

Vol 6 (1) ◽

pp. 102-104

Author(s):

Mrindu Chaudhry ◽

Keerti Mundey ◽

Shikha Baisakhiya ◽

Sumita Sethi

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Intraocular Lens ◽

Rare Case ◽

Intraocular Inflammation ◽

Posterior Chamber ◽

Ocular Lens ◽

Posterior Chamber Intraocular Lens ◽

Developmental Cataract ◽

Posterior Chamber Iol

Objective: To report a rare case of intraocular lens (ACIOL) opacification in the anterior chamber in an adolescent and to discuss the possible mechanism of its occurrence and the ways of its prevention. Case: A 16-year-old male underwent cataract surgery for developmental cataract with placement of a foldable posterior chamber IOL in the anterior chamber. There was subsequent opacification of the IOL, which was replaced by a scleral fixated posterior chamber intraocular lens. The post-operative visual acuity improved to 6/18. Conclusion: The posterior chamber IOL implanted in the anterior chamber can get opacified possibly due to postoperative intraocular inflammation. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10780 Nepal J Ophthalmol 2014; 6 (2): 102-104

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Safety and Efficacy of 25G vitrectomy surgery for malignant glaucoma in pseudophakia

10.21203/rs.2.13438/v1 ◽

2019 ◽

Author(s):

fei you

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Cataract Surgery ◽

Anterior Chamber ◽

Safety And Efficacy ◽

Corrected Visual Acuity ◽

Malignant Glaucoma ◽

Intraocular Hemorrhage ◽

Significant Difference ◽

Best Corrected Visual Acuity

Abstract Background: malignant glaucoma after cataract surgery is still one of the serious complications, if not handled properly，it may lead to serious consequences. It is notoriously difficult to treat. 25G vitrectomy was performed to evaluate the safety and efficacy for the treatment of malignant glaucoma in pseudophakia. Methods: This is a retrospective, comparative case series study. A total of 20 eyes of 20 patients with malignant glaucoma after phacoemulsification were analyzed retrospectively in The First Affiliated Hospital Of Anhui Medical University from May 2015 to January 2018. All Medical Data including the best corrected visual acuity (BCVA), Change of intraocular pressure (IOP), the length of eye axis, and the depth of anterior chamber were recorded. SPSS 17.0 statistical software was used for analysis .Before surgery, the best corrected visual acuity (BCVA) was 1.8±0.6. The intraocular pressure was between 18-57mmHg, with an average of 35.2±10.4mmHg.The depth of anterior chamber was between 0.9-1.9mm, with an average of 1.3±0.2mm.The length of eye axis was 19.7-22.5mm,with an average of 20.6±0.5mm.All the patients were accomplished with 25G vitrectomy. Besides, anterior chamber inflammatory reaction and other complications were also observed postoperation. Results: The patients were followed up for 6-12 months with an average of 9 months. BCVA at the last follow up improved to 0.8±0.1, and there was significant difference compared to that before operation (P<0.01).IOP was from 12-19mmHg, an average of 16.1±2.5mmHg, there was significant difference compared to that before operation (t=7.6, p<0.01).Only one patient occurred low IOP (6mmHg) after surgery, IOP returned to normal level (14mmHg) after conservative treatment. No serious complications including corneal endothelium decompensation, intraocular lens (IOL) capture, intraocular hemorrhage, endophthalmitis and uncontrolled IOP were observed. Conclusions: 25G minimally invasive vitrectomy can treat malignant glaucoma after cataract surgery safely and effectively

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Evaluation of Sutureless, Glueless, Flapless, Intrascleral Fixated Posterior Chamber Intraocular Lens in Children with Ectopia Lentis

Journal of Ophthalmology ◽

10.1155/2018/3212740 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Kannan NB ◽

Piyush Kohli ◽

Bhanu Pratap Singh Pangtey ◽

Kim Ramasamy

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Pediatric Population ◽

Intraoperative Complications ◽

Vitreous Hemorrhage ◽

Posterior Chamber ◽

Ectopia Lentis ◽

Uncorrected Visual Acuity ◽

Posterior Chamber Intraocular Lens

Aim. This paper aims at evaluating refractive outcome and complication profile of sutureless, glueless, flapless, intrascleral fixation of intraocular lens (SFIOL) in pediatric population. Methods. This retrospective study included patients ≤18 years of age who underwent SFIOL for ectopia lentis. Details obtained included preoperative uncorrected visual acuity (UCVA), cycloplegic refraction, and best-corrected visual acuity (BCVA); intraoperative complications; and postoperative UCVA, cycloplegic refraction, and BCVA and complications. Results. Median pre- and postoperative UCVA was logMAR 1.78 (Snellen 20/1200) and logMAR 0.30 (Snellen 20/40), respectively, (p<0.001). Median pre- and postoperative BCVA was logMAR 0.24 (Snellen 20/34) and logMAR 0.18 (Snellen 20/30), respectively. UCVA ≥20/60 was attained in 90% of eyes. BCVA ≥20/30 was attained in 85.0% of eyes. Most common early postoperative complications were hyphaema (10%), transient vitreous hemorrhage (2.5%), and ocular hypotony (2.5%). None of these developed any long-term sequelae. Only one case of subluxation of IOL was seen. No case of late endophthalmitis or retinal detachment was seen. Conclusion. Since refractive error induced is minimal, the procedure is suitable for IOL implantation in children, who are noncompliant with spectacles. The complication profile is similar to that reported in adults.

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Visual outcome of conventional extracapsular cataract extraction with posterior chamber intraocular lens implantation versus manual small-incision cataract surgery

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v1i1.3668 ◽

1970 ◽

Vol 1 (1) ◽

pp. 13-19 ◽

Cited By ~ 4

Author(s):

A Gurung ◽

DB Karki ◽

S Shrestha ◽

AP Rijal

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Postoperative Period ◽

Cataract Extraction ◽

Posterior Chamber ◽

P Value ◽

Extracapsular Cataract Extraction ◽

Small Incision Cataract Surgery ◽

Small Incision ◽

Posterior Chamber Intraocular Lens

Background: An effective method for cataract surgery should be identified to combat cataract blindness. Aim: To study the surgical outcome of conventional extracapsular cataract extraction versus manual small-incision cataract surgery. Materials and methods: A randomized clinical trial was carried out including one hundred eyes (88 patients) which were divided into two groups using systematic randomization: groups of conventional extracapsular cataract extraction with posterior chamber intraocular lens (ECCE with PCIOL) implantation and manual small-incision cataract surgery (MSICS). The postoperative parameters/variables studied were the unaided and best-corrected visual acuity and astigmatism. Statistics: Epi info 2000 version statistical software was used for data analysis and calculation of relative risk, 95% CI and p value. The p value of less than 0.05 was considered as significant. Results: In the immediate postoperative period, unaided visual acuity of =/> 6/18 was achieved in 24 subjects in MSICS group versus 7 in ECCE with PCIOL group (RR=2.05, 95% CI=1.44 - 2.94, p = 0.0002), whereas the same at 6 - 8 weeks postoperatively was found in 28 and 22 subjects in those groups respectively (RR=1.27, 95% CI=0.86-1.89, p=0.23). The astigmatism of =/> 2 at 6 - 8 weeks was found in 35 and 17 subjects from the conventional and MSICS groups respectively ( R=2.28, 95% CI = 1.39-3.73, p=0.0002). Conclusion: Both MSICS and conventional ECCE with PCIOL are safe and effective techniques for treatment of cataract patients. A more rapid recovery of good vision can be achieved with MSICS than with conventional ECCE with PCIOL in the immediate postoperative period. Key words: ECCE; MSICS; visual acuity; astigmatism DOI: 10.3126/nepjoph.v1i1.3668 Nep J Oph 2009;1(1):13-19

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Outcomes of corneal neurotisation using processed nerve allografts: a multicentre case series

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317361 ◽

2020 ◽

pp. bjophthalmol-2020-317361

Author(s):

Adam R Sweeney ◽

Margaret Wang ◽

Christopher L Weller ◽

Cat Burkat ◽

Andrea L. Kossler ◽

...

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Surgical Techniques ◽

Case Series ◽

Retrospective Case ◽

Corneal Sensation ◽

Corrected Visual Acuity ◽

The Mean ◽

Maximal Gain ◽

Prior Infection

BackgroundCorneal neurotisation is a rapidly evolving procedure treating neurotrophic keratopathy. The variety of surgical techniques used and corresponding outcomes after corneal neurotisation are not well understood. This study describes the techniques and outcomes in the largest case series of corneal neurotisation using processed nerve allografts to date.MethodsThis is a retrospective case series of patients who underwent corneal neurotisation with human cadaveric processed nerve allografts. All patients had preoperative and postoperative description of best corrected visual acuity and measurement of corneal sensation. Comparative studies after stratification of techniques were performed.ResultsA total of 17 patients were identified. The cause of corneal anaesthesia was prior infection in eight cases, trigeminal nerve palsy in eight cases and ocular trauma in one case. There were no intraoperative or postoperative complications. Following neurotisation surgery, the time to first gain of corneal sensation and maximal gain of sensation occurred at a mean of 3.7 months (range 1–8 months) and 6.6 months (range 3–15 months), respectively. The mean preoperative and postoperative corneal sensation as measured by Cochet-Bonnet aesthesiometry was 0.36 cm (range 0–3.2 cm) and 4.42 cm (range 0–6 cm), respectively (p<0.01). Visual acuity was unchanged after neurotisation. There were no statistical differences in outcomes based on end-to-end versus end-to-side coaptations, donor nerve selection or laterality of donor nerve.ConclusionCorneal neurotisation with processed nerve allografts is a safe and effective procedure. This study provides further evidence for the use of processed nerve allografts for corneal neurotisation.

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Examining the effect and safety of orthokeratology in controlling the development of myopia: Based on fluorosilicone acrylic breathable material

Materials Express ◽

10.1166/mex.2020.1690 ◽

2020 ◽

Vol 10 (5) ◽

pp. 740-747

Author(s):

Yanxia Song ◽

Haixia Tian ◽

Suling Yang ◽

Feifan Du ◽

Huihui Sun ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Axial Length ◽

Corneal Endothelium ◽

Clinical Effect ◽

Naked Eye ◽

Corrected Visual Acuity ◽

Significant Difference ◽

Before And After

We aimed to evaluate the clinical effect and safety of orthokeratology in controlling the development of myopia. We assessed the changes in visual acuity, diopter change, axial length, corneal endothelium count, intraocular pressure, and corneal Q value in 30 adolescents with 60 years of wearing an orthokeratology lens. In this study, no significant difference was observed between the naked eye vision and corrected visual acuity before wearing the lens (t = –0.23, P = 0.59); furthermore, no significant difference was observed in diopter, axial length, corneal endothelium count, and intraocular pressure 1 year before and after wearing the lens (t = 1.24, P = 0.45; t = –0.89, P = 0.25; t = –0.43, P = 0.57; t = 1.43, P = 0.61); by contrast, there was a significant difference in the corneal Q value before and after wearing the lens (t = –8.37, P = 0.001). These results suggest that the fluorosilicone acrylic breathable material corneal orthopedic lens is safe and effective in controlling myopia, and has little effect on the physiology of the eye.

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