Exophiala Endophthalmitis after Cataract Surgery

Purpose: To report a case of Exophiala endophthalmitis after cataract surgery, which has not been reported previously in Korea.Case summary: A 70-year-old woman visited the hospital 7 days after cataract surgery in her right eye with unilateral vision impairment. At the time of the visit, visual acuity of the right eye was hand motion, and the fundus was not clearly observed due to numerous inflammatory cells with hypopyon in the anterior chamber. With an initial diagnosis of suspected bacterial endophthalmitis, vitrectomy was performed immediately with intravitreal injection of antibiotics and steroid. On day 14 after vitrectomy, inflammation in the anterior chamber and vitreous opacity worsened, and complete vitrectomy, including of the vitreous base, and removal of the intraocular lens and capsule was performed. Exophiala was detected in the biopsy specimen on day 6 after the second surgery, and the patient was discharged with a prescription for voriconazole eye drops. On day 23 after the second surgery, the best-corrected visual acuity in the right eye had improved to 1.0, and there was no evidence of endophthalmitis recurrence and no observed additional abnormal findings of the fundus until 6 months after second surgery.Conclusions: In a case of fungal endophthalmitis that occurred after cataract surgery, good results were obtained by vitrectomy involving complete removal of the peripheral vitreous body, including the intraocular lens and lens capsule, which was the basis for growth of the fungus in the early stage of endophthalmitis.

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Cystoid Macular Edema Associated with Latanoprost Therapy in a Pseudophakic Vitrectomized Patient after Removal of Silicone Oil Endotamponade

European Journal of Ophthalmology ◽

10.1177/112067210301300219 ◽

2003 ◽

Vol 13 (2) ◽

pp. 221-222 ◽

Cited By ~ 7

Author(s):

M. Jäger ◽

J.B. Jonas

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Macular Edema ◽

Cystoid Macular Edema ◽

Silicone Oil ◽

Open Angle Glaucoma ◽

Vitreous Body ◽

Corticosteroid Treatment ◽

Posterior Chamber ◽

Eye Drops

Purpose To describe the occurrence of cystoid macular edema in a pseudophakic vitrectomized patient following use of latanoprost (0.005%). Methods A 58-year-old patient underwent routine cataract surgery with posterior chamber lens implantation complicated by rhegmatogenous retinal detachment three months later. A pars plana vitrectomy was performed with silicone oil endotamponade which was removed six months later. Five months after oil removal, the patient presented with secondary open-angle glaucoma treated with latanoprost 0.005% eye drops once daily. Results Two weeks after initiation of latanoprost treatment, visual acuity dropped from 0.8 to 0.3 due to cystoid macular edema confirmed by fluorescein angiography. After discontinuing latanoprost therapy and with topical corticosteroid treatment, cystoid macular edema slowly resolved, and within 6 months, visual acuity improved to 0.8. Conclusions Despite its marked ocular hypotensive effect, latanoprost should be carefully used in patients after uncomplicated cataract surgery if the vitreous body was removed by pars piana vitrectomy.

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Management of cataract in a case of retinitis pigmentosa with bilateral pseudoexfoliation syndrome

BMJ Case Reports ◽

10.1136/bcr-2020-238936 ◽

2021 ◽

Vol 14 (2) ◽

pp. e238936

Author(s):

Sucheta Parija ◽

Koyel Chakraborty

Keyword(s):

Visual Acuity ◽

Retinitis Pigmentosa ◽

Cataract Surgery ◽

Intraocular Lens ◽

Visual Outcome ◽

Pseudoexfoliation Syndrome ◽

Corrected Distance Visual Acuity ◽

History Of ◽

Hypertensive Woman ◽

The Right

Retinitis pigmentosa (RP) patients are at higher risk for macular oedema, anterior capsular phimosis and spontaneous dislocation of the implanted lens after cataract surgery. A 70-year-old hypertensive woman presented with diminution of vision in her left eye since 2 years. She had history of cataract surgery in the right eye 1 year ago. Her visual acuity was 20/200 in right eye and hand movements in left eye. Slit-lamp examination showed anterior capsular phimosis with intraocular lens in the right eye and pseudoexfoliation in both the eyes. Fundus examination revealed features of RP in both the eyes. Optical coherence tomography showed bilateral foveal atrophy. The patient underwent phacoemulsification cataract surgery with intraocular lens implantation in left eye and Nd:YAG laser capsulotomy in right eye. Postoperative best corrected distance visual acuity was 20/125 in right eye and 20/80 in left eye. This case highlights a rare coincidence of pseudoexfoliation syndrome in a patient with RP and the precautions undertaken during cataract surgery for an optimal visual outcome.

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Experience of the anti-inflammatory eye drops Ivinak®-solopharm use in patients after cataract surgery

Ophthalmology journal ◽

10.17816/ov79196 ◽

2021 ◽

Vol 14 (3) ◽

pp. 71-76

Author(s):

Iurii I. Pirogov ◽

Fedor N. Rozhdestvenskiy ◽

Polina A. Dzitstsoeva ◽

Aleksandra Y. Artiushenko

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Anterior Chamber ◽

Corneal Thickness ◽

Eye Drops ◽

Ocular Surface Disease Index ◽

Age Related ◽

Anti Inflammatory ◽

Chamber Fluid ◽

Number Of Cells

BACKGROUND: The prevalence of inflammatory complications that occur after phacoemulsification remains an unsolved problem. AIM: To analyze the results of the use of Ivinak-SOLOpharm eye drops containing 0.09% bromfenac solution in the complex of anti-inflammatory therapy in patients after cataract surgery in comparison with similar drugs from other manufacturers. MATERIALS AND METHODS: The study included 60 patients (60 eyes) with a diagnosis of age-related cataract, who underwent phacoemulsification. All patients were divided into 2 groups: in the first group, patients used Ivinac eye drops 3 days before surgery and 20 days after it; in the second group, patients used another similar drug containing 0.09% bromfenac solution according to an identical scheme. All patients underwent visual acuity testing and keratopachimetry before and after surgery. On Day 4 and Day 20 after surgery, the degree of inflammatory reaction of the eye was assessed by the number of cells in the anterior chamber fluid, subjective signs of inflammation in patients, using the OSDI (Ocular Surface Disease Index) questionnaire. RESULTS: When analyzing the obtained data, no statistically significant differences were found between the groups in terms of best corrected visual acuity, corneal thickness, number of cells in the anterior chamber fluid, and subjective symptoms of inflammation in patients. CONCLUSIONS: Ivinak-SOLOpharm has proven its effectiveness and safety in the perioperative prevention of inflammatory processes in phacoemulsification.

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Cataract Extraction and Toric Intraocular Lens Implantation for the Management of Pellucid Marginal Degeneration and Cataract

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1012 ◽

2012 ◽

Vol 1 (1) ◽

pp. 66-67

Author(s):

Irit Bahar ◽

Omer Bialer

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Cataract Extraction ◽

Senile Cataract ◽

Posterior Chamber ◽

Intraocular Lens Implantation ◽

Toric Intraocular Lens ◽

Lens Implantation ◽

The Right

ABSTRACT We report cataract surgery with toric intraocular lens implantation for the management of senile cataract combined with pellucid marginal degeneration. A 72-year-old man with bilateral senile cataract and significant against-the-rule astigmatism sought counseling for blurry vision and glare, mostly in the right eye. Based on ophthalmic examination and corneal topography, a diagnosis of pellucid marginal degeneration and cataract was made. Since visual acuity and refraction had been stable in the past 3 years, the patient underwent cataract extraction and implantation of a custom-designed toric posterior chamber intraocular lens. Postoperative follow-up of 1.5-year demons- trated marked improvement in visual acuity, stable refraction and patient satisfaction. This treatment for pellucid marginal degeneration offers the simplicity of regular cataract surgery, and avoids the known complications of keratoplasty and other corneal surgical manipulation for the management of pellucid marginal degeneration. How to cite this article Bahar I, Bialer O. Cataract Extraction and Toric Intraocular Lens Implantation for the Management of Pellucid Marginal Degeneration and Cataract. Int J Keratoco Ectatic Corneal Dis 2012;1(1):66-67.

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Chronic Endophthalmitis after Cataract Phacoemulsification. Сlinical Case

Ophthalmology in Russia ◽

10.18008/1816-5095-2019-1-115-123 ◽

2019 ◽

Vol 16 (1) ◽

pp. 115-123

Author(s):

I. A. Frolychev ◽

N. P. Pashtaev ◽

N. A. Pozdeyeva ◽

D. V. Sycheva

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Intraocular Lens ◽

Cataract Extraction ◽

Treatment Method ◽

Postoperative Endophthalmitis ◽

Visual Functions ◽

Finger Counting ◽

New Treatment ◽

The Right

A clinical case of chronic postoperative endophthalmitis treatment after cataract phacoemulsification is described in the article. The patient received vitrectomy with lens posterior capsule discission and tamponade of vitreal cavity by perfluororganic compound (up to 14 days) and 1mg vancomicin +2.25 mg ceftazidim intravitreally, also anterior chamber washing by 0.5 ml saline containing 5 mg vancomicin. Anterior chamber washing by antibiotics and intravitreal injection of antibacterial medicine combination was repeated on the second and third day after the surgery. This tactics of treatment allowed to save lens capsular bag and intraocular lens. Purpose. To assess efficacy and safety of new treatment method in the patient with chronic postoperative endophthalmitis. Patient B, 65 years old applied to clinic with complaints on the pain in the right eye, visual acuity decrease up to finger counting near face. Symptoms started to disturb in 2 weeks after cataract extraction with IOL implantation. During 6 months courses of antibacterial therapy including vancomicin (antibiotic of reserve) there were no positive dynamics. Cornea edema, multiple precipitates at endothelium and intraocular lens were defined at biomicroscopy; 2.5 mm hypopyon in anterior camera; fibrin in pupil projection; exudation in vitreous cavity. Laser tyndalmetry data (albumen flow in anterior chamber) confirmed inflammation strong enough — 173 f/ms. Surgical treatment according the described method was rendered to the patient. In the postoperative period we saw stable visual functions, uncorrected visual acuity was 0.6, corrected — 0.8. Patient noted the absence of pain and eye’s reddening decrease. At biomicroscopy we observed considerable inflammation decrease, almost total absence of precipitates at cornea endothelium. Laser tyndalmetry data confirmed inflammation decrease, albumen flow in anterior chamber was 17.6 f/ms. Endothelial cells’ loss after surgery was 142 cells/1 mm2 (5.61 %). According to electrophysiologic investigation and ERG there was no deviation from normal values was revealed. This treatment method allows to restore visual functions rather quickly and can be used in case of inefficient lengthy conservative therapy.

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Urrets-Zavalia Syndrome Following Cataract Surgery

Case Reports in Ophthalmology ◽

10.1159/000513959 ◽

2021 ◽

pp. 659-663

Author(s):

Shimon Kurtz ◽

Maayan Fradkin

Keyword(s):

Intraocular Pressure ◽

Case Report ◽

Cataract Surgery ◽

Anterior Chamber ◽

Inflammatory Reaction ◽

Intraocular Lens Implantation ◽

Postoperative Course ◽

Lens Implantation ◽

The Right

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.

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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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Enzymotherapy of toxic anterior segment syndrome after phacoemulsification

Ophthalmology journal ◽

10.17816/ov10287-93 ◽

2017 ◽

Vol 10 (2) ◽

pp. 87-93

Author(s):

Alexander S Suvorov ◽

Timur G Sazhin

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Treatment Initiation ◽

Anterior Segment ◽

Treatment Result ◽

Eye Drops ◽

Group Iii ◽

Group I ◽

Toxic Anterior Segment Syndrome ◽

Observation Period

Purpose. To investigate the efficacy of recombinant prourokinase (RPU) treatment in patients with toxic anterior segment syndrome after phacoemulsification. Material and methods. We observed 123 patients (123 eyes) with toxic anterior segment syndrome after phacoemulsification; patients of the group I (n = 30) received only antiinflammatory treatment; in treatment of patients of the group II (n = 31), instillations of the RPU solution were used, in the group III (n = 31), RPU solution was injected subconjunctivally, in the group IV (n = 31) - RPU solution electrophoresis was used. Treatment result analysis was carried out within 30 days. Results. Initial mean visual acuity in groups was 0.09 ± 0.04; 0.1 ± 0.04; 0.09 ± 0.04; 0.08 ± 0.04, and was virtually the same (p > 0.05). In 24 hours after treatment initiation, mean visual acuity in the group III was higher, than in the others. In three days and up to the end of observation period, the lowest mean visual acuity was noted in the group I (p < 0.05). Anterior chamber assessment showed that beginning from the first 24 hours after treatment initiation, in groups III and IV, fibrin lysis in the anterior chamber was more pronounced, than in groups I and II (p < 0.05); by the end of the observation period, worst indices of anterior chamber state were found in the group I (p < 0.05), in other groups, they were almost identical (p < 0.05). When using RPU, no allergic reaction was noted. Conclusions. RPU use in combined toxic anterior segment syndrome therapy after phacoemulsification allows increasing visual acuity, reducing convalescence time, and reducing the number of laser dissections. It was established that all methods of RPU administration are effective. RPU may be administered as eye drops on an outpatient basis, receiving efficacy similar to other administration methods.

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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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A COMPARISION OF POSTERIOR CAPSULAR OPACITY FORMATION UPTO 1 YEAR IN PATIENTS WITH SMALL INCISION CATARACT SURGERY WITH FOLDABLE INTRAOCULAR LENS AND PHACOEMULSIFICATION WITH THE SAME INTRAOCULAR LENS

10.36106/gjra/7413860 ◽

2020 ◽

pp. 173-176

Author(s):

Kinjal Rathod ◽

Kinjal Trivedi ◽

Snehal Nayi ◽

Somesh Aggarwal

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Nd:Yag Laser ◽

Visual Outcome ◽

Posterior Capsular Opacification ◽

P Value ◽

Small Incision Cataract Surgery ◽

Common Procedure ◽

Age Related

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.

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