ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Removal of cataract with intraocular lens implantation has been a well-accepted treatment for the past two decades. The development of monofocal intraocular lens technology has represented a significant advance over earlier treatments of cataract and, since the advent of widespread implantation of these lenses, most patients with cataract can achieve good postsurgical vision with the use of bifocal spectacles.

ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Cataract is the leading cause of blindness in the world. At present, the only current method for treatment of cataract is surgical extraction. However, efforts are being made to reduce the incidence by identifying the risk factors. This past year additional evidence has linked cigarette smoking with cataract. Most of the persons who are blind from cataracts live in developing countries and are twice as likely to die as age-matched persons without cataract in other countries. High-volume intracapsular cataract camps have good, short-term results in restoring vision; however, blindness from uncorrected aphakia is a significant problem. Thus, there is an increasing inclination toward provision of extracapsular cataract extraction with intraocular lens implantation in these developing countries. The long-term complication of posterior capsular opacification in this setting needs to be addressed.

ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This year the interest in sugar-induced cataract, especially diabetic cataract, continued with increased attention to glycation (the reaction of sugars with lens proteins), and the aldose reductase hypothesis has been further undermined. Oxidation and various experimental models continued to receive attention. Research on human cataracts concentrated on modifications of the proteins and on glutathione, which protects the proteins. Investigations of anticataract drugs, especially of those designed to inhibit aldose reductase and of aspirin-like analgesics, continued. Diabetic cataract in rats was delayed or prevented by aspirin, acetaminophen, ibuprofen, and a new “aldose reductase inhibitor.” Curiously, aldose reductase inhibitors also prevented naphthalene-induced cataract.

ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Recent developments in the areas of cataracts, in both systemic diseases and syndromes, include the association of lenticular autofluorescence with diabetic retinopathy and nephropathy. Animal studies have shown that aspirin, ibuprofen, acetaminophen, and aldose reductase inhibitors prevent diabetic cataracts. Aldose reductase inhibitors have crossplacental and breast milk-mediated lens effects in galactosemia rats. Gene-linkage analysis studies have brought researchers closer to the genes that are responsible for Alport's syndrome and myotonic dystrophy. Many syndromes have been reported to be new associations with cataracts. Chromosomal abnormalities have been identified in association with cataracts, thus providing a better understanding of the pathogenesis of cataracts in complex syndromes.

ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Along with the rapidly improving techniques and approaches to cataract surgery, various approaches to anesthesia have evolved. In just a few years, the popularity of general anesthesia gave way to local anesthesia by retrobulbar which in turn, has been increasingly challenged by peribulbar anesthesia and, most recently, by the use of topical anesthesia. Unfortunately, some of these techniques have been published in ophthalmic newsletters or in special interest journals and have not been presented in a manner that can be adequately validated by follow-up and peer review. Cataract anesthetic techniques continue to evolve and as complications are reported with one technique, other methods are tried to achieve the correct balance of efficacy and safety. Today, an increasing volume of data confirms the safety and effectiveness of anesthesia that is localized to the anterior segment.

ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Extrapolating information from equations that govern fluid flow, a theoretical formula is developed for a sutureless cataract incision. This theoretical formula defines the resistance of aqueous outflow as a function of three variables: length of cataract incision, the length of the scleral tunnel, the tortuosity of the outflow channel, and one constant friction factor. The nonlinear relationship of corneal incisions to length, depth, and distance from the visual axis is also examined with respect to their effect on central corneal curvature and control of astigmatism. Finite element analysis of differential equations is discussed as the most plausible technique for predicting these incisional effects.

ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Cataract surgery continues to evolve as modifications in techniques are introduced. Extracapsular surgery, whether by phacoemulsification or planned extracapsular cataract extraction, is a very safe and effective technique. Maintaining versatility in operative techniques, depending on the clinical situation, is a distinct challenge for the cataract surgeon. Adequate surgical planning, coupled with meticulous surgical technique, gives optimal results. Innovations in wound architecture provide intraoperative and postoperative advantages to the surgeon and to the patient. Capsulorhexis is the preferred method of capsulotomy in phacoemulsification and planned extracapsular cataract extraction. Hydrodissection and related techniques are useful in all types of extracapsular cataract extraction. This article reviews techniques in cataract surgery with an emphasis on the recent literature.

ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Significant advances in intraocular lens designs have not been over the last year. The lack of successful lens implant designs to match the requirements of small-incision cataract surgery is frustrating. Although it is possible to comfortably remove the crystalline lens through a 2.7-mm incision, this incision inevitably has to be enlarged to accommodate even the most malleable lens implant available. Polymethyl methacrylate remains the preferred lens material for most surgeons, but silicone lens implants have gained consideration and have incited controversy. Acrylic polymers are in the early stages of clinical evaluation. Phakic lens implants for high myopia remain controversial while longer-term evidence for the safety of renewed designs is gathered.

ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

As in the past, the current literature on childhood cataracts demonstrates the need for early diagnosis, surgical treatment that is quite different from adult cataract surgery, and prompt and adequate optical correction, as well as long-term and conscientious amblyopia therapy in cases of uniocular cataract. The choice of optical correction continues to generate controversy. Contact lenses, intraocular lenses, and epikeratophakia all have their advocates. Although contact lenses are still the most common option, interest in using intraocular lenses in children has grown. Over the past year, however, two disturbing reports of complications due to intraocular lens implants were published. Treatment of childhood cataracts remains more challenging than treatment of cataracts in adults, and indications for particular approaches to optical rehabilitation in the pediatric population continue to evolve.

ISSN:1040-8738    

出版商:OVID    

年代:1993

数据来源: OVID