ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Postoperative ocular inflammation following cataract surgery is related to the risk of complications like corneal edema, intraocular pressure spikes, cystoid macular edema, and posterior capsule opacification. The degree of postoperative inflammation following cataract surgery is linked to several surgery-dependent factors such as surgical technique, intraocular lens type, and also patient-dependent factors such as history of inflammatory disease and degree of iris pigmentation. During the past decade, major advances have occurred in cataract surgery techniques, equipment, and pharmacologic strategies that decrease the degree of postoperative inflammation following cataract surgery and reduce patients' risk for inflammation-related complications. This article reviews the most recent literature regarding the control of cataract surgery-induced intra-ocular inflammation.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Modern cataract surgery represents an amalgam of new technologists which may include phacoemulsification, foldable intraocular lenses and, in many instances, clear corneal incision. The fusion of newer techniques has allowed for a re-evaluation of the anesthetic needs for cataract surgery. These minimally incisive surgical procedures have allowed us to reintroduce a very old technique: topical anesthesia into cataract surgery. This article reviews the present day techniques that are available from the use of general anesthesia to the use of injection technique as well as topical.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Multifocal intra-ocular lenses (IOLs) are designed to overcome the lack of accomodation to provide useful distance and near vision. Reduced contrast sensitivity has been reported. Refractive IOLs produce two or more focal points depending on the refractive power of the portion of the lens crossed by the light. Diffractive IOLs are strictly bifocal; each point of the lens can create both a distance and near focus. Several clinical investigations show that multifocal IOLs can be used as an alternative to monofocal lenses. However, patient selection, realistic expectations, and adequate control of surgical procedures are necessary.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The transition from incisional methods such as radial keratotomy (RK) to excimer laser surgery,eg,photorefractive keratectomy (PRK) and laserin situkeratomileusis (LASIK) has dramatically increased the volume of corneal refractive surgery performed worldwide in recent years. As the current younger generation of patients who have undergone refractive surgery ages, we can assume that the presently small number of postrefractive patients requiring cataract surgery and intraocular lens implantation will increase correspondingly. This article addresses the problems encountered with calculating intraocular lens power after corneal refractive procedures. Starting with a description of keratometry in normal eyes, the causes of evident mismeasurements and miscalculation of the corneal power after keratorefractive surgery will be discussed, and different approaches to improving IOL power prediction will be described.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Intra-ocular lens (IOL) implantation in a growing eye of a young child brings several problems unique to this age group. Better understanding of the rate of refractive growth in children's pseudophakic eyes may help predicting future refractions in these eyes more accurately. Opacification of the posterior capsule, if remained intact, interferes with visual rehabilitation in children. Primary posterior capsulectomy and anterior vitrectomy provides the clarity of visual axis. Optical rehabilitation of children with unilateral aphakia is usually problematic. Posterior chamber IOLs are preferred to anterior-chamber IOLs for secondary implantation. In the absence of adequate capsular support and contact lens intolerance, a scleral-fixated IOL can be implanted. Scleral fixation of a posterior chamber IOL has encouraging short-term results but the long-term risks are not known yet. Intra-ocular lens implantation in infants is associated with major complications and is not recommended at present. The occurrence of open angle glaucoma is a sight-threatening late complication of pediatric cataract surgery. Intra-ocular lens implantation plays a protective role against aphakic glaucoma in children.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Posterior capsule opacification (PCO) is still the most frequent complication of cataract surgery. A variety of studies has led to a better understanding of the pathogenesis of PCO, and strategies of molecular biology have produced new therapeutic options, such as immunological techniques or gene therapeutic approaches. Surgical strategies and intra-ocular lens–dependent factors also are capable to reduce the rate of PCO. In-the-bag implantation of intra-ocular lenses with a sharp optic edge seems to be effective in inhibiting equatorial lens epithelial cell migration to the center of the posterior capsule. Several PCO documentation systems have been developed that will lead to more exact and better comparable recording of PCO rates. In the year 2000, PCO or secondary cataract is still the most frequent complication after extracapsular cataract surgery. In a 1998 meta-analysis, PCO rates of 11.8% 1 year after extracapsular cataract surgery with intraocular lens implantation, 20.7% after 3 years, and 28.4 % after 5 years have been reported[1]. For the United States, it has been estimated that the overall expenses for treatment of PCO are only exceeded by the costs for cataract treatment itself[2]. In the past decade, a lot of experimental and clinical studies have been performed on this topic. They have led to 1) to a better understanding of the pathogenesis of the development of anterior and posterior capsule opacification; 2) more objective and better comparable systems of documentation and analysis of PCO; and a number of 3) surgical and 4) pharmaceutical strategies to prevent PCO.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The management of cataract in glaucoma patients has been continuously changing over the past decade. Extracapsular cataract extraction has been replaced by small-incision phacoemulsification with foldable lenses, and in glaucoma surgery, adjunctive antifibrotic therapy based on risk factors for failure has become standard. Furthermore, new techniques in filtering and nonfiltering surgery have been suggested. The techniques, however, change so fast that well-controlled studies with a follow-up of more than 12 months are increasingly seldom. The purpose of this paper is to review the current literature and to point out some new ideas for the future investigation.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

If contact lens or spectacle correction is not viable, little debate exists that the secondary placement of an intra-ocular lens (IOL) is the method of choice in the absence of capsular support. The choice of IOL mainly depends on the preoperative status of the eye (eg, aphakia in children) and the selected location for the implant. Theoretically, there are several IOL implantation approaches in cases without capsular support: an angle-supported anterior chamber (AC) IOL, an iris-fixated ACIOL, an iris-sutured or iris-fixated posterior chamber (PC) IOL and a transsclerally sutured PCIOL. No consensus exists, however, on the indications as well as on the relative safety and efficacy of these different options. Implantation of modern ACIOLs, like the refined open-loop or iris-fixated claw (toric) ACIOLs, have regained popularity and provide a valuable alternative to sutured PCIOLs. However, in the absence of capsular support, the transsclerally sutured PCIOLs offer numerous advantages for certain eyes. Because of its anatomic location, the sutured PCIOL is more appropriate for eyes with compromised cornea, peripheral anterior synechiae, shallow anterior chamber, or glaucoma. Moreover, sutured PCIOLs are appropriate if the patient with aphakia is young or has a life expectancy of 10 years or more. Recent technological advances, including PCIOL with iris diaphragm for aniridia, toric ACIOLs, and small-incision surgery with foldable, transsclerally sutured IOLs, seem to further improve clinical outcomes.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This review article will attempt to guide ophthalmologists in deciding the indications for cataract surgery. It will consider this year's visual function questionnaires, ancillary vision tests, and postoperative outcome measures to assess visual function. Cultural factors, age, and gender are a few of the confounding variables in trying to assess visual function. The indications for cataract surgery in the 21st century have evolved dramatically since cataract surgery was first performed in the 1700s. The physicians' dictum in the Hippocratic oath of “do no harm” has determined the indications for cataract surgery over time. Today, doing no harm means operating on cataracts earlier than previously, as this is technically easier than in previous years, when poorer surgical techniques prevailed. However, are we operating on cataracts too early? This review will attempt to highlight the relevant factors that will help to determine the indications for cataract surgery.

ISSN:1040-8738    

出版商:OVID    

年代:2001

数据来源: OVID