Posterior Chamber Intraocular Lens Implantation in High Myopia

We evaluated pseudophakia in high myopic patients whose an axial lenght were 26mm and over. Cataract surgery was performed with ECCE and posterior chamber intraocular lens implantations from May 1986 to May 1991 on 69 patients (80 eyes). The results were as follows; 1. Most myopic patients were good candidates for posterior chamber intraocular lens implantation regardless of axial length. 2. Posterior chamber intraocular lens implantations in high myopia were a good refractive surgery. 3. The theoretical formula had better predictabilized than the empirical formula in apredictive accuracy.

Early Result of Corneal Astigmatism in Sutureless Cataract Surgery

Since surgically induced corneal astigmatism was one of important complications after cataract extraction the authors analyzed corneal astigmatism for 3 months after sutureless cataract surgery. Among the patients who were treated with phacoemulsification and PCL implantation by one surgeon (L. E. H.), 40 patients had sutureless cataract surgery by 5mm incision and 51 patients had 10-0 nylon shoelace suture by 7mm incision. Corneal astigmatism was analyzed by algebraic and vector method. Visual acuity was analyzed in patients who were below 60 years age and without posterior segment disorders, whose predictive refractive errors were -0.75D according to SRK/T formula. 0.19D with-the-rule astigmatism induced at 1 day after 5mm sutureless cataract surgery was nearly unchanged until 3 months postoperatively and induced with-the-rule astigmat ism at 1 day after operation was not changed into against-the-rule astigmatism, visual rehabilitation was faster and corrected visual acuity was better.

Correction of High Myopia by Worst-Fechner Biconcave Lens

For the purpose of correction of high myopia, we had implanted Worst-Fechner Biconcave Lens (Ophtec B.V., Groningen, Holland) in the 10 phakic eyes which were more myopic than -8.0 D. We examined postoperative visual acuity and complications. Postoperative uncorrected visual acuity was from 0.3 to 1.0. Cataract, glaucoma, chronic iridocyclitis and macular edema or retinal detachment did not occur and during the iris fluorescein angiography of 4 eyes there was no leakage of dye at the fixation site of iris by haptic of the lens. But all patients complained of glare. In the 3 eyes which were followed up for 12 months, corneal endothelial cell loss occurred continuously and the endothelial cell loss was 17.2% at the central cornea and 19.5% at the paracentral cornea. Therefore, long term follow up is necessary.

Electron Microscopic Findings of the Acute Retinal Necrosis Syndrome

One case of unilaterally developed acute retinal necrosis syndrome was studied with retina and vitreous from biopsy during operation through electronmicroscope pathologically and virolo gically. In photoreceptor cells, generalized necrosis was found: loss of outer segments, fragmentation of inner segments, and decrease of mitochondria in ellipsoids. Bipolar cells and axons were well preserved. Internal limiting membrane was intact, and covered by an unidentified cell. Degenerated retinal proper had various sized vacuoles. Around the intraretinal vessels, neutrophils and lymphocytes were infiltrated considering vasculitis. In ganglion cells, swelling of mitochondrias were seen, and their cell organelles were decreased, No virus particle was detected in all layers of the retina with electronmicroscope.

Extraction of the Leris Nucleus with the Continuous Circular Capsulorhexis in Planned Extracapsular Cataract Extraction

We rotated the nucleus up to 270 degree and dislocated it into anterior chamber through the diameter of capsulorhexis after hydrodissection by using the planned extracapsular cataract extraction. And later on we delivered the nucleus with hydroexpression using the irrigating Vectis or with rotation using a lens spatuala. As a result of this procedure, the nucleus was safely delivered in all cases without zonular rupture and vitreous prolapse.