ABSTRACT
PURPOSE: To summarize and analyse the results of our experience in treating patients with a "dropped nucleus". METHODS: The case records of nineteen patients who underwent surgery for a "dropped nucleus" at the Ophthalmology Departments of Sahlgren's University Hospital, Gothenburg, and Orebro Medical Centre, Orebro, Sweden during 1994 were retrospectively reviewed to determine the mode of treatment used and the results of surgery. The frequency of this complication was also calculated for Sweden as a whole with the help of the National Cataract Register. RESULTS: The lens was successfully removed in all eyes. No retinal breaks or detachments were present at vitrectomy or follow-up. One eye was lost to panophthalmitis 11 days after the vitrectomy; the remaining 18 eyes showed a favourable outcome. CONCLUSION: The loss of a crystalline lens to the vitreous during cataract surgery is a severe complication. We recommend that an experienced vitreoretinal surgeon should be consulted at an early stage.
Subject(s)
Cataract Extraction , Intraoperative Complications/surgery , Lens Subluxation/surgery , Vitrectomy , Aged , Aged, 80 and over , Humans , Middle Aged , Reoperation , Retrospective Studies , Time Factors , Treatment Outcome , Visual Acuity/physiologyABSTRACT
PURPOSE: Macular pucker patients were re-examined 16-90 months after surgery (mean 72 months) to evaluate visual acuity, metamorphopsia, and complications, with particular reference to cataract development. Surgery had been performed on 48 eyes in 46 patients, 31 eyes having a primary, and 17 eyes a secondary macular pucker. RESULTS: At the 6-month control 65% of the eyes with a primary macular pucker and 35% of the eyes with a secondary macular pucker exhibited an improved visual acuity defined as doubling or more of the visual angle. At the last control 57% of the primary group and 33% of the secondary group had a visual acuity which still exceeded the preoperative value. At the final examination a cataract progression was observed in 22/28 (79%) of the primary group and 8/14 (57%) of the secondary group. In the primary group 11% and in the secondary group 36% of the eyes suffered a retinal detachment. All cases were successfully treated and none were followed by visual deterioration. CONCLUSION: The improvement in visual quality after macular pucker surgery appears to be long-standing, if not permanent, especially in primary cases. In those eyes in which a decrease in visual acuity is observed, the most frequent cause is cataract development.
Subject(s)
Macula Lutea/surgery , Retinal Diseases/surgery , Cataract/diagnosis , Cataract/etiology , Disease Progression , Female , Follow-Up Studies , Fundus Oculi , Humans , Macula Lutea/pathology , Macula Lutea/physiopathology , Male , Middle Aged , Postoperative Complications , Retinal Diseases/pathology , Retinal Diseases/physiopathology , Retrospective Studies , Treatment Outcome , Visual Acuity/physiology , Vitrectomy/adverse effectsABSTRACT
Two perfluorocarbon liquids (perfluoro-n-octane and perfluorodecaline) were evaluated as technical aids in vitreoretinal surgery in 42 patients. Perfluorocarbon liquids were found to stabilize the retina and simplify removal of repiretinal membranes, which in many cases permitted the subsequent use of an expanding gas instead of silicone oil at the conclusion of the operation. The infusion of a perfluorocarbon liquids allowed the drainage of subretinal fluid through peripheral retinal breaks obviating the need for a retinotomy in most cases. No difference could be observed between the two types of perfluorocarbon liquids, and there were no adverse effects associated with their use. The retina was centrally attached in 32 eyes (76%) at 3-10 months follow-up.
