ABSTRACT
A review of 135 consecutive cataract operations identified ten cases (7.4%) of operating microscope light retinopathy. Ophthalmoscopically, these light retinopathy lesions appeared as a focal pigment epithelial change with varying degrees of pigment clumping in the center. Fluorescein angiography accentuated the lesion by demonstrating a sharply demarcated transmission defect, occasionally with multiple satellite lesions. The shape of the lesion matched the shape of the illuminating source of the particular operating microscope used during the surgery. The most significant risk factor associated with the production of these light retinopathy lesions was prolonged operating time. Mean total operating time for the ten patients with light retinopathy was 51 minutes longer than for those without (P less than .0001). Other significant associated factors were the presence of diabetes mellitus (P less than .03), younger age (P less than .05), and the use of hydrochlorothiazide (P less than .04).
Subject(s)
Iatrogenic Disease , Light/adverse effects , Microscopy/methods , Radiation Injuries , Retinal Diseases/etiology , Cataract Extraction/adverse effects , Cataract Extraction/methods , Diabetes Complications , Fluorescein Angiography , Humans , Hydrochlorothiazide/adverse effects , Intraoperative Period , Ophthalmoscopy , Retinal Diseases/chemically induced , Retinal Diseases/pathology , Risk , Time FactorsABSTRACT
Expulsive choroidal hemorrhage (ECH) is a dramatic and serious complication of cataract surgery that occurred in four of 8,285 consecutive cataract operations performed at the Jules Stein Eye Institute from 1970 to 1983, an incidence of 0.05%. This report reviews six patients who had uncomplicated cataract surgery after an expulsive choroidal hemorrhage occurred during cataract operation in the fellow eye. Factors predisposing to ECH are considered, and recommendations to minimize the risk of this complication during preoperative, operative, and postoperative periods are presented.
Subject(s)
Cataract Extraction/adverse effects , Choroid , Hemorrhage/etiology , Adult , Aged , Female , Humans , Male , Risk , Uveal Diseases/etiologyABSTRACT
The natural course of angle recession in a previously traumatized eye and its relationship to the development of glaucoma is still not well defined. Two cases of late-onset glaucoma occurring some 19 and 23 years after the initial contusion injuries to the eye are described. Medical therapy alone was inadequate, and surgical intervention was required in both cases. Life-long follow-up is indicated in patients with significant angle injury following trauma.
Subject(s)
Glaucoma/etiology , Adult , Child , Combined Modality Therapy , Epinephrine/analogs & derivatives , Epinephrine/therapeutic use , Eye Injuries/complications , Female , Glaucoma/drug therapy , Glaucoma/surgery , Humans , Male , Pilocarpine/therapeutic use , Timolol/therapeutic use , Trabecular Meshwork/surgeryABSTRACT
Unilateral macular infarction occurred in a 23-year-old black man with sickle cell hemoglobinopathy (SS), who was already receiving oxygen and hydration treatment for a painful crisis. Visual acuity of 20/200-1 in the affected eye did not improve with 36 hours of "conservative" treatment. Fifteen hours after an exchange transfusion, however, visual acuity started to improve. By 36 hours after transfusion, a visual acuity of 20/40 was achieved, with the gradual return over 8 weeks to 20/20. This case provides strong circumstantial support for the effectiveness of exchange transfusion in sickling maculopathy.
