ABSTRACT
Systemic anticoagulation rarely is responsible for intraocular hemorrhaging and usually does not require cessation before intraocular surgery. Spontaneous hyphema is only rarely described and then usually in patients who have some underlying vascular abnormality. A case is reported of a patient with no other underlying cause except that she was receiving warfarin sodium, in whom spontaneous hyphemas developed in each eye on two separate occasions.
Subject(s)
Hyphema/chemically induced , Warfarin/adverse effects , Female , Humans , Hyphema/physiopathology , Middle Aged , Visual Acuity/drug effectsABSTRACT
A surgical technique for removing black ball hyphema in a pseudophakic patient is described. Three days after a total postoperative hyphema developed, a solution of sodium hyaluronate, Healon, was injected into the anterior chamber through a 160 degrees limbal cataract incision. Healon dissected the clotted blood off the underlying iris and intraocular lens, maintained the anterior chamber, and expressed the clot in toto out of the eye. Postoperatively the patient had no further bleeding, the intraocular pressure remained normal, the pseudophakos remained clear and well positioned, and the cornea remained clear.
Subject(s)
Cataract Extraction , Hyaluronic Acid/therapeutic use , Hyphema/surgery , Aged , Female , Humans , Hyphema/etiology , Methods , Postoperative Care , Postoperative ComplicationsABSTRACT
It has been theorized that prostaglandins E1 and E2 may be responsible for the vascular leakage leading to cystoid macular edema following cataract extraction. Indomethacin is a known inhibitor of prostaglandin synthesis. A prospective, double-blind study to evaluate the effect of oral indomethacin on four and eight week cases of postoperative CME following intracapsular cataract extraction as determined by fluorescein angiography was carried out on 42 patients. Twenty patients received 25 mg of indomethacin three times a day for three days preoperatively and three weeks postoperatively. Twenty-two patients received a placebo on an identical schedule. Four (20%) patients in the indomethacin group and five (22.7%) patients in the placebo group had positive angiograms for CME. No contributory factor resulting in CME was found.