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Fouad YA, Jabbehdari S, Neuhouser A, Soliman MK, Chandra A, Yang YC, Sallam AB. Visual outcomes and postoperative complications of eyes with dropped lens fragments during cataract surgery: multicenter database study. J Cataract Refract Surg 2023; 49:485-491. [PMID: 36700943 DOI: 10.1097/j.jcrs.0000000000001137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/18/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE To analyze the visual outcomes and postoperative complications of phacoemulsification cataract surgery in eyes with posterior capsule rupture (PCR) and dropped lens fragments (DLFs) in comparison with a reference group with uneventful surgery. SETTING 8 UK National Health Service departments. DESIGN Retrospective comparative nonrandomized study. METHODS Demographic, medical history, and ocular examination data were automatically extracted from the electronic records. The main outcome variables were postoperative visual acuity (VA), and the development of postoperative cystoid macular edema (CME) as well as rhegmatogenous retinal detachment (RRD) and epiretinal membrane (ERM) requiring surgery. RESULTS The analysis included 175 589 eyes in the reference group, 2751 eyes in the PCR group, and 519 eyes in the DLF group. During all postoperative intervals, the mean VA in the DLF and PCR groups was significantly worse than the reference group ( P < .001). On multivariate analysis, the odds of having a VA ≤0.3 logMAR at 4 to 12 weeks postoperatively among eyes with DLF and PCR were 88% and 73% lower than the reference group ( P < .001). More eyes developed CME in the DLF and PCR groups ( P < .001). The odds of requiring RRD and ERM surgery were 3.6 and 2.1 times higher in the DLF group, and 1.8 and 1.3 times higher in the PCR group, respectively, as compared with the reference group. CONCLUSIONS Eyes undergoing phacoemulsification complicated by PCR, and more so with DLF, have worse visual outcomes and higher chances of CME, ERM, and RRD when compared with uneventful surgery.
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Affiliation(s)
- Yousef A Fouad
- From the Department of Ophthalmology, Ain Shams University, Cairo, Egypt (Fouad); Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Jabbehdari, Neuhouser, Sallam); Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt (Soliman); University Hospitals Eye Institute, Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio (Soliman); Department of Ophthalmology, Southend University Hospital, Mid & South Essex NHS Foundation Trust, Southend-on-Sea, United Kingdom (Chandra); School of Medicine, Anglia Ruskin University, Chelmsford, United Kingdom (Chandra); Wolverhampton Eye Infirmary, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom (Yang); Department of Ophthalmology, Gloucestershire Hospitals NHS Trust, Cheltenham, United Kingdom (Sallam)
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Ramshekar A, Heczko J, Bernhisel A, Barlow W, Zaugg B, Olson R, Pettey J. Optimizing Tip Diameter in Phacoemulsification of Varying Lens Sizes: An in vitro Study. Clin Ophthalmol 2021; 15:4475-4484. [PMID: 34819719 PMCID: PMC8607188 DOI: 10.2147/opth.s333903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/11/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose We assessed the effect of two lens cube sizes, three tip sizes, and two ultrasound (US) approaches on phacoemulsification efficiency and chatter. Methods After porcine lens nuclei were soaked in formalin, we divided them into cubes measuring 2.0 mm or 3.0 mm. We collected efficiency and chatter data for 30-degree bent 19 G, 20 G, and 21 G tips with a continuous torsional US system; and for straight 19 G, 20 G, and 21 G tips with a micropulse longitudinal US system. Results The average time needed for removal was always higher for the 3.0 mm lens cube than for the 2.0 mm lens cube. Statistically significant differences were observed between the 19 G and 21 G tips with micropulse longitudinal US using a 2.0 mm cube and a 3.0 mm cube, and with continuous transversal US using a 2.0 mm lens cube and a 3.0 mm cube. We did not observe significant differences between 19 G and 20 G tips with either cube size in either US system. However, we noted identical trends for both cube sizes with both US approaches; 19 G tips performed better than 20 G and 21 G tips. Conclusion Regardless of the lens size, 19 G needles were the most efficient, and had both the fewest outliers and the smallest standard deviations.
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Affiliation(s)
- Aniket Ramshekar
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, 84132, USA.,University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
| | - Joshua Heczko
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, 84132, USA
| | - Ashlie Bernhisel
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, 84132, USA
| | - William Barlow
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, 84132, USA
| | - Brian Zaugg
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, 84132, USA
| | - Randall Olson
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, 84132, USA
| | - Jeff Pettey
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, 84132, USA
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Moshirfar M, Lewis AL, Ellis JH, McCabe SE, Ronquillo YC, Hoopes PC. Anterior Chamber Retained Lens Fragments After Cataract Surgery: A Case Series and Narrative Review. Clin Ophthalmol 2021; 15:2625-2633. [PMID: 34188441 PMCID: PMC8232887 DOI: 10.2147/opth.s314148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/11/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Retained lens fragments in the anterior chamber following cataract extraction (CE) with phacoemulsification are rare but can lead to significant patient morbidity. Our study aimed to identify risk factors associated with retained lens fragments. Methods Patients who underwent cataract surgery and subsequently identified to have retained lens fragments in the anterior segment were included. Incidence per year, patient demographics, visual acuity, ocular biometrics, surgical technique, surgeon performing CE, and outcomes were collected retrospectively and compared to a control group. Results Twenty-four patients were identified with retained lens fragments, with an incidence of 0.10%. The mean age was 76 years ±6.72 (60–80) compared to 63 ±11.41 (22–86) in the control group (p <0.001). Patients with UDVA 20/150 or worse experienced a greater average improvement in visual acuity compared to patients with UDVA better than 20/150 (logMAR 0.46 vs logMAR 0.05). The mean intraocular pressures before (CE), after CE but before fragment removal, and following fragment removal were 14 mmHg ±2.59, 19 mmHg ±8.20, and 11 mmHg ±2.75, respectively. Twenty-two patients presented with inferiorly located fragments. Statistically significant biometrics include mean anterior chamber depth (3.1 mm ±0.37 vs 3.33 mm ±0.39, p = 0.01) and lens thickness (4.77 mm ±0.44 vs 4.35 mm ±0.44, p = <0.001). Yearly incidence rates per surgeon ranged from 0.00% to 0.85%. In 2003 and 2004, one surgeon had significantly higher incidence rates (0.31 and 0.40%) compared to the average combined rate of all surgeons throughout the study (0.10), with p values of 0.001 and 0.003, respectively. The mean number of days between CE and fragment removal was 26 ±40 (1–138). Conclusion Increased patient age, shallow anterior chamber depth, and thick lens may be risk factors for retained lens fragments. There may be additional surgeon-specific risk factors. Phacoemulsification technique (Divide-and-Conquer versus Horizontal Chop) showed no significant difference.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.,Utah Lions Eye Bank, Murray, UT, USA
| | | | - James H Ellis
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Shannon E McCabe
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,Mission Hills Eye Center, Pleasant Hill, CA, USA
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Can robotics be the future of ophthalmic surgery? J Robot Surg 2021; 15:975-976. [PMID: 33929707 DOI: 10.1007/s11701-021-01247-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
The future of robotic ophthalmologic surgery looks promising. Innovations in robotic technology and artificial intelligence may provide an ideal machine-human interface with planned and precise movements minimizing unwanted tissue damage and improving clinical outcomes.
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Dzhaber D, Mustafa OM, Tian J, Cox JT, Daoud YJ. Outcomes and complications of iris-fixated intraocular lenses in cases with inadequate capsular support and complex ophthalmic history. Eye (Lond) 2020; 34:1875-1882. [PMID: 31900437 PMCID: PMC7609302 DOI: 10.1038/s41433-019-0759-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND To report the indications, visual outcomes, and intra-operative and post-operative complications of iris-sutured posterior chamber intraocular lens (IOL) in eyes with inadequate capsular support and complex ocular history. METHODS A chart review and data analysis of eyes that underwent iris fixation of posterior chamber (PC) IOL for correction of aphakia, dislocated and subluxed IOLs, ectopia lentis, and IOL exchange. Data included clinical risk factors, associated eye conditions, previous surgeries, and concomitant procedures. The pre-operative and post-operative vision, manifest refraction, endothelial cell density, intraocular pressure (IOP), as well as intra-operative and post-operative complications were also recorded. RESULTS One hundred and seventeen eyes from 114 patients were examined with a mean follow-up of 22.4 months. The most common identifiable predisposing risk factor was high myopia in 23 eyes. A significant improvement in uncorrected and best corrected visual acuity compared with baseline was observed. The most common post-operative complications included recurrent IOL subluxation in 16 (13.7%) eyes, IOP spike in 7 (5.9%) eyes, cystoid macular oedema in 5 (4.3%) eyes, and epiretinal membrane formation in 4 (3.4%) eyes. There was one (0.85%) case of sterile endophthalmitis. CONCLUSIONS Iris suture fixation of PC IOLs is a good treatment option for eyes with inadequate capsular support and complex ocular history.
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Affiliation(s)
- Daliya Dzhaber
- Cornea, Cataract, and External Diseases Division, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Osama M Mustafa
- Cornea, Cataract, and External Diseases Division, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jing Tian
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacob T Cox
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yassine J Daoud
- Cornea, Cataract, and External Diseases Division, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Timing of vitrectomy for retained lens fragments after cataract surgery. Int Ophthalmol 2017; 38:2699-2707. [DOI: 10.1007/s10792-017-0719-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
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Kang S, Park S, Park E, Lim J, Seo K. Influence of an intentionally induced posterior lens capsule rupture on the real-time intraocular pressure during phacoemulsification in canine ex vivo eyes. Vet Ophthalmol 2017; 21:35-41. [PMID: 28503796 DOI: 10.1111/vop.12475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the changes in the intraocular pressure (IOP) following an intentionally induced posterior lens capsule rupture (PLCR) during phacoemulsification in enucleated canine eyes. Furthermore, to compare the IOPs between different stages of phacoemulsification for two different bottle heights (BH). PROCEDURES Coaxial phacoemulsification was performed using a venturi-based machine at a 60 or 90 cm BH. A pressure transducer, inserted into the anterior chamber through the peripheral cornea, monitored real-time IOP. For one half of the lens, the sculpt-segment removal (SS) was followed by irrigation/aspiration (IA). The PLCR was intentionally created, and the SS and IA were repeated on the residual lens fragments. RESULTS For the 60 cm BH, the mean IOP following the PLCR was significantly higher than before the PLCR during SS (28.30 ± 12.56 and 38.71 ± 9.43 mmHg before and after PLCR, respectively) and IA (42.76 ± 12.46 and 47.88 ± 7.10 mmHg before and after PLCR, respectively) stages (P < 0.001). For the 90 cm BH, the mean IOP following the PLCR was also significantly higher than before the PLCR during SS (33.39 ± 11.09 and 58.17 ± 6.89 mmHg before and after PLCR, respectively) and IA (62.39 ± 12.46 and 72.04 ± 8.59 mmHg before and after PLCR, respectively) stages (P < 0.001). CONCLUSIONS The occurrence of a PLCR led to an increase in IOP during both the SS and IA stages. The elevated IOP after the PLCR might be one of the most important factors for ocular tissue damage, as it reduces ocular perfusion. Additionally, the BH should be reduced following PLCR to prevent complications stemming from the raised IOP.
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Affiliation(s)
- Seonmi Kang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - Sangwan Park
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - Eunjin Park
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - Jaegook Lim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - Kangmoon Seo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
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Correspondence. Retina 2015; 35:e63. [PMID: 26398559 DOI: 10.1097/iae.0000000000000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chalam KV, Murthy RK, Priluck JC, Khetpal V, Gupta SK. Concurrent removal of intravitreal lens fragments after phacoemulsification with pars plana vitrectomy prevents development of retinal detachment. Int J Ophthalmol 2015; 8:89-93. [PMID: 25709914 DOI: 10.3980/j.issn.2222-3959.2015.01.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 08/14/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the outcomes of "concurrent vitrectomy" to retrieve dislocated lens fragment during phacoemulsification. METHODS In a retrospective, observational case series, data of patients who underwent "concurrent" pars plana vitrectomy (PPV) for dislocated lens fragments between the period 2000 and 2008 were reviewed. Data collected included patient demographics, pre-operative visual acuity, intra-operative occurrence of retinal breaks, duration of follow up, post-operative intraocular pressure, final best-corrected visual acuity (BCVA), presence of cystoid macular edema (CME) and occurrence of rhegmatogenous retinal detachment (RRD). RESULTS A total of 58 eyes of 58 patients were included in the study. At 12mo the mean postoperative BCVA was logMAR 0.17 (20/30) with a range of logMAR 0 to 0.69 (20/20 to 20/100), with 96.6% (56/58) of patients showing post-operative improvement in visual acuity (P=0.005). None of the patients developed postoperative retinal detachment, endophthalmitis or non-resolving uveitis at 12mo. CONCLUSION Our study results suggest concurrent PPV for retained lens fragments after cataract surgery is beneficial and may decrease the risk of glaucoma and prevent development of RRD.
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Affiliation(s)
- Kakarla V Chalam
- Department of Ophthalmology, University of Florida-College of Medicine, Jacksonville, Florida 32209, USA
| | - Ravi K Murthy
- Department of Ophthalmology, University of Florida-College of Medicine, Jacksonville, Florida 32209, USA
| | - Joshua C Priluck
- Department of Ophthalmology, University of Florida-College of Medicine, Jacksonville, Florida 32209, USA
| | - Vijay Khetpal
- Department of Ophthalmology, University of Florida-College of Medicine, Jacksonville, Florida 32209, USA
| | - Shailesh K Gupta
- Department of Ophthalmology, University of Florida-College of Medicine, Jacksonville, Florida 32209, USA
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Guo S, Patel S, Baumrind B, Johnson K, Levinsohn D, Marcus E, Tannen B, Roy M, Bhagat N, Zarbin M. Management of pseudophakic cystoid macular edema. Surv Ophthalmol 2014; 60:123-37. [PMID: 25438734 DOI: 10.1016/j.survophthal.2014.08.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 08/24/2014] [Accepted: 08/26/2014] [Indexed: 01/08/2023]
Abstract
Pseudophakic cystoid macular edema (PCME) is a common complication following cataract surgery. Acute PCME may resolve spontaneously, but some patients will develop chronic macular edema that affects vision and is difficult to treat. This disease was described more than 50 years ago, and there are multiple options for clinical management. We discuss mechanisms, clinical efficacy, and adverse effects of these treatment modalities. Topical non-steroidal anti-inflammatory agents and corticosteroids are widely used and, when combined, may have a synergistic effect. Intravitreal corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents have shown promise when topical medications either fail or have had limited effects. Randomized clinical studies evaluating anti-VEGF agents are needed to fully evaluate benefits and risks. When PCME is either refractory to medical therapy or is associated with significant vitreous involvement, pars plana vitrectomy has been shown to improve outcomes, though it is associated with additional risks.
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Affiliation(s)
- Suqin Guo
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA.
| | - Shriji Patel
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Ben Baumrind
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Keegan Johnson
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Daniel Levinsohn
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Edward Marcus
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Brad Tannen
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Monique Roy
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Neelakshi Bhagat
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Marco Zarbin
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
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Kang S, Jeong M, Ahn J, Lee E, Kim S, Park S, Yi K, Choi M, Seo K. Evaluation of fluid leakage into the canine vitreous humor during phacoemulsification using contrast-enhanced magnetic resonance imaging. Vet Ophthalmol 2014; 18:13-9. [DOI: 10.1111/vop.12156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Seonmi Kang
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Seoul National University; 1 Gwanak-ro, Gwanak-gu Seoul 151-742 Korea
| | - Manbok Jeong
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Seoul National University; 1 Gwanak-ro, Gwanak-gu Seoul 151-742 Korea
| | - Jaesang Ahn
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Seoul National University; 1 Gwanak-ro, Gwanak-gu Seoul 151-742 Korea
| | - Euiri Lee
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Seoul National University; 1 Gwanak-ro, Gwanak-gu Seoul 151-742 Korea
| | - Soohyun Kim
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Seoul National University; 1 Gwanak-ro, Gwanak-gu Seoul 151-742 Korea
| | - Sangwan Park
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Seoul National University; 1 Gwanak-ro, Gwanak-gu Seoul 151-742 Korea
| | - Kangjae Yi
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Seoul National University; 1 Gwanak-ro, Gwanak-gu Seoul 151-742 Korea
| | - Mincheol Choi
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Seoul National University; 1 Gwanak-ro, Gwanak-gu Seoul 151-742 Korea
| | - Kangmoon Seo
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Seoul National University; 1 Gwanak-ro, Gwanak-gu Seoul 151-742 Korea
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Inflammation and macular oedema after pars plana vitrectomy. Mediators Inflamm 2013; 2013:971758. [PMID: 24288446 PMCID: PMC3833009 DOI: 10.1155/2013/971758] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 09/23/2013] [Indexed: 11/29/2022] Open
Abstract
Cystoid macular oedema (CMO) is a major cause of reduced vision following intraocular surgery. Although the aetiology of CMO is not completely clarified, intraocular inflammation is known to play a major role in its development. The macula may develop cytotoxic oedema when the primary lesion and fluid accumulation occur in the parenchymatous cells (intracellular oedema) or vasogenic oedema when the primary defect occurs in the blood-retinal barrier and leads to extracellular fluid accumulation (extracellular oedema). We report on the mechanisms of CMO formation after pars plana vitrectomy and associated surgical procedures and discuss possible therapeutic approaches.
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