The authors reported the result of extracapsular lens extraction of 45 eyes(42 cases) which were operated in eye clinic of B.N.D. Hospital and red-cross hospital from January 1975 to August 1976. We thought that the major operative and postoperative complications could be reduced with skillful technique of adequate removal of anterior lens capsule and irrigation of lenticular substances for senile mature and hypermature cataract.
Cataract* ; Postoperative Complications

The history of surgical treatment of cataract extends back at least Before Christ. In 1748 Jacques Daviel, French ophthalmic surgeon, was attempted to cataract extraction with modern operating techniques and since then development of operation methods, techniques and instruments were contributed to recovery of the loss of vision. Although the occurrence of during and postoperative complications of cataract extraction diminish, cataract complications still remain troublesome in the minds of cataract operators. The authors reported the result of hyphema in the many complications of cataract extraction for the 7 of the 47 eyes(42 cases), which were operated from January 1976 to August 1977, using the sex, types of cataract, age, methods of operation, onset and procedure.
Cataract Extraction* ; Cataract* ; Hyphema* ; Postoperative Complications

In order to evaluate the effects of the postoperative astigmatism control, we compared 20 eyes measuring astigmatism at the end of operation with the Zeiss surgical keratometer and then had received loosening or tightening of sutures(keratometer group), with 20 eyes that were operated without the keratometer(control group). The mean cylindrical power of the keratometer group was lower than the control group at early postoperative period(P<0.001), but there was no statistical difference between both group at one or two months after operation. However the amount of cylinder was smaller in the keratometer group than in the control group. 19 of 20 eyes(95%) had less than 2D of astigmatism in the keratometer group, but in the control group 15 of 20 eyes(75%) had less than 2D of astigmatism at postoperative 60 days. 4 cases of posterior capsule rupture as intraoperative complication occured in the keratometer group. The posterior capsule rupture was caused by the decrease of surgical field clarity due to farther working distance by 17.5cm through attaching the Zeiss surgical keratometer to the operating microscope. From this study, Zeiss surgical keratometer seems to useful to reduce the early postoperative astigmatism but the intraoperative difficulty because of occupying space and decreasing clarity of surgical field is observed. The posterior capsule rupture as intraoperative complication occurs more frequently due to the disadvantages of this instrument.
Astigmatism* ; Cataract* ; Intraoperative Complications ; Rupture

A group of 25 preoperative against-the-rule(AR) eyes had undergone phacoemulsification and posterior chamber lens implantation, 15 of them prepared with lateral(temporal) scleral pocket incision and 10 with superior scleral incision. Temporal incision group showed early AR astigmatism increment by about 1 diopter(D), which decayed slowly over the next 2 months. Superior incision group showed early with-the-rule (WR) astigmatism by about 2.5D, which shifted toward AR astigmatism at postoperative 10 day and the AR astigmatism increased substantially by the next 2 months. The early postoperative complications were hyphema(2 eyes, 13.3%) and corneal edema(1 eye, 6.7%) in the temporal incision group, which cleared spontaneously within 1 week pctoperative. There were no hyphema and corneal edema in the superior incision group. In summary, the temporal incision effectively achived rapid post-operative astigmatic recovery with strong axial stability in a manner that surgically induced astigmatism favorably reduces pre-existing AR astigmatism.
Astigmatism ; Cataract Extraction* ; Cataract* ; Corneal Edema ; Hyphema ; Phacoemulsification ; Postoperative Complications

The true diabetic cataract is well known as one of the complications of diabetes mellitus. It affects always bilaterally and progresses very rapidly and is found frequently relative young indivisuals. In the past, it has been hesitated of performing cataract extraction in diabetes owing to the complications such as hemorrhages during and after surgeries, delayed wound healing and infection etc. But according to the authors experiences with the proper use of insulin and careful control of the level of sugar either in blood or in urine and general condition, the outcome of cataract extraction in diabetic patient is very unevenful one.
Cataract Extraction ; Cataract* ; Diabetes Complications ; Hemorrhage ; Humans ; Insulin ; Wound Healing

We studied the postoperative visual outcome of 27 congenital cataract patients(45 eyes) whose preoperative vision was 0.1 or better. Twenty-seven eyes(60%) had nuclear cataract and 11 eyes(24.4%) capsular; 39 eyes(86.7%) bilateral and 6 eyes(13.3%) unilateral. Interms of surgical techniques employed, aspiration was performed in 32 eyes(71.1%), phacoemulsification in 13 eyes(28.9%). Intraocular lenses(IOLs) were implanted in 41 eyes(91.1%), of which the power of IOLs was 15 diopers or less in 19 eyes(46.3%). Prooperative best corrected vision ranged from 0.1 to 0.5. Postoperative corrected vision was 0.8 or better in 29 eyes(64.4%), 0.6 to 0.7 in 6 eyes(13.3%) and 0.5 or worse in 10 eyes(22.2%). Among the eyes with 0.8 or better vision, one eye had unilateral cataract and 28 eyes bilateral. Among 16 eyes(35.8%) with 0.7 or worse vision. 5 eyes had unilateral cataract and 11 eyes bilateral. Bilateral cases showed better visual outcome than unilateral. We had been reserving the operation on congenital cataract patients with possible unclear visual outcome due to postoperative complications and am blyopia. However, cataract extraction and IOL implantation improved not only vision but also subjective symptoms, such as glare and knitting brow, in congenital cataract patients with 0.1 or better corrected vision and without any associated ocular or systemic diseases. The results of this study suggest that cataract extraction and IOL implantation may well improve vision and subjective symptoms in selected congenital cataract patients.
Cataract Extraction ; Cataract* ; Glare ; Humans ; Phacoemulsification ; Postoperative Complications

Mitomycin C (MMC) trabeculectomy combined with extracapsular cataract extraction and posteor chamber intraocular lens implantation (glaucoma triple procedure, 30 eyes) was clinically compared with MMC trabeculectomy alone (30 eyes). The age, type of glaucoma, and preoperative number of medications were matched with the previous group (P>0.05). The mean preoperative intraocular pressures (IOPs) were 30.2+/-8.3mmHg (range, 22~56mmHg) in the glaucoma triple procedure group and 31.6+/-8.9mmHg (range, 22~57mmHg) in the trabeculectomy alone group (p=0.55). The mean postoperative IOPs were significantly higher in the glaucoma triple procedure group compared with the trabeculectomy alone group at all postoperative vistis (one month to nine months) (p<0.05). However, there were no statistically significant differences in the mean number of postoperative rise exceeding 30 mmHg within the postoperative one month tended to occur more frequently in the glaucoma triple procedure group (7 eyes (23%)) than the trabeculectomy alone group (2 eyes(7%)) (p=0.13). Conjunctival filtering blebs were significantly frequently observed in the trabeculectomy alone group than the glaucoma triple procedure group (28 eyes (93%), 20 eyes (67%), respectively, P=0.02) at 6 months postoperatively. The common postoperative complications were hyphema (4 eyes) and posterior capsular opacification (4 eyes) in the glaucoma triple procedure group and shallow anterior chamber(4 statistical difference was noted between these two groups (p>0.05). Although hypotensive effect of MMC on the glaucoma triple procedure was less than on the trabeculectomy alone, glaucoma triple procedure using MMC could be recommended to be safe and effective on controlling the high IOP for treating glaucoma patients with coexisting cataract.
Blister ; Cataract ; Cataract Extraction ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Mitomycin* ; Postoperative Complications ; Trabeculectomy*

Trabeculectomy with intracapsular cataract extraction(Group I) on 14 eyes of 14 patients, and trabeculectomy with extracapsular cataract extraction(Group II) on 17 eyes of 17 patients were perfonned during the period of March 1986 to March 1988. The follow-up periods ranged from 3 monthes to 5 monthes. The mean intraocular pressure was reduced by approximately 54%, from 35 mmHg preoperatively to 16 mmHg postoperatively Group I, and was reduced by approximately 50%, from 34 mmHg preoperatively to 17 mmHg postoperatively in Group II. The visual acuity improved in all cases of both groups. The mean intraocular pressure reduction, operative and postoperative complications, and failure rates were not significantly different between Group I and Group II.
Cataract Extraction* ; Cataract* ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Postoperative Complications ; Trabeculectomy* ; Visual Acuity

In recent days, cataract surgery has trend to reduce postoperative astig-matism and acquired early visual rehabilitation.Phacoemulsification with small incision and insertion of foldable intraocular lens has been used popularly, but its high cost and intraoperative or postoperative complication especially in old age with dense nucleosclerosis could be detrimental to patients. Postoperative corneal astigmatic changes and visual rehabilitation were evaluated after extracapsular cataract extraction with 7 mmscleral tunnel incision (Group I, 7 mm-ECCE, 28 eyes)by comparing with those after phacoemulsification with 3.5 mmscleral tunnel incision (Group II, 3.5 mm-Phaco, 41eyes).One piece PMMA intraocular lens was inserted in group I, while foldable intraocular lens in group II.Surgically induced corneal astigmatism was calculated by Cravy's vector analysis.There was no statistically signifi-cant difference between group I and group IIfor surgically induced corneal astigmatism (Kt)after postoperative one month (p>0.05).In group I and group II, corneal astigmatism was with-the-rule in early postoperative days, and changed to against-the-rule in postoperative 3 months.There was no statistically significant difference between group I and group IIincorneal astigmatism during all follow-up period (p>0.05). Therefore, 7 mm-ECCE could be an effective method for old patient with high grade nucleosclerosis or when phacoemulsification was unavailable.
Astigmatism* ; Cataract ; Cataract Extraction ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Postoperative Complications ; Rehabilitation

There are many unknown factors in the surgical treatment of congenital cataract such as time of surgery, surgical problems, and aphakic visual correction. Recently, the advancement of microsurgical technique and visual rehabilitation have reduced the rate of postoperative complications and visual losses. We have studied 81 eyes of 55 patients who had recieved cataract surgery from January 1994 to January 1998 at the department of ophthalmology, Yonsei University College of Medicine. These eyes have been categorized by age into three groups : Group l (0~1 year), Group ll (2~5 years), and Group lll(6~10 years). Cataract extraction was done in all eyes and posterior chamber intraocular lens implantation was performed in groups ll and lllfor aphakic visual correction and the followings were investigated : preoperative vision; surgical method; postoperative vision; refractive error;and complications. Improvements in surgical procedures such as lens aspiration, posterior continuous circular capsulorhexis, anterior vitrectomy, intraocular lens implantation, and intraocular lens capture (Group ll) have brought better visual outcomes in groups II and III as well as decreased incidence of after-cataract. Thus, intraocular lens implantation in congenital cataract of 1year and older should actively be considered.
Capsulorhexis ; Cataract Extraction ; Cataract* ; Humans ; Incidence ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Ophthalmology ; Postoperative Complications ; Rehabilitation ; Vitrectomy