Chronic endophthalmitis following cataract extraction and intraocluar lens implantation has been reported occasionally and Propionibacterium acnes is Known as the most common organism. This infection is often misdiagnosed as uveitis in early stage, and diagnosis depends on anaerobic culture of intraocular specimens. Intravitreal infection of antibiotics, pars plana vitredtomy, removal of IOL with lens capsule are suggested for successful treatment of chronic endophthalmitis. We report a case of Propionibacterium acnes endophthalmitis after extracapsular cataract extraction and posterior chamber lens(PCL) implantation that was treated successfully by PCL removal and intraviteal antibiotic infection.
Anti-Bacterial Agents ; Cataract Extraction* ; Cataract* ; Diagnosis ; Endophthalmitis* ; Propionibacterium acnes* ; Propionibacterium* ; Uveitis

PURPOSE: To evaluate the risk factors for cataract formation and cataract extraction after penetrating keratoplasty to determine whether a combined surgery should be performed. METHODS: Variables from 189 phakic eyes that underwent penetrating keratoplasty from April 1992 to November 2004 were analyzed for the possibility of cataract extraction after penetrating keratoplasty according to sex, age, diagnosis, accompanied glaucoma, preoperative vision and steroid use. The mean interval between penetrating keratoplasty and cataract extraction was also studied. RESULTS: Cataract extraction was performed in 27 eyes (14.3%) and the mean interval between keratoplasty and cataract extraction was 24.5 months. Age was determined to be the most important independent risk factor for cataract extraction (p=0.0009) associated glaucoma also shown to be a risk factor (p=0.0011). Sex and corneal disease before keratoplasty were not shown to be risk factors. In the mean interval cataract extraction following penetrating keratoplasty, no statistically significant difference was found according to age, sex and diagnosis. Posterior subcapsular cataract was predominant (55.6%) and the mean visual acuity improved from 0.10 to 0.42. CONCLUSIONS: The likelihood of cataract formation and cataract extraction subsequent to penetrating keratoplasty increased with age and associated glaucoma. The results from this study can help surgeons to determine whether combined surgery should be performed and help them to counsel patients on the risk of cataract formation.
Cataract Extraction ; Cataract* ; Corneal Diseases ; Corneal Transplantation ; Diagnosis ; Glaucoma ; Humans ; Keratoplasty, Penetrating* ; Risk Factors ; Visual Acuity

PURPOSE: The most serious complication related to cataract surgery is endophthalmitis. Although its incidence is decreasing, it remains the great threat to the outcome of visual acuity in patients who received cataract surgery. METHODS: Retrospective analysis was performed on 18 patients who were diagnosed with endophthalmitis. The following factors were investigated: method of cataract extraction, performance of anterior vitrectomy, presence of posterior capsule rupture, results of bacterial culture, existence of systemic disease, and the duration of time from initial cataract surgery to diagnosis of endophthalmitis and then to subsequent posterior vitrectomy. In addition, the differences in final visual acuity due to variations in these factors were analyzed. RESULTS: Patients who were diagnosed with endophthalmitis and had been commenced on systemic antibiotics within a week of the cataract operation, showed better outcomes in final visual acuity (P=0.043). CONCLUSION: Occurrence of endophthalmitis and subsequent usage of systemic antibiotics within a one-week time frame of cataract surgery, led to statistically significant improvement in final visual acuity compared to cases in which these events occurred one week later.
Anti-Bacterial Agents ; Cataract Extraction ; Cataract* ; Diagnosis ; Endophthalmitis* ; Humans ; Incidence ; Retrospective Studies ; Rupture ; Visual Acuity ; Vitrectomy

PURPOSE: The most serious complication related to cataract surgery is endophthalmitis. Although its incidence is decreasing, it remains the great threat to the outcome of visual acuity in patients who received cataract surgery. METHODS: Retrospective analysis was performed on 18 patients who were diagnosed with endophthalmitis. The following factors were investigated: method of cataract extraction, performance of anterior vitrectomy, presence of posterior capsule rupture, results of bacterial culture, existence of systemic disease, and the duration of time from initial cataract surgery to diagnosis of endophthalmitis and then to subsequent posterior vitrectomy. In addition, the differences in final visual acuity due to variations in these factors were analyzed. RESULTS: Patients who were diagnosed with endophthalmitis and had been commenced on systemic antibiotics within a week of the cataract operation, showed better outcomes in final visual acuity (P=0.043). CONCLUSION: Occurrence of endophthalmitis and subsequent usage of systemic antibiotics within a one-week time frame of cataract surgery, led to statistically significant improvement in final visual acuity compared to cases in which these events occurred one week later.
Anti-Bacterial Agents ; Cataract Extraction ; Cataract* ; Diagnosis ; Endophthalmitis* ; Humans ; Incidence ; Retrospective Studies ; Rupture ; Visual Acuity ; Vitrectomy

To report acute onset lens particle glaucoma associated with a spontaneous anterior capsular dehiscence. A 66-year-old man presented with spontaneous anterior lens capsule dehiscence with an acute onset of right eye pain that was associated with white particles in the anterior chamber angle and intraocular pressure (IOP) of 55 mmHg. No trauma or other inflammatory antecedents were reported. A hypermature cataract was observed at slit lamp exam. After medical treatment without IOP control, we performed extracapsular cataract extraction and anterior vitrectomy. Anterior chamber aspirate confirmed the presence of macrophages. The postoperative IOP at one month was 16 mmHg OD without medication. Spontaneous dehiscence of the anterior lens capsule in a patient with a hypermature cataract may release lens cortical material, resulting in lens particle glaucoma. Prompt surgical removal of the lens material usually controls the high IOP, and the need for additional glaucoma surgery is not common.
Aged ; Cataract ; Cataract Extraction ; Eye Injuries/*complications/surgery ; Glaucoma, Open-Angle/*diagnosis/*etiology/surgery ; Humans ; Male

PURPOSE: Perimetric examination plays an important role in the diagnosis of glaucoma, which is among the leading causes of blindness worldwide. Several examination methods have been developed for early detection of glaucoma. Among those, short-wavelength automated perimetry (SWAP) is the most widely investigated. In this study, the effects of nuclear opacities on SWAP were examined. METHODS: Lens opacities were divided into cortical and nuclear opacity groups ; each group consisted of fifteen eyes. The eyes studied underwent standard white-on-white perimetry and SWAP exams before and after cataract operation. The differences in the results of the examinations were compared between the two opacity groups. The t test was used for comparing the data. RESULTS: In the cortical opacity group, the average difference between the mean deviation before and after the operation was 5.46dB in white-on-white perimetry and 5.02dB in SWAP. In the nuclear opacity group, the average difference between the mean deviation before and after the operation was 4.01dB in white-on-white perimetry and 10.82dB in SWAP. There was no statistically significant difference in the cortical opacity group (p=0.6575). However, there was a statistically significant difference in the nuclear opacity group (p<0.0001). CONCLUSIONS: In clinical situations, more caution should be taken when interpreting the SWAP results of nuclear cataract patients in order to make an accurate decision.
Blindness ; Cataract* ; Diagnosis ; Glaucoma ; Humans ; Visual Field Tests*

We evaluated the clinical results of phacoemulsification and posterior chamber lens implantation in posttrabeculectomy eyes. 26 eyes operated during Jan. 1990 to Dec.1995 were evaluated retrospectively with preoperative and postoperative visual acuity, intraocular pressure(IOP) and antiglaucomatous agent usage.The cataract operations were done by clear corneal incisions avoiding the filtering bleb sites. The average interval between trabeculectomy and cataract surgery was 25 months. From a total of 26 eyes 11 had the diagnosis of primary open angle glaucoma(POAG) and 12 eyes chronic angle closure glaucoma(CACG). The preoperative visual acuity was 0.3 or less in 53.8%, and the postoperative visual acuity was 0.4 or better in 57.7%. The preoperative and postoperative IOPs were 14.4+/-4.3mmHg and 15.3+/-4.6mmHg respectively, showing a slight increase. Filtering bleb failure was observed in one eye in which trabeculectomy was formed twice. Antiglaucomatous agent usage decreased to 8 cases from an initial 10 cases. The preoperative IOP of the 8 cases was 17.3+/-5.1mmHg, while it was 13.1+/-3.3mmHg in the 18 cases in which the IOP was controlled without treatment. There was a significant difference between the two(P=0.03). There was a significant relationship between preoperative and postoperative antiglaucomatous agent usage(P=0.01). Taken individually, POAG showed a greater incidence of postoperative antiglaucomatous agent usage than CACG, but was insignificant(P=0.56).
Blister ; Cataract ; Diagnosis ; Incidence ; Phacoemulsification ; Retrospective Studies ; Trabeculectomy ; Visual Acuity

To elucidate genetic traits, clinical findings and treatment outcomes in Korean families with hereditary congenital cataract, 24 patients(17 families)were retrospectively analysed. Genetic trait was analysed by family pedigree. Chief complaints, ages at diagnosis, bilaterality, types of lens opacity, associated systemic or ocular anomalies were examined. The final best-corrected visual acuity was compared among groups according to the presence of surgery or the age at diagnosis. Among 17 families, 15 belonged to an autosomal dominant trait and two an autosomal recessive trait. Bilateral cataracts were shown in all patients. Twelve(50.0%)out of 24 patients who had cataracts were diagnosed before 3 months of age. Five(29.4%)out of 17 patients who received surgery were done before 3 months of age. Final best-corrected visual acuity was not different between surgery group before 3 months of age and that of after 3 months of age. Associated ocular anomalies were microphthalmia(4 patients), nystagmus(4 patients), and esotropia(3 patients), but no systemic anomalies were found. These results show that most Korean families with hereditary congenital cataract have an autosomal dominant genetic trait and the age at diagnosis or surgery is too late to treat them properly.
Cataract* ; Diagnosis ; Humans ; Pedigree ; Retrospective Studies ; Visual Acuity

In the diagnosis of primary open angle glaucoma, it is very important to evaluate the outflow facility and intraocular pressure. Although tonography affords one of the most convenient methods for the estimating the outflow facility, there have been many efforts to overcome its inhernt inaccuracy. Honan introcular pressure reducer(HIPR) is widely used prior to cataract surgery because it is believed to be clinically safe and effective in reducing intraocular pressure, vitreous volume and the risk of vitreous loss. For the evaluation of the effects of HIPR in relation to outflow facility, the intraocular pressures were measured with applanation tonometer in 30 nonglaucomatous and 30 glaucomatous patients before and immediately after the application of HIPR at a pressure 30mmHg for 30 minutes, and then repeatedly at 5-minute intervals for 30 minutes thereafter. The results were as follows; 1. Mean initial IOPs were 15.6 +/- 2.71mmHg in nonglaucomatous patients and 20.7 +/- 2.71mmHg in glaucomatous patients. 2. Mean IOPs immediately after commpression were 4.3 +/- 1.38mmHg in nonglauco matous patients and 10.3 +/- 0.95mmHg in glaucomatous patients. 3. Mean IOP reductions were 11.20 +/- 1.89mmHg in nonglaucomatous patients and 10.45 +/- 1.69mmHg in glaucomatous patients. 4. Mean IOP reduction rates were 72.8% in nonglaucomatous patients and 50.3% in glaucomatous patients. 5. Mean IOP recovery times were 24.5 minutes in nonglaucomatous patients and more than 30 minutes in glaucomatous patients. 6. Rates of IOP recovery after 25 minutes elapsed were 76.6% in nonglaucomatous patients and 10% in glaucomatous patients. On the basis of the results HIPR may be considered to be beneficial in clinical diagnosis of open angle glaucoma.
Cataract ; Diagnosis ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure*

PURPOSE: To evaluate clinical characteristics of posterior lenticonus associated with pediatric cataracts and to identify the factors associated with final visual acuities after cataract surgery. METHODS: Thirty-eight patients (46 eyes) who were diagnosed with posterior lenticonus preoperatively or during the operation were involved in this study. We investigated the age at diagnosis, the severity of lens opacity, the pre- and postoperative best corrected visual acuity, and the effectiveness of amblyopia treatment. RESULTS: The mean age at presentation was 39.0+/-37.4 months, and the mean follow-up period was 42.8+/-33.5 months postoperatively. Nine patients (23%) had bilateral posterior lenticonus, and the mean age of bilateral cases was lower (p<0.001) and the lens opacity more severe than those of unilateral cases (P=0.001). Fifteen eyes (32.6%) were surgically identified as having posterior lenticonus during lens aspiration, the mean age of surgically identified cases was lower (p<0.001) and the lens opacity more severe then those of preoperatively diagnosed cases (P=0.014). The age at initial examination was negatively correlated with final visual acuities in log MAR (P=0.04). CONCLUSIONS: Bilateral and surgically identified posterior lenticoni were associated with younger age and more severe lens opacity. The final visual acuities were better in patients with late onsets of lens opacities.
Amblyopia ; Cataract* ; Diagnosis ; Follow-Up Studies ; Humans ; Visual Acuity