Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Complicaciones del Embarazo , Resultado del Embarazo , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Adulto , Inhibidores de la Angiogénesis/efectos adversos , Inhibidores de la Angiogénesis/farmacocinética , Bevacizumab/efectos adversos , Bevacizumab/farmacocinética , Bevacizumab/uso terapéutico , Femenino , Humanos , Inyecciones Intravenosas , Inyecciones Intravítreas , Embarazo , Ranibizumab/efectos adversos , Ranibizumab/farmacocinética , Ranibizumab/uso terapéutico , Receptores de Factores de Crecimiento Endotelial Vascular/uso terapéutico , Proteínas Recombinantes de Fusión/efectos adversos , Proteínas Recombinantes de Fusión/farmacocinética , Proteínas Recombinantes de Fusión/uso terapéutico , Retinopatía de la Prematuridad/tratamiento farmacológicoRESUMEN
Phacolytic glaucoma is an open-angle glaucoma that occurs when lens proteins from hypermature cataracts seep through an intact anterior capsule and induce obstruction of the trabecular meshwork by inflammatory cells. We review the case of a 66-year-old man who presented with acute pain, a hypermature cataract, prominent anterior chamber crystals, and elevated intraocular pressure. After cataract surgery was performed, iridescent crystals were noted in the posterior chamber. Anterior chamber crystals have been associated with phacolytic glaucoma, but this is the first case demonstrating crystals in the posterior chamber as well.
Asunto(s)
Segmento Anterior del Ojo/patología , Catarata/complicaciones , Cristalinas/efectos adversos , Glaucoma de Ángulo Abierto/etiología , Segmento Posterior del Ojo/patología , Anciano , Cristalización , Dolor Ocular/etiología , Glaucoma de Ángulo Abierto/diagnóstico , Glaucoma de Ángulo Abierto/cirugía , Humanos , Presión Intraocular , Iridectomía , Masculino , Facoemulsificación , Tonometría Ocular , Malla Trabecular/patologíaRESUMEN
A 48-year-old, black female with a history of heroin and daily alcohol abuse presented to the emergency room in a lethargic state with severe right eye pain and vision loss. She had been unconscious for 10 hours prior to presentation. On exam she was found to have no light perception vision, severe retinal edema, and complete ophthalmoplegia of the right eye. Imaging and clinical course confirmed the diagnosis of Saturday Night Retinopathy--only the second documented case to be published.
Asunto(s)
Alcoholismo/complicaciones , Ceguera/etiología , Dependencia de Heroína/complicaciones , Oftalmoplejía/etiología , Papiledema/etiología , Vasos Retinianos/patología , Ceguera/diagnóstico , Ceguera/fisiopatología , Coroides/irrigación sanguínea , Dolor Ocular/etiología , Femenino , Angiografía con Fluoresceína , Humanos , Isquemia/diagnóstico , Imagen por Resonancia Magnética , Persona de Mediana Edad , Oftalmoplejía/diagnóstico , Oftalmoplejía/fisiopatología , Papiledema/diagnóstico , Papiledema/fisiopatologíaRESUMEN
PURPOSE: To determine the incidence of intraocular pressure (IOP) elevation on postoperative day 1 (POD1) after cataract surgery performed by resident surgeons compared with attending surgeons and to examine the influence of associated variables on the incidence of postoperative IOP elevation. PATIENTS AND METHODS: Retrospective review of 2472 consecutive 2.2 to 2.8 mm temporal clear corneal cataract extractions by phacoemulsification performed by either residents or attending surgeons at Henry Ford Health System. Fellow eyes were excluded, resulting in 1847 eyes. IOP measurements of >40, >30, and >23 mm Hg were noted along with incremental IOP elevations of ≥10 and 20 mm Hg over preoperative/baseline IOP. Associated variables included: age, sex, diabetes mellitus, hypertension, glaucoma, glaucoma suspect, uveitis, prior ocular trauma, and vitreous loss at surgery. RESULTS: Resident-performed cataract surgery was associated with statistically significant higher rates of IOP elevation in all categories and in all clinical situations known to be associated with postoperative IOP spike, that is, vitreous loss at surgery, prior ocular trauma, and preexisting glaucoma. CONCLUSIONS: The incidence of postoperative day 1 IOP elevation after phacoemulsification performed by resident surgeons was 2 to 5 times that of experienced cataract surgeons. Variables including vitreous loss at surgery, prior ocular trauma, preexisting glaucoma, glaucoma suspect status, and male sex were significant contributors. Consideration for prophylactic IOP lowering is advised in high-risk patients.