Chemical injuries of the eye: current concepts in pathophysiology and therapy.

Objective: To better define the effectiveness and risks of modern cataract surgery Design: Meta-analysis (formal systematic identification, selection, review, and synthesis) of published literature Patients: Patients described in 90 studies published between 1979 and 1991 that addressed visual acuity (n=17 390 eyes) or complications (n=68 316 eyes) following standard extracapsular cataract extraction with posterior chamber intraocular lens implantation, phacoemulsification with posterior chamber intraocular lens implantation, or intracapsular cataract extraction with flexible anterior chamber intraocular lens implantation Main Outcome Measures: The proportion of eyes with postoperative Snellen visual acuity of 20/40 or better and the proportion of eyes with each of 18 complications Results: The pooled percentage of eyes (weighted by sample size) with postoperative visual acuity of 20/40 or better was 955% (95% confidence interval [CI], 951% to 959%) among eyes without preexisting ocular comorbidity and 897% (95% CI, 893% to 902%) for all eyes The pooled percentage of eyes experiencing complications (weighted by sample size and, when pertinent, by quality score of the individual studies but not adjusted for variation in duration of follow-up) ranged from 013% for endophthalmitis to 197% for posterior capsule opacification Pooled proportions of eyes with other complications were as follows: bullous keratopathy, 03%; intraocular lens malposition/dislocation, 11%; clinically apparent cystoid macular edema, 15%; and retinal detachment, 07% Pooled results for postoperative Snellen visual acuity and most complications were similar for surgery performed via phacoemulsification vs standard extracapsular cataract extraction, although comparisons of the outcomes between these procedures should be interpreted with caution Conclusions: The published literature indicates that modern cataract surgery yields excellent visual acuity and, although not free of complications, is a very safe procedure regardless of the extraction technique used

Synthesis of the Literature on Visual Acuity and Complications Following Cataract Extraction With Intraocular Lens Implantation

National Outcomes of Cataract Extraction: Retinal Detachment and Endophthalmids after Outpatient Cataract Surgery

As in last year's review, only a few selected topics of particular interest are discussed here. A limited number of papers have been reviewed; thus many significant contribu¬ tions in other areas of research on the cornea and sclera have been omitted. The list of references includes only those which are mentioned in the text. However, a complete bibliography for the period Oct 1, 1962, through Sept 30, 1963, containing close to 800 references, may be obtained on micro¬ film upon request.

https://jamanetwork.com/journals/OPHTH/articlepdf/627472/archopht_71_2_021.pdf

Cornea and Sclera

Prostaglandins and Cystoid Macular Edema

Acute Posterior Multifocal Placoid Pigment Epitheliopathy

Retinal detachment after extracapsular cataract extraction with posterior chamber intraocular lens

Fluorescein Angiography of the Choriocapillaris

Cystoid macular edema associated with topically applied epinephrine in aphakic eyes.

The injection of antigen into the center of the avascular cornea of homologously sensitized animals induced a ring of opacification between the center of the cornea and the limbus. This ring of opacification was composed of a line of deeply eosinophilic amorphous material in a matrix of swollen collagen fibers, palisaded by polymorphonuclear leucocytes. By use of fluor-tagged antigen, it was shown that the line of damage in the cornea coincided with the precipitation of antigen presumably by antibody entering the cornea from the limbal vessels. With the passage of time, the antigen-antibody precipitates were removed, at least in part by phagocytosis, and the ring of opacification was replaced by ingrowing blood vessels surrounded by plasma cells. Treatment of sensitized animals with nitrogen mustard showed that antigen-antibody interaction could injure the corneal stroma in the relative absence of polymorphonuclear leucocytes.

/pdf/immunohistologic-studies-on-antigen-antibody-reactions-in-4ev6o2ypy3.pdf

A. Edward Maumenee

Papers

Acute Posterior Multifocal Placoid Pigment Epitheliopathy

Retinal detachment after extracapsular cataract extraction with posterior chamber intraocular lens

Fluorescein Angiography of the Choriocapillaris

Cystoid macular edema associated with topically applied epinephrine in aphakic eyes.

Immunohistologic studies on antigen-antibody reactions in the avascular cornea i. reactions in rabbits actively sensitized to foreign protein