Dataset Information

Asteroid Hyalosis Migration into the Anterior Chamber during Cataract Surgery.

ABSTRACT: A 70-year-old male presented for cataract surgery in the right eye with pre-operative assessment significant for nuclear sclerotic cataract and asteroid hyalosis. Upon irrigation and aspiration during cataract surgery, yellow-white spheres consistent with asteroid hyalosis were visualized circulating into the anterior chamber despite an intact capsule and no apparent zonular weakness. The asteroides particles were completely aspirated by the irrigation and aspiration ports, and an intraocular lens was implanted into the capsular bag. Postoperatively, the patient did well with final visual acuity of 20/20 and no vitreous prolapse, retinal tears, or detachments noted. There are only four cases in the literature of asteroid hyalosis migrating in the anterior chamber; none of these cases are associated with migration during intraocular surgery. We hypothesize that the asteroid hyalosis migrated anteriorly and around the zonules due to the synuretic nature of the vitreous and microscopic gaps in the zonular fibers. This case demonstrates the importance of the cataract surgeon to be aware of potential migration of asteroid hyalosis into the anterior chamber during surgery.

SUBMITTER: Saeed O

PROVIDER: S-EPMC10294124 | biostudies-literature | 2023 Jan-Dec

REPOSITORIES: biostudies-literature

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Asteroid Hyalosis Migration into the Anterior Chamber during Cataract Surgery.

Saeed Omar O Bloom Jeffrey J Mihok Brian B

Case reports in ophthalmology 20230101 1

A 70-year-old male presented for cataract surgery in the right eye with pre-operative assessment significant for nuclear sclerotic cataract and asteroid hyalosis. Upon irrigation and aspiration during cataract surgery, yellow-white spheres consistent with asteroid hyalosis were visualized circulating into the anterior chamber despite an intact capsule and no apparent zonular weakness. The asteroides particles were completely aspirated by the irrigation and aspiration ports, and an intraocular le ...[more]

PMID: 37383168

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Project description:PurposeTo investigate the relationship between early post-operative anterior chamber inflammation (aqueous flare) and central corneal thickness (CCT) after cataract surgery and to evaluate the effect of anti-inflammatory prophylaxis on CCT.SettingDepartment of Ophthalmology, Rigshospitalet-Glostrup, University Hospital Copenhagen, Denmark.DesignPost-hoc analysis of a prospective randomized controlled trial.Patients and methodsA total of 470 participants who underwent standard cataract surgery were randomly allocated to prophylactic treatment with nonsteroidal anti-inflammatory drug (NSAID, groups C and D) or a combination of NSAID and steroid eye drops (groups A and B), commenced either pre-operatively (A and C) or post-operatively on the day of surgery (B and D), or "drop-less surgery" (peri-operative subtenon depot of dexamethasone, group E). Aqueous flare was measured before and three days after surgery. CCT was measured before surgery, three days, three weeks, and three months after surgery. Data were analyzed according to the intention-to-treat method.ResultsDoubling of aqueous flare increased mean CCT by 15.6 microns (95% CI 9.8; 21.3, P<0.001) three days after surgery. Mean CCT increased from 549 microns (95% CI 545; 552) at baseline to 594 microns (95% CI 585; 602) three days after surgery and returned to 551 microns (95% CI 545; 557) three months after surgery. Mean CCT was thinner in group C compared to group A three days after surgery. No difference was found for any other groups or time points.ConclusionIncreased anterior chamber inflammation was associated with significant corneal thickening three days after cataract surgery. Choice of anti-inflammatory regimen seemed to be of no or minimal importance on CCT when the effect of inflammation was accounted for. Corneal thickening is possibly mediated by underlying deterioration of the blood-aqueous barrier and corneal endothelium pump function caused by a post-operative inflammatory response.

Dataset Information

Asteroid Hyalosis Migration into the Anterior Chamber during Cataract Surgery.

Publications

Asteroid Hyalosis Migration into the Anterior Chamber during Cataract Surgery.

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