The study included 188 patients, in which a posterior chamber intraocular lens was implanted after extracapsular cataract extraction. After modifications of the intraocular lens constants (SRK formula and SRK II formula) and correction of the axial length measurements (Colenbrander-Hoffer formula) had been made, the mean differences between the actual postoperative spherical equivalent and that predicted by the three formulas were -0.23D, -0.22D and -0.46D, respectively. More than +/-1.0D deviation from the predicted postoperative refraction occurred in about one-third of the cases. Inter-observed discrepancy regarding the accuracy of the preoperative measurement of the ocular axis length is suggested to be the main cause of unpredicted postoperative refractive errors.
During the period 1962-1986, 54 patients received the diagnosis hysterical visual impairment, i.e. 1 out of every 631 patients admitted to our department. Isolated visual acuity impairment was the most common symptom, followed by combined visual acuity impairment and visual field constriction, whereas isolated visual field constriction occurred most infrequently. The mean age of the patients in the first group was significantly lower than that of the patients in the latter group. A questionnaire sent to all patients in 1987 was answered by 41 patients. Twenty-one of these (51%) felt that their visual function now was good, whereas 20 (49%) claimed that their visual function was still poor. Nine patients (22%) were disabled because of their visual problems. Twenty-nine of the patients who answered the questionnaire were re-examined. Sixteen of these (55%) still showed visual impairment at the follow-up, while 13 (45%) showed complete disappearance of visual complaints. The younger patients appeared to have a better prognosis than the older ones.
A questionnaire was sent to 379 patients referred for cataract extraction, asking them to assess their visual disability and their need for surgery. Two hundred and seventy‐nine patients (73.6%) answered the questionnaire, this group being representative for the 379 patients regarding all relevant variables. The patient's answers were analyzed in relation to data extracted from their referral notes (visual acuity, monocular pseudophakia, age, sex, place of residence, referring ophthalmologist). The overall level of self‐reported visual problems and need for cataract surgery were significantly correlated to a reduced best‐eye visual acuity, although the correlaion factor was low. A similar correlation between the subjective need for surgery and a worst‐eye visual acuity ≤6/24 was also found. Forty‐seven patients (16.9%) answered that cataract surgery was not needed for the time being, and this attitude was not significantly correlated to the visual acuity, provided the acuity was ≥6/24 in the best eye and ≥6/36 in the worst eye. One hundred and twenty patients (43.0%) felt that their visual disability was so severe that they had to be operated within 1 month and 67 patients (24.0%) within 3 months, while 45 patients (16.1%) felt that surgery could be postponed for at least 6 months. Age, sex, place of residence and the presence of monocular pseudophakia were not found to significantly influence the level of self‐reported visual problems. Only 18.3% preferred to be treated as out‐patients.
A case of bilateral spontaneous carotid cavernous sinus fistula is presented. The diagnostic value of Doppler ultrasound examination is discussed, as well as therapeutic measurements, such as manual compression of the carotid artery and embolization treatment. The frequent spontaneous closure of these fistulas is emphasized, and a conservative attitude is recommended.
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