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T. Oshitari, K. Hanawa, J. Yotsukura, E. Adachi-Usami; Cataract Surgery in Over 90-Year-Old Patients - Two Representative Cases of 95-Year-Old Patients Performed on Same Day. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5470.
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To report the results of cataract surgery on two 95-year-old patients performed on the same day and the results of over 90-year-old cataract surgeries in our hospital.
Two 95-year-old patients underwent cataract surgery with phacoemulfisication and aspiration, followed by intraocular lens (IOL) implantation in our hospital on the same day. The preoperative visual acuities were 0.01 OS in Patient 1 and 0.3 OD in Patient 2. No complications developed intraoperatively. Although one case developed endophthalmitis, the final visual acuity was good in both. Beside these two, 18 patients over 90-year-old underwent IOL implantation were reviewed.
A total of 1048 cataract surgeries were performed in our hospital during the past four years (2002 - 2005), and the mean age of the patients was 73.7 ± 9.8 years. Among these, 20 were 90 years or older (27 eyes). The mean age of the patients >90 years was 92.4 ± 2.2 years (n = 20). The mean preoperative visual acuity was 0.30 ± 0.22 (n = 27) and mean postoperative visual acuity was 0.68 ± 0.29 (n = 27). All patients had an improvement in their visual acuities after cataract surgery. No intraoperative complications were observed in all surgeries, though one eye developed endophthalmitis (Patient 2). The postoperative visual acuities of Patient 1 and Patient 2 were 1.0 OS and 0.4 OD, respectively. In Patient 2, endophthalmitis developed nine days after the cataract surgery. Six hours after detecting the endophthalmitis, vitrectomy and posterior capusulotomy were performed. Antibiotics were perfused into the anterior chamber, and the IOL was not removed because the inflammation was not so severe. Six months after the vitrectomy, the visual acuity was 0.6 in this eye, which was better than that before suffering from endophthalmitis.
Cataract surgery with IOL implantation can be successfully performed on very old patients under local anesthesia.The visual acuity of 95-year-old patients can be improved after cataract surgery and even after vitrectomy. To the best of our knowledge, this is the oldest patient in Japan who had vitrectomy for postoperative endophthalmitis.
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