Biomedical subjects
Publications and source records attributed to C Keroub.
The prevalence of glaucoma in a rural population of 6232 people over the age of 40 years, including patients with previously diagnosed glaucoma, was found to be 1.21%. There were 41 cases of open-angle glaucoma compared to 32 cases of angle-closure glaucoma. The prevalence of glaucoma among subjects over the age of 60 years was 3.07%.
Two hundred and sixty-seven eyes which underwent peripheral iridectomy for presumed angle-closure glaucoma were investigated. The diagnosis of angle-closure glaucoma was confirmed postoperatively in 258 eyes, in 201 of which the intraocular pressure became normal without further treatment and in 57 of which the postiridectomy IOP was elevated because of visible damage to the anterior chamber angle. Three eyes had open-angle glaucoma with a narrow angle. Six eyes had possible mixed (combined mechanism) glaucoma (2-2%). Mixed glaucoma is a rare, fortuitous combination of open-angle and angle-closure glaucoma rather than a distinct entity, and it might be advisable to avoid the term, which tends to be used for primary glaucomas of uncertain classification.
Expulsive hemorrhage occurring during cataract extraction was successfully treated by immediate wound closure, without evacuation of blood through the sclera. Only two such cases have been reported previously. Modern micro-surgical techniques are not ideal for the management of this condition.
Nine cases are presented, six of them in detail, which suggest that there is a high risk of bullous keratopathy developing when the lens is removed for the treatment of acute glaucoma due to an intumescent cataract. In some cases the keratopathy is due to detachment of Descemet's membrane from the cornea. Acute glaucoma due to an intumescent cataract should be treated medically or by peripheral iridectomy. The lens should be removed only after the intraocular pressure has been normal and the cornea free of edema for at least 6 weeks.
118 consecutive patients with angle-closure glaucoma (ACG) were investigated. The primarily affected eye presented with acute ACG in 71 patients, with intermittent or chronic ACG in 41, and with acute ACG secondary to intumescent cataract in six. ACG was demonstrated in the fellow eye in 85 of the 118 patients (72 per cent.), including 72, 71, and 83 per cent. respectively of the three groups distinguished above. In 27 fellow eyes, ACG was demonstrable only by provocative testing. Eleven patients failed to return for follow-up investigation. A routine prophylactic peripheral iridectomy in the fellow eye is justified in patients who are unlikely to attend for follow-up examinations,, but may be avoided in about 23 per cent. of patients who attend regularly.