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Biomedical subjects

E Hodapp

Publications and source records attributed to E Hodapp.

13 recordsLinked to original sources

Vitrectomy lens for examination of the optic disk in young children with glaucoma.

PURPOSE/METHODS: To examine the optic disk in infants and young children with glaucoma after the administration of anesthesia, a lens designed for vitrectomy surgery was used to obtain magnified stereoscopic images of the optic disk. RESULT/CONCLUSIONS: Excellent visualization of the optic disk was obtained with our method. Comparison of optic disk appearance is facilitated by using an inexpensive lens designed for vitrectomy surgery.

Anesthesia↗

Zonular dialysis during extracapsular cataract extraction in pseudoexfoliation syndrome.

Five patients with pseudoexfoliation syndrome (PES) and glaucoma developed extensive zonular dialyses during extracapsular cataract extractions. Weakness of the lens zonules or their attachments to the ciliary processes, which has been described in association with PES, may explain this complication. We believe that patients with PES are at particular risk for developing large zonular dialyses during extracapsular surgery. Preoperative phakodonesis, anterior chamber depth asymmetry, and excessive lens movement during the anterior capsulotomy should alert the surgeon to this problem.

Aged↗

Glaucoma filtering surgery with 5-fluorouracil.

A life-table analysis of surgical outcomes was performed on the first eye of 155 patients who were enrolled in a pilot study of glaucoma filtering surgery with postoperative subconjunctival 5-fluorouracil (5-FU) injections. The success rates at 1-, 2-, and 3-year intervals were 68, 63, and 63%, respectively, for 88 patients with non-neovascular glaucoma in aphakia; 82, 75, and 75% for 39 patients with non-neovascular glaucoma after unsuccessful filtering surgery; and 68% at each yearly interval for 28 patients with neovascular glaucoma. Complications which resulted from filtering surgery and the 5-FU injections included corneal epithelial defects (55.5%), conjunctival wound leaks (36.8%), suprachoroidal hemorrhage (5.8%), rhegmatogenous retinal detachment (2.6%), endophthalmitis and phthisis (1.9% each), and corneal scarring, late bleb leak, malignant glaucoma, and traction retinal detachment (1.3% each). A Cox Model regression analysis failed to demonstrate a correlation between surgical success and age, race, type of filtering procedure, or total dose of 5-FU received. Postoperative subconjunctival 5-FU may increase the operative success rate for selected patients with a high risk for failure after glaucoma filtering surgery.

Actuarial Analysis↗

5-Fluorouracil and glaucoma filtering surgery. III. Intermediate follow-up of a pilot study.

Ninety-five patients (104 eyes) were enrolled in a pilot study of subconjunctival 5-fluorouracil (5-FU) injections after filtering surgery in eyes with poor surgical prognoses. At least a six-month follow-up was available on 84 patients, of whom four were excluded from the analysis of surgical outcome because they suffered retinal detachments within six months of their filtering surgery. The initial 5-FU procedures on the remaining 80 patients were successful (no further glaucoma surgical procedures were either performed or recommended, and the intraocular pressures [IOPs] were either 21 mmHg or lower with ocular hypotensive medication[s] or 25 mmHg or lower without ocular hypotensive medication) in 33 (68%) of the 48 aphakic eyes with non-neovascular glaucomas, 13 (81%) of the 16 phakic eyes with non-neovascular glaucomas after unsuccessful filtering surgery, and 12 (75%) of the 16 eyes with neovascular glaucoma (NVG). The follow-up on the successful eyes ranged from 6 to 34 months (mean +/- SD = 18.5 +/- 7.5). The visual acuities remained within one line of their preoperative levels or improved in 38 (79%) of the 48 aphakic eyes with non-neovascular glaucoma, 11 (69%) of the 16 phakic eyes with non-neovascular glaucoma after unsuccessful filtering surgery, and 12 (75%) of the 16 eyes with NVG. The initial 5-FU procedures on the 104 eyes were complicated by the following: corneal epithelial defects (50%); conjunctival wound and suture tract leaks (36%; 2% underwent surgical repair); suprachoroidal hemorrhages (9%); retinal detachments (3%); subepithelial corneal scarring (3%); endophthalmitis (2%); and malignant glaucoma (1%). It is the authors' impression that postoperative subconjunctival 5-FU increases the likelihood of achieving IOP control after filtering surgery in eyes with poor surgical prognoses; however, a randomized clinical trial is necessary to confirm this impression.

Aphakia↗

Trabeculectomy in aphakic eyes.

One hundred twenty-seven trabeculectomies performed on aphakic eyes at the Bascom Palmer Eye Institute (BPEI) between 1972 and 1982 were reviewed. Forty-five cases were excluded from data analysis: 28 in eyes with confounding conditions, such as neovascular glaucoma; ten with follow-up of less than six months; and seven that were the second or third trabeculectomy performed at the BPEI in six eyes. Of the remaining 82 trabeculectomies in 82 eyes: 32 (39%) were categorized as successes (eyes that achieved an intraocular pressure of less than or equal to 21 mmHg with medication or less than or equal to 25 mmHg without medication); eight (10%) were categorized as qualified failures (eyes that had an intraocular pressure of greater than 21 mmHg despite medication or greater than 25 mmHg without medication); and 42 (51%) were categorized as complete failures (eyes that underwent further glaucoma surgery, had further glaucoma surgery recommended, or lost light perception). In the 20 eyes of the patients younger than 50 years of age, only one (5%) was categorized as a success; while in the 62 eyes of the patients 50 years of age or older, 31 (50%) were categorized as successes.

Adolescent↗

5-fluorouracil and glaucoma filtering surgery. II. A pilot study.

5-Fluorouracil (5-FU) was injected subconjunctivally after glaucoma filtering surgery in a pilot study of eyes with poor surgical prognoses. Twenty-seven (79%) of the 34 aphakic eyes with glaucoma achieved an intraocular pressure (IOP) of less than or equal to 21 mmHg (range of follow-up on nonreoperated eyes, 91 -468 days). Nine (69%) of 13 eyes with neovascular glaucoma achieved an IOP of less than or equal to 21 mmHg (range of follow-up on nonreoperated eyes, 120-379 days). Eight (89%) of nine phakic eyes with glaucoma following unsuccessful filtering procedures achieved an IOP of less than or equal to 21 mmHg (range of follow-up on nonreoperated eyes, 134-394 days). Visual acuities remained within one line of their preoperative levels or improved in 32 (94%) of the 34 aphakic eyes with glaucoma, eight (62%) of the 13 eyes with neovascular glaucoma, and six (67%) of the nine phakic eyes with glaucoma following unsuccessful filtering procedures. Postoperative corneal epithelial defects occurred in 45% of the cases. Conjunctival wound and conjunctival needle tract leaks were observed in 41% of the cases, but only one eye required wound revision. No other serious side effects that we attributed to 5-FU were observed. It seems that postoperative subconjunctival 5-FU increases the likelihood of achieving IOP control following filtering surgery in eyes with poor surgical prognoses; however, a randomized clinical trial is necessary to confirm this.

Adolescent↗

Timolol and epinephrine: long-term evaluation of concurrent administration.

Thirty-two ocular hypertensive subjects were treated for 90 days with either 0.5% timolol maleate or 2% epinephrine hydrochloride twice daily to one eye and both drugs to the fellow eye. The ocular hypotensive effects of timolol and epinephrine were partially additive throughout the course of this study. On the 91st day, eyes treated with epinephrine had a 25.8% mean reduction of intraocular pressure from baseline, whereas their fellow eyes treated with epinephrine and timolol had a 33.9% reduction. Eyes treated with timolol had a 27.2% mean reduction of IOP, whereas fellow eyes treated with timolol and epinephrine had a 29% reduction. These results suggest that the majority of patients being treated with either drug are unlikely to have a substantial long-term reduction in IOP when the other drug is added to their therapeutic regimen.

Administration, Topical↗

Part I. Patient administration of eyedrops: interview.

Interviews of 141 patients were conducted to determine their use of eyedrops. This study indicates a need to improve patient instruction concerning drug compliance and proper time scheduling of eyedrop treatments.

Adult↗

Flurbiprofen and intraocular pressure.

Systemic or topical administration of corticosteroids may produce a rise in intraocular pressure (IOP). Nonsteroidal anti-inflammatory drugs (NSAI drugs) are alternate therapy for ocular inflammatory disease. Flurbiprofen, a new NSAI drug, was tested in double-masked fashion to delineate its effect on IOP. Flurbiprofen did not alter IOP in known high corticosteroid responders nor did it block corticosteroid-induced ocular hypertension.

Adult↗