Use of intraocular gas in flat anterior chamber after filtration surgery.
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Aged↗
Biomedical subjects
E J Higginbotham
Publications and source records attributed to E J Higginbotham.
Internal sclerostomy with the Nd: YAG contact laser versus thermal sclerostomy in rabbits.
The authors undertook an investigation to evaluate the efficacy and complications of performing internal sclerostomy with the synthetic sapphire contact neodymium:YAG (Nd:YAG) laser compared with standard external thermal sclerostomy. Fifteen rabbits underwent internal laser sclerostomy in one eye; 12 additional rabbits underwent a standard external thermal sclerostomy in one eye. The fellow eyes served as controls. The differences between the groups in duration of functional blebs and pressure reduction were statistically significant (P = 0.034 and 0.0013, respectively). The evaluation of success (as determined by a pressure reduction greater than 3 mmHg between both eyes after digital pressure) using life-survival analysis indicated that the success rate of the laser-treated group was significantly different from the standard surgical group (P = 0.002). Histologically, there was less inflammation in the laser-treated group 2 days postoperatively. The complications of the laser treatment include focal injury to the overlying cornea, adjacent iris stroma, and lens.
Aluminum Silicates↗
ALO 2145 reduces the intraocular pressure elevation after anterior segment laser surgery.
The effect of an alpha adrenergic agonist, ALO 2145 (para-amino-clonidine [PAC]), was examined in a double-masked, multicenter study on the postoperative intraocular pressure (IOP) elevation after laser surgery in 165 patients (83 trabeculoplasty, 36 iridotomy, and 46 capsulotomy). One drop of 1.0% ALO 2145 or vehicle was instilled 1 hour before and immediately after laser surgery. The mean IOP increase in the ALO 2145-treated group was lower (P less than 0.05) than in the placebo group at each of the first three postoperative hours. Overall, 18% of placebo-treated eyes experienced IOP increases greater than or equal to 10 mmHg as compared with 4% of ALO 2145-treated eyes (P less than 0.003). Ocular and systemic side effects were minimal and did not differ between the treatment groups. ALO 2145 safely and effectively reduced the incidence and magnitude of potentially harmful IOP elevations after anterior segment laser surgery.
Aged↗
Lens clarity after argon and neodymium-YAG laser iridotomy in the rabbit.
Focal lenticular damage has occurred after argon and neodymium (Nd)-YAG laser iridotomies. Since the latter disrupts nonpigmented membranes, it is of particular concern. To determine the effects of argon and Nd-YAG laser iridotomies on the lens, we treated adult pigmented rabbits and quantitatively evaluated their lenses. The right eyes of ten adult pigmented rabbits underwent argon laser (five eyes) or Nd-YAG laser (five eyes) iridotomies. The left eyes served as controls and were not treated. The Scheimpflug camera (Zeiss) and fluorophotometry were used to quantitate lens clarity six weeks postoperatively. There was no statistically significant difference in lens clarity between treatment groups when the experimental and control eyes were compared after six weeks. Thus, no diffuse lens opacification appeared evident after argon laser or Nd-YAG laser iridotomy.
Animals↗
Lensectomy and vitrectomy in the presence of filtering blebs.
We describe a technique for preserving a filtering bleb in glaucoma patients undergoing pars plana lensectomy and vitrectomy. It involves making a conjunctival incision away from the filtering site and injecting the anterior chamber and bleb with (hyaluronic acid) Healon before vitreous surgery is begun.
Adult↗
Effect of vitamin A on glycoconjugate: synthesis in the trabecular meshwork. A preliminary report.
We studied the effect of vitamin A on glycoconjugate synthesis in trabecular meshwork (TM) cells in vivo. The aqueous flow system of two cats and one monkey was exposed in vivo to retinoic acid dissolved in dimethyl sulfoxide (DMSO). One hour prior to enucleation, [3H]glucosamine was injected into all eyes. The tissue was subsequently processed for autoradiography. The density of grains (grains micron-2) in the vitamin A-treated eyes of Cats I and II was 77% and 30% less, respectively, than the density of grains in the control eyes. In the monkey the grain density was 56% less in the experimental eye compared with the control eye. These data suggest that exogenous vitamin A suppresses glycoconjugate synthesis in TM cells in vivo.
Animals↗
Response of exfoliation glaucoma to laser trabeculoplasty.
The comparative response of exfoliation (EF) glaucoma and primary open-angle glaucoma (POAG) to laser trabeculoplasty (LTP) was studied retrospectively. The effectiveness of argon laser trabeculoplasty (LTP) was compared in 26 eyes of patients with EF glaucoma (uncontrollable by maximally tolerated medical therapy) and 28 eyes of patients with POAG (controls). 64% of the POAG group and 46% of the EF glaucoma group received treatment of the entire angle in two divided sessions in order to reduce the intraocular pressure (IOP) to less than or equal to 22 mmHg. All second treatments were performed at least four to six weeks after the initial session. Evaluation of the postoperative course of IOP by means of the Kaplan-Meier curve for data analysis indicated that EF patients 'failed' at a faster rate than POAG patients after both the initial and consecutive laser treatments. The rate of failure in the EF group, however, was greater following the initial 180 degrees treatment. Although patients with EF glaucoma have a large initial reduction in intraocular pressure after LTP, to increase the probability of maintaining intraocular pressures of less than or equal to 22 mmHg consecutive 180 degrees treatments should be considered.
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Laser trabeculoplasty.
Over a decade, laser trabeculoplasty has evolved from being a novel new treatment to one that is a commonly accepted intervention in the management of open-angle glaucoma. Despite its widespread use, however, there are still many unanswered questions about laser trabeculoplasty, including its mechanism of action and the ideal treatment parameters. In this review, we will discuss the history of the technique, the clinical experience, and some of the experimental studies that have been conducted to answer the questions regarding its mechanism of action.
Glaucoma, Open-Angle↗
Contact transscleral Nd:YAG laser cyclophotocoagulation for the treatment of refractory pediatric glaucoma.
BACKGROUND AND OBJECTIVE: Nd:YAG contact transscleral laser cyclophotocoagulation (CTLC) has been used in the treatment of adult glaucoma patients. However, little information is available regarding the use of this modality in pediatric glaucoma. PATIENTS AND METHODS: We retrospectively studied 10 pediatric patients (ages 8 months to 13 years) treated with Nd:YAG CTLC for refractory glaucoma. All patients were treated using our standard technique in an outpatient setting. Average treatment energy was 190.5 +/- 35.0 J. RESULTS: The overall result was an average intraocular pressure (IOP) reduction of 48% +/- 6%. An IOP of less than 21 mm Hg was achieved in five patients (50%), and the average follow up was 15.5 +/- 5 months. Retreatment was required in 7 of 10 eyes. Loss of vision was seen in four patients, and one case of phthisis bulbi was noted. CONCLUSION: Nd:YAG CTLC effectively lowers IOP in refractory pediatric glaucoma.
Child↗