Argon laser trabeculoplasty (ALT) was used as the initial treatment in 30 eyes of 20 patients with uncontrolled open-angle glaucoma in Egypt. None of the patients had received previous medical or surgical therapy. The average reduction of intraocular pressure with ALT alone was 10.1 mm Hg. Medical and surgical glaucoma therapy was avoided in 83% (25 eyes) of the treated eyes during an average follow-up period of 7 1/2 months. The data indicate that ALT can be used as a safe and effective initial treatment for glaucoma in developing countries where socioeconomic factors make the medical treatment of glaucoma impractical.

Developing Countries↗

PubMed1984

Pupillary and iridovitreal block in pseudophakic eyes.

Twenty-six cases of pupillary and iridovitreal block in pseudophakic eyes are reported. Although ten patients presented with acute angle closure glaucoma, the majority were asymptomatic and had normal intraocular pressures. While cure was finally achieved in all cases, recurrence of block occurred in six eyes as late as two months after initial successful treatment. A variety of therapeutic modalities including argon laser iridectomy, argon laser gonioplasty (iridoplasty), surgical iridectomy, surgical vitrectomy, Q-switched Nd:YAG laser iridectomy and Nd:YAG laser photodisruption of the anterior vitreous face were needed. Despite successful relief of pupillary and iridovitreal block in these eyes with no evidence of glaucoma prior to cataract and lens implant surgery, four eyes developed eight or more clock hours of peripheral anterior synechiae, and nine eyes continue to require chronic medical therapy for glaucoma.

Aged↗

PubMed1984

Laser trabeculoplasty: technique, indications, results, and complications.

Explore the source record for details and available documents.

Adult↗

PubMed1984

Other uses of laser in the anterior segment of the eye.

Explore the source record for details and available documents.

Anterior Eye Segment↗

PubMed1984

Endothelial guttata and facility of aqueous outflow.

Thirty-eight eyes of 22 patients with corneal endothelial guttata were examined by slit lamp, tonometry, tonography, and wide-field specular microscopy. The mean value for facility of outflow (C55) was 0.23, and it was not statistically different from reported values for a normal population. Also, there was no correlation between extent of guttata as seen with wide-field specular microscopy and facility of outflow. Thus, contrary to a previous report, endothelial guttata does not seem to predispose to impaired facility of outflow.

Aqueous Humor↗

PubMed1983

Relationship of patient age and tolerance to carbonic anhydrase inhibitors.

A retrospective review of the records of 222 patients indicated a significantly higher incidence of long-term tolerance to carbonic anhydrase inhibitors among patients 40 years of age or less than in older patients. This finding indicated that since argon laser trabeculoplasty and conventional glaucoma surgery have low rates of success in young individuals, it seems prudent to consider carbonic anhydrase inhibitors as part of long-term maximum medical therapy particularly in younger individuals unless specific contraindications exist.

Adolescent↗

PubMed1983

Acute glaucoma following Nd: YAG laser membranotomy.

A 65-year-old aphake with a functioning filtration bleb underwent neodymium:YAG laser membranotomy. Shortly thereafter, he acutely developed pain, nausea, and visual blur with an intraocular pressure of 42 mm Hg. The mechanism of the acute glaucoma is believed to be occlusion of the fistula by herniated vitreous.

Acute Disease↗

PubMed1982

Additive effect of epinephrine to timolol therapy in primary open angle glaucoma.

Previous studies have suggested that the effect on intraocular pressure resulting from the combined use of timolol and epinephrine might be different when they are administered hours rather than minutes apart. Fourteen patients were randomly assigned to one of two treatment sequences in which 1% epinephrine borate was added either five minutes or three hours after 0.5% timolol maleate. Combined therapy was continued for two weeks, after which epinephrine administration was stopped for a two-week washout period. The patient groups were then crossed over to the other dosage interval. There was an initial enhancement of pressure reduction when epinephrine was added to timolol in both sequences. After crossover, epinephrine was significantly additive to timolol in reducing pressure only when administered three hours after timolol. This additive effect was still present after three months of combined therapy.

Adult↗

PubMed1982

Argon laser trabeculoplasty in the presurgical glaucoma patient.

The trabecular meshwork in 334 eyes of 260 patients with medically uncontrolled primary and secondary open-angle glaucoma was treated with the argon laser. The average intraocular pressure reduction obtained was 7.1 mm Hg. Tonographic data showed significant increase in the facility of outflow. Glaucoma surgical intervention was avoided in 87.5% of phakic eyes and in 62.1% of aphakic eyes. Laser trabeculoplasty was found to be effective in primary open-angle glaucoma, pseudoexfoliation glaucoma, pigmentary glaucoma, angle recession glaucoma, glaucoma secondary to uveitis, and in eyes with failed glaucoma surgical procedures. The length of follow-up in this series ranged from one week to 21 months, with an average of five months. The major complication noted was a rise in intraocular pressure following treatment. In one eye, a small central island of vision was lost due to this intraocular pressure elevation. Treating one-half of the angle in each of two treatment sessions separated by a few weeks reduces the degree of this pressure elevation. The glaucoma status of 3% eyes was made worse after treatment with trabeculoplasty.

Adolescent↗

PubMed1981

Timolol and epinephrine in primary open angle glaucoma. Transient additive effect.

A randomized, double-blind clinical study was conducted on patients with primary open angle glaucoma to determine whether timolol and epinephrine have an additive effect in lowering intraocular pressure. Sixteen patients were randomly assigned to one of two treatment sequences (timolol alone, supplemented after two weeks with epinephrine, and vice versa). An initial additive effect in lowering IOP was found in both sequences. However, after several weeks of combined therapy, complete loss of additive effect was found. Patients who were treated first with epinephrine for two weeks and then supplemented with timolol had significantly lower IOPs, for at least two weeks, than patients in the reverse treatment sequence. Epinephrine treatment alone caused a significant increase in facility of outflow, but this effect did not occur with simultaneous timolol treatment. The results are discussed in terms of possible fundamental beta- and alpha-adrenergic influences on aqueous dynamics and their potential clinical relevance.

Adult↗

PubMed1981

Long-term drift and continued efficacy after multiyear timolol therapy.

The clinical courses of 41 patients who received timolol maleate for experimental protocols were reviewed. We reevaluated the conditions of 17 patients with the elevated pressures of primary open angle glaucoma who had received timolol alone or in combination with other glaucoma medications for a maximum of 35 months (average, 26 months). Withdrawal of timolol led to an average intraocular pressure rise of 5 mm Hg. Eight patients treated with timolol alone showed a progressive, significant, 3-mm Hg upward rise, or "long-term drift" in IOP during the follow-up period. Pressure rise after timolol withdrawal, however, was not significantly less than pressure reduction when timolol was initiated. At least two weeks are required for "washout" or disappearance of timolol effect after timolol is withdrawn, and re-treatment for one week restores IOP to prewithdrawal levels.

Acetazolamide↗

PubMed1981

Serum cholinesterase, serum lipase, and serum amylase levels during long-term echothiophate iodide therapy.

Previous studies have found increased pancreatic intraductal pressures in dogs and the development of acute pancreatitis in humans after cholinergic stimulation. However, we did not find abnormally high levels of serum lipase or serum amylase in 44 patients with glaucoma using therapeutic doses of echothiophate iodide for intraocular pressure control on a long-term basis.

Amylases↗

PubMed1981

Tractional venous loops in diabetic retinopathy.

A venous loop developed in a patient with proliferative diabetic retinopathy. Fluorescein angiography showed staining of the vessel wall and nonperfusion of the surrounding capillary bed. Light microscopy and scanning and transmission electron microscopy showed the loop to consist of a telangiectatic retinal vein that had passed through a discontinuity in the internal limiting membrane. The thin-walled vessel loop was lined by an attenuated endothelium and occasional pericytes. The vitreous was detached posteriorly except at the venous loop and a few other points at which there was tenting of the internal limiting membrane. These findings suggested that vitreous traction plays a role in the pathogenesis of these venous loops.

Aged↗

PubMed1981

Study of the additive effect of timolol and epinephrine in lowering intraocular pressure.

A randomised, double-masked clinical study was conducted in patients with primary open-angle glaucoma to determine if timolol and epinephrine have an additive effect in lowering intraocular pressure. Sixteen patients were randomly assigned to one of 2 treatment sequences (timolol alone, supplemented after 2 weeks with epinephrine, and vice versa). An initial additive effect in lowering intraocular pressure was found in both sequences. However, after several weeks of combined therapy complete loss of additive effect was found. Patients who were treated first with epinephrine for 2 weeks and then supplemented with timolol had significantly lower intraocular pressures for at least 2 weeks than patients in the reverse treatment sequence. Epinephrine treatment alone caused a significant increase in facility of outflow, but this effect did not occur with simultaneous timolol treatment. The results are discussed in terms of possible fundamental beta and alpha adrenergic influences on aqueous dynamics and their potential clinical relevance.

Adult↗