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Biomedical subjects

S Fourman

Publications and source records attributed to S Fourman.

At least 19 recordsLinked to original sources
PubMed1998

Subacute angle-closure glaucoma as a cause of headache in the presence of a white eye.

Three patients, initially diagnosed with headache syndromes, were subsequently found to have subacute angle-closure glaucoma. In each case, the eye appeared grossly normal and there were no visual symptoms. A comprehensive ophthalmologic examination, including gonioscopy, confirmed the diagnosis. Laser iridotomy was curative with complete resolution of head and face pain. Subacute angle-closure glaucoma is an exception to the maxim that a white eye is not the cause of a painful eye.

Aged↗
PubMed1995

Scleritis after glaucoma filtering surgery with mitomycin C.

BACKGROUND: Adjunctive intraoperative mitomycin C increases the success of glaucoma filtering surgery, but also the postoperative complications. This is the first report of scleritis after its use. PATIENTS: In five patients, scleritis developed 3 to 24 weeks after inferior trabeculectomy with mitomycin C. The onset was characterized by acute pain, redness of the eye, and decreased vision. Three patients had anterior scleritis and two had posterior scleritis. Infection or bleb leakage was not seen in any patient. RESULTS: All patients responded to a course of topical steroids and oral ibuprofen or prednisone. CONCLUSION: Anterior and posterior scleritis may complicate the use of topical mitomycin C during trabeculectomy, Prompt diagnosis and treatment reverses the inflammation, maintaining the success of the surgical procedure.

Administration, Oral↗
PubMed1991

Late-onset elevation in intraocular pressure after neodymium-YAG laser posterior capsulotomy.

We retrospectively studied the long-term change in intraocular pressure after neodymium-YAG laser posterior capsulotomy. Uncomplicated extracapsular cataract extraction with posterior chamber intraocular lens implantation was performed in 446 consecutive normal eyes (401 patients), 237 (53%) of which subsequently underwent uncomplicated neodymium-YAG laser posterior capsulotomy. Late-onset elevation in intraocular pressure was seen in three eyes (1.4%) after cataract surgery alone (mean follow-up, 2.7 +/- 1.7 years) and in 14 eyes (5.9%) after cataract and laser surgeries (mean follow-up, 3.0 +/- 1.1 years). This difference was statistically significant (P less than .03). These results suggest that, in addition to immediate changes in intraocular pressure, neodymium-YAG laser posterior capsulotomy may be associated with an increase in intraocular pressure long after the laser surgery, even in normal eyes without obvious postoperative complications.

Aged↗
PubMed1991

Tissue plasminogen activator modifies healing of glaucoma filtering surgery in rabbits.

The healing response after glaucoma filtering surgery was analyzed immunohistochemically in rabbit eyes that had been treated with tissue plasminogen activator immediately after surgery and in the fellow eyes that had not been so treated. In the untreated eyes, at 1 day after surgery, fibronectin-like immunoreactivity was seen in the scleral fistula tract but not in the subconjunctival space of the filtering bleb. At 3 days immunoreactivity for fibronectin, collagen III, and collagen I could be seen in the bleb and fistula tract. By 14 days staining for collagen I and collagen III filled the surgical site, but fibronectin could only be seen in the fistula tract. In the eyes treated with tissue plasminogen activator immediately after surgery, the deposition of fibronectin and collagen III in the subconjunctival space and fistula tract was apparently delayed and diminished. This delayed and reduced deposition was correlated with the delayed clinical failure of surgery in these eyes. These results suggest that alteration of the biochemical changes in the extracellular matrix occurring after filtering surgery may influence the success of this surgery.

Animals↗
PubMed1990

Management of cornea-lens touch after filtering surgery for glaucoma.

The success of filtering surgery for glaucoma may be compromised by a postoperative flat anterior chamber associated with cornea-lens touch, hypotony, and absence of wound leakage. The clinical course of eight patients with this complication was reviewed. Six patients had chronic angle-closure glaucoma. Only one patient responded to medical therapy which included frequent topical application of atropine sulfate 3.0% for 1 hour. Reformation of the anterior chamber with air and drainage of any suprachoroidal fluid was immediately performed in the remaining seven. At the time of follow-up (mean, 16 months), the glaucoma was controlled in all eyes except one. The mean intraocular pressure (IOP) was 14 mmHg in those eyes not requiring reoperation. Six (75%) of eight eyes had diffuse, succulent filter blebs. Five eyes (63%) required no antiglaucoma medications, one eye (12%) required one, one eye (12%) required two, and one eye (12%) underwent repeat filtering surgery. The results suggest that, once medical therapy is not immediately successful, prompt surgical reformation of the anterior chamber along with drainage of any suprachoroidal fluid may preserve the filter blebs in these eyes.

Adult↗
PubMed1989

Acute closed-angle glaucoma after arteriovenous fistulas.

Unilateral secondary acute closed-angle glaucoma was associated with a ciliochoroidal detachment in two patients. One patient, aged 17 years, had an orbital arteriovenous fistula. The other patient, aged 73 years, had a dural arteriovenous fistula that originated from branches of the right internal maxillary artery. In each patient there was increased intraocular pressure, a moderately shallow central anterior chamber, and a flat peripheral anterior chamber. The ciliochoroidal detachment was postulated to displace the iris-lens diaphragm, resulting in the closed angle. Closure of the orbital fistula in the 17-year-old patient reduced the ciliochoroidal detachment and relieved the glaucoma, but visual acuity was reduced to 20/200. The glaucoma in the 73-year-old patient was relieved with topical instillation of timolol 0.5%, homatropine 5%, and systemic administration of acetazolamide. The fistula closed spontaneously, with relief of other ocular signs of the arteriovenous fistula.

Acute Disease↗
PubMed1989

Angle-closure glaucoma complicating ciliochoroidal detachment.

Acute angle-closure glaucoma complicating ciliochoroidal detachment developed in eight eyes of six patients. The clinical presentation was uniform: extremely shallow central anterior chamber depth, flat peripheral anterior chamber, closed angle, and elevated intraocular pressure (IOP). There were three patients with uveal effusion syndrome, two with posterior scleritis, and one with an arteriovenous malformation. Cycloplegia, along with aqueous suppressants and corticosteroids, successfully resolved the acute glaucoma in all eyes. This rare, secondary glaucoma must be differentiated from primary angle-closure glaucoma, because the treatment is markedly different. Although primary angle-closure glaucoma is treated with miotics and peripheral iridectomy, such therapy may worsen the glaucoma in eyes with angle-closure glaucoma due to a ciliochoridal detachment.

Aged↗
PubMed1989

Correlation of tonography and constant pressure perfusion measurements of outflow facility in the rabbit.

The values of aqueous outflow facility, determined using tonography and constant pressure perfusion, were compared in the New Zealand white rabbit. Four-minute indentation tonography was followed by multi-level constant pressure perfusion lasting 60 minutes in one randomly chosen eye of each animal. Mean outflow facility was 0.26 +/- 0.07 microliter/(min) (mmHg) using tonography and 0.26 +/- 0.6 microliter/(min) (mmHg) using constant pressure perfusion. These values are similar (p greater than 0.6) and show significant correlation (r = 0.914, p less than 0.001). Constant pressure perfusion was associated with a time-dependent facility increase, and with increased flow and stable resistance at higher infusion pressures. These results suggest that tonography may represent a repeatable, reproducible, and valid noninvasive technique to monitor outflow facility in this animal. This may be important in the evaluation of medications which alter wound healing after glaucoma filter surgery.

Animals↗
PubMed1989

Effects of tissue plasminogen activator on glaucoma filter blebs in rabbits.

Tissue plasminogen activator (tPA), a zymogen associated with fibrinolysis, was used in an attempt to prevent scarring and the consequent loss of glaucoma filtration blebs. Bilateral trephine filter procedures were performed in 10 new Zealand white rabbits. In a randomized, masked fashion, one eye received intracameral tPA (25 micrograms), and the fellow placebo, immediately following surgery. One week after surgery, outflow facility in the tPA-treated eyes was significantly greater than that in the control (P less than 0.01). Two weeks after surgery, the outflow facility returned to preoperative levels in all eyes. Eyes receiving tPA had larger blebs than the controls. No increase in postoperative complications, such as hemorrhage or wound leak, was attributable to tPA use. The results suggest that tPA interferes with the wound healing process after surgery and may promote glaucoma filter bleb formation.

Animals↗
PubMed1988

Effects of aminoproprionitrile on glaucoma filter blebs in rabbits.

Aminoproprionitrile was used topically in rabbits for 4 weeks following glaucoma filtration surgery in an attempt to prevent loss of the filter bleb from scarring. At 2 and 4 weeks after surgery, the outflow facility in eyes receiving aminoproprionitrile was greater than in the fellow eyes which served as controls (p less than 0.002 at 2 weeks and p less than 0.015 at 4 weeks). By 8 weeks after surgery, there was no difference in the outflow facility of the eyes in each animal. No increase in postoperative complications was attributed to aminoproprionitrile. These results suggest that aminoproprionitrile, which interferes with collagen cross-linking, may promote filter bleb formation.

Aminopropionitrile↗