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PubMed1985

Gonioscopy after implantation of the semiflexible McGhan/3 M, style 70, anterior chamber lens. A prospective study.

Gonioscopy was performed in 64 patients 3-8 (mean 4) months after intracapsular cataract extraction with implantation of the semiflexible McGhan/3 M, style 70, anterior chamber lens. Iris tucking was present in 19 (30%) eyes. Iris-haptic adhesions (strands of iris-like tissue encircling the lens feet) were present in 24 (38%) eyes. Absence of iris tucking was statistically significantly (P less than or equal to 0.05) related to surgical expertise, while the occurrence of iris-haptic adhesions was independent of surgical experience. Pupillar deformation, usually an elongation in the axis of the implant, was present in 50%. The absence or presence of an abnormal gonioscopy could not with certainty be deduced from the form of the pupil. The majority of gonioscopically visible pathological changes in the chamber angle were located posterior to the trabecular meshwork.

Aged↗
PubMed2006

Gonioscopy in adult Chinese: the Liwan Eye Study.

PURPOSE: To assess gonioscopic characteristics of the drainage angle in adult Chinese in an urban area of southern China. METHODS: Clustered random sampling was used to select adults aged 50 years and older in Liwan District, Guangzhou. Gonioscopy was performed on all the subjects. The geometric angle width was graded in the superior and inferior quadrants, according to the Spaeth system. In addition, apparent and true iris insertion was classified in four quadrants with static and dynamic gonioscopy. The peripheral iris profile was described as steep, regular, concave, and plateau. Data are presented for all phakic right eyes. Secondary or iatrogenic cases were excluded in the analysis of peripheral anterior synechiae (PAS). RESULTS: Among 1405 participants in the study, data from 1330 (95%) right eyes were available for analysis. Iridotrabecular angles (ITA) < or =20 degrees were present in 36.9% (95% CI: 34.3%-40.0%) of eyes superiorly and in 27.9% (95% CI: 25.5%-30.4%) inferiorly. Narrower ITAs were more common in the older people (sex-adjusted odds ratio [OR] = 1.1 per year of life; P < 0.001) and the women (age-adjusted OR = 2.5, P < 0.001). Apparent iris insertion of grade A or B (with pigmented trabecular meshwork not visible) by quadrant was observed in 27.2% superiorly, 12.0% nasally, 7.7% inferiorly, and 14.2% temporally. Narrow angles (in which pigmented trabecular meshwork was not visible in three or more quadrants) were identified in 11.0% (95% CI: 9.3%-12.7%) of right eyes. Overall, 33.3% of eyes had a steep iris profile, 54.2% were normal, 2.7% were concave, and 10.1% were graded plateau. PAS were seen in 30 of 146 (20.5%) eyes with narrow angles and in 7 (0.6%) of 1184 eyes with angles that did not meet criteria for narrow angles. PAS were more likely with narrower angles, with 0%, 0.3%, and 1.9% of eyes with a mean ITA of 40 degrees, 30 degrees, and 20 degrees, respectively, having PAS as opposed to 12.6% and 27.5% for those with ITA 10 degrees and 0 degrees , respectively. CONCLUSIONS: Ten percent of this population of southern Chinese persons 50 years of age and older had narrow angles. PAS were present in one fifth of these people. From these cross-sectional data, it is unclear which of these individuals are at highest risk of the development of primary angle-closure (PAC) glaucoma. Longitudinal studies are necessary to determine appropriate strategies for preventing this potentially blinding outcome.

Aged↗
PubMed1977

Gonioscopy: evaluation and interpretation.

Gonioscopy is the ocular health examination technique which offers to the practitioner the means to directly study the anterior chamber angle. Its uses are numerous and include glaucoma classification, predilation angle evaluation, and the presence of iris tumors, foreign bodies and anterior synechiae. Since a meaningful gonioscopic examination depends upon the examiner's recognition of the chamber landmarks, a detailed analysis of each structural element is presented. In addition, the techniques for performing gonioscopy with the popular lens types are viewed as is the system for interpretation and recording.

Adult↗
PubMed1981

A gonioscopy lens for pulsed-laser trabeculotomy.

We designed an indirect gonioscopy lens capable of handling the high powers generated by short-duration pulsed lasers. The lens is composed of an equilateral quartz prism within which the entire laser beam is internally reflected and connected to the cornea with saline solution. The reflected beam subsequently passes through the index-matched cornea to the trabecular region. Chromatic aberration is minimal because refraction is eliminated by arranging the laser beam so that is crosses the dielectric interfaces in a near-normal direction. The reflection losses amount to less than 5%, even without antireflection coatings. A prism of glass is sufficiently robust to handle the 100-kW pulses from a dye laser.

Gonioscopy↗
PubMedDate not supplied

Historical notes on gonioscopy.

The evolution of gonioscopy is reviewed, beginning with the first in vivo examination of the angle of the anterior chamber in 1867. The people and events responsible for the successful development of this important technique are discussed.

Europe↗
PubMed1989

[Comparative studies of the width of the anterior chamber angle using echography and gonioscopy].

Using a thin B-scan probe the anterior chamber angle was ultrasonographically studied using a contact eye cup filled with saline. The width of the chamber angle was measured on the display video copy and compared with the gonioscopic findings. Sixty-four eyes with primary glaucoma and 53 nonglaucomatous eyes were examined. In eyes with gonioscopic narrow angle the real ultrasonographic width of the chamber angle was varied considerably from case to case. In eyes where the chamber angle was not visible by gonioscopy it was not always closed. The correlation between the width of the angle and the depth of the anterior chamber was weak. There was often a plateau iris, which was demonstrated clearly by B-scan ultrasonography.

Anterior Chamber↗
PubMed1989

[Gonioscopy of the shallow anterior chamber].

During gonioscopy the aqueous humor can be shifted by appropriate indentation with the goniolens (Forbes test). The iris root is affected in a variety of ways: it may sink in, troughlike, or be deformed to an S-shape, or remain unchanged. The different findings depend on the configuration of the ciliary processes and the position of the lens equator; they enable conclusions to be drawn concerning the risks of inverse reaction to miotics or of ciliary lens block (malignant) glaucoma.

Anterior Chamber↗
PubMed2002

Gonioscopy in primary angle closure glaucoma.

Primary angle closure is a condition characterized by obstruction to aqueous humor outflow by the peripheral iris, and results in changes in the iridocorneal angle that are visible through gonioscopic examination. Gonioscopy in these eyes, however, can be difficult. This chapter discusses techniques that might help in the examination. These include beginning the examination with the inferior angle, methods to help in looking over the iris, cycloplegia, locating the corneal wedge, indentation, van Herick estimation, examining the other eye, and topical glycerin. Finally, there is a discussion about the pathology associated with the closed angle, with emphasis on the appearance of iris bombé, plateau iris, and the distinction between iris processes and peripheral anterior synechiae.

Glaucoma, Angle-Closure↗
PubMed2003

Bleeding during gonioscopy after deep sclerectomy.

PURPOSE: To show a new complication after deep sclerectomy (DS). METHODS: We described two eyes of two patients with open-angle glaucoma and cataract who were operated on of an uneventful phacoemulsification and DS with SK-gel implantation. RESULTS: Bleeding during gonioscopic examination occurred in both eyes 7 and 8 months after combined surgery. The blood originated from the vessels around the Descemet window, and was probably due to manipulation or rocking of the goniolens. Pressure was immediately applied to the gonioscopic lens and the hyphema was interrupted. CONCLUSION: These cases show the presence of new vessels around the Descemet window after DS with SK-gel. Bleeding from the Descemet window vessels can occur during gonioscopy even months after DS. We recommend conducting a careful gonioscopic examination in patients who have undergone DS to avoid this complication.

Aged↗
PubMed1986

Goniodysgenesis in elderly glaucoma and non-glaucoma patients. A masked slit-lamp and gonioscopy study.

The aim was to elucidate whether goniodysgenesis is more frequently observed in elderly patients with glaucoma, and furthermore, which signs of goniodysgenesis are of importance and most unanimously detected. Thus, 3 examiners evaluated 21 glaucoma patients and 19 non-glaucoma patients in a masked fashion. None of the patients had a first-degree heredity. Gonioscopy, slit-lamp examination and measurements of the corneal and pupillary diameter were performed, in all 26 variables. Significantly (P less than 0.05) more frequent in glaucoma were an increased corneal diameter, scleral overriding, hypoplasia of the pupillary seam, abnormal Schwalbe's line and an opaque pretrabecular membrane (one examiner). Less frequent were a peripupillary yellow pigment ring and pigment stars on the lens. Inter-observer variation was small regarding e.g. corneal diameter but rather large regarding e.g. the pretrabecular membrane.

Aged↗
PubMed1984

A new use of K-Y jelly as a gonioscopy fluid.

Methylcellulose drops varying in strength between 0.3% and 2.0% and isotonic saline are the fluids currently used for gonioscopy and posterior segment examination of the eye with diagnostic contact lenses. The author reports the use of K-Y jelly for such examinations in over 80 patients after having it used on his own eyes without any immediate or delayed ill effects. No observable difference was found between saline drops, methylcellulose drops of 0.3% and 2.0%, and K-Y jelly as regards the visibility of the anterior and posterior segments of the eyes. The more viscous fluids of 2% methylcellulose and K-Y jelly were more convenient to use, as they rarely allowed interposition of air bubbles between the cornea and the contact lens. K-Y jelly was well tolerated by all subjects.

Cellulose↗
PubMed2002

Biometric gonioscopy and the effects of age, race, and sex on the anterior chamber angle.

AIM: To utilise a novel method for making measurements in the anterior chamber in order to compare the anterior chamber angles of people of European, African, and east Asian descent aged 40 years and over. METHODS: A cross sectional study on 15 people of each sex from each decade from the 40s to the 70s, from each of three racial groups-black, white, and Chinese Singaporeans. Biometric gonioscopy (BG) utilises a slit lamp mounted reticule to make measurements from the apparent iris insertion to Schwalbe's line through a Goldmann one mirror goniolens. The main outcome measures were BG measurements of the anterior chamber angle as detailed above. RESULTS: There was no significant difference in angle measurement between black, white, and Chinese races in this study. However, at younger ages people of Chinese race appeared to have deeper angles than white or black people, whereas the angles of older Chinese were significantly narrower (p = 0.004 for the difference in slope of BG by age between Chinese and both black and white people). CONCLUSION: The failure to detect a difference in angle measurements between these groups was surprising, given the much higher prevalence of angle closure among Chinese. It appears that the overall apparent similarity of BG means between Chinese and Western populations may mask very different trends with age. The apparently more rapid decline in angle width measurements with age among Chinese may be due to the higher prevalence of cataract or "creeping angle closure." However, longitudinal inferences from cross sectional data are problematic, and this may represent a cohort phenomenon caused by the increasing prevalence of myopia in the younger Singaporean population.

Adult↗
PubMed1997

[Gonioscopy after foldable lens implantation through a sutureless tunnel incision].

OBJECTIVE: To investigate the changes of internal incision and the peripheral iris after cataract surgery through a sutureless tunnel incision. METHOD: Gonioscopy was performed on 58 eyes of 56 cases having undergone phacoemulsification and foldable intraocular lens implantation through a 3.5 mm sutureless tunnel incision. RESULTS: Gonioscopic findings showed that the internal incision was located in clear cornea anterior to Schwalbe's line in 56 eyes and just at the line in 2 eyes. Forty-two eyes (72.41%) had a smooth linear internal incision. There were small tags or curls in 14 eyes (24.14%). The Descemet's membrane detachments were detected in 5 eyes (8.62%) and peripheral iris anterior synechiae in 2 eyes (3.45%). CONCLUSION: The results suggest that the incidence of peripheral iris anterior synechiae be relatively low, however Descemet's membrane detachments easily occur in foldable lens implantation through sutureless tunnel incisions.

Aged↗
PubMed1992

Combined cataract-glaucoma surgery using the THC:YAG (holmium) laser ab interno without gonioscopy.

We describe a simple method of combined cataract-glaucoma surgery, involving use of the THC:YAG (holmium) laser ab interno, without gonioscopy, in which the initial cataract incision remains small and the glaucoma filtering procedure can be completed relatively quickly, with minimal surgical manipulation of the conjunctiva. In a series of 15 eyes (13 patients) with visually significant cataracts and medically uncontrolled glaucoma, followed for an average of 14 weeks (range, 1 to 26 weeks), 13 of the 15 eyes had decreased IOP. Visual acuity was improved in 9 eyes, remained the same in 4 eyes (with age-related macular degeneration), and was worse in 2 eyes (with opacification of the posterior capsule sufficient to account for the decrease in acuity).

Aged↗
PubMed1990

An alternative gonioscopy and fundus contact lens protocol.

The clinical procedures for gonioscopy and fundus contact lens examination traditionally have required the use of a topical anesthetic and an interface solution. I have replaced the topical anesthetic and interface solution with a disposable contact lens. The alternative protocol was performed on 18 volunteers, none of whom showed any significant adverse effects of the procedure. The pre- and post-slit lamp microscopic results are discussed in addition to the advantages and potential pitfalls of the new protocol.

Adult↗
PubMed1993

[Usefulness of a gel with a new composition for gonioscopy and laser microsurgery].

A newly composed gel was examined with a view of determining its usefulness for gonioscopy and laser microsurgery. It was found, that it did not exert any adverse effect on ocular tissue, it displayed perfect transparency and proper consistency facilitating manual operation. Experimental procedures confirmed its clinical usefulness.

Gels↗