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At least 433 records · Page 24Linked to original sources
PubMed1999

Trabecular outflow facility and formation rate of aqueous humor during anesthesia with sevoflurane-nitrous oxide or sevoflurane-remifentanil in rabbits.

UNLABELLED: In the present study, we examined the effect of sevoflurane and remifentanil on intraocular pressure (IOP) and fluid dynamics. Twenty-eight rabbits were anesthetized with halothane, and IOP was measured via a 25-gauge needle in the anterior chamber. Rabbits were then assigned to one of four groups, and halothane was replaced with sevoflurane 1% (n = 7), 2% (n = 7), 3% (n = 7), or 1% + remifentanil 0.65 microg kg(-1) x min(-1) i.v. (n = 7). In all groups, a series of intraocular infusions was made into the anterior chamber, and IOP, trabecular outflow facility, the rate of aqueous humor formation, and intraocular compliance were determined. With sevoflurane only, intraocular compliance decreased (55 +/- 14, 39 +/- 22, 31 +/- 17 nL/mm Hg; P < 0.05) as the concentration of sevoflurane increased. With sevoflurane 1% + remifentanil, intraocular compliance was significantly increased (100.1 +/- 30.5 nL/mm Hg; P < 0.05) compared with sevoflurane 1%, 2%, or 3%. Trabecular outflow facility, rate of aqueous humor formation, and IOP did not differ among groups, and IOP was similar to values obtained during halothane anesthesia. IMPLICATIONS: The dose-related effects of sevoflurane on intraocular compliance did not produce significant intraocular pressure differences. Adding remifentanil to sevoflurane increased intraocular compliance. Sevoflurane or sevoflurane + remifentanil causes a decrease in intraocular pressure compared with the average of previously reported values in awake rabbits, and the magnitude of the decrease is similar to that previously reported in rabbits anesthetized with ethyl urethane, pentobarbital, or halothane alone or in combination with propofol, cocaine, or lidocaine.

Anesthesia↗
PubMed2004

Photochemical keratodesmos as an adjunct to sutures for bonding penetrating keratoplasty corneal incisions.

PURPOSE: To evaluate the benefit of photochemical keratodesmos (PKD) in acute wound closure of penetrating keratoplasty (PKP) corneal incisions in vivo. SETTING: Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA. METHODS: Penetrating keratoplasty incisions were performed in both eyes of 6 New Zealand white rabbits, followed by application of 1.5 mM rose bengal dye at the wound edges. The incision in 1 eye of each rabbit was irradiated with neodymium:YAG laser light at 532 nm and fluence of 40 J/cm2; the contralateral control eye was untreated. Intraocular pressure at which fluid leaked at the edges (IOPL) was determined immediately after surgery. RESULTS: The mean IOPL was 410 mm Hg +/- 70 (SD) in the PKD-treated eyes and 250 +/- 150 mm Hg in the unirradiated eyes. The difference was statistically significant by paired t test (P<.05). CONCLUSIONS: Photochemical keratodesmos may be a useful adjunct to sutures for approximating PKP corneal incisions in the immediate postoperative period. This process does not induce high temperature, and thus denaturation can be avoided and structural integrity restored.

Animals↗
PubMed1984

Toxicity of intravitreal antiviral drugs.

Two systemic agents, vidarabine and acyclovir, were tested for ocular toxicity in intravitreal injection and vitrectomy infusion solutions. On the basis of this study we recommend using up to 30 mcg/0.1 ml of vidarabine as an intraocular injection or 8 to 16 mcg/ml in vitrectomy infusion fluid. For acyclovir, 80 mcg/0.1 ml as an intraocular injection or 40 mcg/ml in vitrectomy infusion fluid may be a therapeutic adjunct for managing viral retinitis.

Acyclovir↗
PubMed2006

Experimental retinal ablation using a fourth-harmonic 266 nm laser coupled with an optical fiber probe.

PURPOSE: To explore the ablation potential of 266 nm laser pulses, with an intact porcine retina preparation. METHODS: Segments of porcine eyes were used in an in vitro preparation in which localized areas of intact retina and choroid could be exposed to 266 nm laser irradiation. The segments of ocular tissue were bathed in fluid, to mimic the intraocular environment. Contact between the probe and the retinal surface was established before the first laser pulse. Single or multiple pulses (5-7 ns duration) at fluence levels of 0.4 to 1.2 J/cm2 were delivered via a tapered fiber optic probe with a tip size of approximately 110 microm. The retinal tissue was then fixed and sectioned for histologic examination. The ablation depth and extent of damage were measured and related to fluence level and the number of pulses applied. RESULTS: Ablation of the inner retina was achieved by single pulses at fluence levels of 0.6 J/cm2 and higher. The depth of retinal ablation was highly dependent on fluence for lesions generated with a single pulse but less so for multiple pulses (3-10), particularly at lower fluence levels. Higher numbers of pulses (50-100) did not increase ablation depth in a predictable manner. CONCLUSIONS: Pulsed laser (266 nm) irradiation at low pulse counts and high fluence levels is a possible alternative for localized retinal ablation with minimal collateral damage in a fluid environment.

Animals↗
PubMed2001

Interface fluid after laser in situ keratomileusis.

We report a case in which raised intraocular pressure (IOP) was associated with interface fluid after uneventful bilateral laser in situ keratomileusis (LASIK). The patient presented with diffuse lamellar keratitis in both eyes 3 weeks postoperatively that was treated aggressively with topical corticosteroids. A steroid-induced rise in IOP resulted in interface fluid accumulation and microcystic edema. Measurements with the Goldmann tonometer revealed an IOP of 3.0 mm Hg in both eyes. However, Schiotz tonometry recorded a pressure of 54.7 mm Hg in both eyes. Reduction in the dosage of topical corticosteroid and medical treatment of the raised IOP resulted in resolution of the microcystic edema and interface fluid accumulation. This case highlights the inaccuracies of IOP measurement after LASIK and the resulting complications.

Administration, Topical↗
PubMed1998

A new model to assess staphylococcal adhesion to intraocular lenses under in vitro flow conditions.

Adhesion of staphylococcal cells to intraocular lenses coated with heparin was studied under in vitro flow conditions (280 microl min(-1)) at 37 degrees C. The intraocular lenses were incubated with human cerebrospinal fluid for 1 h or with cerebrospinal fluid including 0.50% plasma for 12 h, prior to bacterial challenge. Two strains of Staphylococcus epidermidis selected for this study, were isolated from biomaterial-associated infections. Bacterial adhesion was quantitated by bioluminescence and visualized by fluorescence microscopy of acridine orange stained bacteria. Surface coating with heparin significantly decreased bacterial adhesion of both strains after incubation with cerebrospinal fluid including 0.50% plasma for 12 h (p = 0.0209). However, no difference in bacterial adhesion was obtained between intraocular lenses with and without heparin, after incubation with cerebrospinal fluid for 1 h (p = 0.327). Microscopy showed that more bacteria were present on intraocular lenses without heparin than on intraocular lenses with heparin. The results show that preincubation with a proteinaceous fluid influences subsequent bacterial adhesion to the polymer surface. The results suggest that IOLs with heparin coating may be less prone to bacterial adhesion under perfusion conditions after surface conditioning in human CSF with 0.50% plasma and a preincubation period of 12 h. Heparin coating might be a valuable tool to decrease implant-associated bacterial endophthalmitis.

Acridine Orange↗
PubMed2001

Macular changes after peeling of the internal limiting membrane in macular hole surgery.

PURPOSE: To report the incidence of macular changes following pars plana vitrectomy with peeling of the internal limiting membrane (ILM) for idiopathic macular hole. DESIGN: Prospective consecutive series. METHODS: In a prospective study 105 eyes of 105 patients underwent vitrectomy for idiopathic macular holes. Surgery consisted of a standard three-port vitrectomy, induction of a posterior hyaloid detachment, removal of epiretinal membranes including the ILM, fluid-air exchange and intraocular gas tamponade (15% hexafluoroethane (C2F6) gas mixture) followed by head-down positioning for at least five days. No adjuvants were used during surgery. In addition to the clinical examination, static microperimetry using a Rodenstock scanning laser ophthalmoscope (SLO-105) was performed pre- and 6 or 12 weeks postoperatively. The stimulus size was 0.2 degrees (Goldmann II), intensities employed were 0 and 12 dB. For all tests, 20-degree fields were used. RESULTS: Anatomic closure of macular holes was achieved in 92 (87.6%) of 105 patients by one operation. Eight patients underwent a successful second procedure. The closure rate after two operations was 95.2%. Best corrected visual acuity increased from a median of 0.2 (range 0.05 to 0.5) preoperatively to a median of 0.5 (range 0.05 to 1.0) postoperatively. Anatomical macular changes were found in 8 (7.6%) patients: There were two cases of macular edema following secondary cataract extraction and six cases of retinal pigment epithelium changes. Formation of postoperative epiretinal membranes or late reopenings were not noted. Small, mostly asymptomatic paracentral scotomata were seen in 59 (56.2%) of 105 patients. CONCLUSION: Anatomical changes of the macula following vitrectomy with removal of the ILM are infrequent. However, paracentral scotomata observed in our series might be caused by a trauma to the nerve fibers during ILM peeling. To achieve reliable results a standardized procedure for microperimetry should be developed.

Aged↗
PubMedDate not supplied

[Comparative evaluation of the tolerability of proxofelin and clofelin and their effects on the eye in patients with glaucoma].

Tolerance and effects of proxofelin (1% proxodolole and 0.25% clofelin) and clofelin were compared in 39 patients (50 eyes) with primary open-angle glaucoma by open and double-blind methods. Intraocular pressure, ocular hydrodynamics, arterial pressure, and heart rate were examined before and on day 28 of treatment. The hypotensive effect of proxofelin was more expressed than that of clofelin, the drugs decreasing intraocular pressure by 37 and 27% of the initial value, respectively. Proxofelin decreased ophthalmic tone, significantly increasing the coefficient of fluid discharge easiness by 50% and decreasing the production of aqueous humor by 51.9%, while clofelin slightly (14%) increased the coefficient of fluid discharge easiness and decreased intraocular pressure mainly at the expense of suppressing aqueous humor secretion. Hence, the combined drug is preferable in comparison with the monopreparation. Moreover, proxofelin was well tolerated by the patients, which differs it favorably from clofelin.

Aged↗
PubMedDate not supplied

Rhegmatogenous retinal detachment with Schwartz's syndrome following Nd:YAG laser peripheral iridectomy in the management of pigmentary glaucoma.

A case of rhegmatogenous retinal detachment complicated by Schwartz's syndrome following Nd:YAG laser peripheral iridectomy in the management of pigmentary glaucoma is described. A 36-year-old man underwent Nd:YAG laser peripheral iridectomy for pigmentary glaucoma. Three days later, he had a rhegmatogenous retinal detachment. The break remained open following scleral buckling with persistent subretinal fluid, "iridocyclitis," and elevated intraocular pressure. Two months later, the patient underwent revision of the scleral buckle. Following closure of the retinal break, the retina flattened, and within 2 weeks the "iridocyditis" resolved and the intraocular pressure decreased to approximately 20 mm Hg. Rhegmatogenous retinal detachment may occur following laser peripheral iridectomy, and suggests the necessity for a prospective dinical trial to evaluate the role of laser peripheral iridectomy in the management of pigmentary glaucoma.

Adult↗
PubMed1985

Endotoxins and medical devices.

The FDA Center for Devices and Radiological Health requires devices in contact with circulating blood or cerebrospinal fluid to be nonpyrogenic. Intraocular lenses also are required to be nonpyrogenic. Requirements for other products are decided on a case-by-case basis by the FDA. Manufacturers planning to use the Limulus Amebocyte Lysate (LAL) test as a pyrogenicity test for devices must validate and test according to the FDA draft LAL guideline or submit data from an alternate method to FDA for review. Traditionally, nonpyrogenic water or saline is used to rinse devices for LAL testing. Data from our initial studies on endotoxin recovery from devices using sodium lauryl sulfate demonstrate higher recovery than with nonpyrogenic water. This method, which provides an alternate rinse solution for recovery of endotoxin from medical devices is undergoing collaborative study.

Endotoxins↗
PubMed1983

Uveal compartmentalization in the hamster eye revealed by fine structural and tracer studies: implications for uveoscleral outflow.

The uveal tracts of hamster eyes have been examined using electron microscopy and electron opaque tracer infusion. A heretofore undescribed intrauveal "compact zone" was detected at the level of the ora serrata. Together with extensive, sheet-like fibroblastic layers within the lamina fusca and the well-known junctional barriers of the pigment epithelium, the compact zone appears to separate anterior and posterior uveal regions into defineable compartments. To test this possibility and study potential pathways of uveoscleral outflow with special reference to these morphologic features, horseradish peroxidase or anionic ferritin was infused into the anterior chamber at physiologic pressures, in some experiments coincident with vascular rinsing and/or fixation to prevent tracer redistribution. Tracer rapidly permeated outflow and connective tissue spaces of the anterior uvea and spread into the sclera and adventitia. However, it did not appear in the inner choroid unless vascular recirculation and redistribution of tracer was allowed. Potential structural boundaries that might prevent direct choroidal penetration include the compact zone, which never contained tracer, and tight-junctioned, sheet-like fibroblastic lamellae of the lamina fusca. The choriocapillaris and internal choroidal interstitium may thus be isolated to an appreciable degree as a "posterior uveal compartment." The position of this compartment is comparable developmentally to the subarachnoid space of the brain and optic nerve. The anterior margin of the compartment (the compact zone) limits the space available for uveoscleral outflow of aqueous humor in the hamster and may provide a focus for control of that process.

Animals↗
PubMed1982

[Retinal detachment recurrences. 1. Frequency and risk factors (author's transl)].

Retinal detachment recurrence is defined the reappearance of a detachment after an initial complete success, whatever the delay between surgery and recurrence. This eliminates immediate failures due to inadequate buckles or major complications during surgery, exsudative retinal detachments that reattach spontaneously within a few days and cases where it is not sure that the retina had been completely reattached initially (cloudy media). Employing these criteria, a retrospective study demonstrated 130 eyes with recurrences out of a total of 1237 eyes operated between 1-10-69 and 31-12-79 (10,5 per cent rate); recurrences occurred in this series between 3 days and 7 years after initial surgery, 53,5 per cent of them within an interval of less than 3 months. The most important recurrence risk factors appear to be: detachment due to a retinal tear and not a hole, bullous detachment, abnormal vitreous but not full blown, massive vitreo-retinal retraction and massive intraocular bleeding during subretinal fluid drainage.

Drainage↗
PubMed1982

[Retinal detachment recurrences. 2. Mechanisms and treatment (author's transl)].

Retinal detachment recurrences are almost always caused by vitreous tractions or vitreo-retinal retractions. Classical methods of prevention: as atraumatic surgery as possible, no superfluous subretinal fluid drainage, prevention of intraocular bleeding during drainage were employed in the series reported but with a 10.5 per cent recurrence rate. Prevention is based on two methods: encircling laser photocoagulation in the postoperative period when possible and if it is not dangerous for the vitreous, and preventive vitrectomy which has the following indications: bullous detachment, important pre or peroperative intraocular bleeding, or presence of clear signs of impending vitreo-retinal retraction. Using the classical therapeutic methods of indentation, the treatment a 50 per cent success rate for of recurrence was obtained. Treatment can be improved by vitrectomy in every case of recurrence, with combined internal retinal contention, preferably by silicone injection, recurrences due to massive vitreo-retinal retraction.

Female↗
PubMed1994

Chorioretinal biopsy in the diagnosis of intraocular lymphoma: a case report.

A patient with non-Hodgkin lymphoma with low grade malignancy complained of gradual visual loss. Symmetric multiple deep retinal yellow dots were disseminated in both fundi. The patient developed progressive papilledema associated with further decreasing visual acuity. Other signs of uveitis were absent. A chorioretinal biopsy confirmed the intraocular lymphomatous involvement. Cerebrospinal fluid revealed abnormal lymphocytes and local Ig-M production thus proving the lymphomatous meningeal involvement.

Choroid Neoplasms↗
PubMed1998

Effect of plasma colloid osmotic pressure on intraocular pressure during haemodialysis.

BACKGROUND: In a previous case report, it was shown that an increase in plasma colloid osmotic pressure induced by the removal of fluid during haemodialysis was instrumental in decreasing intraocular pressure. The relation between changes in intraocular pressure, plasma osmolarity, plasma colloid osmotic pressure, and body weight before and after haemodialysis is evaluated. METHODS: Intraocular pressure, plasma osmolarity, plasma colloid osmotic pressure, and body weight were evaluated before and after haemodialysis in 36 patients. RESULTS: Intraocular pressure and plasma osmolarity both decreased significantly after haemodialysis (p < 0.0001). Plasma colloid osmotic pressure increased significantly after haemodialysis (p < 0.0001). Body weight decreased significantly because of the removal of fluid during haemodialysis (p < 0.0001). No significant correlation was found between the change in intraocular pressure and that in plasma osmolarity (r = -0.206, p = 0.2297), whereas the change in intraocular pressure was correlated with the change in plasma colloid osmotic pressure (r = -0.510, p = 0.0012) and the change in body weight (r = 0.534, p = 0.0006). A significant correlation was found between the change in plasma colloid osmotic pressure and that in body weight (r = -0.756, p < 0.0001). CONCLUSION: The change in intraocular pressure was inversely correlated with the increase in plasma colloid osmotic pressure caused by the removal of fluid during haemodialysis.

Adult↗