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At least 451 records · Page 25Linked to original sources
PubMed2005

Clinical management of silicone intraocular lens condensation.

PURPOSE: To report a novel technique in the management of silicone intraocular lens condensation after gas-fluid exchange. DESIGN: Interventional case report. METHODS: Clinical management of an obstacle to treatment. setting: Private retina practice. patient population: One patient with silicone posterior chamber intraocular lens implant and posterior capsulotomy who subsequently experienced complicated retinal detachment. intervention: Application of a heating pad to clear intraocular lens condensation. main outcome measure: Visibility of the fundus for laser treatment. RESULTS: Application of a heating pad to the closed eyelid significantly reduced the intraocular lens condensation and provided a clear view for the surgeon to apply laser retinopexy. CONCLUSIONS: Treatment of retinal detachment is complicated by lens condensation after gas-fluid exchange in patients who have undergone silicone posterior chamber intraocular lens implantation and posterior capsulotomy. We report a simple, inexpensive, and effective method to reduce lens condensation and enable in-office examination and laser treatment.

Aged↗
PubMed1987

Photodisruption of intraocular gas bubbles.

During gas-fluid exchange bubbles can form in the vitreous cavity. These bubbles can interfere with visualization of the fundus for retinal examination, photocoagulation, or cryopexy. We used the Nd:YAG laser to eliminate these bubbles in vitro and in two patients.

Aged↗
PubMedDate not supplied

The clinicopathologic significance of vitreous fluid cytology examinations in a series of 38 patients.

The authors systematically analyze a series of 38 patients having a total of 40 vitreous fluid cytology determinations. Nine of the 38 patients (23.7%) have cytologic results diagnostic for, or at least highly suggestive of, a specific disease process. These include two cases of bacterial endophthalmitis; two cases of fungal endophthalmitis; one case of vitreal amyloidosis; and four cases called positive for intraocular lymphoma. There are no vitreous fluid cytology determinations falsely positive or falsely negative for malignancy in this series. Intraocular lymphoma and the increasingly important role of vitreous fluid cytology examination in its diagnosis are discussed. The authors conclude that a strong commitment to quality control concepts, including detailed clinical follow-up, is essential in order to develop clinician trust and help achieve optimal patient care benefit from this valuable diagnostic modality.

Adolescent↗
PubMed1993

Self-tonometry under microgravity conditions.

During a space mission flown in microgravity early changes in intraocular pressure due to the fluid shift effect in microgravity were analyzed with an automatic self-tonometer. In total, 13 pressure readings per eye were obtained during the mission. The first pressure readings 16 min after reaching microgravity revealed a 92% rise in intraocular pressure compared to the daytime-correlated baseline data on earth followed by an adaptation phase lasting for several hours. Diurnal pressure profiles during the mission showed no relevant difference in altitude and amplitude.

Humans↗
PubMed2000

[Sterilization of phacoemulsification and vitrectomy instruments. Contamination and evaluation].

BACKGROUND: Contamination of automated surgical equipment is widely disregarded as a potential source of perioperative infection. We investigated the possibility of contamination of the aspiration fluid by the vacuum control manifold (VCM). The normal, unsterile internal VCM was compared with a modified external VCM that was regularly disinfected. MATERIALS AND METHODS: We investigated 37 aspiration fluid specimens from routine cataract and vitrectomy operations performed with automated evacuation systems. There were 25 specimens from three automated evacuation systems equipped with an internal VCM (experimental groups) and 12 specimens from one system equipped with a modified external VCM (control group). No hygiene procedures were used with the hidden internal VCM, but the modified external VCM was regularly rinsed and filled with 70% isopropanol overnight. Specimens were collected under sterile conditions, centrifuged, cultured for bacterial growth on blood agar and MacConkey agar for 24-48 h at 37 degrees C, and analyzed microbiologically. RESULTS: Aspiration fluids of irrigation/aspiration systems used for intraocular surgery were found to be severely contaminated with bacteria originating from the VCM. In all aspiration fluid specimens from internal VCM systems, 2(+)-4+ bacterial growth was found. Stenotrophomonas maltophilia (17), Comamonas acidovorans (8), and Agrobacterium radiobacter (13) were found most frequently. All specimens from the modified external VCM system remained sterile. There was a significant difference with regard to the frequency of contamination of the aspiration fluid between experimental and control groups (P = 0.0001, chi 2). CONCLUSIONS: We found that the aspiration fluid of common phaco- and vitrectomy systems was strongly contaminated by bacteria originating from the internal VCM. The technical modification of an external VCM allows easy disinfection and prevents contamination of the aspiration fluid.

Bacteriological Techniques↗
PubMed1994

Intraocular gentamicin sulfate and postcataract anterior chamber aspirate cultures.

We cultured anterior chamber aspirates of 28 patients who had uncomplicated cataract surgery. Fourteen patients had received 80 micrograms/ml of gentamicin in balanced salt solution through irrigation of the anterior chamber throughout cataract extraction, and 14 patients had received 8 micrograms/ml of gentamicin. Cultures of anterior chamber fluid obtained at the end of surgery from all 28 patients had no growth on two nonselective media. There was no clinical evidence of ocular toxicity. This study demonstrates that antibiotic in the intraocular irrigation fluid can reduce or eliminate the expected intraocular bacterial load after cataract surgery.

Anterior Chamber↗
PubMed1998

Penetrating keratoplasty with a valved glaucoma drainage implant for congenital glaucoma and corneal scarring secondary to hydrops.

The simultaneous management of glaucoma and corneal opacification is sometimes required in infants with severe congenital glaucoma if timely visual rehabilitation is to be achieved. A 1-month-old female infant presented with an enlarged, protuberant, opaque cornea in each eye and elevated intraocular pressure. An intrastromal, fluid-filled cleft was noted in both corneas. It resolved over 3 weeks as corneal scarring progressed. Peripheral corneal clearing allowed a view of an essentially normal anterior chamber. Penetrating keratoplasty and Ahmed (New World Medical Inc., Rancho Cucamonga, CA) valve implant surgery with mitomycin-C were performed simultaneously in the two eyes 1 months apart. At 15 months of age, the patient's grafts were clear and the intraocular pressure was well controlled in both eyes. One eye required multiple procedures for eventual glaucoma control. No postoperative overfiltration occurred. The authors conclude that the use of a valved implant should be considered in patients who require urgent simultaneous corneal and glaucoma surgery for severe congenital glaucoma. This combination may improve early postoperative control of aqueous outflow and positively affect long-term graft survival in these difficult cases.

Administration, Topical↗
PubMed1998

[Secondary implantation of posterior chamber intraocular lenses in reconstructive surgery of the anterior segment and infusion of fluid through the pars plana].

BACKGROUND: A deep anterior chamber can be perioperative maintained by irrigation solution or by viscoelastic material. By longlasting reconstructive procedures after penetrating injuries we use an infusion through a pars plana cannula. METHODS: Between January 1994 and February 1995 five patients (aged 17-28 years) underwent secondary IOL implantation after penetrating eye injury with traumatic cataract. The reconstructive procedure was performed 6-11 years after the injury and linear cataract extraction. In all eyes corneal scars, iris anterior and posterior synechias, vitreous prolaps, and fibrotic posterior capsule remnants were present. The preoperative visual acuity ranged from 0.05-1.0. A pars plana infusion cannula was positioned 3 mm posterior to the limbus. In one eye with glaucoma a trabeculectomy and in two eyes with a greater defect of the posterior capsule, a lamellar scleral flap for transscleral suturing of one IOL haptic were performed. Then the prolapsed vitreous between cornea and infusion cannula was removed using the vitreous cutter. Iris synechiae were blunt or sharp dissected, the cortical masses were aspirated, the fibrotic or calcificated lens remnants were ectomised and an IOL was implanted into the ciliary sulcus. Two haptics were transsclerally fixated. The follow-up period ranged from 4-18 months. RESULTS: The surgery duration ranged between 45-90 minutes. No perioperative complications were recorded. On the fourth postoperative day bleeding into the anterior chamber and vitreous in one patient with transsclerally fixated haptic was observed. The blood reabsorbed spontaneously within a week. No complications from the infusion cannula could be observed. The postoperative visual acuity is 0.1-1.0. CONCLUSIONS: The permanent pars plana infusion maintains a stabile anterior chamber depths and intraocular pressure. The deep anterior chamber allows long-lasting surgical manoevers with less risk of corneal endothelium damage.

Adolescent↗
PubMed2000

NGF administered by microdialysis into rabbit vitreous.

PURPOSE: Microdialysis has been used in eye research for almost a decade. We have previously developed and used it mainly for chronic experiments and here it is used in acute experiments. It is highly suitable for both administration and withdrawal of substances from the eye, as it only permits molecules to cross the intraocular membrane without any net fluid movement in or out of the eye. METHODS: We have here investigated the ability of 125I labeled NGF (nerve growth factor) to cross a previously implanted high permeability membrane of a new type (polyether sulphone, PES, cutoff at 100000 daltons) in the rabbit vitreous. It was perfused for different time periods with a solution containing NGF The radioactivity of the entire vitreous was then counted. RESULTS: The results show detectable levels (up to 10(-11)M) of the substance after the perfusions. CONCLUSION: We conclude that microdialysis with PES membranes is a possible method for the intraocular administration of NGF.

Animals↗
PubMed1997

HsS versus a balanced salt solution as a corneal wetting agent during routine cataract extraction and lens implantation.

PURPOSE: To evaluate HsS (elastoviscous hylan surgical shield, 0.45%) as an alternative to repeated corneal irrigation with a balanced salt solution during cataract surgery. SETTING: York Finch General Hospital, Toronto, Ontario (Center A), and Centre Hospitalier de St. Laurent, St. Laurent, Quebec (Center B), Canada. METHODS: This dual-center, randomized, prospective clinical trial comprised 60 patients (40 at Center A; 20 at Center B) who had routine small incision cataract surgery (Center A, endolenticular phacoemulsification; Center B, Khoury manual phacofragmentation) with in-the-bag implantation of a posterior chamber intraocular lens. The corneal irrigating fluid was randomly assigned to be HsS or a balanced salt solution. The frequency of required applications, duration of efficacy of each application, and assessment of corneal moisture, clarity, transparency, and reflection in the HsS and balanced salt solution groups were recorded and compared. RESULTS: Mean frequency of applications was 13.9 per procedure in the balanced salt solution group and 1.3 per procedure in the HsS group (P = .0001). Mean duration of effectiveness per application was 23.4 minutes for HsS and 2.0 minutes for balanced salt solution (P = .0001). No significant differences in safety or effect on corneal health were observed between the two solutions. CONCLUSION: The HsS was significantly more effective than a balanced salt solution in maintaining corneal moisture, clarity, and transparency. The use of HsS may be a safer, more effective option in ophthalmic surgery because it minimizes the obstructed visualization of the surgical field caused by frequent corneal irrigation and loss of surgeon concentration.

Acetates↗
PubMed1997

Does cryotherapy before drainage increase the risk of intraocular haemorrhage and affect outcome? A prospective, randomised, controlled study using a needle drainage technique and sustained ocular compression.

AIMS/BACKGROUND: A prospective, randomised, controlled clinical trial was conducted to investigate the effect of performing cryotherapy before drainage of subretinal fluid (SRF) on the incidence of intraocular haemorrhage (IOH) in the management of retinal detachment. METHODS: Eighty eyes of 80 patients with rhegmatogenous retinal detachment requiring SRF drainage were recruited. Thirty four cases were randomised to receive drainage before cryotherapy (drainage, air injection, cryotherapy, and explant = DACE group) while 46 cases had drainage after cryotherapy (cryotherapy, drainage, air injection, and explant = CDAE group). All cases had trans-scleral drainage of SRF using a 27 gauge hypodermic needle combined with prolonged, intraocular hypertension. RESULTS: There was a low incidence of IOH associated with drainage in both groups with no statistically significant difference between the groups (DACE group = 2.9%; CDAE group = 4.3%; p = 0.43). There was no significant difference between the groups in the rate of anatomical success with a single operation (DACE group = 82.4%; CDAE group = 86.9%; p = 0.38). There was no significant difference between the groups in the visual outcome. An improvement of two Snellen lines or more occurred in 52.9% of the DACE group and in 56.5% of the CDAE group (p = 0.93). CONCLUSION: It was concluded that the surgical sequence of applying cryotherapy before drainage of SRF can be safely and effectively performed. The sequences CDAE and CDE, when air injection is not required, along with DACE should all be part of the surgical repertoire for the management of retinal detachments.

Adolescent↗
PubMed1997

Molecular characterization and differential gene induction of the neuroendocrine-specific genes neurotensin, neurotensin receptor, PC1, PC2, and 7B2 in the human ocular ciliary epithelium.

The ocular ciliary epithelium is a bilayer of neuroepithelial cells specialized in the secretion of aqueous humor fluid and the regulation of intraocular pressure. In this study, we report on the expression of the regulatory peptide neurotensin (NT) and a set of differentiated neuroendocrine markers including neurotensin receptors (NTrs), the prohormone convertases furin, PC1, and PC2, and the neuroendocrine polypeptide 7B2 in the ciliary epithelium. Using a human cell line, ODM-2, derived from the nonpigmented ciliary epithelium, we demonstrate that (1) NT expression is highly activated by nerve growth factor, glucocorticoid, and activators of adenylate cyclase; (2) NTr expression is up-regulated by selective ligand-activated beta2-adrenergic receptor; and (3) PC1 and PC2 expression are up-regulated via distinct signaling transduction pathways. PC1 gene expression is activated by phorbol ester, and PC2 by the same inducers as those of NT expression. A radioimmunoassay for NT detected an NT-like immunoreactivity in human ciliary epithelium and ODM-2 cell extracts, in aqueous humor, and in conditioned culture medium. The results support the view that the entire ciliary epithelium functions as a neuroendocrine tissue, synthesizing, processing, and releasing NT into the aqueous humor where it may exert important physiological functions through autocrine and/or paracrine mechanisms.

Aspartic Acid Endopeptidases↗
PubMed1991

Genomic DNA analysis of rat retinal tumor induced by adenovirus type 12.

To elucidate the pathogenesis of human retinoblastoma, we investigated the genomic expression in retinal tumors induced by human adenovirus type 12 in rats, using various DNA probes. Seven rats received a single intraocular inoculation of concentrated virus fluid within 24 hours after birth. Intravitreous tumors were induced in two out of seven animals (28.5%) within 30 to 64 days after the inoculation. A remarkably uniform histologic feature, i.e., neuroblastic cells in association with Homer-Wright pseudorosettes, was present in all cases. The adenovirus-related oncoprotein gene E1A and human retinoblastoma susceptibility gene were detected in the tumors by Southern blot hybridization. In situ hybridization analysis demonstrated expression of adenovirus type 12 E1A gene in the inner granular layer of the retina. It was suggested that integration of adenovirus type 12 E1A fragment with the host genome and expression of the gene were required for induction of this tumor.

Adenovirus Infections, Human↗
PubMedDate not supplied

Upper eyelid extension of a filtering bleb following glaucoma shunt surgery.

The authors describe a case of a filtering bleb that extended into the eyelid of a 71-year-old man following glaucoma surgery with a shunt implant. The patient presented with a left upper eyelid mass and had ocular surface and mechanical sequelae. Computed tomography scan demonstrated a fistula between the original filtering tract and the eyelid, creating an inadvertent filtering bleb. Cytology revealed fluid consistent with aqueous humor. Intraocular pressure remained normal and symptoms improved with conservative management. The patient deferred any surgical revision. Glaucoma tube shunts may lead to ocular and rare orbital complications from inadvertent bleb extension, as seen in this case.

Aged↗
PubMed2002

[Therapeutic vitrectomy for severe uveitis and its complications].

OBJECTIVE: To investigate the therapeutic value of vitrectomy for uveitis and its complications. METHODS: Vitrectomy was performed on 14 patients (14 eyes) with uveitis. In these 14 eyes, there were 6 eyes with severe opacity of vitreous, 5 eyes with cataract, 5 eyes with retinal detachment, and 3 eyes with poor response to medication. Pars plana lenectomy, scleral cryopexy, buckling procedure, endolaser photocoagulation, gas-fluid exchange or silicone oil intraocular tamponade were added according to the different needs. The follow-up varied from 18 to 45 months. RESULTS: Twelve of the 14 eyes obtained better visual acuity, and in the other two light perception remained; less drugs were used after operation in all cases, and the uveitis was controlled. CONCLUSION: Vitrectomy is an effective method for severe uveitis and its complications both in the improvement or stabilization of visual acuity and in the reduction or cessation of systemic treatment.

Adolescent↗
PubMed2005

[Influence of regenerated fluid in vitreous cavity at various periods after vitreoretinal microsurgery on the proliferation and bFGF secretion of cultured human retinal pigment epithelial cells].

OBJECTIVE: To demonstrate the mechanism of positive effects of the sequential air-fluid exchange on the use of complicated vitroretinal microsurgery. METHODS: Seventy-one patients who underwent vitreoretinal microsurgery were performed 2 or 3 times sequential air-fluid exchange. The regenerated fliud in vitreous cavity at various periods was collected to act on cultured human retinal pigment epithelial (RPE) cells,and then the secretion of bFGF and the expressions of bcl-2 and ki-67 by RPE cells were observed. RESULTS: The expressions of bcl-2 and ki-67 were up-regulated and the secretion of bFGF significantly increased after RPE cells was acted with the regenerated fluid in the vitreous cavity. CONCLUSION: The sequential air-fluid exchange can mechanically reduce intraocular growth factors after the vitreoretinal microsurgery, indirectly restrain the proliferation of RPE cell, and improve the successful rate of vitreoretinal microsurgery.

Cell Division↗