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PubMed1992

Combined no-stitch phacoemulsification cataract extraction with foldable silicone intraocular implant and holmium laser sclerostomy followed by 5-FU injections.

In an attempt to overcome some of the problems associated with combined cataract extraction and glaucoma filtration surgery, we attempted a new combined procedure: a small-incision phacoemulsification cataract removal with placement of a silicone foldable implant and no-stitch closure combined with a holmium laser sclerostomy in an adjacent quadrant, followed by injections of 5-fluorouracil.

Aged↗
PubMed1992

Progressive color visual field loss in glaucoma.

Twenty one eyes with primary open angle glaucoma were tested with standard (white stimulus-on-white background) and color (blue stimulus-on-yellow background) visual fields over a range of 6-26 mo. There was no significant increase in threshold between the initial and final standard fields overall or by quadrant (P less than 0.188, overall field). A significant increase in mean log thresholds for all areas of the color visual field (P less than 0.019, overall field) was found. Of the 21 patients, nine worsened by greater than 0.2 log units, two improved by greater than 0.2 log units, seven worsened by less than 0.2 log units, and three improved by less than 0.2 log units. When these same patients were matched to 21 normal eyes by age, lens density, and acuity they showed significantly reduced thresholds throughout their color visual fields (P less than 0.023). Whereas normal age-related increases in threshold for the short-wavelength system are only 0.10 log units per decade (n = 88), 10 glaucomatous eyes with increases of 0.14-0.75 log units were found within only 26 mo. The authors conclude that color visual fields may indicate significant change in visual function before it is apparent on standard visual fields.

Adult↗
PubMed1992

[Effect of argon laser trabeculoplasty on unrestricted outflow of aqueous humor in eyes with simple glaucoma].

In this prospective study we used the oculopressions-tonometry (OPT) for determination of the aqueous humor outflow facility (C). 53 phacic eyes with glaucoma simplex were examined pre- and postoperatively. One hour after operation C decreased from 0.15 to 0.14. In correlation to this fact the IOD increased. After 7 days C was higher already than preoperatively, 30 days and 6 months after operation C showed normal values. After 6 months the mean decrease in IOD was 5.8 mm Hg, the mean increase in C was 39%. The rate of success after 30 days was 77.4%. IOP and C showed statistically significant changes. The problems with determining C and the causes of the fluctuation of C during our follow-up are discussed.

Adult↗
PubMed1992

Argon laser trabeculoplasty: a review.

A review of argon laser trabeculoplasty (ALT) indicates that it appears to be a viable tool in the treatment of many forms of open angle glaucoma. It effectively lowers intraocular pressure with few relative risks to the patient. Unfortunately, its pressure-lowering effects diminish with time. The primary risks of ALT are a transient rise in IOP (20 percent incidence) and the development of peripheral anterior synechia (20-46 percent incidence). The Glaucoma Laser Trial (GLT), a multi-institutional study, is currently evaluating the long-term effect of ALT.

Glaucoma, Open-Angle↗
PubMed1992

Pigmentary dispersion syndrome and pigmentary glaucoma: a new mechanism concept, a new treatment, and a new technique.

Reverse pupillary block is introduced as a new cataract-implant complication and as the principle mechanism in pigmentary dispersion syndrome (PDS) and pigmentary glaucoma (PG), causing posterior iris bowing and zonular rubbing. This mechanism was investigated by performing laser iridotomy on six patients. Following surgery, the iris moved forward completely and permanently to the planar position. A new technique, locating the iridotomy by transillumination, reduced the laser energy needed for iridotomy. Laser iridotomy located with transillumination is recommended as the treatment for iris-zonular rubbing in PDS and PG caused by reverse pupillary block.

Adult↗
PubMed1992

5-fluorouracil in trabeculectomy for patients under the age of 40 years.

In an attempt to enhance the success of trabeculectomy in patients under 40 years old, beginning 48 hours after surgery, we injected 5 to 45 mg (mean, 35 mg) of 5-fluorouracil in 10 eyes of six patients. After a mean follow up of 14.9 months (range, 6 to 27 months), intraocular pressure was below 21 mm Hg in 9 of the 10 eyes, with no antiglaucoma medication.

Adolescent↗
PubMed1979

Peripheral nasal field defects in glaucoma.

One hundred fifty-one eyes of 101 consecutive patients with chronic open-angle and low tension glaucoma showed typical visual field changes. Sixty of the eyes had a nasal step, either alone or in combination with other defects. In 17 of these eyes, it was possible to demonstrate an isolated scotoma in the nasal periphery. It was concluded that the peripheral nasal step is a nerve fiber bundle defect that in its earliest phase produces a scotoma. In this sense, it behaves similar to the more central defects, rather than simply as a depression of isopters nasally.

Adult↗
PubMed1977

Diathermo-trabeculotomy ab externo: indications and long-term results.

The authors present the results of 2 years' observation of 47 eyes operated with diathermo-trabeculotomy ab externo. This technique, based on a diathermic effect in association with trabeculotomy ab externo, allows an ample opening of Schlemm's canal and of the trabecular meshwork, with normalisation of intraocular pressure and outflow facility, for a period of up to 2 years, in open-angle and congenital glaucoma.

Electrocoagulation↗
PubMed1976

Combined cyclodialysis and cataract extraction.

Combined cyclodialysis and cataract extraction was performed on 78 eyes in a consecutive series of 26 years duration. This operation was performed on eyes with severe glaucoma, inadequately controlled on maximum medical therapy, and with a cataract needing extraction. Glaucoma types included open-angle, angle-closure with peripheral anterior synechias, combined open-angle and angle-closure, and secondary to uveitis. Seventy of the 78 eyes had follow-up of six months or more and the results in these 70 eyes were analyzed. In thirteen percent of the eyes in this study the postoperative intraocular pressure was the same or higher than the preoperative level, or reductions of intraocular pressure were not clinically significant. Eighty-seven percent (61 eyes) had a clinically significant lowering of intraocular pressure following the combined procedure. Thirty-nine percent (27 eyes) of the 70 eyes in this study had a tension of 0-14 mm Hg, and 44% (31 eyes) had a tension of 15-20 mm Hg. Intraocular pressure was improved significantly more often in patients over 60 years of age. Resulting intraocular pressures of 14 mm Hg or less were more likely when the cyclodialysis was performed in the lower quadrant. The results of the combined procedure were not significantly influenced by the type of glaucoma involved or by a history of previous glaucoma surgery. Bleeding was a frequent complication, but was not related to resulting intraocular pressure. Other complications were rare. We conclude that combining cyclodialysis with cataract extraction is safe and effective, and is a suitable procedure when there is need for surgery to relieve severe glaucoma, along with a need for cataract extraction.

Adolescent↗
PubMed1977

[Topical oxpernolol in the treatment of various forms of glaucoma (author's transl)].

Oxprenolol is a new beta-adrenergic blocking drug, whose effectiveness in the treatment of various forms of glaucoma has been evaluated. The drug was administered topically as 0.5% -1%-2% solution. The results of the investigation may be summarized as follows: The instillation of the drug produces a transient and slight conjunctival hyperaemia and a not significant miosis. A significnat ocular hypotensive action has been observed in the treatment of chronic open-angle, hemorrhagic and congenital glaumiosis. A significnat ocular hypotensive action has been observed in the treatment of chronic open-angle, hemorrhagic and congenital glaucoma. The concentration of 0.5% Oxprenolol seems to be as effective as topical 1% Propranolol. At the same concentration (0.5%), Oxprenolol produces no significnat change of the systemic blood pressure or of the heart rate. Topical pre-treatment with 1% Oxprenolol inhibits the systemic side-effects (tachycardia) produced by topical Isoproterenol, a wellknown ocular hypotensive drug. The authors conclude the investigation affirming that Oxprenolol may represent a new effective means for the medical treatment of glaucoma.

Chronic Disease↗
PubMed1976

Pilocarpine therapy in glaucoma: effects on anterior chamber depth and lens thickness in patients receiving long-term therapy.

The effect of pilocarpine hydrochloride on the anterior chamber depth and lens thickness was measured in 20 eyes of patients with chronic open-angle glucoma who were receiving long-term glaucoma therapy with pilocarpine. Measurements were made with high-resolution ultrasonic biometry. This study demonstrated that regardless of their age (58.4 years, average) and the fact that they had been regularly using pilocarpine from two to four times a day, 85% of these patients demonstrated narrowing of the anterior chamber (AC) depth (average, 0.19 mm) and thickening of the lens (average, 0.21 mm) with each instillation of pilocarpine. In approximately 15% of eyes, a repeatable deepening of the AC depth and flattening of the lens was noted.

Administration, Topical↗
PubMed1975

The histopathology of pigmentary dispersion syndrome with glaucoma.

Iris tissue and trabecular meshwork, obtained at time of trabeculectomy, was studied using the light and electron microscope in a 54-year-old woman with pigmentary dispersion syndrome with glaucoma. The specific defect was a loss of the outer epithelial cells of the iris with marked thinning of the remaining outer layers so that the two-cell architecture of the iris epithelium was maintained. In addition, the radial muscle layer was increased in both number and size of muscle fiber. It would appear that the pigmentary dispersion syndrome may represent a congenital or developmental abnormality of the iris epithelium, or both, and that the glaucoma which occasionally occurs in conjunction with this syndrome is of the usual open-angle type.

Atrophy↗
PubMedDate not supplied

[Use of cytostatics as anti-cicatricial drugs after anti-glaucoma surgery in children, adolescents and young adults].

Anti-cicatricial cytostatic therapy with 5-fluorouracil and prospidin was carried out after antiglaucoma surgery in 78 eyes of 67 patients aged 6 to 42 (2/3 of the patients were aged from 21 to 40). Half (34) of the patients suffered from open-angle (pigmented in 3 cases) and 6 from closed-angle glaucoma, the rest patients presented with common hydrophthalmia, the Frank-Kamenetsky, Sturdge-Weber, Riger's syndromes, etc. The cytostatics were injected subconjunctivally. The results of 67 surgeries were followed up for 6 months to 3 years. Stable normalization of the ophthalmic tone and stabilization of the process were achieved in 60 eyes (89.2%). The authors emphasize that cytostatics may be recommended for children and young subjects after surgery involving fistulization, on condition of thorough biomicroscopic monitoring in the postoperative period, because of a possible disadaptation of the edges of the mucosal incision and corneal diseases.

Adolescent↗
PubMed1977

Glucocorticoid responsiveness associated with HLA-B12.

Primary open-angle galucoma (POAG) patients are more responsive to glucocorticoids, and have increased prevalences of the histocompatibility antigens HLA-B7 and HLA-B12. We report herein a comparison of in vitro cellular responsiveness to glucocorticoids and HLA classification for 25 POAG patients, and 25 individuals who respond to topical dexamethasone with intraocular pressure is greater than 31 mm. HG. (GG responders). Within both the POAG and GG groups, significantly greater responsiveness to prednisolone occurs in patients with HLA-B12 antigen. No such association occurs for patients with HLA-B7.

Aged↗
PubMed1978

Diurnal variations in outflow facility.

Tonography was carried out at 8 AM, 2 PM, and 8 PM on 43 normal eyes, 58 open-angle glaucomatous eyes and 10 ocular hypertensive eyes. Diurnal variations in outflow facility and their relation to those in intraocular pressure (IOP) were studied. Diurnal variations in outflow facility were present in almost all eyes, with approximately a 10% exception. The average diurnal variation in true outflow facility (deltaCtrue) was 0.10 microliter/min/mm Hg in normal eyes and 0.07 microliter/min/mm Hg in glaucomatous eyes. The average rate of diurnal variation in true outflow facility: formula: (see text) was 43.6% in normal eyes and 69.1% in glaucomatous eyes. The value was greater in glaucomatous eyes than in normal eyes. The curve of diurnal variations in true outflow facility was divided into 5 types, and in glaucomatous eyes the value of outflow facility was apt to increase in the morning and decrease in the evening. In 42% of the normal and 45% of the glaucomatous eyes, inverse relation was seen between diurnal variations in outflow facility and diurnal rhythm in IOP. It is thought that diurnal variations in outflow facility, along with diurnal fluctuations in the rate of aqueous formation, are one of the factors responsible for the diurnal rhythm found in IOP.

Adult↗