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At least 523 records · Page 29Linked to original sources

PubMed2005

Ingress of India ink into the anterior chamber through sutureless clear corneal cataract wounds.

BACKGROUND: Sutureless clear corneal cataract incisions may be associated with an increased risk of endophthalmitis. OBJECTIVE: To assess the degree of ocular surface fluid ingress into the anterior chamber of cadaveric human globes with clear corneal wounds. METHODS: Self-sealing clear corneal incisions were created in 4 eyes, and intraocular pressure was controlled with an infusion cannula. To evaluate possible flow of surface fluid through the corneal wound, india ink was applied to the corneal surface while the intraocular pressure was varied, so as to simulate the intraocular pressure fluctuations secondary to blinking or eye squeezing. The optical density from aqueous samples of globes were measured both before and after india ink application using a spectrophotometer. RESULTS: Aqueous aspirates from the 3 globes with sutureless clear corneal wounds revealed a significant increase in spectrophotometric readings (P<.01), in contrast to the sutured wound, which did not show an increase in absorbance level relative to the baseline. Ink particles were both grossly and microscopically visible inside the sutureless corneal wounds. CONCLUSIONS: Fluctuations of intraocular pressure following sutureless clear corneal cataract surgery may allow entry of surface fluid into the anterior chamber during the initial postoperative period when the wound is not healed.

Anterior Chamber↗

PubMed2001

Slow release of the antimetabolite 5-fluorouracil (5-FU) from modified Baerveldt glaucoma drains to prolong drain function.

Drainage devices are routinely placed in the eyes of patients with glaucoma to reduce intraocular pressure (IOP) by providing controlled outflow of fluid (aqueous humor) via a filtering bleb. However, the natural wound healing response often interferes with fluid outflow by thickening the walls of the bleb over time, so that these devices rarely remain functional for more than 5 years. We investigated the use of controlled release of an antimetabolite, 5-fluorouracil (5-FU), within glaucoma drains to determine if the wound healing response could be reduced and the useful life span of the device increased. Collagen plugs containing 1.125 mg of 5-FU were placed in the silicone tubes of modified Baerveldt glaucoma drains. Eight drains with 5-FU and eight drains without 5-FU were implanted in one eye each of 16 New Zealand white rabbits: the contralateral eyes served as unoperated controls. Results were evaluated in terms of IOP, fibrous capsule thickness, macrophage density. and presence of type III collagen surrounding the drain plate, 3 and 6 months after implantation. In general, eyes implanted with antimetabolite-containing drains demonstrated significantly lower values for all evaluated parameters at 3 months and lower or equal values at 6 months, compared with the eyes not receiving 5-FU and the unoperated controls, indicating improved IOP-lowering function, reduced bleb wall thickness, and earlier achievement of a steady-state wound healing response. All eyes remained healthy throughout the 6-month duration of the study with no cytotoxicity complications in any of the eyes. Thus, biodegradable plugs placed within the silicone tubes of glaucoma drains can safely deliver 5-FU to filtering blebs over time, which could prolong the functional life of the bleb by decreasing the thickness of the anterior fibrous capsule and permitting sufficient fluid outflow to reduce IOP to physiological levels.

Animals↗

PubMed1997

Balanced fluid exchange by volume homeostatic fluid-fluid exchanger--a new solution to postvitrectomy vitreous hemorrhage.

We introduce a new device and a new technique that facilitate the clearance of postvitrectomy vitreous hemorrhage. We have developed a volume homeostatic fluid-fluid exchanger--Chen's Infusion/Aspiration (Chen's I/A) device. Due to reciprocal synchronized hydraulic action, Chen's I/A provides simultaneous infusion and aspiration of fluid of equal amounts. Therefore, it can be used to perform vitreous cavity lavage through smaller caliber needles and at the same time maintain a constant intraocular pressure. This improved vitreous cavity lavage technique is named Balanced Fluid Exchange. Performing Balanced Fluid Exchange with Chen's I/A can reduce trauma to the eyeball and decrease complications resulting from unstable intraocular pressure. Thus, it increases both the intra-operative and post-operative clearance rates of postvitrectomy vitreous hemorrhage, and is a promising method for the management of postvitrectomy vitreous hemorrhage.

Hemostatic Techniques↗

PubMed2004

Conventional buckling surgery or primary vitrectomy with silicone oil tamponade in rhegmatogenous retinal detachment with multiple breaks.

BACKGROUND: There is controversy about the most appropriate operating methods for complicated rhegmatogenous retinal detachment (RD) including multiple tears, and surgical techniques may be changed according to the preference of the surgeon. In this retrospective study, we compared the surgical results of conventional buckling surgery and vitrectomy with silicone oil tamponade for rhegmatogenous (RD) with multiple breaks. METHODS: Thirty patients who underwent scleral buckling surgery (group 1) and 22 patients who underwent pars plana vitrectomy with silicone oil tamponade (group 2) as the primary surgery for rhegmatogenous RD with multiple breaks were included in this study. The follow-up period was longer than 6 months after surgery. The anatomical success rates and complications were evaluated for both groups. RESULTS: Retinal reattachment was achieved in 24 of 30 eyes (80%) in group 1 and in 20 of 22 eyes (90.9%) in group 2 after the initial surgery. In group 1, subretinal hemorrhage developed due to the drainage of subretinal fluid in 2 eyes (6.6%) intraoperatively. Elevated intraocular pressure (3.3%), ocular motility disturbances (13.2%), and proliferative vitreoretinopathy (3.3%) were seen in the postoperative period. In group 2, iatrogenic breaks (7.3%) and lens damage (9.09%) occurred during the operation. Macular pucker (4.5%), postoperative cataract progression (22.7%), ocular hypertension (9.09%) and PVR (9.09%) were noted postoperatively. CONCLUSIONS: Both surgical procedures can achieve favorable and comparable anatomic outcomes in the majority of patients in the treatment of RD with multiple breaks. Intra-and postoperative complications are different in the two procedures.

Adolescent↗

PubMed1998

Cystoid macular edema following combined phacoemulsification and vitrectomy for macular hole.

PURPOSE: To evaluate the incidence of cystoid macular edema (CME) in patients undergoing either combined or consecutive pars plana vitrectomy (PPV) and phacoemulsification (PE) for the treatment of macular hole and cataract. METHODS: Retrospective review of a consecutive surgical series of 22 patients with idiopathic macular holes. Seven patients underwent combined PPV with air-fluid-C3F8 gas exchange and PE with intraocular lens insertion; 15 patients underwent PE subsequent to PPV. RESULTS: Visual acuity improved by 2 or more lines in 3/7 patients in the combined group and in 15/15 in the consecutive group. Of seven patients in the combined group, two required a second PPV for treatment of the macular hole and one declined further treatment. Of importance, 3/7 in the combined group and 1/15 in the consecutive group developed clinical and angiographic CME, all treated successfully with sub-Tenon's triamcinolone injections. CONCLUSIONS: Both combined PPV/PE and consecutive PPV/PE offer excellent potential therapeutic benefits for the treatment of idiopathic macular holes. The incidence and pathogenesis of CME must be further investigated.

Aged↗

PubMed1985

Heterogeneity of humoral immune components in human cysticercosis.

Twelve Taenia solium cysticerci, obtained from several human organs, were examined by immunofluorescence for IgG, IgM, IgA, IgE and C3b on their surfaces. Anti-cysticercus antibodies of the 4 classes of immunoglobulins were looked for in the cerebrospinal fluid of most neurologic patients, in the intraocular humors of a patient with eye cysticercosis, and in the serum of some other patients. The morphological appearance of the parasites as well as the clinical features of the patients were recorded. The distribution of components was heterogeneous among the different parasite surfaces. IgG was the most frequent, followed by IgA, IgM, C3b and IgE. No correlation was found between the presence of these molecules and signs of damage in the cysticerci, or with the classes of immunoglobulins found as anti-cysticercus antibodies. Possible explanations of these findings as well as the implications of heterogeneity in cysticercosis are discussed.

Adolescent↗

PubMed1997

A sensitive ocular perfusion apparatus measuring outflow facility.

PURPOSE: To build an improved apparatus for measuring outflow facility by one- and two-level, constant pressure perfusion. METHODS: A computer-controlled and -monitored tower adjusts the height of a fluid reservoir by a stepper motor every 5 min, to keep intraocular pressure (IOP) constant at one or two desired pressure levels (e.g. 2.5 and 12.0 mm Hg above the spontaneous IOP). The fluid flow rate is calculated by the equation Q = (Pres - IOP)/R, where Pres is the pressure of the reservoir as calculated by the term "pgh," h being the height of the reservoir, measured by the rotation of stepper motor, g, the gravity constant, and p, the fluid density. IOP is measured by the transducer, and R is the resistance of 180 microns tubing. Outflow facility is calculated by delta Q/ delta P. delta Q is the difference between flow rate at the two pressure levels, and delta P is the intraocular pressure difference. Perfusion was performed on live albino rat eyes by the two-level constant pressure technique, and on artificial steel eyes at a single constant pressure perfusion (20 mm Hg). RESULTS: Outflow facility of albino rat eyes and artificial steel eyes perfused for 40 and 30 min, respectively was 0.0507 +/- 0.0039 microliter/min/mm Hg and 0.3546 +/- 0.0034 microliter/min/mm Hg (mean +/- SD), respectively. CONCLUSIONS: Our perfusion apparatus is highly stable, sensitive, and capable of measuring subtle changes in outflow facility in vivo and in vitro.

Animals↗

PubMedDate not supplied

[Extra-scleral balloon catheterization. Report 3. New ways of its use--prevention of hypotonia and intraocular hemorrhages in vitreo- retinal surgery].

Hypotonia and ex vacuo hemorrhages are the most grave complications of vitreoretinal surgery; the known methods of their prevention are altogether inadequate. The authors have developed extra-scleral ballooning (ESB) methods that improve the efficacy of surgery and reduce the rate and severity of complications in subretinal fluid draining during surgery for detachment of the retina and in arresting intraocular hemorrhages during closed vitrectomy. ESB application helped elevate intraocular pressure in the patients with drastic hypotonia, permitting a reliable and easy-to-perform monitoring of intraocular pressure over the course of surgery. This was conducive to complete evacuation of subretinal fluid, thus preventing the development of hypotonia and its complications, as well as to a rapid arrest of intraocular hemorrhage due to rapid elevation of intraocular pressure up to the values essential for the bleeding vessel collapse. Surgical methods are described and their results analyzed in 65 cases. The developed ESB methods for the prevention of hypotonia and intraocular hemorrhages in vitreoretinal surgery are effective, low traumatic, and may be recommended as alternative ones.

Catheterization↗

PubMed2004

The challenge of determining aqueous contamination rate in anterior segment intraocular surgery.

PURPOSE: To determine aqueous contamination rate in anterior segment intraocular surgery using two different techniques of obtaining aqueous fluid and to assess whether a 3-day application of topical 0.3% ofloxacin reduces this contamination rate compared with a 1-hour application. DESIGN: Randomized clinical trial. METHODS: One hundred and thirty-three eyes of 130 patients undergoing anterior segment intraocular surgery were randomized to either control (64 eyes received topical ofloxacin 1 hour before surgery) or study groups (69 eyes received topical ofloxacin four times a day for 3 days before surgery in addition to 1 hour preoperatively). Eyes in both groups received a periorbital iodine scrub and two drops of topical 5% iodine. Aqueous fluid was obtained at the beginning and conclusion of surgery using a cannula passed through a paracentesis or a needle passed through clear cornea. The aqueous, cannula, and needles were inoculated in blood culture media broth and bacterial growth was identified. RESULTS: Overall, eight of 89 aqueous samples (9%) obtained using a cannula at the beginning of surgery were culture-positive. Similarly, six of 41 aqueous samples (15%) obtained through a needle through clear cornea at the beginning of surgery showed contamination. At the conclusion of surgery, nine of 112 samples (8%) showed positive cultures. There was no difference in the aqueous contamination rates between the control and study groups. CONCLUSIONS: Despite the use of a needle to obtain aqueous fluid at the beginning of surgery before creating a paracentesis, the aqueous contamination rate remained higher than that found at the conclusion of surgery. A 3-day application of topical ofloxacin before surgery did not reduce the anterior chamber aqueous contamination rate relative to a 1-hour application.

Anterior Eye Segment↗

PubMed1989

Expression of gastrointestinal endocrine tumours in culture systems.

Human endocrine tumours were studied in in vitro systems (cell suspensions and tissue cultures) and in in vivo systems (tumour transplants to the anterior eye-chamber of immunosuppressed rats). In the experimental systems the tumour cells were demonstrated to synthesize and secrete the same hormonal products as in the patient. Intraocular transplants of a gastrinoma secreted gastrin-17 into the chamber fluid. This molecule, normally not secreted in the rat, was also detected in the peripheral plasma of tumour-bearing rats. Intraocular transplants of midgut carcinoid tumours released serotonin (5-HT) at adrenoceptor stimulation, of a similar type as demonstrated in acute tumour cell suspensions. However, in tissue cultures genuine beta-adrenoceptors seemed to be modified, since pretreatment with beta-adrenoceptor antagonists or calcium deprivation did not prevent stimulated 5-HT release. Tachykinins were not liberated by adrenoceptor stimulation. In certain cultures of midgut carcinoid tumour cells, two different phenotypes developed: small rounded endocrine tumour cells with positive immunoreactions against 5-HT and tachykinins (TK), and large elongated neuron-like cells, which gradually lost 5-HT immunoreactivity, while TK immunoreactivity remained unchanged. These cultured tumour cells may produce an endogenous factor inducing transformation into a neuron-like phenotype. One candidate factor is nerve growth factor (NGF), since NGF-like immunoreactivity was demonstrated in cells of the endocrine phenotype.

Gastrointestinal Neoplasms↗

PubMedDate not supplied

Succinylcholine and intraocular pressure.

Thirty-one patients (61 eyes) had a rise in intraocular pressure averaging 8.2 mm Hg following the use of succinylcholine as a muscle relaxant prior to general anesthesia. Just prior to the start of surgery (an average of 14 minutes following Anectine administration), the tension had returned to the control level. Ten patients (20 eyes) had pancuronium used without succinylcholine. No change in intraocular tension was noted with this agent and pressure remained unchanged at the start of surgery. Work of other investigators, using the "spring back balance" test and strain gauge force measurement to rotate the globe, indicate that the effect of Anectine upon the extraocular muscles may take 20 to 30 minutes to wear off. This is long after the return of intraocular pressure to control values and suggests that monitoring of intraocular tension may not be accurate method of assessing the action of Anectine upon the eye muscles. The mechanism of increased fluid outflow, not muscle relaxation, probably accounts for this lowering of intraocular pressure.

Adolescent↗

PubMed1983

[Similarities between intraocular and intracranial pressures].

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Anesthesia↗

PubMed1995

Self-tonometry under microgravity conditions.

Microgravity leads to a "fluid shift" towards the upper parts of the body and, therefore, to a rise of the intraocular pressure. Parabolic flights have also demonstrated some rise of the intraocular pressure. During the first German Spacelab mission D1, changes of the intraocular pressure were investigated for the first time in space. The first pressure readings were obtained 44 min after entering microgravity and showed a pressure rise of 20 to 25% compared to the baseline data. To get earlier measurements in microgravity a fully automatic self-tonometer was developed which functioned independent of position and microgravity. It was used during an 8-d manned space mission in March 1992. Measurements of the intraocular pressure have been performed 16 min after reaching microgravity. The pressure readings revealed a 92% rise of the intraocular pressure compared to the daytime-correlated baseline data on Earth.

Fluid Shifts↗

PubMed2005

Possible air embolism during eye surgery.

We report a case of possible air embolism during a three-port pars plana vitrectomy and air-fluid exchange of the vitreous cavity of the eye. After the start of intraocular air flushing, sudden tachycardia, a decrease in oxygen saturation and end-tidal carbon dioxide tension, and a distinct "mill-wheel" murmur were observed. Venous air embolism was suspected but other sources of air entry into the circulation and a thromboembolic event were excluded. Once intraocular air flushing was ceased, clinical variables returned to normal within minutes. In conclusion, during air-fluid exchange of the vitreous cavity, air embolism should be considered as a possible rare complication.

Blood Gas Analysis↗

PubMed1990

A two-stage technique for intraoperative fluid-gas exchange following pars plana vitrectomy.

We describe herein a two-stage technique of intraoperative fluid-gas exchange following pars plana vitrectomy. The first stage is a complete fluid-air exchange using an air pump and intraocular linear suction. The air pump then maintains the intraocular pressure at the desired level during adjunctive procedures, such as laser endophotocoagulation. The second stage is an air-gas mixture exchange in which the desired gas, premixed in air to the desired final intraocular concentration, is manually flushed through the eye. This technique allows the attainment of an accurate concentration of intraocular gas if the air-gas mixture exchange is complete. In vitro and in vivo experiments in aphakic human eyes demonstrated that an effectively complete air-gas mixture exchange occurs with a 25-mL flush volume. This result compares favorably with the theoretical prediction derived from a "pharmacokinetic approximation" equation.

Body Fluids↗

PubMed1999

Primary intraocular lymphoma with a low interleukin 10 to interleukin 6 ratio and heterogeneous IgH gene rearrangement.

Primary intraocular lymphoma is almost always a central nervous system B-cell non-Hodgkin lymphoma. Primary intraocular lymphoma is commonly diagnosed by demonstrating lymphoma cells in the vitreous or cerebrospinal fluid. An interleukin (IL) 10 to IL-6 ratio greater than 1.0 in these fluids and the detection of immunoglobulin gene rearrangement are useful adjuncts in the diagnosis of primary intraocular lymphoma. We report a case of primary intraocular lymphoma diagnosed by chorioretinal biopsy in which no malignant cells were identified in the vitreous and in which the IL-10 to IL-6 ratio was less than 1.0. The detection of IgH gene rearrangement heterogeneity in the tumor cells by polymerase chain reaction, a high tumor mitotic figure rate, and the rapid onset of multiple brain lesions suggest an aggressive malignant neoplasm.

Adult↗

PubMed2006

[A clinical study of intraocular malignant lymphoma].

PURPOSE: We investigated whether vitreous cytology and the measurement of intravitreous cytokine were useful for the diagnosis of intraocular malignant lymphoma. SUBJECTS AND METHODS: 8 eyes of 5 patients with suspected intraocular malignant lymphoma during the past 15 months. 3 vitreous samples were collected from 3 patients at the time of pars plana vitrectomy. Polymerase chain reaction(PCR) amplification and flowcytometric analysis(FACS) of the vitreous samples were performed. Interleukin (IL)-10 and IL-6 concentrations were measured. RESULTS: Vitreous cytology showed increased atypical B lymphocytes. The vitreous IL-10/IL-6 ratio was higher than 1 in all cases. Monoclonal rearrangement of the immunoglobulin heavy chain gene and the light chain restriction of immunoglobulin were detected. CONCLUSION: The detection of the monoclonality of infiltrated cells into the vitreous by PCR amplification and FACS, and the measurements of IL-10 and IL-6 concentrations in the vitreous fluid may be useful in the diagnosis of intraocular malignant lymphoma.

Adult↗

PubMed1997

Capsulorhexis-related lacteocrumenasia.

Three patients who presented with a milky fluid in the space between the posterior surface of implanted intraocular lens (IOL) and the anterior surface of the distended posterior capsular bag are described. The patients were followed and were noted to have changes in their benign course after several years. The occurrence of this milky-fluid-filled capsular bag is extremely uncommon and is difficult to perceive if the observer is not looking for it.

Aged↗