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At least 559 records · Page 31Linked to original sources
PubMed1995

Modified vitreous surgery for subretinal neovascularization and hemorrhage.

PURPOSE: To modify vitreous surgery for subretinal neovascularization (SRNV) and to determine the effects of this operation. METHODS: Six patients with SRNV were performed with this operation. The methods of examination before and after operation included: testing the best-corrected visual acuity before operation and 1, 3 or 6 months after operation; 30 degrees and macular 10 degrees Humphrey visual field examination; FFA examination preoperatively and 1, 3 or 6 months postoperatively. Modified surgery procedure is: a preventive buckling; pars plana vitrectomy; peeling the vitreous cortical; no intraocular diathermy; small retinotomy; subretinal surgery; air-fluid exchange. RESULTS: SRNV was taken off in 4 cases. Subretinal hemorrhage was washed in 2 cases. After 4 to 7 months follow-up, the visual acuity was improved in 4 cases, unchanged in 2 cases. The visual field was improved in 4 cases, unchanged in 1 case, decraesed in 1 case. The complications included macular hole due to surgery in 1 case and subretinal hemorrage in 1 case. CONCLUSION: The surgery criteria were: 1) massive subretinal hemorrhage; 2) some patients of SRNV included: FFA evidence they showed the membrane is beneath fovea, the best V. A is 20/100 or lower, and can't be treated by laser and the patient consent. This modified subretinal operation is safe, and effective for massive hemorrhage and some SRNVS.

Adult↗
PubMedDate not supplied

Limitation of iris and ciliary body resection in primates.

The authors evaluated the limitation of iridocyclectomy in primate eyes. Six-clock-hour resections were tolerated and the intraocular pressure was reestablished to preoperative levels (17 mm Hg) within 1 month after surgery. Seven- to eight-clock-hour resections were also tolerated by the eyes, but the intraocular pressure remained low (7-10 mm Hg) for the extent of the study (5 months). Eyes in which the vitreous fluid was replaced with Healon showed a trend toward faster recovery of the intraocular pressure than those having a physiologic saline solution.

Animals↗
PubMed2000

Perfluorodecalin condensation on posterior surface of lens capsule and corneal endothelium during vitrectomy.

BACKGROUND: High-density vitreous substitutes, including perfluorodecalin, are widely used in current vitreoretinal surgery. We report 4 cases of perfluorodecalin condensation on the posterior capsule of the lens or corneal endothelium during vitrectomy. To the best of our knowledge, no such phenomenon has ever been reported. METHODS: This study consisted of 4 patients with retinal detachment and large retinal tears. All patients were men. All of the patients underwent pars plana vitrectomy, perfluorodecalin injection, endolaser retinopexy and air-fluid exchange. Two patients received additional surgery for scleral buckling. RESULTS: Perfluorodecalin condensation was observed on the posterior surface of the lens capsule in one phakic patient and on the endothelium in three aphakic patients during vitrectomy. The condensation obscured the image of the fundus and made air-fluid exchange difficult. The condensation could be dissipated by first removing the perfluorodecalin as completely as possible, and then by lowering the intraocular pressure below the vapor pressure of perfluorodecalin. CONCLUSIONS: Perfluorodecalin condensation may occur when perfluorodecalin is not properly used. To avoid forming condensation, high-density vitreous substitutes should never be injected into eyes that are completely air-filled, prolonged air-fluid exchanges should be avoided, and the intraocular pressure should always be kept at a higher level during air-fluid exchange.

Adult↗
PubMed1996

Anterior chamber fluid cultures following phacoemulsification and posterior chamber lens implantation.

BACKGROUND AND OBJECTIVE: A randomized, prospective study was undertaken to evaluate the incidence of positive cultures in the anterior chamber following cataract surgery when using intracameral gentamicin compared with no antibiotic. PATIENTS AND METHODS: A total of 97 patients were enrolled-- 48 receiving gentamicin in the irrigating solution and 49 receiving no intracameral antibiotics (control group). Each cataract extraction was accomplished by phacoemulsification followed by intraocular lens implantation. At the end of surgery, o.1 ml of anterior chamber fluid from each case was collected and cultured. RESULTS: All cultures were negative in the group receiving gentamicin. However, one positive culture occurred in the control group. There was no significant difference in the positive culture rate between the two groups (P = .52). CONCLUSION: This study suggests that cataract extraction with phacoemulsification and intraocular lens implantation has greatly reduced the incidence of bacterial contamination of anterior chamber fluid, with or without the use of intracameral antibiotic.

Anterior Chamber↗
PubMed1982

Use of gram stain to predict vitreous fluid infection.

To determine whether vitreous fluid Gram stains can successfully predict and indicate the nature of intraocular bacterial infection while awaiting culture results, a retrospective study of Gram stain and culture results on 12 endophthalmitis cases over the last two years was conducted. Out of ten culture-positive vitreous fluids, seven demonstrated bacteria on direct Gram stain and three had negative Gram stain results. Vitreous fluid artifacts resembling bacteria were seen in two other Gram stains and are described. When organisms are present in the vitreous fluid, they are frequently visible on a Gram-stained smear. The microbiologist must be able to differentiate the Gram stain appearance of normal vitreous fluid, probable artifacts, and infected vitreous fluid. Experience and diligence of the microbiologist are essential to correctly evaluate the vitreous fluid Gram stains.

Bacteria↗
PubMed1997

Macular hole surgery without face-down positioning. A pilot study.

PURPOSE: To investigate whether postoperative face-down positioning is necessary for successful macular hole repair. BACKGROUND: Although never proven, face-down positioning is strongly considered an important maneuver to achieve macular hole closure. Face-down posturing is inconvenient, and for patients with physical or mental limitations, weeks of face-down positioning may be an impossible task. A gas bubble that completely fills the vitreous cavity will tamponade a macular hole despite head position and may close a macular hole as effectively as a partial gas fill with face-down positioning. If face-down positioning were not necessary, more patients would be eligible to benefit from this surgery. METHODS: Thirty-three consecutive eyes in 31 patients aged 65-79 years with Stage II, III, or IV full-thickness macular holes underwent macular hole surgery with a complete 15% C3F8 vitreous fill. Hole duration varied from 1 month to 10 years; in 21% of eyes, (seven of 33) holes had been present for more than 1 year. All phakic eyes (n = 25) had cataract extraction with intraocular lens insertion when macular hole surgery was done. No patients were positioned face down. RESULTS: The follow-up period was 6-40 months; 73% of the patients have been observed for more than 1 year. Preoperative hole duration did not affect hole closure rate. The success rate after one surgery was 79% (26 of 33 eyes), and with additional vitrectomy surgery, the total success rate was 85% (28 of 33 eyes). Forty-eight percent of eyes attained visual acuity of 20/50. Eighty percent of eyes with preoperative acuity of > 20/100 attained > 20/50 acuity. Significant complications included iris incarceration into the cataract wound during a postoperative fluid-gas exchange (one eye), posterior synechiae (four eyes), intraocular lens capture (two eyes), elevated intraocular pressure (three eyes), and retinal detachment (three eyes). Most of these problems can be avoided or reduced. CONCLUSION: This pilot study suggests that successful macular hole closure is possible without face-down positioning. This technique may be an alternative for patients with macular holes in pseudophakic eyes who are unable to assume face-down posturing. Combining cataract surgery with this technique for macular hole repair is reasonable for phakic patients who cannot maintain prone positioning. Major disadvantages of combined surgery include the morbidity of the second procedure and removal of a visually insignificant cataract. This approach should be considered for those patients unable to tolerate face-down positioning.

Cataract↗
PubMedDate not supplied

Endophthalmitis following intraocular lens implantation: report of 30 cases and review of the literature.

Bacterial endophthalmitis is a postoperative complication of intraocular lens implantation. A review of 30 cases showed that 77% occurred within seven days of initial cataract surgery and that all cases occurred within 32 days. Common presenting symptoms and signs included pain localized to the involved eye, decreased visual acuity, conjunctival injection, anterior chamber inflammation, hypopyon, and absent or poor red reflex. Diagnosis of an infectious etiology was made by aqueous and vitreous sampling for gram stain and culture. The commonest bacterial agents were coagulase-negative staphylococci and Staphylococcus aureus, but a wide variety of gram-negative and -positive organisms were also isolated. On the basis of this series and review of the literature, optimal treatment includes prompt diagnosis by culture and gram stain of vitreous fluid, frequent application of topical antibiotics, and administration of intraocular antibiotics. Intravenous antibiotics and vitrectomy may improve the visual outcome. Removal of the intraocular lens is unnecessary for bacteriologic cure and is not associated with improved visual outcome.

Aged↗
PubMed2006

Aquaporins as potential drug targets.

The aquaporins (AQP) are a family of integral membrane proteins that selectively transport water and, in some cases, small neutral solutes such as glycerol and urea. Thirteen mammalian AQP have been molecularly identified and localized to various epithelial, endothelial and other tissues. Phenotype studies of transgenic mouse models of AQP knockout, mutation, and in some cases humans with AQP mutations have demonstrated essential roles for AQP in mammalian physiology and pathophysiology, including urinary concentrating function, exocrine glandular fluid secretion, brain edema formation, regulation of intracranial and intraocular pressure, skin hydration, fat metabolism, tumor angiogenesis and cell migration. These studies suggest that AQP may be potential drug targets for not only new diuretic reagents for various forms of pathological water retention, but also targets for novel therapy of brain edema, inflammatory disease, glaucoma, obesity, and cancer. However, potent AQP modulators for in vivo application remain to be discovered.

Animals↗
PubMed1999

Bacterial contamination of anterior chamber during IOL surgery.

PURPOSE: To study the nature and frequency of bacterial contamination during cataract surgery. METHODS: The preoperative smears from the conjunctiva and anterior chamber (AC) fluid aspirates during extra-capsular cataract surgery (ECCE) with posterior chamber intraocular lens (PCIOL) implantation in 40 eyes were analysed for aerobic and anaerobic bacteria. Any change in the bacterial strains isolated before and after cataract surgery was also studied. RESULTS: AC fluid aspirates were positive for bacteria in 15 eyes (37.5%). Coagulase-negative Staphylococcus was the most common aerobe (39.4%) and Propionibacterium acnes the most common anaerobe. Of the 15 cases with positive AC fluid cultures, 6 showed an organism in the AC aspirate different from the conjunctival smear. CONCLUSION: Clinically there was no endophthalmitis in any of the eyes. Factors such as preoperative antibiotic use, the antibacterial properties of aqueous, or low inoculum size could explain this. The preoperative conjunctival smear may not be useful in predicting the AC fluid contamination or outcome of cataract surgery.

Adult↗
PubMed2001

[Diagnosis and treatment of Sturge-Weber syndrome associated with retinal detachment].

OBJECTIVE: To access the diagnosis and treatment of Sturge-Weber syndrome at late stage. METHODS: The male patient aged 65 visited the eye clinic with presenting symptom of visual loss of the left eye for 2 months. Ocular examination disclosed a facial hemangioma with the size of 2 cm x 3 cm on the nasal side of the left upper eyelid associated with engorged bulbar conjunctival and episcleral vessels in the upper nasal quadrant. Ophthalmoscopy revealed total detachment of the retina. Esotropia was measured as 10 degrees. Intraocular pressure was 24 mmHg. Electroretinogram (ERG) demonstrated an indistinguished pattern. Posterior trans-scleral and ciliary body cryocoagulation was applied followed by external release of the subretinal fluid. RESULTS: The retina became reattached with visual acuity of 0.3 and intraocular pressure was 15 mmHg of the left eye at 5 months postoperatively. Fluorescein angiographical findings were consistent with diffuse hemangioma of the choroid. Follow-up study for 6 years revealed that the retina remained attached with visual acuity of 0.8 and essentially normal electroretinogram. CONCLUSION: The small facial hemangioma was the clue for the diagnosis of Sturge-Weber syndrome and cryocoagulation was the procedure of choice for the treatment of retinal detachment with favorable visual outcome.

Aged↗
PubMedDate not supplied

Biomechanical response of the cornea to phototherapeutic keratectomy when treated as a fluid-filled porous material.

PURPOSE: Surgical effect on corneal deformation has been traditionally analyzed based on the solid material assumption. We examine the validity of this assumption by treating the cornea as a fluid-filled porous material and separately modeling the solid and fluid constituents inside the cornea. In particular, the internal sub-atmospheric fluid pressure is treated as an important part of the mechanical loading in addition to the intraocular pressure. METHODS: Finite element simulations of phototherapeutic keratectomy (PTK) were conducted with the cornea treated as a fluid-filled porous material, and through-the-thickness difference in swelling phenomena was taken into account. The results were compared with the same PTK simulations based on the solid material assumption of the cornea. RESULTS: The PTK simulation results based on the fluid-filled porous material assumption demonstrated a significantly higher amount of unintended hyperopic shift compared to the results based on the traditional solid material assumption. The proposed approach qualitatively matched experimental observations. CONCLUSIONS: The internal sub-atmospheric pressure significantly influenced corneal deformation. The simulation results based on the fluid-filled porous material assumption raise serious questions regarding the validity of existing models in corneal surgery, where the effect of the internal sub-atmospheric pressure on corneal deformations is neglected.

Biomechanical Phenomena↗
PubMedDate not supplied

TIMP-1 and TIMP-2 levels in vitreous and subretinal fluid.

To understand the role of tissue inhibitors of metalloproteinase-1 and -2 (TIMP-1 and TIMP-2) in intraocular diseases, levels of TIMP-1 and TIMP-2 were measured by enzyme immunoassay in 47 patients with various ocular diseases: in subretinal fluid of 7 patients with rhegmatogenous retinal detachment and in vitreous of 12 patients with proliferative diabetic retinopathy, 4 with proliferative vitreoretinopathy, 2 with vitreous hemorrhage due to branch retinal vein occlusion, 12 with idiopathic macular hole, 3 with retinal detachment due to high-myopic macular hole, 4 with macular epiretinal membrane, and 3 with choroidal neovascular membrane due to age-related macular degeneration. TIMP-1 levels were significantly higher in subretinal fluid than in vitreous fluid with any diseases (P < 0.0001, Mann-Whitney U test). TIMP-1 levels in vitreous fluid of the eyes with proliferative diabetic retinopathy and proliferative vitreoretinopathy were higher than those in vitreous with other diseases (P < 0.0001). In contrast, TIMP-2 levels were not elevated in the subretinal fluid and vitreous. TIMP-1, but not TIMP-2, was secreted into the subretinal space in rhegmatogenous retinal detachment, and also into the vitreous in eyes with proliferative disease, suggesting that TIMP-1 would play a specific role in the process of these diseases.

Biomarkers↗
PubMed1993

Perfluoropropane 12% versus 20%. Effect on intraocular pressure and gas tamponade after pars plana vitrectomy.

A randomized prospective study was performed on 30 nonglaucomatous eyes undergoing pars plana vitrectomy and intraoperative fluid-gas exchange, comparing the effect of two perfluoropropane gas concentrations (12% and 20%) on postoperative intraocular pressure, early postoperative bubble size, and intravitreal longevity. No significant differences in mean intraocular bubble size at 36 to 48 hours and mean peak and final follow-up intraocular pressure were found between the 12% group (n = 15) and the 20% group (n = 15, unpaired T-test). Intravitreal longevity was significantly greater for the 20% concentration (mean +/- standard deviation = 8.4 +/- 1.8 weeks) compared with the 12% concentration (mean +/- standard deviation = 6.7 +/- 1.6 weeks). In nonglaucomatous eyes under careful observation and appropriate antiglaucoma therapy, the choice between a 12% or 20% concentration of perfluoropropane gas determined primarily longevity of gas tamponade rather than postoperative pressure or early bubble size.

Double-Blind Method↗
PubMed2000

Short-term effect of latanoprost and timolol eye drops on tear fluid and the ocular surface in patients with primary open-angle glaucoma and ocular hypertension.

PURPOSE: To investigate and compare the short term effects of topical latanoprost and timolol on the tear fluid and ocular surface condition in patients with bilateral primary open angle glaucoma or ocular hypertension. METHODS: Thirty-seven patients were included in this randomized, double-masked, parallel group study. Patients received either latanoprost 0.005% (n= 18) or timolol 0.5% (n= 19) instilled once daily in the morning for a treatment period of 27 days. Routine ophthalmic examinations, including intraocular pressure measurement, as well as tests to evaluate tear fluid and the ocular surface were performed. RESULTS: After one drop of medication, tear secretion was significantly reduced by timolol, but not by latanoprost. At the end of the study the break-up time (BUT) was significantly decreased in the timolol group but not in the latanoprost group. The BUT still remained in the normal range in both groups, although it is important to note that timolol was administered at half the clinical dose. Both latanoprost and timolol tended to increase Rose-Bengal staining of the cornea and conjunctiva after one month of treatment but no statistically significant difference was found between the groups. Corneal sensitivity was within the normal range for all patients during the study. CONCLUSION: Regarding ocular surface effects, no clinically important differences between latanoprost and timolol were observed as all the effects remained in the normal range.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Elevated intraocular pressure, pigment dispersion and dark hypopyon in endogenous endophthalmitis from Listeria monocytogenes.

Listeria monocytogenes endophthalmitis occurred in an immunologically competent patient with no identifiable extraocular septic focus. The patient presented with a dark hypopyon and markedly elevated intraocular pressure, and the diagnosis was established by culture and histopathologic examination of ocular fluid. Four of the fourteen reported cases of Listeria monocytogenes endophthalmitis also presented with a dark hypopyon, and all cases had markedly elevated intraocular pressure. The presence of a dark hypopyon and elevated intraocular pressure may indicate endogenous intraocular infection with Listeria monocytogenes, even in an apparently healthy host.

Aged↗
PubMed1999

Accumulation of milky fluid: a late complication of cataract surgery.

We describe 3 patients who presented with an accumulation of homogeneous milky fluid in the capsular bag several years after continuous curvilinear capsulorhexis, phacoemulsification, and posterior chamber intraocular lens (IOL) implantation. In each case, the entire edge of the anterior capsule opening was tightly attached to the peripheral IOL optic. The milky fluid was present in the closed chamber between the IOL optic and the posterior capsule. The fluid was sampled in 2 patients, and its concentration of sodium hyaluronate was determined by high-performance liquid chromatography. The concentration of sodium hyaluronate resembled that in normal aqueous humor. In 1 case, the protein concentration was measured and found to be elevated. Electrophoresis showed that human serum albumin was the main protein constituent. While the outcome was favorable in all 3 patients, this delayed complication of cataract surgery merits further study to clarify its etiology and pathogenesis.

Aged↗
PubMedDate not supplied

Cytologic diagnosis of intraocular lymphoma in vitreous aspirates.

OBJECTIVE: To evaluate the cytologic findings of vitreous fluids with atypical, suspicious for malignancy or malignant lymphoid cells to assess cytologic parameters that may help in reaching the diagnosis of intraoclular lymphoma. STUDY DESIGN: Vitreous aspirates with a malignant, suspicious for malignancy or atypical lymphoid population were identified from the files of Barnes-Jewish Hospital during the previous 11 years. Cytologic preparations were reviewed. Pertinent clinical information was obtained from medical records. RESULTS: Thirteen vitreous aspirates from 12 patients were included. The chief complaints included floaters, blurred vision and decreased visual aculity. Bilateral ocular involvement was present in 8 (67%) patients. Three patients had a history of an extraocular lymphoid malignancy. All patients underwent pars plana vitrectomy and collection of the vitreous aspirate. Cytologic diagnoses included: malignant lymphoma (9 of 13), suspicious for malignant lymphoma (3 of 13) and atypical lymphoid population (1 of 13). Most samples had high cellularity (11 of 13) and necrosis (9 of 13). Abnormal lymphoid cells were large (2-4 times the size of a lymphocyte) and had a high nuclear/cytoplasmic ratio, prominent nucleoli, irregular nuclear contours and a fine to coarse chromatin pattern. All cases with malignant cytology had abundant abnormal lymphoid cells; inconclusive cases had few. Immunocytochemistry for CD20 and CD45RO was performed on 9 of 13 samples and was conclusive in 6 of 9. CONCLUSION: Cytologic analysis of vitreous aspirates can be useful in diagnosing intraocular involvement by malignant lymphoma. Sparse cellularity is the main factor leading to inconclusive diagnoses. Immunostaining can be useful in confirming the lymphoid nature of the malignant cells.

Adult↗