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At least 721 records · Page 40Linked to original sources

Retained ophthalmic viscosurgical device material in the capsular bag 6 months after phacoemulsification.

We present a 63-year-old man who developed low-grade endophthalmitis 6 months after phacoemulsification and implantation of a foldable posterior chamber intraocular lens (IOL). The capsular bag was distended, but shallowing of the anterior chamber was not observed. Chemical analysis of the clear fluid aspirated from the capsular bag behind the IOL revealed the presence of an ophthalmic viscosurgical device.

Endophthalmitis↗

Retinal detachment as a complication of neodymium: yttrium aluminum garnet laser cyclophotocoagulation.

We report a traction retinal detachment that developed within one month of transscleral neodymium: yttrium aluminum garnet (Nd:YAG) laser cyclophotocoagulation, a previously unreported complication of the new cyclodestructive procedure. A 17-year-old boy was referred to our department with uncontrolled aphakic glaucoma OD after having undergone cyclocryotherapy twice. Three treatments with transscleral Nd:YAG cyclophotocoagulation were done over nine months to lower his intraocular pressure. Hypotony and traction retinal detachment occurred after the third laser treatment and was managed successfully by vitrectomy with a fluid-gas exchange. Thus, the possibility of this additional complication should be remembered when doing transscleral Nd:YAG cyclophotocoagulation.

Adolescent↗

Late postoperative capsular block syndrome.

The authors report the case of a 61-year-old man with late postoperative capsular block syndrome who had undergone phacoemulsification and posterior chamber intraocular lens (IOL) implantation 3 years earlier. He presented with a decreased vision in the right eye caused by the accumulation of liquefied milky fluid in the space between the posterior surface of IOL optic and the posterior capsule. Neodymium: YAG laser posterior capsulotomy allowed a resolution of the milky fluid and the improvement of the visual acuity to 20/20.

Capsulorhexis↗

Xyloglucan as a novel vehicle for timolol: pharmacokinetics and pressure lowering activity in rabbits.

This study was aimed at verifying the performances of a mucoadhesive polysaccharide from tamarind seed (xyloglucan or TSP, tamarind seed polysaccharide) as an adjuvant for ophthalmic vehicles containing timolol. Three formulations (one experimental vehicle based on TSP and two reference commercial eye drops) containing 5 mg/ml timolol base equivalents were administered to the eyes of pigmented rabbits. Drug concentrations in tear fluid, cornea, iris-ciliary body, aqueous humor and plasma were determined, as well as intraocular pressure. The polymer under investigation, in spite of a comparatively low viscosity, produced high timolol concentrations in the ocular tissues and a low systemic absorption. The performances of the TSP vehicle were comparable to those of a reference "in situ" gelling formulation (Timoptic XE). The results point to TSP as a potentially useful adjuvant for ophthalmic delivery systems.

Adrenergic beta-Antagonists↗

New instrumentation for fluid-air exchange.

To facilitate fluid-air exchange, we have recently adapted and modified an instrument that has been designed to maintain the anterior chamber of an eye with pressurized air at levels which are pre-set by the surgeon. We have now altered this instrument to provide us with a means of performing a fluid air exchange that obviates the need for changing or refilling the air syringe. The intraocular pressure can be maintained at a predetermined level throughout the procedure, with unlimited filtered air controlled by the surgeon via an uncomplicated automated foot pedal control system.

Air↗

Ocular hypothermia: anterior chamber perfusion.

The anterior chambers of 27 rabbit eyes were perfused at constant pressure with room temperature (25 degrees C) or cooled (11 degrees C) balanced salt solution at constant flow rates of 4.8 ml/min or 8.5 ml/min. Intraocular temperature changes in the anterior chamber, anterior vitreous, mid vitreous, and posterior vitreous and on the retina surface were monitored with an intraocular thermocouple probe. Perfusion of the anterior chamber of the pigmented rabbit eye with cooled fluid significantly reduced the temperature of the anterior chamber and anterior vitreous and even that of the retina. Both an increase in the rate of perfusion and a lowering of the perfusion temperature enhanced the cooling effect. The observed decrease in temperatures returned to approximately normal 4 minutes following the cessation of perfusion.

Animals↗

Removal of blood from the retinal surface in pars plana vitrectomy.

The technique of removal of blood from the retinal surface in pars plana vitrectomy using a blunt-tipped needle open to the atmosphere has two disadvantages: uncontrolled suction force at the tip of the needle, and a drop in intraocular pressure to zero when the needle is vented to the atmosphere. Modification of the procedure can eliminate these problems. By connecting the blunt-tipped needle to a bag of intravenous fluid, the suction force of the needle can be controlled; and by elevating both the bag connected to the infusion line and that connected to the suction needle, the intraocular pressure can be increased and the problem of intraocular bleeding minimized or eliminated.

Blood↗

Intraocular and extraocular colobomatous cysts in adults.

A 29-year-old woman had a colobomatous multiloculated cystic left eyeball. None of the normal structures of the globe were discernable by clinical examination. The cyst had been present since birth and had not grown in size since early childhood. Another patient, a man of 73, had an intraocular colobomatous cyst occupying the temporal half of the large choroidal bridge coloboma in his left eye. This cyst was partially filled with shimmering crystalline fluid. This patient had bilateral open-angle glaucoma which had caused advanced damage to the optic nerve in the structurally normal right eye. It is interesting that glaucoma did not affect the left eye with choroidal coloboma and intraocular colobomatous cyst, which had normal vision. The author thinks that ectatic sclera in the area of coloboma might have protected the eye from elevated intraocular pressure.

Adult↗

Intraocular pressure and retinal vascular changes during transient exposure to microgravity.

We measured intraocular pressures and retinal vascular diameters from 11 subjects during 20 seconds of microgravity produced by parabolic flight on board a KC-135 aircraft. Intraocular pressures increased 58% during parabolic flight compared to baseline values (19 +/- 1 mm Hg vs 12 +/- 1 mm Hg, respectively; P < .001). A 4% reduction in the caliber of retinal arteries was also noted during microgravity, but this change did not achieve statistical significance (7.8 +/- 0.3 pixels at zerogravity vs 8.1 +/- 0.3 pixels at 1g; P = .07). The increase in intraocular pressure and trend of arteries to constrict are thought to result from cephalad shifts in intravascular and extravascular body fluids as a result of the absence of the 1g hydrostatic gradient. The results of our study confirm that this fluid shift and its effects on the eye occur rapidly, within 20 seconds of exposure to microgravity.

Adult↗

Endocapsular surgery and capsular bag fixation of intraocular lenses in phacolytic glaucoma.

Performing endocapsular surgery can be more difficult in eyes with phacolytic glaucoma because the capsule is fragile and zonules are weak. In this study, I investigated the safety and efficacy of a technique for performing endocapsular surgery with and without posterior chamber intraocular lens (IOL) implantation in 19 eyes of 19 patients with phacolytic glaucoma. This technique involves aspiration of the fluid cortex from the capsular bag using a 26 gauge bent needle. After anterior capsulotomy with angled Vannas scissors, the nucleus is delivered using minimal pressure on the irrigating vectis. The remaining cortex is completely removed using minimal irrigating fluid. At the end of the procedure, a posterior chamber IOL is inserted in the bag as indicated. A V-shaped anterior capsulectomy is completed using Vannas scissors, without exerting traction on the zonules. Intraoperatively, internal structures can be clearly visualized and the entire procedure performed with minimal trauma to the fragile lens capsule and zonular apparatus. I encountered no major complications. Follow-up ranged from 12 to 36 months with satisfactory visual outcome and good intraocular pressure control without antiglaucoma medication in all patients.

Aged↗

Intraocular IgE antibody induced in guinea pigs with Ascaris suum larvae.

The systemic and local (intraocular) IgE antibody responses to infective and heat-killed Ascaris suum larvae were examined in guinea pigs. IgE antibody, demonstrated by the 6-day P-K test, was found in anterior chamber fluid following primary intravitreal injection of live second-stage A. suum larvae and in some instances occurred when no serum P-K activity was demonstrable. No intraocular IgE antibody was induced by primary intravitreal injection of heat-killed larvae. A brisk intraocular and systemic IgE antibody response followed the secondary intravitreal injection of either live or heat-killed larvae into animals systemically infected with A. suum. The guinea pig system promises to be a useful model for studying the immunopathology of human ocular parasite infections.

Animals↗

Intraocular irrigating solutions and vitrectomy-related changes (in protein, lactic and ascorbic acid) in rabbit vitreous.

Vitrectomy and the subsequent vitreous fluid exchange alter the chemical and physical properties of the vitreous. This study assessed the time course alterations of total protein, ascorbic acid and lactic acid in the rabbit vitreous cavity following vitrectomy. Normal values were 2.2 +/- 1.2 mg/ml, 8.5 +/- 1.0 mg/100 ml and 16.8 +/- 3.5 mumol/ml, respectively. Nine groups of 5-10 adult albino rabbits underwent closed vitrectomy using physiologic saline, Ringer's lactate and BSS plus solutions. Samples were withdrawn at 3 and 24 h and 7 days after vitrectomy. Total protein levels increased in all groups at 3 and 24 h (20-30 mg/ml). Ascorbic acid measurements at 24 h rose only with saline and BSS plus. At 24 h the BSS plus group was the only one demonstrating an increased lactic acid concentration.

Animals↗

Intrusion of scleral implant associated with conjunctival epithelial ingrowth.

A 26-year-old boxer sustained a rhegmatogenous retinal detachment that was repaired successfully. Repeated blunt trauma caused a second retinal detachment two years later. Three attempts at repair by scleral buckling with diathermy and drainage of subretinal fluid were unsuccessful, and the eye was enucleated. Pathologic examination showed internal erosion of the intrascleral silicone implant into the vitreous compartment. Conjunctival-like epithelium lined the intrascleral bed of the implant and extended through the internal erosion onto intraocular structures, and this conjunctival epithelium was traced onto the external surface of the eye. Repeated dissection and applications of diathermy, combined with drainage of subretinal fluid, had weakened the sclera so that the silicone implant eroded internally and epithelium grew into the eye.

Adult↗

Aqueous humor flow rate and intraocular pressure during and after pregnancy.

Intraocular pressure and aqueous humor formation rate have been determined from the first trimester of pregnancy through term, with further determinations 3 months postpartum, in 7 patients. The intraocular pressure showed a consistent, statistically significant fall during pregnancy, returning to values seen in early pregnancy after delivery. Aqueous humor formation rate showed no change during pregnancy. The data indicate that the sustained elevated hormonal levels during pregnancy, either directly or indirectly, cause an increase in fluid outflow conductance from the eye without altering the rate of fluid entry.

Adult↗