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At least 937 records · Page 52Linked to original sources

PubMed1988

Study of prostaglandins and intraocular pressure in rabbits after Nd:YAG laser anterior segment procedures.

Radioimmunoassay of rabbit aqueous humor one hour after Nd:YAG laser anterior capsulotomies revealed increased concentrations of 6-keto-prostaglandin F1 alpha (PGF1 alpha), and thromboxane B2 (TBB2). Coincidental rises in intraocular pressure (IOP) and aqueous humor protein were observed. These changes correlated with the laser power used. Pretreatment with topical 1% prednisolone acetate or 1% indomethacin prior to anterior capsulotomies inhibited the post laser rise in PGF1 alpha and TBB2, but did not eliminate the post laser rise in IOP. Small rises in IOP and the concentrations of aqueous PGF1 alpha, TBB2, and protein were observed after Nd:YAG laser iridectomies. These changes were not affected by prior treatment with 1% topical prednisolone acetate. Although PGF1 alpha and TBB2 are elevated after Nd:YAG laser anterior segment procedures, a causal relationship between post treatment IOP rise and PGF1 alpha or TBB2 release could not be determined.

Animals↗

PubMed1988

Intraocular pressure following secondary anterior chamber lens implantation.

Secondary anterior chamber implantation has become relatively simple since the advent of viscoelastic materials. Still, glaucoma, cystoid macular edema, endophthalmitis, and astigmatism remain vision-threatening complications. We studied intraocular pressures (IOPs) following this surgery in 102 patients (124 eyes) over 6 years. Elevated IOP was noted in 32 eyes (25.8%), but only 14 (11.3%) needed long-term medical treatment. None, however, required laser iridectomy, trabeculoplasty, or trabeculectomy. Patients should be selected for secondary anterior chamber implantation only after more conservative measures have been exhausted.

Adult↗

PubMed1988

Trabeculectomy, ECCE with PC-IOL implant, and vitrectomy after malignant glaucoma.

A patient with narrow-angle glaucoma developed a post peripheral iridectomy malignant glaucoma in both eyes. The intraocular pressure (IOP) in both eyes was controlled with mydriatics, cycloplegics, and Diamox for 2 years. Subsequently the patient developed a dense cataract and uncontrollable IOP in her left eye. An extracapsular cataract extraction, posterior chamber lens implant, and trabeculectomy were combined with an anterior vitrectomy. The IOP in both eyes has been controlled for 3 years postoperatively.

Aged↗

PubMed1988

Recurrent closure of neodymium: YAG laser iridotomies requiring multiple treatments in pseudophakic pupillary block.

We present a rare case of repeated closure of Nd:YAG laser iridotomies and recurrent iris bombe configuration with angle-closure attacks in a pseudophakic eye. Until recently, patent Nd:YAG laser iridotomies were considered incapable of being closed, and the only reported closure was in an eye with concomitant iritis. Our patient developed iris bombe five times following extracapsular extraction, anterior vitrectomy, and anterior-chamber intraocular lens implantation. The first occurred following closure of the surgical iridectomy; the next three times, following closure of previously patent Nd:YAG iridotomies; and the final episode occurred despite patent iridotomies. This last time one drop of pilocarpine 2% was administered and resulted in immediate iris flattening and reopening of the third iridotomy. Possible mechanisms for closure of the Nd:YAG iridotomies in this case are discussed. We suggest the combination of Nd:YAG laser iridotomies and the stretching of the iris by pilocarpine might have liberated the trapped aqueous humor behind the iris, maintaining the patency of the iridotomies and the depth of the anterior chamber.

Cataract Extraction↗

PubMed1987

Eye diseases in the elderly in Singapore.

Ocular disorders in the elderly have become more important because of increased longevity and the demand for good vision. Many serious ocular conditions are age-related and they include cataract, glaucoma, diabetic retinopathy and other retinal conditions. The most important ocular disorder is cataract which fortunately is curable with excellent results when a posterior chamber implant is inserted. Angle closure glaucoma is common in the elderly Singapore Chinese and can be effectively treated with microscopic peripheral iridectomy or trabeculectomy. Blindness from diabetic retinopathy can be prevented with argon laser photocoagulation. In most cases blindness is preventable with early diagnosis e.g. in glaucoma and diabetic retinopathy. Severe visual loss in the elderly requires careful explanation and compassion by doctors and social workers.

Aged↗

PubMed1987

Combined cataract-glaucoma operation and its complications with the 7-S-intraocular lens.

The new generation of intraocular lenses placed in the sulcus or in the bag allows implantation even in glaucoma patients under certain conditions. Patients with intraocular pressure between 25 and 30 mm Hg underwent Argon laser trabeculoplasty before implantation. In patients with regulated intraocular pressure between 15 and 20 mm Hg not even an iridectomy was performed implanting the 7-S posterior chamber lens. An average degree of the intraocular pressure of 1.5 mm Hg was found after 6 months. Preoperative endothelial cell counting facilitates the indication for implanting an intraocular lens.

Atrophy↗

PubMed1987

Usefulness and limit of silicone in management of complicated retinal detachment.

Among various substances used for intraocular tamponade in the treatment of vitreous opacity and complicated retinal detachment, silicone oil is superior to hyaluronic acid or sulfur hexafluoride. Its low gravity and hydrophobic nature permit good tamponade effect to be obtained and its high transparency allows us to detect remnant vitreous traction in the far periphery and/or retinal tears. Furthermore, preretinal membrane can be peeled off easily after silicone oil removal. The hydrophobic nature of silicone prevents clouding due to postoperative hemorrhage and fibrin reaction. It should also be stressed that intravitreal silicone oil suppresses iridial rubeosis or prevents its development. However, the use of silicone has limitations, since it gives rise to various complications that include pupillary block glaucoma, secondary glaucoma, cataract formation and corneal complications including band-shaped keratopathy. Pupillary block in aphakic eyes can be prevented by placing peripheral iridectomy at the 6 o'clock position, since silicone is lighter than water. After silicone injection, glaucoma is more often seen in diabetic aphakic eyes than in phakic or nondiabetic eyes. On the other hand, corneal complications were less frequent in diabetic than in nondiabetic eyes; in nondiabetic eyes the complications were more frequent in aphakic than in phakic eyes. Due to possible complications, silicone should be removed after a certain follow-up period, during which time detection and management of the causes of redetachment of the retina are possible due to the high transparency of silicone.

Cataract↗

PubMed1985

The corneal endothelium and Descemet's membrane in the iridocorneal endothelial syndrome.

A 39-year-old woman with progressive left unilateral glaucoma associated with corneal edema, iris changes, and peripheral anterior synechia formation underwent a left trabeculectomy and iridectomy in an attempt to control the intraocular pressure. Shortly after surgery the edema worsened despite low intraocular pressure measurements. A repeat trabeculectomy combined with a full thickness keratoplasty was performed 11/2 years later. The posterior corneal surface was found to be covered by a partially doubled layer of endothelial cells with ultrastructural features resembling epithelium. Similar cells were not noted on the surface of the initial trabecular meshwork and iris specimens, but were seen on the surface of the specimens obtained at the second trabeculectomy. The anterior and middle portions of Descemet's membrane, formed during perinatal and early adult life, appeared normal, but its posterior portion appeared abnormal. The ultrastructural changes in the endothelial cells and the abnormalities observed in Descemet's membrane suggest that the endothelial cells were initially normal but subsequently acquired epithelial-like features as they degenerated and proliferated. The continued presence of corneal edema despite the hypercellularity of the endothelium suggests that the proliferating cells were permeable to aqueous.

Adult↗

PubMed1985

Lens implantation combined with trabeculectomy.

The results in seventeen cases of combined trabeculectomy and posterior lens implantation after extracapsular surgery are presented with a follow-up of three to 17 months. The mean reduction of intraocular pressure was 13 mmHg. There was no relationship between the histological localisation of the filter site and the effectiveness of the operation. As the postoperative inflammation is increased as compared to simple lens implantations, a combined operation is only indicated where no alternative to a filtering operation is possible. The use of an iris suture after iridotomy will prevent a later retraction of the iridectomy limbs.

Follow-Up Studies↗

PubMed1986

Cardiac dysrhythmias associated with ophthalmic atropine.

Atropine sulfate, a mydriatic and cycloplegic agent, is frequently used in patients undergoing glaucoma surgery. Trabeculectomy with peripheral iridectomy is the most common glaucoma surgery performed to decrease intraocular pressure and preserve vision. Systemic absorption of ophthalmic atropine does occur and may result in toxic and adverse side effects. Cardiac dysrhythmias are one of the major adverse reactions. This case study reviews three patients who had a trabeculectomy for glaucoma and received ophthalmic atropine. One patient received both systemic and ocular atropine. Two patients developed atrial fibrillation and one a supraventricular tachycardia. Two patients required admission to a cardiac intensive care unit for management of the dysrhythmia and a third reverted to normal sinus rhythm spontaneously. The cardiac effects of ophthalmic atropine should be considered in the preoperative and postoperative assessment of patients with dysrhythmias.

Absorption↗

PubMed1985

[Glaucoma in dogs and cats. Review and retrospective evaluation of 421 patients. II. Clinical aspects].

The pathobiological backgrounds, breed predispositions and classification of glaucoma have been described in a previous publication. The symptoms of acute glaucoma (corneal edema and vascular injection of the scleral conjunctiva) may bear an insidious resemblance to those of a 'keratoconjunctivitis'. However, it is of great importance to diagnose glaucoma as soon as possible after onset, since lack of treatment may lead to irreversible blindness within one week. When glaucoma becomes chronic the eyeball becomes enlarged. The prognosis concerning vision is then grave. The most important diagnostic and prognostic examinations are retrograde illumination, slitlamp examination, gonioscopy, examination of the fundus and tonometry. Provocative tests may also be useful. Glaucoma can be treated medically or surgically. Medical treatment includes the administration of timolol). Combinations may be useful. Surgical treatment is directed toward improving the outflow of aqueous humor (iridectomy, iridencleisis) and decreasing the rate of formation of aqueous humor (cyclocryotherapy). When all therapies have failed to lower the intraocular pressure and there is no hope of preserving vision, enucleation of the globe can be performed.

Animals↗

PubMed1985

Pupillary block associated with posterior chamber lenses.

Two patients developed pupillary block glaucoma after extracapsular cataract extraction with implantation of a posterior chamber lens but without peripheral iridectomies. The intraocular pressure of each eye was successfully controlled with laser iridotomy. No long-term medication was necessary to control their intraocular pressures.

Adult↗

PubMed1985

Retinal burns from experimental laser iridotomy.

Simulated argon laser iridotomy was performed in 12 cynomolgus monkey eyes to evaluate the effectiveness of the Abraham iridectomy lens in preventing inadvertent retinal burns. At 600 milliwatts, only two of the three eyes developed small retinal burns using the Abraham lens, whereas three eyes developed larger retinal burns without the Abraham lens. At 1000 milliwatts, retinal burns occurred with or without the Abraham lens, but the size and intensity of the burns were reduced with the lens.

Animals↗

PubMed1985

Posterior synechiae in extracapsular cataract extraction with posterior-chamber intraocular lenses.

Posterior synechiae formation was studied in 294 consecutive cases of extracapsular cataract extraction with posterior-chamber intraocular lens implantation. The synechiae are mainly a cosmetic blemish and may hinder future pupillary dilation. Formation can be reduced by elimination of the iridectomy, elimination of routine mydriatic drops, and minimization of iris trauma at the time of surgery.

Cataract Extraction↗

PubMed1979

Increased pressure after paracentesis of the rabbit eye is completely accounted for by prostaglandin synthesis and release plus pupillary block.

Paracentesis of the anterior chamber of the rabbit eye results in hyperemia, increased protein in the aqueous, elevated intraocular pressure, and miosis. Aspirin does not affect miosis but attenuates the pressure and protein response by about 60%. Pupillary block resulting from miosis aggravates the rise in intraocular pressure (as does mydriasis). Pretreatment with aspirin plus iridectomy virtually eliminates the elevation of intraocular pressure consequent to paracentesis.

Animals↗

PubMed1979

[Surgery on the eye under anticoagulative therapy (author's transl)].

Surgery on the eye of patients on long term anticoagulation therapy is possible. To avoid bleeding suprarenin solution 1:1000, coagulation of conjunctival and scleral blood vessels, incision into the cornea when removing cataracts and iridectomy under the operating microscope are recommended. Local anaesthesia is advisable, has however the risk of a retrobulbar hematoma. Thromboplastin time (Quick) under 15% of the norm should be avoided, and only raised in cooperation with the responsible internist.

Anesthesia, Local↗

PubMed1979

[Is a general operative prophylaxis of the fellow eye in cases of acute glaucoma necessary? (author's transl)].

The fellow eyes of 136 patients suffering from acute glaucoma were checked during their hospitalization by means of provocation-tests and gonioscopy. Ten cases had a simultaneous attack of both eyes, and 27 were submitted to a peripheral iridectomy prophylactically after a positive provocation-test. Of the remaining 99 patients observed up to 12 years after the operation only 22 developed an attack in the fellow eye; 11 of them were below the age of 60 years, and only 4 over 70.

Acute Disease↗

PubMed1979

[Clinical experience in glaucoma surgery utilizing silicon catheters (author's transl)].

In 7 probands exhibiting haemorrhagic glaucoma a combined thermosclerostomy with insertion of a silicons tubing (with or without basal iridectomy) has been performed. The catheter had an inner diameter of 0,5 mm, measuring about 5 mm in length and projecting about 1,5 mm into the anterior chamber. The tubing has been anchored proximally with two nylon sutures (10--0) to the corneal wound edge going through full thickness cornea; the distal end has been anchored with two more nylon sutures to underlying sclera. Tenon's capsules and conjunctiva were closed separately. In all cases the tubing has been well tolerated and did not exhibit any sign of displacement, the intracameral opening remained patent. During an observation period of 3--16 months with or without additional antiglaucomatous medication an intraocular pressure between 14--22 mm Hg could be achieved; all patients remained asymptomatic.

Adult↗