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At least 937 records · Page 52Linked to original sources

PubMed1990

Capsular bag distension after endophacoemulsification and posterior chamber intraocular lens implantation.

Six cases of capsular bag distension after capsulorhexis, endophacoemulsification, and posterior chamber intraocular lens (IOL) implantation are presented. Five cases had prominent posterior subcapsular cataracts preoperatively. In three cases, the anterior chamber depths were shallower and the apparent refractive errors were more myopic than normal after surgery. All six cases exhibited an apparent early complete sealing of the anterior capsular remnant against the anterior IOL optic. In each case, the capsular bag contained moderate particulate debris and flare while the adjacent vitreous and anterior chambers were clear. I suspect the particles are epithelial cell and cortical debris suspended in a fluid comprising lens epithelial protein, cellular breakdown products, balanced salt solution, and water. Five cases have received no specific treatment. In one case, a neodymium:YAG laser anterior capsulotomy allowed a forward egress of fluid from the distended capsular bag and a return to normal pseudophakic anatomy.

Aged↗

PubMed1989

Intraocular pressure measurement after pars plana vitrectomy.

The ability of various tonometers to measure intraocular pressure (IOP) accurately after pars plana vitrectomy was determined by using Schiøtz, Goldmann, and Digilab pneumatic tonometers before and after the procedure in 47 eyes. Seventeen of these eyes underwent intraoperative fluid-gas exchange and had an intravitreal gas bubble on the first postoperative day. The Schiøtz tonometer underestimated the Goldmann IOP by more than 10 mmHg in 6 (35%) of 17 eyes after vitrectomy with intravitreal gas and 4 (13%) of 30 eyes without intravitreal gas. The Digilab tonometer did not underestimate the Goldmann IOP by more than 10 mmHg in any eye postoperatively. However, the Digilab tonometer underestimated the Goldmann IOP by more than 5 mmHg in 3 (18%) of 17 eyes after vitrectomy with intravitreal gas and two (7%) of 30 eyes without intravitreal gas.

Adult↗

PubMed2005

Novel roles of aquaporins revealed by phenotype analysis of knockout mice.

The aquaporins (AQPs) are small integral membrane proteins that transport water and in some cases small solutes such as glycerol. Physiological roles of the ten or more mammalian AQPs have been proposed based on their expression in epithelial, endothelial and other tissues, their regulation, and in some cases the existence of humans with AQP mutation. Here, the role of AQPs in mammalian physiology is reviewed, based on phenotype analysis of transgenic mouse models of AQP deletion/mutation. Phenotype studies support the predicted roles of AQPs in kidney tubule and microvessel fluid transport for urinary concentrating function, and in fluid-secreting glandular epithelia. The phenotype studies have also shown unexpected roles of AQPs in brain and corneal swelling, in neural signal transduction, in regulation of intracranial and intraocular pressure, and in tumor angiogenesis and cell migration. The water/glycerol-transporting AQPs were found to play unexpected roles in skin hydration and in fat metabolism. However, many phenotype studies were negative, such as normal airway/lung and skeletal muscle function, despite AQP expression, indicating that tissue-specific AQP expression does not indicate physiological significance. The mouse phenotype data suggest that modulators of AQP expression/function may have such wide-ranging clinical applications as diuretics and in the treatment of brain swelling, glaucoma, epilepsy, obesity, and cancer.

Animals↗

PubMed1999

Differential diagnosis of CMV retinitis.

Diagnosis of cytomegalovirus retinitis (CMVR) is usually made by retinal examination by an experienced ophthalmologist. The characteristic appearance of the infection is distinctive enough that recourse to ancillary tests or diagnostic procedures is rarely needed. However, atypical cases of CMVR or infections with other organisms in individuals at high risk for CMVR may require invasive diagnostic testing of ocular fluids or tissues using comparative antibody titers, amplification of organismal DNA or RNA, culture, or histology. A small number of other organisms are frequent enough as causes of intraocular infection that the typical appearances of these infections have become known. Familiarization of the clinician with the expected clinical presentation of various infections can facilitate diagnosis, selection of confirmatory diagnostic tests, and empiric therapy.

Animals↗

PubMedDate not supplied

810 nm diode grid laser treatment for massive chronic serous retinal detachment following combined kidney and pancreas organ transplantation.

An insulin-dependent diabetic woman of 42 years received a combined pancreas and kidney transplant five years prior to referral to our clinic for ophthalmic consultation. Her systemic immunosupression included oral steroids and she subsequently developed huge bilateral central serous retinal detachments affecting both posterior poles and the temporal midperiphery of the left eye. Her vision was reduced to count fingers (CF) in both eyes. Fluorescein angiography (FA) revealed diffuse mild retinal pigment epithelium (RPE) staining in both eyes. As an empiric treatment grid laser photocoagulation with an 810 nm diode laser (Iridex Corp., Mountain View, California) was performed with complete resorption of subretinal fluid in both eyes and visual improvement to 20/70 in the right eye and 20/200 in the left eye at 18 months post-treatment. In patients diagnosed with atypical central serous retinal detachment whose fluorescein angiogram displays widespread RPE damage and in whom systemic steroids are medically necessary, diode grid laser photocoagulation may be a reasonable treatment option.

Body Fluids↗

PubMed1996

Suprachoroidal effusion following argon laser trabeculoplasty.

PURPOSE: This is first report of suprachoroidal effusion occurring subsequent to argon laser trabeculoplasty (ALT). METHODS: Review of the records of the patients in question. RESULTS: A 77-year-old woman with bilateral pseudophakia and primary open-angle glaucoma was treated with ALT when her visual fields deteriorated despite topical timolol therapy. Although ALT was initially performed without complication in one eye, treatment of the other eye led to a choroidal detachment. This was associated with temporary reduction in visual acuity, shallowing of the anterior chamber and hypotony. CONCLUSION: Suprachoroidal effusion appears to be another complication of ALT. In the reported case, this application and its effects were temporary and resolved with conservative management.

Aged↗

PubMedDate not supplied

[Study on the influence of silicone oils of various viscosities on anterior eye structures].

Intraocular silicone oil tamponade plays important role in the treatment of complicated retinal detachments. Aim of present study was an investigation of the effects of different silicone oil fluids on the anterior chamber structures. Standard silicone oils with 100, 990, 3690 mPa.s viscosity and highly purified silicone oil with viscosity 5000 mPa.s were used. Corneal silicone oil impregnation was observed in corneas which were in contact with silicone oil with 100 mPa.s. viscosity. Silicone oil impregnation of uveal structures was observed in all cases after the 4 months follow-up. "Posterior collagenous layer" was observed subendothelial in eyes injected with various silicone oil fluids including highly purified one. Results of our investigation show that use of highly purified silicone oil does not allow to reduce the side effects on ocular structures caused by emulsification or a barrier to the nutrition and exchange of products of metabolism provided by silicone oil bubble.

Animals↗

PubMed1996

Cystoid macular edema.

Cystoid macular edema (CME) may develop in association with a wide variety of ocular conditions. It is the result of cystic accumulation of extracellular intraretinal fluid in the outer plexiform and inner nuclear layers of the retina, as a result of breakdown of the blood-retinal barrier. It is most common following intraocular surgery, and in patients with venous occlusive disease, diabetic retinopathy, and posterior segment inflammatory conditions. A variety of approaches to the treatment of CME have been attempted, with a variable degree of success. These options have included topical and oral steroids, nonsteroidal anti-inflammatory agents, and laser photocoagulation treatment. The exact cause of CME and the effective treatment of this condition have remained elusive.

Cataract Extraction↗

PubMed1994

Effects of intraocular bubble duration in the treatment of macular holes by vitrectomy and transforming growth factor-beta 2.

PURPOSE: To compare the effect of a long-acting (16% perfluoropropane [C3F8]) versus a short-acting (air) intraocular gas tamponade on visual outcome and macular hole closure rate after vitrectomy and intravitreal instillation of transforming growth factor-beta 2 (TGF-beta 2) on the macula. METHODS: Vitrectomy with removal of the posterior hyaloid fluid-gas exchange with instillation of TGF-beta 2 was performed in 15 eyes treated with air and 37 eyes treated with 16% C3F8 using identical surgical techniques (mean follow-up, 5.6 months). RESULTS: The macular hole was closed successfully in 36 (97%) of 37 eyes treated with 16% C3F8 and in 8 (53.3%) of 15 eyes treated with air (P = 0.00007). The visual acuity improved by a mean of 3.1 lines on the Early Treatment of Diabetic Retinopathy Study chart for eyes treated with 16% C3F8 and 1.3 lines for eyes treated with air (P = 0.003). CONCLUSIONS: A longer duration intraocular gas tamponade from 16% C3F8 gives a much higher rate of successful closure of macular holes and improved visual acuity using vitrectomy and TGF-beta 2 than does air.

Aged↗

PubMed1986

Sterile hypopyon secondary to ultrasonic cleaning solution.

During a 20-week period, 21 cases of sterile hypopyon occurred 24 hours after uncomplicated extracapsular cataract extraction and in-the-bag posterior chamber intraocular lens implantation at the Valley Eye Institute. While all cases responded to steroid treatment and exhibited no residual ocular effects, the cause of the hypopyon remained a mystery despite an on-going reevaluation of the surgical procedure and sterilization techniques. Several suspected causes were investigated and eliminated. It was clinically determined that surgical instruments placed in older ultrasonic cleaning solution caused the hypopyons. Further analysis at the Center for Intraocular Research at the University of Utah revealed that the instruments were contaminated by a heat-stable endotoxin that remained on the instruments through the autoclaving process. Surgeons currently using ultrasonic instrument cleaners should be aware that, with some models, following the manufacturer's recommended fluid changing procedures could result in endotoxic contamination of surgical instruments which could, in turn, cause severe inflammatory reactions in the immediate postoperative period.

Animals↗

PubMed2000

[Sclerothalamectomy (STE): stable postoperative intraocular pressure regulation in primary open-angle and pseudoexfoliative glaucoma].

BACKGROUND: Since the 70th years we operated the hemorrhagic glaucoma by a ciliary body exposure after Benedikt. In a few patients we noted a stable intraocular pressure regulation for years, often in these cases where there is no filtering bleb. This signifies, that the ciliary body is heavily involved in the resorption of the anterior chamber fluid. During the following next years we further developed this operating technique and we use it today successfully in the operative treatment of primary open angle- and pseudoexfoliative glaucoma. PATIENTS AND METHODS: Since march 1996 we performed a sclerothalamectomy in 46 eyes. In approximate the half of cases the operation was done combined with a cataract surgery. 27 eyes had a primary open angle and 19 eyes a pseudoexfoliative glaucoma with a mean preoperative intra-ocular pressure of 29.79 +/- 7.96 mm Hg respectively of 33.58 +/- 9.32 mm Hg. RESULTS: The mean follow-up was in the case of primary open angle glaucoma 18.3 +/- 8.9 (median 20) and in the case of pseudoexfoliative glaucoma 15.8 +/- 11 (median 16) months. The mean postoperative intra-ocular pressure, which range in the group of primary open angle glaucoma 13.9 +/- 1.6 mm Hg and in the group of pseudoexfoliative glaucoma 12.9 +/- 2.5 mm Hg, was significant lower with significant less postoperative medication compared with the preoperative values during the complete follow-up (p < 0.01). There was no evidence in a significant difference between the both groups regarding the postoperative complication rate and intra-ocular pressure. We observed altogether in 7 eyes a flat filtering bleb, 5/27 in the primary open angle glaucoma and 2/19 in the pseudoexfoliative glaucoma group. In all of other cases we didn't state a filtering bleb. CONCLUSION: The sclerothalamectomy leeds to a long-term stable intra-ocular pressure with a contemporary low complication rate in the case of primary open angle- and pseudoexfoliative glaucoma.

Exfoliation Syndrome↗

PubMed2005

Indocyanine green-mediated photothrombosis with intravitreal triamcinolone acetonide for subfoveal choroidal neovascularization in age-related macular degeneration.

BACKGROUND: There is a need for alternative treatments for the management of exudative age-related macular degeneration (AMD). The purpose of this paper is to determine the feasibility, safety, and clinical effect of indocyanine green (ICG)-mediated photothrombosis (IMP) combined with intravitreal triamcinolone acetonide (TA) in patients with subfoveal choroidal neovascularization (CNV) in AMD. METHODS: Thirty-one eyes of 26 patients who were treated with IMP immediately followed by an intravitreal injection of 4 mg of TA were investigated in the study. The patients had a mean follow-up of 9 months (range 3 months to 26 months). Patients underwent one to four sessions of IMP combined with intravitreal TA. RESULTS: Visual acuity showed stability in 19 eyes (61.3%), improvement of visual acuity (VA) in seven eyes (22.6%), and worsening of VA in five eyes (16.1%). A significant regression of the CNV, and diminishing of subretinal fluid, was demonstrated with fluorescein angiography and optical coherence tomography. We found no complications associated with the intravitreal injection procedure or IMP. Five (16.1%) eyes developed an increase in intraocular pressure related to the presence of TA in the vitreous cavity. However, it was medically controlled with topical anti-glaucoma medications. Nineteen of 31 eyes (61.2%) required at least one re-treatment (mean 1.7; range 1-4) during the study period. CONCLUSIONS: Combined IMP and intravitreal TA may provide stability or improvement in visual acuity and fundus findings in choroidal neovascularization. Further evaluation in a multicenter, randomized, placebo-controlled clinical trial with longer follow-up is needed to accurately assess the safety and efficacy of this new treatment modality.

Aged↗

PubMed1999

Idiopathic giant retinal tears in identical twins.

PURPOSE: To report idiopathic unilateral giant retinal tears with retinal detachment in identical twins that occurred 2 weeks apart. METHODS: Case reports. RESULTS: In both patients, giant retinal tear and retinal detachment was treated with pars plana vitrectomy, placement of encircling scleral buckle, fluid-perfluorocarbon exchange, endolaser treatment, perfluorocarbon-air exchange, and 16% perfluoropropane injection. One year after retinal detachment surgery, cataract developed in both postoperative eyes. Phacoemulsification with posterior chamber intraocular lens implantation was performed on both eyes. Three and a half years after retinal surgery, corrected visual acuity in both treated eyes was 20/20, and retinal reattachment was successful. CONCLUSIONS: To our knowledge, this is the first report of idiopathic giant retinal tears in identical twins and raises the issue of genetic influences in the pathogenesis of this disease.

Adult↗

PubMed2002

[Comparative investigation of the etiology of visual field defects after epimacular surgery].

BACKGROUND: Sectorial visual field defects after macular hole surgery were described by several authors. The intraocular gas tamponade is discussed to be a possible causative factor for this complication. PATIENTS AND METHODS: Goldmann perimetry and threshold perimetry were performed preoperatively and 6 weeks postoperatively in 48 patients who underwent epimacular surgery because of macular pucker (23 eyes) or macular holes stage II - IV (25 eyes). Laser polarimetry was performed additionally using the Nerve Fiber Analyzer. The results were compared quantitatively. In all cases an epimacular membrane was peeled off. Eyes with macular holes underwent fluid-gas exchange with SF 6 without drying up the retina completely. RESULTS: No patient showed a sectorial visual field defect. The quantitative comparison of visual field examinations did not prove a difference between both groups. CONCLUSIONS: We could not detect any impairing influence of the intraocular gas tamponade in our patients. Without complete desiccation of the vitreous cavity, visual field defects after macular hole surgery are unlikely.

Aged↗

PubMed1997

Postoperative contamination after using vancomycin and gentamicin during phacoemulsification.

OBJECTIVE: To investigate if the addition of vancomycin and gentamicin to the irrigating solutions during phacoemulsification with lens implantation reduces the incidence of positive postoperative intraocular cultures. DESIGN: Two-part double-masked, placebo-controlled, randomized clinical trial. PATIENTS: In the preliminary study, intracameral antibiotic concentrations were measured immediately after surgery (in 10 eyes) and 2 hours after surgery (in 10 eyes) in patients treated with antibiotics. In the primary study, 120 eyes underwent uncomplicated surgery. The treatment group and the placebo group were composed of 60 eyes each. INTERVENTION: The treatment group received vancomycin, 20 micrograms/mL, and gentamicin, 8 micrograms/mL, in the irrigating fluid. The placebo group received only irrigating fluid. All patients in the primary study underwent anterior chamber aspiration following surgery, and culturing was performed 2 hours later. MAIN OUTCOME MEASURE: Identification and quantification of positive cultures in thioglycolate broth and chocolate agar. RESULTS: In the preliminary study, the half-life of both intraocular antibiotics was less than 2 hours. In the primary study, intraocular aspirates yielded positive cultures in 3 specimens (5.0%) in the antibiotic-treated group and in 7 specimens (12.0%) in the placebo group. CONCLUSIONS: Although we found a higher rate of positive postoperative cultures in the placebo group (odds ratio = 2.51), 2 hours of contact between the antibiotic solution and bacteria did not produce results that reached statistical significance (P =.18) to support adding vancomycin and gentamicin to the irrigating solutions during phacoemulsification. Further studies are needed to evaluate the clinical implications of using antibiotics in irrigating solutions.

Adult↗

PubMed1990

Corneal endothelial permeability after anterior chamber silicone oil.

One of six silicone oils, differing in both viscosity and manufacture, was infused into the anterior chambers of rabbit eyes. Polydimethylsiloxane oil, 5000 cps, caused an increased corneal endothelial permeability to inulin and dextran at 24, 96, and 168 hours after placement into the eye. Intraocular pressures were slightly elevated in the experimental eyes, compared with contralateral controls, at 24 and 144 hours after infusion. The effects of five other oils on corneal endothelial permeability were examined 168 hours after infusion. All oils increased permeability and caused thinning of endothelial cells, together with the appearance of a retrocorneal membrane, except Dow Corning Medical Fluid 360. The results indicated that contact of most silicone oils with corneal endothelium rapidly induces physiologic and morphologic changes.

Animals↗

PubMed1990

The effect of prostaglandin F2 alpha on trabecular outflow facility in cynomolgus monkeys.

Cynomolgus monkeys were treated topically in one eye with 2 micrograms of prostaglandin F2 alpha -l-isopropylester (PGF2 alpha-IE) twice daily. On day 4, 3 hr after the seventh dose, intraocular pressure (IOP) was 8.1 +/- 0.7 mmHg lower in the treated than in the control eyes. On day 5, after the ninth PGF2 alpha dose, gross facility was measured in both eyes by determining the rate of fluid flow from an external reservoir into the eye at two different IOP levels. Simultaneously, trabecular facility was measured by determining the rate of accumulation of intracamerally infused radioiodinated albumin in the general circulation. Gross facility was 40-60% higher in PGF2 alpha treated than in control eyes, but there was no difference in trabecular facility. The increase in gross facility sometimes reported following PGF2 alpha probably represents increased pseudofacility or uveoscleral facility, rather than true facility of outflow through the trabecular meshwork and Schlemm's canal.

Animals↗

PubMed1998

Delayed-onset Pseudomonas stutzeri endophthalmitis after uncomplicated cataract surgery.

An 88-year-old woman had uneventful extracapsular cataract extraction with posterior chamber intraocular lens (IOL) implantation in her right eye. Seven weeks later, an anterior vitrectomy with removal of the IOL was performed because of endophthalmitis resistant to topical and systemic amoxicillin, cephalosporin, aminoglycoside, and steroids. Microbiological examination of the vitreous biopsy, capsule, and anterior chamber fluid disclosed Pseudomonas stutzeri, gram-negative nonfermentative bacteria sensitive to tetracycline, ceftazidime, gentamicin, ofloxacin, and piperacillin. Pseudomonas stutzeri should be considered in the treatment of delayed-onset endophthalmitis.

Aged↗