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At least 127 records · Page 7Linked to original sources
PubMed1979

Combined thermotrabeculocanalotomy cataract extraction.

The results of combined thermotrabeculocanalotomy-cataract extraction are reported on 9 cases, 7 of which are glaucoma cases controlled by medical therapy, one secondary glaucoma following chronic angle-closure, and one secondary glaucoma following trauma. The results were satisfactory both in terms of visual acuity and lessening reliance on medical therapy of the glaucoma following surgery. More importantly, the safety of the procedure is emphasized, which further indicates that the combined procedure should be considered as the procedure of choice when a cataract must be extracted in a patient with glaucoma.

Acetazolamide↗
PubMed1992

Surgical management of closed angle glaucoma: our experience.

In this paper we present our experience of the last three years in the surgical treatment of eyes with closed angle glaucoma. We have performed an extracapsular lens extraction and posterior chamber intraocular lens implantation on 34 eyes of 34 patients. All of them were affected by closed angle glaucoma with variable control after a Yag laser iridotomy: 6 eyes had high I.O.P. notwithstanding maximal therapy, 11 eyes had I.O.P. under control (less than 21 mmHg) without therapy, 9 with I.O.P. controlled with topical therapy, 8 with I.O.P. controlled with maximal therapy (C.A.I. included). The cases with well controlled glaucoma were operated on because of the presence of a more or less significant lens opacities. After a follow-up of up to 40 months (mean = 20.3, range = 1-40), all eyes show satisfactory intraocular pressure and no eye needed a filtering procedure. The results of our studies are as follows (values are mean +/- SD). In the group of 6 eyes with high I.O.P., the mean pre-operative intraocular pressure was 29.7 +/- 5.6 mmHg and the mean post-operative I.O.P. was 15.1 +/- 1.4 mmHg. The mean reduction was 14.5 +/- 6.6 mmHg (p < 0.005). In the 28 eyes with pre-operative I.O.P. under control (17.5 +/- 1.6), the mean post-operative I.O.P. was 14.4 +/- 2.3 mmHg, with a mean reduction of 3.1 +/- 3.1 mmHg (p < 0.005). Before the E.C.C.E., 11 eyes had I.O.P. less than 21 mmHg without anti-glaucoma medication, whereas after the E.C.C.E. 28 eyes did not need such a medication.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Biometric data of eyes after the onset of acute glaucoma].

Biometric measurements were performed in 67 patients after acute glaucoma and in 67 patients of a matched control group. For patients with acute glaucoma the subjective refraction was +0.91 +/- 2.82 dpt, ocular axial length was 21.73 +/- 0.96 mm, lens thickness was 4.95 +/- 0.63 mm and the ratio lens thickness to ocular axial length amounted to 2.27 +/- 0.29. There was a statistically significant difference between the glaucoma and the control group concerning the parameters subjective refraction, ocular axial length, lens thickness and the lens thickness to axial length ratio. A statistically significant positive correlation was found between corneal radius and axial length, both, in the control and the glaucoma group, a significant negative correlation between axial length and subjective refraction only in the control group. In contrast to other authors, who reported on patients with narrow angle glaucoma with and without acute attack; we found no significant difference. These results support the suggestion that biometric data do not allow a prediction whether a patient with narrow anterior chamber angle will suffer glaucoma attack or not. The etiology of this disease seems to have a multifactorial origin.

Acute Disease↗
PubMed1992

Angle closure glaucoma following a combined blepharoplasty and ectropion repair.

This paper reports an occurrence of angle closure glaucoma following a combined blepharoplasty and ectropion repair. We are unaware of any previous reports of such an incident. Specific to this case was the coexistence of a cataract that contributed to the narrowing of the anterior chamber. This condition, along with pupil dilation secondary to the anesthetic, precipitated a phacomorphic angle closure glaucoma attack, necessitating emergency cataract surgery. Because other procedures involve pupillary dilation as a potential side effect, we recommend an increased awareness of this potential postoperative complication.

Acute Disease↗
PubMed1992

A photometric study of the effect of pupil dilatation on Nd:YAG laser iridotomy area.

A photometric study of the effect of pupil dilatation on Nd:YAG laser iridotomy area was performed in 21 eyes of 21 patients. The iridotomy area was 0.075 (0.055) mm-2 (mean (SD)) before pupil dilatation and 0.073 (0.070) mm-2 after pupil dilatation (t test NS). Iridotomy area after pupil dilatation correlated with iridotomy area before pupil dilatation (r = 0.815, p < 0.01) but did not significantly correlate with measures of iridotomy shape or position, or with changed iris area following pupil dilatation. Two iridotomies became reduced to less than 20% of their initial area following pupil dilatation. Our findings suggest that the only effective method of avoiding development of unacceptably small iridotomy area after pupil dilatation is to create a sufficiently large iridotomy at the time of initial laser surgery.

Acute Disease↗
PubMed1990

Soap gets in your eyes.

We present a previously unreported series of five cases of acute angle closure glaucoma associated with watching the Australia soap opera "Neighbours". Two cases were bilateral and associated with watching two episodes of "Neighbours" on the same day. The pathogenesis, and possible role of watching soap operas in the causation of primary angle closure glaucoma is discussed.

Aged↗
PubMed1992

[YAG laser treatment in anterior segment disease of the eye].

Three hundred and fifty-two eyes (230 patients) with various diseases were treated with the first China-made YAG laser therapy instruments. The success rate was 100%. Two hundred and seventy-six eyes with primary angle closed glaucoma were treated by peripheral iridotomy. Postoperatively, the IOP was lowered by 0.267 kPa (2.43 mmHg). The dose and frequency of medication could then be lowered. The closed chamber angle index improved. Forty-nine eyes with membranous cataract were treated by posterior capsulotomy: Visual acuity was improved by 95%. The main complications during or immediately after operation were as follows: transient elevation of IOP, hyphema, anterior uveitis and corneal edema. All of these were well controlled.

Adult↗
PubMed1992

Pupillary dilation: an eye-opening problem.

Dilation of the pupil is a procedure with both clinical and legal ramifications. Optometrists must be familiar with the requirements of informed consent, which must be met when utilizing dilation on the 4-8 percent of patients with anterior chamber angles that are narrow enough to cause an angle closure. Optometrists also must recognize those circumstances under which pupillary dilation is necessary, both for symptomatic and asymptomatic patients. The correct drug regimen must be selected, whether it is for "routine" pupillary dilation or for a patient with a condition requiring a special drug regimen. Patients with dilated pupils must be appropriately managed, and failure to warn a patient of common and expected side effects may create liability if the failure to warn is the cause of injury. If complications--such as acute angle closure--occur, the optometrist must be prepared to manage the situation so as to minimize the risk of injury to the patient.

Eye Diseases↗
PubMed1975

The management of glaucoma in nanophthalmos.

Patients with nanophthalmos are prone to develop a chronic painless type of glaucoma in middle age, probably due to the natural increase in the size of the lens which is already relatively too large for the small eye. Although the underlying mechanism is obscure, a slowly progressive "creeping" chronic angle-closure is postulated, but gonioscopic evaluation is difficult due to the shallow anterior chamber, with grade I and slit angles. Response to medical treatment is poor and miotics may even make the condition worse by producing relative pupillary block and by relaxing the lens zonule. Ordinary glaucoma surgery is to be avoided in nanophthalmos because of the fear of postoperative ciliary-block malignant glaucoma. Periopheral iridectomy performed in five eyes at an advanced stage of the chronic angle-closure did not facilitate glaucoma control in three eyes, and in two eyes in which the operation was combined with posterior sclerotomy, the eyes became blind from vitreous hemorrhage. Lenx extraction in five eyes controlled the glaucoma but was followed by choroidal effusion and nonrhegmatogenous retinal detachements in two eyes and blindness in another eye when combined with a posterior sclerotomy. No firm therapeutic recommendations can be made on the basis of the author's experience in the six reported cases. Conventional medical therapy seems ineffectual even when begun early in the glaucoma. Conventional glaucoma surgery must be performed early, before permanent damage to the outflow mechanism occurs but removal of the lens must be anticipated. The surgeon must also remain aware of the high incidence of serious posterior-segment complications which inexplicably follow glaucoma or lens surgery in nanophthalmos, as described by Brockhurst.

Adult↗
PubMed1975

The prediction of glaucoma from ocular biometric data. Part 1. An application of multiple regression analysis.

Two sets of multiple regression equations (prediction systems) were derived from the analysis of ocular biometric data obtained from glaucoma patients (16 open angle; 16 angle-closure) and 75 normal subjects. Discriminant scores were established for both sets of equations which minimised the number of false negatives. One set, the 'Glaucoma Equations' was applied to the data to segregate the glaucoma from the normal subjects. The other prediction system, the 'Classification Equations,' was then applied to the group defined as glaucomatous to discriminate between patients in the angle-closure and open angle categories. The performance of these equations, obtained by comparing the predicted and actual classifications for this sample, was such that between 9 and 12% of false positives and 0 and 3% false negatives were found on the 'Glaucoma Equations' and between 6 and 12% of false positives with no false negatives on the 'Classification Equations.'

Age Factors↗
PubMed1976

Survey of the first-degree relatives of glaucoma patients.

Family histories were taken from 124 index patients, who had presented with either angle-closure or open angle glaucoma to the University Department of Ophthalmology, Manchester, between 1967 and 1972. Their first-degree relatives numbered 886, i.e. siblings, offspring and parents. Relatives were contacted by post and asked to attend for eye examination. Out of a total of 886 relatives, only 187 relatives were actually examined. The reasons for this low attendance rate are discussed; e.g. 423 relatives had already died.

Age Factors↗
PubMed1977

Trabeculectomy: long-term follow-up.

The postoperative course of 309 eyes subjected to trabeculectomy has been studied over a 7-year period. The results have been compiled with regard to effectiveness to maintain a normal range of intraocular pressure with and without postoperative medication. The figures have been assessed in toto and for 3 groups of glaucoma, namely, open angle, chronic angle-closure, and acute angle-closure. Results support those of other reports to show that trabeculectomy gives satisfactory control over the years in a reasonably high proportion of eyes and with relatively few postoperative complications. There is also a small group of combined trabeculectomy with cataract extraction.

Cataract Extraction↗
PubMed1976

Combined cyclodialysis and cataract extraction.

Combined cyclodialysis and cataract extraction was performed on 78 eyes in a consecutive series of 26 years duration. This operation was performed on eyes with severe glaucoma, inadequately controlled on maximum medical therapy, and with a cataract needing extraction. Glaucoma types included open-angle, angle-closure with peripheral anterior synechias, combined open-angle and angle-closure, and secondary to uveitis. Seventy of the 78 eyes had follow-up of six months or more and the results in these 70 eyes were analyzed. In thirteen percent of the eyes in this study the postoperative intraocular pressure was the same or higher than the preoperative level, or reductions of intraocular pressure were not clinically significant. Eighty-seven percent (61 eyes) had a clinically significant lowering of intraocular pressure following the combined procedure. Thirty-nine percent (27 eyes) of the 70 eyes in this study had a tension of 0-14 mm Hg, and 44% (31 eyes) had a tension of 15-20 mm Hg. Intraocular pressure was improved significantly more often in patients over 60 years of age. Resulting intraocular pressures of 14 mm Hg or less were more likely when the cyclodialysis was performed in the lower quadrant. The results of the combined procedure were not significantly influenced by the type of glaucoma involved or by a history of previous glaucoma surgery. Bleeding was a frequent complication, but was not related to resulting intraocular pressure. Other complications were rare. We conclude that combining cyclodialysis with cataract extraction is safe and effective, and is a suitable procedure when there is need for surgery to relieve severe glaucoma, along with a need for cataract extraction.

Adolescent↗