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At least 163 records · Page 9Linked to original sources
PubMed1993

Perfluoroperhydrophenanthrene (Vitreon) in the management of giant retinal tears: results of a collaborative study.

Fifty cases of retinal detachment with a giant retinal tear were managed using perfluoroperhydrophenanthrene (Vitreon) as an intraoperative and postoperative tool. The giant tear was less than 180 degrees in 76% of the eyes, greater than 180 degrees in 22%, and greater than 270 degrees in 2%. Proliferative vitreoretinopathy was present in 40%. Vitreon was used only intraoperatively in 84% of the eyes, and was left in 16% for up to 4 weeks. Intraoperative retinal reattachment was achieved in 98%. Retinal attachment was maintained in 88%, with a mean follow up of 8.6 months. Postoperative visual acuity was better than 20/400 in 52%. Postoperative complications included cataract in 23%, choroidal effusion in 2%, hypotony in 4%, and recurrent retinal detachment with proliferative vitreoretinopathy in 26%.

Adolescent↗
PubMed1993

Closed-system phacoemulsification and posterior chamber implant combined with penetrating keratoplasty.

The main intraoperative difficulties of performing a procedure combining open-sky extracapsular cataract extraction, implantation of posterior chamber intraocular lens (PC-IOL), and penetrating keratoplasty ("triple procedure"), most frequently caused by the uncompensated posterior pressure created when the cornea is open, include incomplete capsulorhexis, incomplete aspiration-irrigation of the cortex, uncertain placing of the IOL, posterior capsule rupture, choroidal effusion, and even expulsive hemorrhage. We recommend a two-step procedure that eliminates these problems: The first step begins with removal of epithelium, half-thickness trephining of the cornea, and capsulorhexis; proceeds through phacoemulsification and aspiration-irrigation; and ends with implantation of the PC-IOL, using a pressurized system. The second step is penetrating keratoplasty. In the six cases undergoing this procedure, none of these complications developed or even tended to develop. Although the follow up in these six cases is very short (from 1 to 6 months), the advantage of the technique is that it effectively precludes the above mentioned intraoperative complications, which could affect late results.

Aged↗
PubMed1996

Low-dose mitomycin C trabeculectomy in patients with advanced glaucoma.

PURPOSE: The purpose of this study was to analyze the efficacy and safety of low-dose (0.2 mg/ml) intraoperative mitomycin C in primary trabeculectomy. METHODS: Twenty-eight eyes of 28 patients with advanced primary open-angle glaucoma undergoing primary trabeculectomy were randomized to either mitomycin C (0.2 mg/ml) or saline solution intraoperatively for 3 min. Intraocular pressure was measured at 1 day; 1 week; 1, 3, and 6 months postoperatively; and at the final visit. RESULTS: Mean follow-up was 17.0 +/- 5.6 months for the mitomycin C group and 15.7 +/- 5.1 months for the control group. Mean intraocular pressures were significantly lower in the treated group on the first postoperative day (p = 0.021), at the 6-month interval (p = 0.001), and at the final visit (p = 0.001). At the last follow-up examination, intraocular pressure was < or = 15 mm Hg in 12 (85.7%) of the mitomycin C-treated eyes and in four (28.6%) of the control eyes (p = 0.002). Life table analysis showed a significantly higher probability of intraocular pressure control in the mitomycin C group than in the control group (p = 0.0065). Choroidal effusion was observed in five (35.7%) treated eyes and two (14.3%) control eyes, whereas shallow anterior chamber were present in five (35.7%) treated eyes and one control eye (7.1%). CONCLUSION: Despite inducing a higher short-term complication rate, low-dose mitomycin C may be an alternative in the treatment of eyes with advanced glaucomatous damage requiring low final intraocular pressures.

Aged↗
PubMed1997

Simultaneous use of mitomycin-C with Baerveldt implantation.

BACKGROUND AND OBJECTIVE: To evaluate the outcome of Baerveldt implantation with adjunctive mitomycin-C in cases of complicated glaucoma. PATIENTS AND METHODS: The authors reviewed the charts of all patients who had undergone Baerveldt implantation with mitomycin-C between January 1993 and March 1995. Success was defined before data collection as an intraocular pressure (IOP) between 5 and 21 mm Hg, with or without medications. The success rate was calculated using the Kaplan-Meier actuarial method. RESULTS: Twenty-nine patients were identified. The mean preoperative IOP was 33.6 mm Hg, with an average of 2.0 antiglaucoma medications. The probability of success at 6 and 12 months for patients who received mitomycin-C during Baerveldt implantation was 82.4% and 73.3%, respectively. Choroidal effusion with a flat anterior chamber (10.3%), corneal edema (6.8%), and conjunctival erosion (6.8%) were the most frequent complications. CONCLUSION: In this retrospective series of complicated glaucoma, the implantation of a Baerveldt drainage device with adjunctive mitomycin-C had a satisfactory outcome. The complications encountered and the clinical efficacy were comparable to those of previously reported series in which mitomycin-C was not used.

Antibiotics, Antineoplastic↗
PubMed1997

[The Baerveldt implant in refractory glaucoma: clinial results].

25 Baerveldt glaucoma implants were placed in 22 patients, between 1992 and 1997. The indications were: 14 cases of neovascular glaucoma, 4 congenital glaucomas, 3 glaucomas due to intraocular silicone oil and 4 various glaucomas. The mean preoperative intraocular pressure was 46 mmHg (26-77) on a mean of 2.1 glaucoma medications. The postoperative mean intraocular pressure was 17 mmHg (5-50) on a mean of 0.5 glaucoma medications with a mean follow-up of 16 months (1 week-48 months). The final intraocular pressure was less than or equal to 20 mmHg in 20 of the 25 eyes. The final visual acuity improved or remained the same in 10 of the 25 cases and worsened in 11 cases (4 cases undetermined). The most frequently observed complications were: hyphema, choroidal effusion and corneal edema. Our results, in terms of intraocular pressure control, with the Baerveldt implant in patients with complicated glaucomas appear to be satisfactory. The use of this implant could be extended.

Adolescent↗
PubMed1989

Expulsive choroidal hemorrhage in rabbits. A histopathologic study.

Expulsive hemorrhage is a catastrophic complication of intraocular surgery that can result in total loss of vision. Suprachoroidal effusion and hemorrhage may precede the development of expulsive hemorrhage; however, the relationship remains unclear. After sedation with intravenous pentobarbital sodium, 11 rabbits were given lactated Ringer's solution and heparin sodium intravenously. The right eyes were proptosed, and the central cornea, lens, and anterior vitreous were removed. After surgery, all 11 eyes (100%) developed choroidal effusion, choroidal hemorrhage, or expulsive hemorrhage. The rabbits were killed at various intervals after surgery so that the eyes could be enucleated and processed for light microscopy. Histologic examination revealed four sequential stages of expulsive hemorrhage as follows: (1) There was engorgement of the choriocapillaris. (2) Suprachoroidal effusion occurred mainly near the posterior pole. (3) As the effusion enlarged, stretching and tearing of choroidal vessels as well as tearing of the vessels and attachments at the base of the ciliary body occurred. (4) Massive extravasation of blood, primarily from the torn vessels at the ciliary body base, resulted in suprachoroidal hemorrhage and expulsion of blood through the surgical wound. This experimental model may provide new information relating to the cause and prevention of expulsive choroidal hemorrhage.

Animals↗
PubMed1999

Sclerotomy in uveal effusion syndrome.

PURPOSE: To report visual and anatomic outcomes after modified scleral surgery in patients with uveal effusion syndrome with retinal and choroidal detachment. METHODS: In five eyes of four patients with retinal and choroidal detachment and uveal effusion syndrome due to nanophthalmos, we performed pars plana full-thickness unsutured sclerotomies without sclerectomy. RESULTS: In all cases, uveal effusion with choroidal and retinal detachment resolved within 3 weeks, and all patients showed improved vision. The functional and anatomic results remained stable for over 2 years. CONCLUSIONS: Uveal effusion syndrome that is refractory to medical treatment (high-dose systemic corticosteroids) can be managed effectively by pars plana full-thickness unsutured sclerotomy without sclerectomy.

Adult↗
PubMedDate not supplied

Posterior scleritis.

Posterior scleritis must be considered in the differential diagnosis of many ocular conditions, including angle closure glaucoma, choroidal folds, optic disk edema, circumscribed fundus mass, choroidal detachment, and exudative retinal detachment. Because it is rare, a high index of suspicion is necessary. Anterior scleritis, pain, or a history of collagen-vascular disease, when present, help to alert the clinician to the correct diagnosis. Posterior scleritis affects women more often than men, but annular ciliochoroidal effusion and choroidal folds are more common in men. Exudative macular detachment and a circumscribed fundus mass are more common in women. This paper reviews the world literature on posterior scleritis and describes findings in a series of 43 patients seen at Wills Eye Hospital. It stresses the clinical features and ancillary diagnostic tests that help to establish the diagnosis.

Diagnosis, Differential↗
PubMed2006

Vitrectomy-phacoemulsification-vitrectomy for the management of aqueous misdirection syndromes in phakic eyes.

OBJECTIVE: To describe vitrectomy-phacoemulsification-vitrectomy, a sequential 3-step surgical approach, in the management of malignant glaucoma/aqueous misdirection syndromes in phakic eyes. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Five eyes (4 angle-closure glaucoma and 1 open-angle glaucoma) of 5 patients with mean age of 66 years (range, 56-78). Four patients presented with aqueous misdirection syndrome and 1 patient presented for cataract extraction, having previously had malignant glaucoma in the fellow eye after phacoemulsification surgery. INTERVENTION: The operation performed had three steps: vitrectomy, phacoemulsification, and vitrectomy. Step 1: Preliminary vitrectomy involved limited core vitrectomy to "debulk" the vitreous and soften the eye. Step 2: Phacoemulsification was performed in a standard manner. Step 3: Residual vitrectomy, zonulohyaloidectomy and peripheral iridectomy (if not already present) were performed to create a free communication between the posterior and anterior segments. MAIN OUTCOME MEASURES: Intraocular pressure, visual acuity, biomicroscopic anterior chamber depth, and complications. RESULTS: The time interval between the onset of malignant glaucoma and surgery ranged from 2 weeks to 3 months. All 4 patients with aqueous misdirection syndrome had relief of the aqueous misdirection postoperatively with anterior chamber deepening. Intraocular pressures on day 1 ranged from 6 to 28 mmHg (mean 15.6, mmHg), and at the last visit ranged from 8 to 30 mmHg (mean, 20.4 mmHg). One eye developed an early choroidal serosanguinous effusion requiring drainage. CONCLUSIONS: The vitrectomy-phacoemulsification-vitrectomy approach was effective in this pilot series in the management of aqueous misdirection syndromes and malignant glaucoma in phakic eyes.

Aged↗
PubMed1992

Which is better? One or two? A randomized clinical trial of single-plate versus double-plate Molteno implantation for glaucomas in aphakia and pseudophakia.

PURPOSE: Previous studies have suggested that primary double-plate Molteno implantation may be beneficial. Therefore, the authors performed a randomized clinical trial to evaluate the relative effectiveness and safety of single- versus double-plate Molteno implantation. METHODS: From March 1988 to February 1990, 132 patients who underwent Molteno implantation for medically uncontrollable non-neovascular glaucomas in aphakia or pseudophakia were randomly assigned to receive either single- or double-plate implants. RESULTS: The 1- and 2-year life-table success rates (success [survival] defined as 6 mmHg < or = final intraocular pressure [IOP] < or = 21 mmHg without additional glaucoma surgery or devastating complication) were 55% and 46% with single-plate implantation and 86% and 71% with double-plate implantation, respectively. The final postoperative visual acuities were within one line of the preoperative visual acuities or had improved in 73% and 80% of patients, respectively. Choroidal hemorrhages and/or effusions, corneal decompensation, flat anterior chambers, and phthisis bulbi were more common in the patients who had undergone double-plate Molteno implantation; however, transient elevations of IOP during the first few postoperative months were more common in the patients who had undergone single-plate Molteno implantation. CONCLUSIONS: Double-plate Molteno implantation more frequently affords IOP control than single-plate Molteno implantation; however, double plates are associated with greater risks of choroidal hemorrhages and/or effusions, corneal decompensation, flat anterior chambers, and phthisis bulbi.

Adolescent↗
PubMedDate not supplied

Bilateral angle-closure glaucoma associated with uveal effusion: presenting sign of HIV infection.

A 40-year-old homosexual man presented with acute myopia and bilateral angle-closure glaucoma. Recognition of an anterior chamber configuration of a modestly shallowed central chamber with marked peripheral shallowing clinically suggested uveal effusion. B-scan echography provided definitive, confirmatory evidence of diffuse choroidal thickening with ciliochoroidal effusion. Treatment with aqueous suppressants, cycloplegics, and topical steroids resulted in complete resolution of the angle closure and reversal of induced myopia. The patient, who was systemically well without signs of AIDS or AIDS-related complex, was later tested and found to be serologically-positive for the human immunodeficiency virus.

Adult↗
PubMed1988

Hemorrhagic peripheral pigment epithelial disease.

Hemorrhage under the retinal pigment epithelium and neurosensory retina occurred in the temporal periphery of ten patients with aging macular degeneration and one patient with histoplasmosis syndrome. The macula was not the source of bleeding. Peripheral subretinal neovascularization, commonly seen histopathologically, may be the cause. The visual recovery was poor, and most patients failed to regain lost vision once peripheral hemorrhage occurred. The differential diagnosis includes retinal detachment, uveal effusion, hemorrhagic retinoschisis, choroidal melanoma, and metastatic tumor.

Aged↗
PubMed2002

Malignant glaucoma induced by a phakic posterior chamber intraocular lens for myopia.

A 23-year-old woman with -14.00 diopters of myopia requested emmetropia for professional reasons. An ICM 130 V2 myopic phakic intraocular lens (IOL) (Staar Surgical AG) was implanted in the posterior chamber. Three days later, the patient developed malignant glaucoma. Pupillary block glaucoma and choroidal hemorrhage or effusion were ruled out. As maximum medical treatment failed, rapid secondary surgery was performed with sclerotomy, aspiration in the midvitreous cavity, and removal of the IOL. The follow-up was 43 months.

Adult↗
PubMed1997

Ultrasound biomicroscopic imaging of the anterior aspect of peripheral choroidal melanomas.

PURPOSE: To correlate ultrasound biomicroscopic features of the anterior aspect of peripheral choroidal melanoma with respect to histopathology. METHODS: We examined 17 eyes of 17 patients who had clinically diagnosed peripheral choroidal melanomas that approached the ora serrata or extended into the ciliary body and who had been assessed with ultrasound biomicroscopy before enucleation. Comparisons were made between anterior tumor margins imaged by ultrasound biomicroscopy and histopathologic specimens. Anatomic features noted on ultrasound biomicroscopy before enucleation were correlated with enucleation specimens, including supraciliary effusion, rotation of the ciliary body, angle involvement, and internal reflectivity patterns. Anterior tumor margin position was determined with reference to the scleral spur. RESULTS: Mean distances from the anterior tumor margin to the scleral spur were 1.47 mm on ultrasound biomicroscopy and 1.65 mm on pathologic examination. This difference was not statistically significant (P = .325). Tumor features evident on ultrasound biomicroscopy were also seen on pathologic examination: supraciliary choroidal effusions in seven of seven, ciliary body rotation in seven of eight, and angle involvement in seven of eight. All tumors were mixed-cell melanomas, and 12 of 17 (70%) demonstrated homogeneous ultrasound biomicroscopic internal reflectivity. Irregular internal reflectivity was seen in five of 17 tumors (29%) and was related to prominent internal vascularity on pathology in three of five. CONCLUSIONS: Ultrasound biomicroscopy is an accurate imaging technique for the in vivo assessment of anterior tumor margins of peripheral choroidal melanomas and can provide detailed imaging of the tumor's interface with the ciliary body.

Anterior Eye Segment↗
PubMed1976

[Micrometastasis of the uvea: a rare cause of uveal effusion (author's transl)].

A clinicopathological report is given on a case of spontaneous chorioideal detachment in a patient with metastatic carcinoma. Histological there was infiltration of the ciliary body and peripheral choroid and a large uveal effusion. Pain would seem to be a pathognomic sign of metastatic tumor in choroideal detachment caused by metastatic tumor.

Aged↗