[Laser gonioplasty in therapy-resistant acute closed-angle glaucoma].
Technical details of gonioplasty by argon laser and the risk involved in cases of medically uncontrolled acute angle-closure glaucoma are discussed.
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Biomedical subjects
G Strasser
Publications and source records attributed to G Strasser.
[Argon laser iridotomy in primary angle-block glaucoma].
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Glaucoma↗
[Gonioscopic changes following cyclocryocoagulation].
Gonioscopic changes after cyclocryocoagulation are reported in 4 patients with angle-closure glaucoma resistant to all forms of therapy. During cryoapplication frozen aqueous humor was observed in the chamber angle near the treated area. Widening of the angle followed in the same place. Possible causes of this change are reported.
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[A simplified ultrasonographic measuring technic in combination with a computer program for calculating the power of intraocular lenses].
In the last few years intraocular lens implantations have gained in popularity. In biometry new electronic methods have been introduced. For measuring the axial length by ultrasound we use the Ocuscan DBR 400 ST unit in combination with the digital storage system and an immersion technique. For lens power calculation we have developed a new computer program for a Commodore CBM 4032 using R.D. Binkhorst's formulae. In a series of 50 Kelman S-Flex anterior chamber lenses we found a mean error of +0.250 D and a standard deviation of +/- 0.662 D. Sixty-four percent of predictions were within the +/- 0.5 D range, and in 88% of these patients we predicted within the +/- 1.0 D range. The maximum errors of prediction were -1.0 D and +/- 1.75 D. Using an immersion technique an accurate axial length measurement can be obtained.
Computers↗
Pigmentary dispersion syndrome. A biometric study.
A-Scan biometry was performed on both eyes of 5 patients suffering from unilateral pigmentary dispersion syndrome, partly with glaucoma. The anterior chamber was significantly deeper and the lens significantly flatter in the eyes with pigmentary dispersion syndrome.
Adult↗
[Laser gonioplasty in chronic narrow-angle glaucoma].
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Chronic Disease↗
[Sectorial racemose vascular malformation of the iris].
A sectorial racemose vascular malformation of the iris in the left eye of a 32-year-old man is reported: a dilated episcleral artery disappeared in the limbal sclera; it reappeared in the chamber angle and after dichotomous branching, continued toward the pupil. The peripupillary capillaries of this sector were dilated, and drained into dilated iris veins.
Adult↗
[Laser trabeculoplasty in low-tension glaucoma].
Eight patients suffering from bilateral low-tension glaucoma underwent laser trabeculoplasty on one eye; the contralateral eye was used as a control. Facility of outflow and the intraocular pressure in both eyes were measured before and after laser treatment. After laser trabeculoplasty a significant increase in outflow (means = 0.084 +/- 0.031) and a reduction in intraocular pressure (means = -4.13 +/- 1.25 mmHg) were observed.
Glaucoma↗
The influence of long-term treatment with timolol on human tear lysozyme albumin content.
The long-term effect of timolol maleate on lacrimal secretion was tested by investigating the concentration of lysozyme and albumin in tears before the start of treatment and after different follow-up periods. A total of 25 patients (45 eyes) were treated with 0.25% or 0.5% timolol as the only antiglaucomatous therapy over a 7.6 month mean observation period (2-13 months). No significant change was found either in the lysozyme or in the albumin concentration.
Adult↗
[Laser treatment for tightening the trabecular meshwork in open-angle glaucoma (trabeculoplasty)].
Forty eyes with medically uncontrolled open-angle glaucoma underwent argon laser therapy through 360 degrees of the trabecular meshwork. The mean pressure change in the treated eyes after two weeks showed a decrease of 9.95 mmHg. Thirty-five eyes (87.5%) were clinically controlled (tension less than or equal to 20 mmHg) either by laser treatment alone (25 eyes) or by continuation of previous therapy (10 eyes) over the various follow-up periods ranging from one to ten months (means = 3.31). Laser therapy showed no hypotensive reaction in five eyes. Increased pressure immediately after therapy seems to be the most severe side effect, which was of short duration in all cases but two.
Glaucoma, Open-Angle↗
[The effect of neural mediation on the immediate rise in intraocular pressure in glaucomatous eyes after cyclocryotherapy (author's transl)].
As a rule, there is a transient rise in intraocular pressure following cyclocryotherapy. The preoperative administration of retrobulbar anaesthesia to a group of patients significantly reduced intraocular pressure after cyclocryotherapy in this group as compared with a control group without anaesthesia. These results imply that the temporary rise in intraocular pressure after cyclocryotherapy is mediated by a neural pathway.
Ciliary Body↗
Mediation of the ocular response to cyclocryocoagulation.
The possible roles of prostaglandins and a neural pathway in the disruption of the blood-aqueous barrier in the rabbit eye after cyclocryocoagulation were studied. Both the preoperative IV administration of the prostaglandin inhibitor acetylsalicylic acid and the application of retrobulbar and topical anesthesia reduced IOP and decreased breakdown of the blood-aqueous barrier, as measured by protein in the aqueous humour. These results imply that the acute response of the animal eye to cyclocryocoagulation is mediated partly by prostaglandins and partly by a neural component resistent an inhibitor of prostaglandin synthesis. When administered together, acetylsalicylic acid and ocular anesthesia yielded a further reduction in postoperative reactions and protein concentrations in the aqueous humour, but were unable to abolish the ocular response completely. The dual ocular mediation to cyclocryocoagulation is apparently due to the combined thermal and mechanical injury caused to ocular structures which synthesize prostaglandins and receive sensory innervation from the trigeminal nerve. The considerable breakdown of the blood-aqueous barrier in cyclocryocoagulation allows leakage of different molecular weight proteins, in equal ratio, into the aqueous humour.
Animals↗
[Arden test for early glaucomatous damage (author's transl)].
With the aid of the Arden grading test 27 eyes with early glaucomatous visual field defects and 80 normal control eyes were examined in a double-blind study. Eighteen eyes with early glaucomatous visual field defects had values which were clearly higher (83-130) than the control eyes. In nine of the diseased eyes Arden scores were 68-82, i.e., similar to those obtained in the normal eyes.
Glaucoma↗
[Timolol in the treatment of glaucoma (author's transl)].
Untolerated or insufficiently effective Therapy in 32 patients (63 eyes) with primary open-angle glaucoma was discontinued and substituted with Timolol, and all patients were followed up over a period of 60 weeks. Timolol was well tolerated in all cases without any local or systemic side effects. Either alone or in combination with other medications Timolol brought about an adequate reduction in intraocular pressure in eyes which hitherto had no longer responded to conventional conservative therapy.
Follow-Up Studies↗
[Modified trabeculectomy with scleral wick (author's transl)].
Scar formation at the edge of the scleral flap may cause insufficient pressure regulation in trabeculectomies. A scleral wick (modified after Kottow) could improve the success rate of fistulizing operations. In 24 eyes with glaucoma a modified trabeculectomy with scleral wick was performed. No re-closure of the scleral flap could be observed over a period up to 15 months (mean = 5.9).
Cicatrix↗
[Cryo-marker for scleral marking of retinal holes (author's transl)].
According to the Lincoff's procedure, a cryoprobe is used for the localization of retinal holes. A cryo-marker developed for Keeler-cryoprobes simplifies the marking of the scleral impression of the cryoprobe, which is often invisible after thawing. The cryo-marker is fixed on the cryoprobe before cryotherapy. During thawing the toothed ring of the cryo-marker is pushed downwards and placed on the sclera. The centre of the ring on the sclera can now be marked by cauterization after the removal of the cryoprobe.
Cryosurgery↗
Decompensation of chronic open-angle glaucoma following mydriasis-induced pigmentary dispersion into the aqueous humour: a light and electron microscopic study.
A patient with well controlled chronic open-angle glaucoma developed after dilatation of both pupils persistent increase in intraocular pressure (IOP) due to extensive pigmentary dispersion into the aqueous humour. Trabeculectomy specimens obtained from both eyes after 3 and 7 weeks were studied by light and electron microscopy. It seems evident that the initial phase of raised IOP was caused by a clogging mechanism to the outflow channels by melanin and phagocytic cells. The permanent increase in IOP is attributed to the damage induced in the fibrous components of the trabecular sheets as a result of a complete breakdown of their endothelial covering.
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Scimitar syndrome: MR assessment of hemodynamic significance.
We report a case of anomalous pulmonary venous drainage into the inferior vena cava (scimitar syndrome) in which the hemodynamic significance was noninvasively assessed by means of velocity-encoded cine MR. Left-to-right shunt was calculated from direct blood flow measurements performed in the ascending aorta, main pulmonary artery, and aberrant pulmonary vein.
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