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J Kopel

Publications and source records attributed to J Kopel.

At least 19 recordsLinked to original sources
PubMed1995

[Treatment of refractory glaucoma by diode semiconductor laser cyclophotocoagulation].

PURPOSE: Ciliary photocoagulation was used to reduce pressure in eyes with refractory glaucoma or to suppress pain in blind painful eyes. The efficiency of transscleral cyclophotocoagulation (TSCPC) with a clinical diode laser system (Iris Medical Instrument, Oculight SLX) was evaluated. METHODS: This diode laser system (wavelengh: 810 nm) provides light energy to the eye through a specially designed quartz glass fiberoptic probe allowing precise location centered 1.2 mm behind the limbus, i.e. in front of the ciliary body. Thirty eight eyes in 38 patients with refractory glaucoma underwent TSCPC with the diode laser. RESULTS: Three months after surgery, intra-ocular pressure was controlled at 20 mmHg or below in 70% of the patients. Patients who most failed with the TSCPC had higher initial IOP (neovascular and congenital glaucoma). Seventy five percent of the painful glaucoma were painless after the laser treatment. Only a few cases (10%) of transient secondary hypertony were observed. The inflammatory response (21%) was mild and transient. No case of scleral perforation, no case of posterior uveitis, cararact or hypotony were observed. CONCLUSION: The transscleral ciliary photocoagulation laser diode system is efficient to reduce intraocular pressure in refractory glaucoma. Complications are mild compared with other methods of cyclophotocoagulation. A long-term study is necessary to evaluate the results on IOP and the incidence of hypotony.

Adolescent↗
PubMed1995

[Treatment of refractory glaucoma with Nd:YAG laser cyclophotocoagulation].

We treated 54 eyes of 51 patients with refractory glaucoma by using contact transscleral Neodymium: YAG laser cyclophotocoagulation; 32 burns (7 watts during 0.7 second) were applied to each eye by positionning the anterior edge of the probe at 0.5 to 1 mm from the limbus. The mean preoperative intraocular pressure (IOP) was 33.7 mmHg and the mean postoperative IOP was 25.6 mmHg with a follow-up of five months. There was a decrease of IOP in 72.3% of the cases. The postoperative IOP was controlled (IOP < 21 mmHg) in 41.3% of the treated eyes. Pain decreased in 6.7% of the cases that had no control of IOP and they could stop their medical treatment. During the follow-up period we observed neither early post operative hypertonia nor phtisis bulbi. Three eyes had scleral perforations. Laser treatment can be repeated if necessary in no controlled IOP cases. We had less complications with the laser treatment than with cyclocryoapplication. We described the advantages of the contact probe used.

Adult↗
PubMed1995

[Treatment of refractory glaucoma with high density focused ultrasonics].

The efficacy of therapeutic ultrasound was retrospectively assessed in 456 patients who presented with uncontrolled glaucoma refractory to maximal medical therapy and filtration surgery from April 1987 to January 1992. Treatment was performed under local anaesthesia in ambulatory outpatients. Therapeutic ultrasound induced local destruction of the ciliary epithelium and a thickening of the sclera. A 47% decrease in intraocular pressure (IOP) was obtained from the mean preoperative (33.8 mmHg) and the mean postoperative (18.2 mm Hg) values. After a 33-month mean follow-up, 65% of treated eyes had an IOP less than or egal to 20 mmHg. Therapeutic ultrasound was effective in most of the glaucomas, especially in open angle, closed angle, aphakic, pseudophakic and post-silicone oil glaucoma. The main complications were immediate ocular hypertension and corneoscleral alterations. Phtysis bulbi occurred in 5.7% of the eyes. The therapeutic interest of ultrasound were compared with those of the other cyclodestruction techniques.

Adolescent↗
PubMed1992

[Ultrasonic treatment of hypertonia caused by intraocular silicone oil].

The authors treated 53 patients with uncontrolled glaucoma in silicone oil filled eyes with high intensity focused ultrasound. The silicone oil filled eyes present unusually difficult problems in glaucoma management, since the silicone oil rapidly obstructs filtration openings, and laser techniques have not been effective. The mean pretreatment pressure was 34.2 mmHg. The patients were followed for a mean of 17 months. Seventy-five per cent of ultrasound treated eyes had successful reduction of intraocular pressure to below 20 mmHg with or without concomitant medical treatment at two years after treatment. The complication rate was low in this group of eyes. Five eyes developed hypotonia and three eyes had full thickness scleral perforations but were effectively controlled and developed no other complications during two years of follow-up. This technique appears more effective than cyclo-destructive techniques alone.

Adolescent↗
PubMed1992

Therapeutic ultrasound for the treatment of glaucoma.

We present a summary of the results obtained on 1142 treatments of 1072 eyes treated in our hospital during the last 5 years. Ultrasound has been used to treat 843 eyes with refractory glaucoma and also to restore failed trabeculectomy filtering blebs in 229 eyes. The single treatment success rate with success defined as an IOP > or = 20 mm Hg was 59% at one year and 46% at 3 years. In cases of failed blebs, ultrasound treatment performed 3 to 12 weeks after trabeculectomy revived the blebs of 82% of the phakic eyes when 5 FU subconjunctival injections were performed in the following days.

Glaucoma↗
PubMed1989

Treatment of glaucoma with high intensity focused ultrasound.

Focused high intensity therapeutic ultrasound has been used since 1982 by Coleman and all, to treat patients with uncontrollable intraocular pressure. Three mechanisms may be responsible for lowering intraocular pressure: decreased aqueous humor production in the ciliary epithelium, transscleral outflow of aqueous humor, and increased uveal outflow. We began the use of focused ultrasound to treat glaucoma in April 1987. Up to now (April 1988), we have treated 220 patients. We describe results from patients that had a follow up of 3, 6, 12 months. Successful treatment resulting in pressure less than 20 mm Hg, was obtained in over 80% of patients treated at 90 days post treatment and of 50% after 6 and 12 months. The complication rate is low. Retreatment is safe and effective. Additionally, the use of U.S. to open closed filtering blebs, recently postoperative, has been a success in 90% of the treated eyes after 3 months. The follow-up period of this study is short which makes conclusions about long-term effects and side effects not possible.

Follow-Up Studies↗
PubMed1987

[Use of 5-fluorouracil in the surgery of glaucoma].

63 eyes (46 patients) with different types of glaucoma have been operated by filtering surgery with subconjunctival 5 fluoro-uracil (5-FU) injections. The mean follow up is 7 months. Two groups of patients have been studied: In the 33 eyes with previous unsuccessful glaucoma surgery, the result was very good: 73% of complete success (IOP less than or = 20 mmHg without additional therapy) 18% of qualified success (IOP less than or = 20 mmHg with additional therapy) 8% of failure. The other group included 30 eyes without previous glaucoma surgery, but with a bad surgical prognosis. In all the cases, the result was good, only one eye required additional therapy. The corneal complications are the most frequent, but do not last long. The other complications depend upon the indications, there are many in the aphakic patients. The durable flat anterior chamber must also be quoted.

Conjunctiva↗
PubMed1985

[Results 1 year after trabeculoretraction by 360 degree argon laser in the treatment of open-angle glaucoma].

On 210 glaucomatous patients (119 men, 91 women), 390 eyes with open angle chronic glaucoma, we have performed an argon laser trabeculoplasty according to Wise technique (360 degrees in one time). ALT was presented as an alternative to surgery. Therefore results were appreciated so that ALT allowed or not to avoid surgery. After one year, the rate of failures was: on all the 390 eyes: 15 p. cent on O.A.C.G. simplex: 6.7 p. cent on myopic glaucoma: 7 p. cent on pigmentary glaucoma: 29.5 p. cent on capsular glaucoma: 6 p. cent after trabeculectomy: 62 p. cent on aphakic glaucoma: 50 p. cent on secondary glaucoma: 33 p. cent on combined glaucoma: 0 p. cent In the group of successful results, ALT allowed to lower medical treatment in at less 70 p. cent after one year of follow-up except for pigmentary glaucoma where, in almost all cases, medication before ALT had to be continued.

Age Factors↗
PubMed1982

[Technique employing argon laser coagulation to obtain trabecular retraction].

A technique for treating primary open angle glaucoma by argon laser photocoagulation is described. Its elective action on the trabeculum and on trabecular "collapse" in the absence of any trabecular perforation suggested the name of "trabecular retraction" for this procedure. Its efficacy depends on very good visibility of the trabeculum through 360 degrees, on perfect focalization of the point of impact to 50 mu, and on the application of one hundred or so impacts distributed throughout 360 degrees. Any pretrabecular obstacle must be eliminated. Mean pressure drap obtained is 10 mmHg. Complications are minimal and results comparable or superior to those of surgery.

Aged↗