Search PubMed⌕ Search

Biomedical subjects

L J Katz

Publications and source records attributed to L J Katz.

At least 37 records · Page 2Linked to original sources
PubMed1997

Evaluation of Nd:YAG laser membranectomy in blocked tubes after glaucoma tube-shunt surgery.

PURPOSE: To determine the effectiveness of Nd:YAG laser membranectomy for reopening blocked glaucoma tube shunts and maintaining the patency over time. METHODS: We reviewed retrospectively the records of 13 patients (13 eyes) who, during the period January 1990 through June 1996, underwent Nd:YAG laser membranectomy in an attempt to reopen a blocked glaucoma tube shunt. Intraocular pressure and tube patency were evaluated at each follow-up visit. RESULTS: Nd:YAG laser membranectomy effectively opened the blocked glaucoma tube shunts in 11 (84.6%) of 13 eyes. Two tubes could not be reopened. Reblockage occurred in seven eyes (53.8%) within the first 11 weeks; four tubes (30.8%) remained patent through follow-up periods of 39, 82, 106, and 169 weeks. Postlaser complications were moderate anterior chamber reaction in four eyes (30.8%), hyphema in two eyes (15.4%), corneal edema in two eyes (15.4%), pressure spike in one eye (7.7%), and shallow anterior chamber in one eye (7.7%). CONCLUSIONS: Nd:YAG laser membranectomy is effective in reopening blocked glaucoma tube shunts but is associated with a relatively high rate of subsequent reblockage in the initially successful cases.

Aged↗
PubMed1997

Tube-shunt surgery versus neodymium:YAG cyclophotocoagulation in the management of neovascular glaucoma.

OBJECTIVE: To determine the relative effectiveness of neodymium:YAG (Nd:YAG) cyclophotocoagulation (CPC) and tube-shunt surgery on intraocular pressure (IOP) control in eyes with neovascular glaucoma (NVG). DESIGN: Retrospective, case-by-case matched, comparative group study. PARTICIPANTS: Twenty-four patients with NVG treated with noncontact Nd:YAG-CPC were matched with 24 patients who underwent tube-shunt surgery. Matching criteria included the underlying disorder causing angle neovascularization, the lens status, and patient's age. INTERVENTIONS: Tube-shunt surgery or Nd:YAG-CPC. MAIN OUTCOME MEASURE: Postoperative IOP (IOP > or = 6 and < or = 25 mmHg), visual acuity, and presence of any postoperative complications. RESULTS: Satisfactory IOP control (IOP < or = 25 mmHg and > or = 6 mmHg) was achieved in 9 eyes (37.5%) treated with Nd:YAG-CPC compared with 16 eyes (66.7%) receiving a tube-shunt procedure (P = 0.04) over a mean follow-up of 16.9 +/- 14.6 and 15.2 +/- 11.8 months, respectively. In the matched pairs in both groups that had nonequivalent outcomes, the proportions with persistently high IOP or hypotony were both greater in the CPC group than in the tube-shunt group. The cumulative proportion of failure in the CPC group was 20.8% at 6 months, 35.4% at 1 year, and 71.2% at 3 years postoperatively. In the tube-shunt group, the cumulative proportions of failure at 6 months and 1 year were close to those in the CPC group (12.5% and 29.2%, respectively), but lower 3 years after surgery (43.3%). Eleven eyes (45.8%) in the CPC group lost light perception versus four eyes (16.7%) in the tube-shunt group. Complication rate was higher in the tube-shunt group. CONCLUSIONS: This study suggests that, in the management of NVG, tube-shunt surgery more frequently controls IOP in a satisfactory range, with less hypotony and less visual loss, than noncontact Nd:YAG-CPC.

Adult↗
PubMed1997

Ultrasound biomicroscopy in infantile glaucoma.

BACKGROUND: Glaucoma in infants has many causes: Evaluation of the anatomy of the anterior segment of eyes with infantile glaucoma may help to determine the pathogenesis of an infant's disease and influence therapeutic decisions. METHODS: Eleven eyes of six infants with glaucoma were evaluated with ultrasound biomicroscopy (UBM) to evaluate the anatomic characteristics and relationships of the anterior segment structures. RESULTS: The anterior chamber angle, iris, lens, ciliary body, and posterior chamber angle could be imaged in detail. Elongated and anteriorly placed ciliary processes were noted in all eight eyes with trabeculodysgenesis. There were no apparent anomalies in the trabecular meshwork, or anterior chamber. In three eyes with dense corneal opacities, ultrasound biomicroscopy showed severe anterior segment disorganization and thin central corneas with posterior corneal excavation. CONCLUSIONS: Ultrasound biomicroscopy is a useful non-invasive method for evaluating infants with glaucoma in cases with corneal opacities. This information can help in surgical planning for glaucoma management.

Anterior Eye Segment↗
PubMed1997

Long-term effects of tube-shunt procedures on management of refractory childhood glaucoma.

PURPOSE: The authors evaluated the long-term results of tube-shunt surgery in management of childhood glaucoma. METHODS: The results of tube-shunt surgery in children who had glaucoma refractory to medical or alternative surgical treatment in the Glaucoma Service of Wills Eye Hospital during the period 1986 through 1993 were reviewed. Eighteen eyes of 15 patients were included in the analysis. Follow-up ranged from 14 to 80 months (mean +/- standard deviation, 47.3 +/- 25.1 months). RESULTS: In the early postoperative course (6 months after surgery), the intraocular pressure (IOP) was between 6 and 21 mmHg in 13 eyes (72.2%) with or without glaucoma medication. Two or more years later, IOP was between 6 and 21 mmHg in four eyes without further glaucoma medication (22.2%) and four eyes (22.2%) with the addition of antihypertensive therapy. Five eyes (27.8%) lost light perception, whereas seven (38.9%) remained within one line of preoperative vision or improved. Twelve eyes underwent 28 additional surgical procedures after the tube-shunt operation, mostly to control IOP or manage tube-related complications. CONCLUSION: The limited success rate, relatively high complication rate, and need for frequent surgical intervention suggest caution regarding the prognosis of tube-shunt surgery in children with glaucoma.

Adolescent↗
PubMed1997

Familial exudative vitreoretinopathy associated with nonneovascular chronic angle-closure glaucoma.

PURPOSE: Cases of angle-closure glaucoma in patients with familial exudative vitreoretinopathy have been reported secondary to neovascularization of the anterior segment. Cases secondary to nonneovascular mechanisms have not been previously reported. METHODS: Two cases are presented of angle-closure glaucoma as a result of a nonneovascular mechanism. RESULTS: Neovascularization was found to be a very unlikely explanation for the angle closure in these two cases. CONCLUSION: There may be an association between familial exudative vitreoretinopathy and angle-closure glaucoma as a direct result of a retrolental process or more likely a relative lens-iris pupillary block with a large lens.

Anterior Eye Segment↗
PubMed1997

Severe visual loss after autologous blood injection for mitomycin-C-associated hypotonous maculopathy.

It has been shown that mitomycin-C increases the success rate of trabeculectomy; however, a rise in the incidence of postoperative complications has also been reported. Consequently, the use of antimetabolite is usually reserved for patients who are at high risk of surgical failure or for patients with advanced glaucoma in whom low intraocular pressure is desired. This report describes a patient who suffered severe visual loss which was a direct result of hypotonous maculopathy after trabeculectomy with mitomycin-C and various other complications from the subsequent interventions.

Adult↗
PubMed1997

Infectious keratitis in a paracentesis tract.

A paracentesis is performed in glaucoma procedures as a flat, beveled tract to allow access into the anterior chamber after the filtration fistula is made. Complications related to the paracentesis are infrequent because it is a self-sealing wound. The authors report a case of infectious keratitis that developed in a paracentesis tract.

Abscess↗
PubMed1997

Quantitative estimation of retinal nerve fiber layer height in glaucoma and the relationship with optic nerve head topography and visual field.

PURPOSE: The authors estimated the retinal nerve fiber layer height (RNFLH) measurements in patients with glaucoma compared with those in age-matched healthy subjects as obtained by the laser scanning tomography and assessed the relationship between RNFLH measurements and optic and visual field status. METHODS: Parameters of optic nerve head topography and RNFLH were evaluated in 125 eyes of 21 healthy subjects and 104 patients with glaucoma using the Heidelberg Retina Tomograph ([HRT] Heidelberg Engineering GmbH, Heidelberg, Germany) for the entire disc area and for the superior 70 degrees (50 degrees temporal and 20 degrees nasal to the vertical midline) and inferior 70 degrees sectors of the optic disc. The mean deviation of the visual field, as determined by the Humphrey program 24-2 (Humphrey Instruments, Inc., San Leonardo, CA, U.S.A) was calculated in the entire field and in the superior and inferior Bjerrum area. RESULT: Retinal nerve fiber layer height parameters (mean RNFLH and RNFL cross-sectional area) were decreased significantly in patients with glaucoma compared with healthy individuals. Retinal nerve fiber layer height parameters was correlated strongly with rim volume, rim area, and cup/disc area ratio. Of the various topography measures, retinal nerve fiber layer (RNFL) parameters and cup/disc area ratio showed the strongest correlation with visual field mean deviation in patients with glaucoma. CONCLUSION: Retinal nerve fiber layer height measures were reduced substantially in patients with glaucoma compared with age-matched healthy subjects. Retinal nerve fiber layer height was correlated strongly with topographic optic disc parameters and visual field changes in patients with glaucoma.

Female↗
PubMed1996

Formula revealed.

Explore the source record for details and available documents.

Antibiotics, Antineoplastic↗
PubMed1996

Effects of apraclonidine on short-term outcome of glaucoma surgery.

We evaluated the influence of apraclonidine on the outcome of filtering surgery. Patients treated with apraclonidine who underwent a guarded filtration procedure were retrospectively evaluated and compared to a control group. Complications were more frequent in patients treated with apraclonidine than in the control group, but the difference was not statistically significant. We encourage further studies regarding the effects of apraclonidine in filtering procedures.

Adrenergic alpha-Agonists↗
PubMed1996

Lack of effect of calcium channel blockers on open-angle glaucoma.

PURPOSE: The objective of this study is to evaluate the effect of calcium channel blockers (CCB) on the clinical course of glaucoma. METHODS: Open-angle glaucoma patients receiving oral CCB for nonophthalmic diseases were sequentially selected from the private practice of the Glaucoma Service of Wills Eye Hospital. The course of visual fields and optic discs and serial intraocular pressures were analyzed in subsequent follow-ups. The findings in these 83 cases were compared with a control group of patients with the same ocular diagnosis, but who were not on CCB. A subset of 43 cases of the study group was compared with an age-matched subset of the control group. RESULTS: There was no apparent difference in the absolute intraocular pressure, stability/change of visual fields or optic discs when we compared patients using CCB with the control group. Among patients with the diagnosis of "low-tension glaucoma," we also could not demonstrate any statistically significant difference between the two groups. CONCLUSIONS: In this study, neither a beneficial nor a detrimental effect of CCB on the course of the patients glaucomatous disease was apparent.

Aged↗
PubMed1996

Management of coexisting corneal disease and glaucoma by combined penetrating keratoplasty and trabeculectomy with mitomycin-C.

BACKGROUND AND OBJECTIVE: The management of coexistent corneal disease and uncontrolled glaucoma continues to be a challenging clinical situation. The purpose of this study is to evaluate the results of combined penetrating keratoplasty and trabeculectomy with mitomycin-C. PATIENTS AND METHODS: A retrospective study was undertaken to review the records of nine patients who had corneal edema and high intraocular pressure managed by simultaneous penetrating keratoplasty and trabeculectomy with mitomycin-C. RESULTS: The nine patients had an average pre-operative intraocular pressure of 26 mm Hg (range 17 to 41 mm Hg) and associated corneal edema. The average postoperative intraocular pressure at last follow-up was 19 mm Hg (range 5 to 53 mm Hg). Three patients needed additional procedures. Six of nine patients had intraocular pressures judged to be adequately controlled (11 +/- 5 mm Hg, range 5 to 18 mm Hg) throughout the postoperative period (average follow-up 16 months). Grafts remained clear in seven patients. The grafts failed in two cases in which additional glaucoma surgery was necessary. CONCLUSION: Combined penetrating keratoplasty and trabeculectomy with mitomycin-C should be considered for selected patients with uncontrolled glaucoma and corneal disease who have sufficient conjunctiva for a filtering procedure.

Aged↗
PubMed1995

Management of overfiltering and leaking blebs with autologous blood injection.

We describe our experience with intrableb autologous blood injection to manage over-filtering and leaking blebs. Autologous blood was injected into 12 thin cystic filtration blebs of 12 eyes. Indications for blood injection included symptomatic hypotony in five eyes, hypotony associated with bleb leakage in five eyes, and bleb leakage without hypotony in two eyes. Seven eyes (58.3%) were classified as successes and five eyes (41.7%) were classified as failures. The mean (+/- SD) follow-up was 6.8 +/- 2.6 months. Among the eyes classified as successes, a significant increase was noted in intraocular pressure and visual acuity by a mean (+/- SD) of 5.1 +/- 2.9 mm Hg and 5.3 +/- 2.1 lines, respectively. Bleb leakage resolved in four of seven eyes. The most common complication was hyphema formation. Injection of autologous blood into a filtration bleb is an alternative procedure for management of excessive filtration or bleb leakage in selected patients.

Adult↗
PubMed1995

Retrobulbar arterial hemodynamic effects of betaxolol and timolol in normal-tension glaucoma.

PURPOSE: beta-Adrenergic blocking drugs lower intraocular pressure. The question of whether these drugs also alter, either directly or indirectly, orbital hemodynamics is potentially of great importance for patients with normal-tension glaucoma who may have some degree of reversible vasospasm. METHODS: We compared the effect of selective (betaxolol) and nonselective (timolol) beta-adrenergic blocking drugs on flow velocities (as determined by color Doppler imaging) in orbital vessels in 13 patients with normal-tension glaucoma (mean age, 62 +/- 3 years; mean intraocular pressure, 15 +/- 2 mm Hg). A one-month drug treatment double-masked crossover design, with a three-week washout before each drug, was used. RESULTS: Neither drug changed peak systolic velocity in any of the four vessels studied (ophthalmic, nasal and temporal posterior ciliary, and central retinal arteries). Additionally, timolol did not alter end-diastolic velocity or resistance index (defined as [peak systolic velocity minus end-diastolic velocity] divided by peak systolic velocity) in any of the vessels measured. In contrast, betaxolol tended to increase end-diastolic velocity and to decrease resistance index: the four-vessel average end-diastolic velocity increased 30% (P = .08), and the four-vessel average resistance index decreased significantly (P = .04). These reductions in resistance index occurred despite that betaxolol, in contrast to timolol, did not significantly decrease intraocular pressure. CONCLUSIONS: These results suggest that, in patients with normal-tension glaucoma, selective beta-adrenergic blockade (betaxolol) may have ocular vasorelaxant effects independent of any influence on intraocular pressure, whereas nonselective blockade (timolol) lowers intraocular pressure without apparently altering orbital hemodynamics.

Arteries↗