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Total iridectomy in the primate in vivo: surgical technique and postoperative anatomy.

A simple, brief surgical procedure for in vivo removal of the entire primate iris is described. A small peripheral corneal incision is made, and the prolapsed iris is torn from its insertion by forceps, without intraocular instrumentation. The eye recovers quickly and, except for the aniridia, the clinical and histologic appearance of the anterior segment is essentially normal. Experimental uses for the aniridic monkey eye are noted.

Animals↗

Surgical decisions in chronic angle-closure glaucoma.

A retrospective study of 57 eyes with chronic angle-closure showed that eyes with visual field loss are less likely to be improved by iridectomy than those without visual field loss in the presence of visual field loss, trabeculectomy achieved more satisfactory control of glaucoma than did iridectomy, and there was no noticeable difference in surgical complications between iridectomy and trabeculectomy in this small series. It is suggested that iridectomy is indicated for most cases of chronic angle closure without visual field loss, especially if the pressure is medically controllable. In the presence of visual field loss, iridectomy is usually a wise choice if medical control is easily achieved preoperatively. However, trabeculectomy might be the best choice in most patients with visual field loss and medically uncontrolled pressure, regardless of the gonioscopic findings.

Glaucoma↗

[Acute angle-closure glaucoma despite previous Nd:YAG laser iridotomy: a report on 13 cases].

BACKGROUND: Nd:YAG laser iridotomy is routinely used as a procedure for primary acute angle-closure glaucoma (AACG). The clear advantage of Nd:YAG laser iridotomy is to resolve pupillary block without opening the eye. Nevertheless it remains unclear whether Nd:YAG laser iridotomy is equally effective as surgical iridectomy. In this context cases in which AACG recurred despite patent Nd:YAG laser iridotomy are of interest. PATIENTS AND METHODS: In a retrospective study, we analyzed the charts of 90 patients who presented with unilateral primary AACG in our department over 3 years and were treated with a surgical iridectomy. Surgical iridectomy at the 12 o'clock position was performed using a self-sealing corneal incision. RESULTS: Of the 90 patients with primary AACG, 13 (14.4%) had already been treated with Nd:YAG laser iridotomy. Despite the laser iridotomy, these eyes developed recurrent AACG. The presenting intraocular pressure (IOP) of these 13 eyes was 49.07+/-12.65 mmHg. In 4 eyes, continuous medical glaucoma therapy was used prior to AACG, 8 eyes showed signs of glaucoma damage at the optic disk or/and the visual field. In 2 eyes, the presenting high IOP at AACG could be lowered by medication. All other eyes were operated at high IOP. The average interval between the Nd:YAG laser iridotomy and the AACG was 24.5 weeks. After surgical iridectomy, the IOP was reduced to 12.69+/-4.11 mmHg and was 16.62+/-3.86 mmHg at the end of the observation period. CONCLUSIONS: In spite of Nd:YAG laser iridotomy recurrent AACG can occur. Surgical iridectomy is capable of permanently resolving the pupillar block in these cases.

Glaucoma, Angle-Closure↗