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At least 559 records · Page 31Linked to original sources
PubMed1991

A new technique of iridotomy in extracapsular cataract extraction and implantation.

In 1346 consecutive patients undergoing cataract surgery and intraocular lens implantation, we prospectively studied the complications associated with iris iridectomies or iridotomies as compared with those occurring when iris openings were made. We found that the transfixion of the iris with the discission knife is easy, relatively harmless, and prevents a number of complications seen when no iridectomy was performed or if a large iris opening had been made with scissors.

Cataract Extraction↗
PubMed1990

[Surgical therapy of glaucoma].

During recent years, glaucoma surgery has been modified by the introduction of new antiglaucoma drugs and by laser therapy. Various glaucoma operations have, however, retained their value in the treatment of severe glaucoma cases. Acute angle-closure glaucoma is best treated by iridectomy. When a clear cornea is present, laser iridectomy can be performed. Prophylactic treatment of the contralateral eye is mandatory. In chronic open-angle glaucoma, filtration surgery with a scleral flap is usually performed (goniotrephination or trabeculectomy). Modifications in the conjunctival incision and the use of antifibroblastic drugs may reduce the failure rate for difficult cases in the future. Individual adjustment of postoperative treatment is of great importance for the development of functioning filtering blebs. Reoperations retain their high incidence of subconjunctival scarring. In congenital glaucoma, the success rate of trabeculotomy equals the success rate of goniotomy. Trabeculotomy has advantages when the cornea is cloudy, but may be more difficult to perform in eyes with a stretched anterior segment or in secondary congenital glaucomas. In neovascular glaucoma, cryotherapy of the peripheral retina often normalizes the intraocular pressure by reduction of neovascularization. Cyclocryotherapy of the anterior pars plicata often results in cataract and phthisis bulbi and is only rarely used. In non-neovascular secondary glaucoma or numerous reoperations for primary glaucoma, the implantation of a Molteno or Schocket implant may be helpful. Cyclodialysis is seldom used because its outcome is extremely variable. It is mostly replaced by modified filtering surgery, including ciliary tendon disinsertion (Watson trabeculectomy). If the IOP is high in coexisting glaucoma and cataract, two separate procedures are normally performed successively: when the filtering surgery has been successfully performed and settled, a separate extracapsular cataract operation is performed via a clear corneal incision. Simultaneous procedures, if necessary, can be performed with a trabeculotomy or with a filtering operation. If the IOP is borderline, an extracapsular cataract operation is normally sufficient to lower the IOP for some mmHg. Cataract formation after filtering surgery has become a less severe complication, as posterior chamber lens implantation is also possible in glaucomatous eyes. Therefore, filtering surgery nowadays seems indicated at earlier stages of glaucoma.

Cataract Extraction↗
PubMed1990

The Weill-Marchesani syndrome: report of two cases and a review.

Two cases of the Weill-Marchesani syndrome are reported. The diagnosis very likely is being missed in some cases in which the skeletal abnormalities are minor and the patients are not referred for systemic examination. Medical therapy has not been successful in most patients for the management of the pupillary-block angle-closure glaucoma encountered in this syndrome. Laser iridectomy, which does not risk vitreous fluid loss and other serious surgical complications in this disorder, probably is a safer choice as an initial procedure than is the use of peripheral iridectomy. A review of the pathogenesis of the syndrome and of its treatment is included.

Adult↗
PubMed1990

[Clinical evaluation of indentation gonioscopy].

The chamber angles of 31 cases (44 eyes) of angle closure glaucoma were studied by Iwata indentation gonioscopy and Goldman gonioscopy. (1) In 39 (89%) of the 44 eyes, the extent of open filtering angle under the indentation gonioscopy was larger than the that under Goldmann gonioscopy. (2) Peripheral iridectomy was indicated in only 68% of the cases when examined by Goldmann gonioscopy, while all cases were performed peripheral iridectomies successfully as indicated by indentation gonioscopy. Therefore, indentation gonioscopy is very useful in the differentiation of functional apposition of the chamber angle from the pathological peripheral synechiae.

Adult↗
PubMed1990

Acute angle-closure glaucoma in a patient with acquired immunodeficiency syndrome successfully treated with argon laser peripheral iridoplasty.

Laser iridectomy relieves pupillary block and is the procedure of choice for angle-closure glaucoma. Since not all cases of angle closure glaucoma are due to this mechanism, iridectomy is not always curative. Argon laser peripheral iridoplasty causes a contraction of peripheral iris away from the trabecular meshwork, and is useful in these circumstances. We successfully treated bilateral acute angle-closure glaucoma in a patient with acquired immunodeficiency syndrome with this procedure.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Laser light: its nature and its action on the eye.

Lasers produce a coherent, focused, monochromatic, high-energy form of light. Because laser surgery is more versatile and precise and is freer of complications than conventional surgery it has become widely accepted in ophthalmology over the past 10 years. Applications range from routine procedures in the fundus to recent, more delicate interventions in the cornea. The argon laser is the most widely used to treat extrafoveal chorioretinal diseases such as age-related macular degeneration and diabetic retinopathy; it has also been used successfully to treat glaucoma by iridectomy or trabeculoplasty. The krypton red laser is the argon laser's counterpart in the treatment of subfoveal and pigment-epithelium-related diseases. Posterior capsulotomy is the most widespread and successful intervention with the neodymium:yttrium-aluminum-garnet crystal laser; this laser is also used to cut vitreous traction bands and is increasingly used in iridectomy. Although the use of the excimer laser in corneal surgery is still largely investigational it has been shown to produce precise cuts in corneal layers for the correction of myopia or astigmatism. The variable-wavelength dye laser, capable of reaching a specific level in the retina or choroid, has offered exciting new developments, and it promises to soon be part of the ophthalmologist's armamentarium in the treatment of eye disease.

Eye↗
PubMed1979

Anterior chamber volume. Its measurement and clinical application.

Measurement of anterior chamber volume is discussed and attention drawn to a new, convenient slit-image method, which was used to study anterior chamber depth and volume before and after prophylactic peripheral iridectomy in the fellow eyes of patients presenting with unilateral acute angle-closure glaucoma. There was no significant change in depth after iridectomy but the mean anterior chamber volume increased significantly (P less than 0.01), by nearly 3 per cent. This increase was due to elimination of peripheral iris bombé which was not present in two control groups of normal eyes, one matched for anterior chamber depth and the other for age and refraction. Peripheral iris bombé may be a quantifiable factor predisposing to the development of acute angle-closure glaucoma.

Adult↗
PubMed1979

[Morphology of the primary damage caused by the argon-ion laser to the iris of the pigmented rabbit (author's transl)].

The effects of the argon-ion laser upon the iris of the pigmented rabbit were analysed by ultrastructural methods. 1. Apart from the physical parameters of the energy source, the damage strongly depends on the concentration, location, and distribution of the iris pigment. 2. The irradiation of the iris results in the formation of a crater. Depending on the distance of the epicentre of the impact, various degrees of ultrastructural damage are observed. a. The region immediately adjacent to the crater lumen at a revealing distance of 25 microns consists of homogenous collagenous masses, revealing a vacuolar structure. As the only residuals of destroyed cells, melanin granules are observed within the homogenous masses. b. Destruction of the collagen fibrils and their disintegration into subfibrils with elimination of all cell compartments is found in an area ranging from 25 microns to 300 microns from the wall of the crater. c. Damage to the chromatin structure is visible up to a distance of 300 microns to 375 microns from the wall of the crater. 3. Characterised by an invasion of macrophages into the damaged area, the cleaning phase starts 24 h after irradiation. 4. The results of this experiment indicate that because of the great energy dose required for man with the inherent widespread tissue damage and low probability of a lasting iridectomy, the cw argon-ion laser appears to be an unsuitable energy source for clinical iridectomy.

Animals↗
PubMed1985

Manipulation of the iris in extracapsular lens extraction.

Successful extracapsular cataract surgery depends on adequate mydriasis, which will facilitate the anterior capsulotomy and provide a full field of view throughout the operation. The surgeon, especially the neophyte, must recognise which irises may present a difficulty in establishing, maintaining, and reversing mydriasis, with or without the introduction of an intraocular lens. The author describes the preliminary assessment of the iris for disease, previous iris surgery, ease of dilatation, and the place of primary iridectomy. Topical and subconjunctival preoperative mydriatics are assessed, and a practical account of the pharmacological, mechanical, and surgical means of maintaining intra-operative mydriasis is given. The indication for iridectomy in extracapsular lens extraction with or without an intraocular lens is reviewed, and the postoperative manipulation of the iris is described with reference to the problems caused by rebound mydriasis.

Cataract Extraction↗
PubMed1985

Treatment of primary angle-closure glaucoma by argon laser iridotomy: a long-term follow-up.

Argon laser iridotomy was performed in a total of 140 eyes of 104 patients with primary angle-closure glaucoma. A total of 69 eyes were treated by the long-burn technique and followed for an average period of 2.7 years; 71 eyes were treated by the short-burn technique and followed for an average period of 1.7 years. The effects on the IOP control and various factors of glaucoma were similar between both techniques, and the results of iridotomy were analyzed for all eyes. The IOP was controlled at or lower than 20 mmHg in 29% without medication, in 52% with reduced or the same medication as the preoperative treatments, and in 13% with increased medication. However, in 6% the IOP could not be controlled. The incidence of IOP control by iridotomy alone was significantly higher in eyes with peripheral anterior synechia (PAS) less than half the angle circumference than in eyes with more extensive PAS. Visual acuity loss occurred in 51%, and the loss by more than three lines of the acuity chart was seen in 19%; the visual loss was thought to be due to cataract progression or development. No significant differences were found in the visual field, cup-disk ratio, the extent of PAS or tonographic C-value before and after iridotomy. The IOP control and visual acuity loss were comparable with those seen after surgical iridectomy. Because of the absence of significant complications and ease of performance, iridotomy may replace surgical iridectomy in the treatment of angle-closure glaucoma.

Aged↗
PubMed1985

Extracapsular cataract extraction: an analysis of 240 operations in dogs.

A total of 240 extracapsular cataract extractions were performed on 214 dogs at the University of Illinois between 1968 and 1980. Overall success of the surgery, defined as restoration of functional vision for at least 6 weeks after surgery, was 79%. The success rates, on the basis of various parameters, were compared with the following results. The greater the number of years experience each surgeon had, the greater the surgical success rate. In dogs in which a second eye was operated on, the overall success rate on the second eye was approximately 20% less than that for the study as a whole. There was a significant difference in success rates between surgery on congenital and juvenile cataracts when compared with surgery on diabetic and senile cataracts, the first being 15% higher than the second. The success rate was 18% less for lensectomy with concurrent iridectomy than for lensectomy without iridectomy. There was no significant difference in success rates among the 3 procedures for extracapsular extraction used in this study, nor among the various breeds studied. There was no significant difference in the success rate of surgeries on the left eye, compared with surgeries on the right eye.

Age Factors↗
PubMed1983

Spherophakia in a Newfoundland family: 8 years' experience.

In a family with eight siblings, five siblings have had spherophakia. One patient has died, but the other four have been followed up for 8 years. Two have undergone peripheral iridectomy because of steadily rising intraocular pressure. The operations were only partially successful in controlling the pressure. Whether associated with the Weill-Marchesani syndrome or not, spherophakia is difficult to manage. The lenticular myopia must be corrected (sometimes an additional reading correction is needed), and the intraocular pressure and visual field must be carefully monitored. The ability of the retinal circulation to withstand a high intraocular pressure for long periods may not be matched by a corresponding resilience of the drainage mechanism. Therefore, early peripheral iridectomy is probably advisable.

Adolescent↗
PubMed1982

Corneal sensitivity after surgery.

A total of 38 eyes were examined at regular intervals for change in corneal sensitivity after surgery. Twenty-nine eyes underwent cataract surgery and nine trabeculectomy or iridectomy. It was found that complete loss of sensitivity occurred in the sector of cornea enclosed by the arc of the incision in every case. Recovery of sensitivity was found in eyes having trabeculectomy and iridectomy after approximately 9 months. All of the eyes having had cataract surgery showed almost complete anaesthesia in the upper half of the cornea after one year and only three had normal sensitivity after 2 years. Recovery of sensitivity appeared to take place from the 3 and 9 o'clock positions towards the 12 o'clock position.

Cataract Extraction↗
PubMed1982

Nanophthalmos: a perspective on identification and therapy.

Nanophthalmos is a rare and blinding disease. Diagnostic features include a small eye, small cornea, shallow anterior chamber, narrow angle, high lens/eye volume ratio, and uveal effusion. Intraocular surgery has a high rate of disastrous complications and blindness. The 32 eyes (16 patients) presented are in three categories based on angle closure and intraocular pressure levels. Treatment methods included medication, laser iridotomy and gonioplasty, peripheral iridectomy, filtration surgery, and cataract extraction. Glaucoma medication was effective, although miotics sometimes increased pupillary block. Laser iridotomy was successful in 83% of six eyes; laser gonioplasty in 91.6% of 12 eyes. Peripheral iridectomy succeeded in two of seven eyes, and filtering operations provided tension control in two of five eyes. Thirteen of 15 eyes undergoing filtration surgery suffered severe postoperative visual loss. Cataract extraction improved vision in only three of six eyes. The authors' experience confirms that surgery in nanophthalmic eyes has an extremely high complication rate with disastrous results. Medication and laser therapy are the procedures of choice for angle-closure glaucoma in nanophthalmos.

Adult↗
PubMed1978

[Malignant glaucoma (author's transl)].

A 35-year-old male, one of three siblings with spherophakia and glaucoma, was treated surgically by aspiration of vitreous through a posterior sclerotomy wound, and air insufflation of the anterior chamber in each eye. Previous peripheral or sector iridectomies were not helpful in contolling the condition. Some improvement was noted with intensive cycloplegic therapy in each eye. In the right eye, one surgical procedure was sufficient to arrest the condition. In the left eye, a sector iridectomy, and three posterior sclerotomies combined with air insufflations of the anterior chamber have been unsuccessful in controlling the pressure. A further sclerotomy with a vitrectomy instrument to remove most of the formed vitreous followed by air insufflation of the anterior chamber is proposed for the uncontrolled eye and if this is not successful in controlling the condition, lens extraction will be carried out.

Adult↗
PubMedDate not supplied

[Laser gonioplasty in the treatment of primary chronic closed angle glaucoma].

The aim of the study was to evaluate of Nd:YAG laser gonioplasty performed together with iridectomy in the patients with primary chronic closed angle glaucoma. The results were compared with those achieved in patients with the same disease in whom only Nd:YAG laser iridectomy was done. In the first group normalization of the intraocular pressure was achieved in 64% and in the second only in 29% of the eyes. The best results were observed in cases with duration of the glaucoma less than 2 years and with intraocular pressure before treatment lower than 38 mmHg.

Adult↗
PubMedDate not supplied

Spectrum of trabecular pigmentation in open-angle glaucoma: a clinicopathologic study.

In eight patients with chronic open-angle glaucoma and associated trabecular pigmentation, trabeculectomy and peripheral iridectomy specimens were studied by light and electron microscopy. Clinically, three patients displayed signs of classic pigmentary glaucoma (Group 1). In the other cases chronic open-angle glaucoma was associated with varying degrees of expression of the full pigmentary glaucoma syndrome (Group 2). Histopathologic examination of peripheral iridectomy and trabeculectomy specimens from Group 1 showed: (1) marked focal atrophy and hypopigmentation of iris pigmented epithelium with an apparent delay in melanogenesis. The dilator muscle was thickened except for occasional thinned areas. (2) The trabeculectomy specimens revealed excessive amounts of pigmented epithelial melanosomes and moderate accumulation of electron-dense basement membrane-like material in the juxtacanalicular meshwork. Similar specimens from Group 2 showed: (1) minimal hypopigmentation of the iris pigmented epithelium with normal melanogenesis. The iris stroma and dilator muscle were normal. (2) Trabeculectomy specimens displayed excessive electron-dense basement membrane-like material in the juxtacanalicular meshwork and minimal to moderate accumulation of melanosomes.

Adolescent↗
PubMed1997

[A case of Cogan-Reese syndrome (iris nevus syndrome)].

A case of 37 years old woman with a classic form of Cogan-Reese iris naevus syndrome is presented. Closure angle glaucoma, being a part of syndrome, with glaucomatous disc damage was initially treated with drugs (betaxolol, trusopt) without effective IOP decrease. A surgery was performed (goniotrepanatio by Fronimopoulos modified by Palmberg, but without iridectomy), 5 fluorouracil subconjunctival injections were given to the patient postoperatively for 5 days. We received a good IOP control on the level of 12 mm Hg. The visual acuity was 1.0 after surgical procedure. We wanted to present this case because of its rarity and a typical surgical procedure (without applying iridectomy).

Adult↗