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At least 613 records · Page 34Linked to original sources
PubMed1985

Primary angle closure glaucoma in a myopic kinship.

Three related myopic individuals with primary angle closure glaucoma are reported. They had true myopia and not pseudomyopia secondary to increased lenticular index of refraction. We believe one of these individuals (-8.62 spherical equivalent) to have the most myopic case of primary angle closure glaucoma reported in the literature. Although myopia is associated with anatomical factors that offer considerable protection from primary angle closure glaucoma, its presence does not eliminate the possibility of this disease. Laser iridectomy was effective in the treatment of these patients.

Adult↗
PubMed1986

Q-switched neodymium-YAG laser iridotomy in patients in whom the argon laser fails.

We conducted a short-term prospective clinical study to evaluate Q-switched neodymium-YAG laser iridotomy in 33 eyes with pupillary block glaucoma in which the argon laser was unable to create an iridotomy. These eyes had chronic angle closure glaucoma (11 eyes), acute angle closure glaucoma (five eyes), pseudophakic pupillary block (seven eyes), uveitic pupillary block (three eyes), and contralateral eyes (five eyes); also included were both eyes of a patient with a head tremor. In all eyes, a patent iridotomy was created in one treatment session, with a mean of 5 +/- 5 pulses and a mean total energy of 55 +/- 120 millijoules. Complications included iridotomy closure (two eyes with preexisting active uveitis), focal nonprogressive corneal opacities (six eyes), and minimal bleeding from the iridotomy margin (12 eyes). Q-switched neodymium-YAG laser iridotomy appears to be an effective next step in the management of pupillary block glaucoma prior to surgical iridectomy when argon laser iridotomy fails.

Argon↗
PubMed1988

A new multipurpose goniolens.

A new goniolens, called the "trabeculens," provides x 1.6 magnification and enhanced resolution of the trabecular meshwork by means of a new optical system that consists of a 30-diopter convex contact lens, hollow funnel, and four mirrors set at 62 degrees angles to one another. The trabeculens can also be used for laser trabeculoplasty, with the addition of an indentor, and for laser iridectomy, with the addition of a 20-diopter planoconvex button lens.

Anterior Chamber↗
PubMed1990

In vivo videography of the rhesus monkey accommodative apparatus. Age-related loss of ciliary muscle response to central stimulation.

Fourteen rhesus monkeys, aged 1 to 24 years, underwent permanent implantation of a bipolar stimulating electrode into the Edinger-Westphal nucleus and complete unilateral or bilateral iridectomy. Slit-lamp Scheimpflug videography of the lens and slit-lamp goniovideography of the lens equator, zonule, and ciliary body allowed direct real-time observation and video recording of the movements of these structures during centrally stimulated accommodation and during disaccommodation. Scalloping of the lens capsule at the zonular insertion sites was clearly visible during disaccommodation and even during accommodation when the zonules were folded. During accommodation, the lens became axially thicker, the ciliary ring narrowed, and, at high levels of accommodation, the zonular fibers slackened and even folded and the lens moved downward. With increasing age and concomitantly decreasing accommodative amplitude, these excursions all diminished, so that in the oldest animals, they were very minimal or absent. Maximum centrally stimulated accommodative amplitude declined with age on a time scale similar to that for cholinomimetic drug-induced accommodation in the rhesus monkey and voluntary accommodation in the human.

Accommodation, Ocular↗
PubMed1990

Respiratory epithelium in a cystic choristoma of the limbus.

A female newborn had a cystic, whitish gray mass at the inferotemporal limbus of the left eye. At age 3 weeks, the newborn underwent excision of the tumor, corneal patch grafting, and superior sector optical iridectomy. Histopathologic and electron microscopic examination of the excised tissue revealed a choristoma consisting of cysts lined with respiratory epithelium. To our knowledge, respiratory epithelium in a limbal choristoma has not been previously reported.

Choristoma↗
PubMed1991

Chronic postoperative endophthalmitis associated with Actinomyces species.

Actinomyces species, gram-positive, non-spore-forming anaerobic bacilli were isolated from intraocular fluid obtained from four otherwise healthy patients with a delayed onset of postoperative endophthalmitis. One patient had a mixed anaerobic infection with recovery of both Actinomyces israelii and Propionibacterium acnes. In all four patients, early postoperative visual acuity was good but was eventually markedly reduced by intraocular inflammation that was first observed between 21 days and 4 months following uneventful extracapsular cataract extraction and posterior chamber intraocular lens implantation. Inflammation was characterized by anterior segment and vitreous cellular debris in all cases. All eyes responded to therapy that included intraocular, topical, and systemic antibiotics as well as pars plana vitrectomy and partial iridectomy. These cases further illustrate the need for microbiologic investigation, including anaerobic cultures, in all cases of chronic postoperative inflammation following extracapsular cataract extraction, regardless of the time of onset.

Actinomyces↗
PubMed1992

Late histopathological findings of neodymium:YAG laser iridotomies in humans.

We studied three sector iridectomy specimens from three patients who had undergone neodymium:YAG (Nd:YAG) laser iridotomies 3 to 5 years earlier for treatment of imminent angle closure glaucoma. The specimens were obtained during cataract extraction and were examined by light and transmission electron microscopy. In all iris specimens, the edges of the iridotomy sites consisted of loosely arranged melanocytes, fibrocytes, and vessels. In the iris stroma, there were numerous pigment-laden cells. The iris vessels appeared to be intact; there were no fibrinous aggregates, no inflammatory response or scarring, nor any signs of proliferation of the iris pigment epithelium. Our findings suggest that in humans, iris wound healing after Nd:YAG laser iridotomy occurs without induction of fibrous scars or proliferation of the iris pigment epithelium. This indicates that there is no tendency toward late closure of the iridotomy sites.

Aged↗
PubMed1992

Cataract extraction in eyes filled with silicone oil.

A surgical technique for cataract extraction in eyes filled with silicone oil was developed that has two major objectives: removal of the entire cataractous lens and complete preservation of the silicone oil volume. A regular extracapsular cataract extraction or phacoemulsification is performed, and the incision is closed with the final sutures. All steps are performed under continuous positive pressure achieved with an anterior chamber maintainer connected to a bottle of balanced saline solution. An inferior basal iridectomy is created with a vitrectomy probe, and the posterior capsule is then slowly pulled out through the limbal incision with intraocular forceps, again under positive pressure, in an eye that is actually a closed system, without any loss of silicone. This step results in transformation of the extracapsular cataract extraction condition into an intracapsular cataract extraction condition. The described technique was successfully performed in nine eyes. In the younger patients, the whole procedure was completed through two very small limbal openings.

Adult↗
PubMed1995

The incidence of corneal abnormalities in the Silicone Study. Silicone Study Report 7.

OBJECTIVE: To determine factors that were prognostic of corneal abnormalities in eyes following surgery for severe proliferative vitreoretinopathy. DESIGN: Subgroup analysis of the Silicone Study. SETTINGS: Community and university-based ophthalmology clinics. MATERIALS: Eyes with attached maculae at the 24-month follow-up examination that did not have a pre-existing corneal abnormality. INTERVENTIONS: Vitrectomy surgery with long-acting gas or silicone oil. OUTCOME MEASURES: Epithelial and/or stromal edema, corneal opacity and/or previous corneal transplant. RESULTS: The incidence of corneal abnormalities at 24 months was 27% and did not differ significantly between treatment groups. Prognostic factors were preoperative aphakia or pseudophakia (P = .003), preoperative iris neovascularization (P = .006), reoperation (P = .001), the absence of a fluid/gas exchange (P = .03), corneal touch by silicone oil (P = .02), and the presence of aqueous cells (P = .009) or aqueous flare (P = .08). In a multivariate analysis, independent prognostic factors were iris neovascularization (relative risk [RR] = 13.1), aphakia or pseudophakia (RR = 3.0), postoperative aqueous flare (RR = 5.4), and reoperations (RR = 3.4). Corneal abnormalities were correlated with poor visual acuity and hypotony (P < .001). CONCLUSIONS: To our knowledge, this is the first study to document that the incidence rates of corneal abnormalities are equivalent between oil and gas. The incidence of corneal abnormalities in gas-filled eyes was higher than expected, and remained high in oil-filled eyes, despite the use of an inferior iridectomy. Successful surgical repair of the retinal detachment with a single operation, and prevention and early management of corneal touch by silicone oil should help to prevent corneal abnormalities. If rubeosis iridis or severe aqueous flare is present, preoperative treatment with intense topical and possibly periocular steroids might reduce inflammation, which might mediate corneal damage.

Adult↗
PubMed1997

Exfoliation syndrome in a 17-year-old girl.

A 17-year-old girl with unilateral congenital glaucoma who had undergone trabeculectomy and peripheral iridectomy in infancy developed apparent exfoliation syndrome (XFS) in the eye that underwent the surgical procedures. A conjunctival biopsy was performed and the specimen was fixed in 2.5% glutaraldehyde, embedded in epoxy resin (Epon-Araldite, Electron Microscopy Sciences, Fort Washington, Pa), and processed for routine electron microscopy and immunostaining for elastin. Results of ultrastructural study showed scattered fibrillar aggregates compatible with those of XFS in an older adult, differing chiefly in sparsity of granular interfibrillar matrix. The XFS fibers were closely associated with elastic fibers and microfibrils. Elastosis of the actinic-aging type was somewhat greater than expected for age. To our knowledge, this is the youngest patient described with characteristic ocular findings of XFS to date, supporting others who have suggested an association between iris surgery in youth and early onset XFS. Electron microscopy was essential in ruling out the possibility of a clinically similar entity caused by ultrastructurally different material.

Adolescent↗
PubMed1983

Proliferation of epidermal melanocytes during the healing of skin wounds in newborn mice.

A full-thickness cut 7 mm long was made on the middorsal skin of C57BL/10J mice using fine iridectomy scissors. Specimens from the wounded skins were fixed at various days after wounding and were subjected to the dopa reaction and to the combined dopa-premelanin reaction. In the epidermis within 1 mm from the wound edge, the melanocyte population positive to the dopa reaction as well as the melanoblast-melanocyte population positive to the combined dopa-premelanin reaction increased dramatically until the third day, then gradually decreased. In contrast, both populations in the regenerating wound epidermis appeared on the third day and increased until the seventh day, then gradually decreased. However, the maximal population density in the regenerating epidermis did not exceed the initial density. The size of the melanocyte population in both the epidermis within 1 mm from the wound edge and the regenerating epidermis did not differ from that of the melanoblast-melanocyte population in all stages of wound healing. Moreover, pigment-producing melanocytes in mitosis were found immediately after wounding in the epidermis within 1 mm from the wound edge, but not in the regenerating epidermis and control epidermis. These results indicate that the epidermal melanocytes in neonatal mouse skin can be stimulated to undergo mitosis immediately adjacent to a skin wound and, thereafter, to migrate into the regenerating epidermis.

Animals↗
PubMed1982

Dye laser in ophthalmic disease.

From September 1978 to May 1980, dye lasers have been used in the treatment of 56 cases of eye disease (60 eyes), including among others peripheral retinal breaks, macular breaks, prebreak stage degeneration, congenital iris residual membrane, incomplete surgical iridectomy, secondary glaucoma iris bombé, closed-angle glaucoma, vireous hemorrhage, periphlebitis retinae, Coats disease, thrombosis of central and branch retinal vein. Most of the results are satisfactory. Dye laser irradiation has the advantage in iridotomy. Only one pulse can perforate the iris and no serious complication has been encountered. There is a definite therapeutic effect in treatment of vitreous hemorrhage by dye laser.

Coloring Agents↗
PubMed1979

Four year follow-up of a glaucoma operation. Prospective study of the double flap Scheie.

This paper presents the four-year follow-up results of a prospective study on the results of the Double Flap Scheie. The study was started in 1971 and the pre- and post-operative evaluation was carried out according to carefully selected criteria. Admitted were only open angle glaucoma patients. Diurnal IOP-curves, static perimetry, evaluation of lens and optic disc in mydriasis were included in the complete pre- and post-operative examination. In the Douible Flap Scheie a conjunctival and scleral flap are made followed by a cornea-scleral cauterization and incision after which a peripheral iridectomy is made. 51 eyes of 48 patients were operated. After 4 years 42 eyes of 37 patients could still be examined. The mean IOP was reduced from 33.0 to 17.3 mm without additional therapy. This is a mean percentage reduction of 48.5%. 75% of the mean IOP was under 21 mm; with additional therapie 91% was under 21 mm. Diurnal variation decreased from 7 to 4 mm. 48% of the eyes showed a decreased visual acuity of which 38% was caused by cataract. 52% showed visual field deterioration of which one third was attributed to cataract. In 24% the visual field deterioration was considered clinically important. There was no clear relation between IOP level and visual field deterioration.

Aged↗
PubMed1986

Timolol and intra-ocular pressure elevation following neodymium: YAG laser surgery.

The intra-ocular pressure in 76 patients, undergoing Neodymium: YAG laser surgery was measured just before treatment, and one and two hours afterwards. The fellow eye served as a control. Serious elevation of the intra-ocular pressure was demonstrated, especially in capsulotomy in the aphakic eye, to a lesser extent in pseudophakic eyes. Intra-ocular pressure elevation of more than 20 mm was seen in iridectomies. Timolol 1/2% eyedrops given before Neodymium: YAG laser treatment minimized the elevation of the intra-ocular pressure. Prolonged follow-up of the intra-ocular pressure is recommended.

Aphakia, Postcataract↗
PubMedDate not supplied

Glaucoma filtering surgery, a retrospective study of 300 operations.

The results of 300 consecutive glaucoma filtering procedures, which were performed in our clinic between January 1982 and September 1985, are described. The overall combined success rate (complete + qualified) was 66.5% (Heuer's classification). This is in good agreement with other glaucoma referral centers. The peak of the age distribution curve at the time of operation was between 70 and 75 years. Nevertheless, 30% of operations was performed on patients under 50 years of age. Relatively poor success rates were obtained in operations following prior unsuccessful filtering surgery (50.5%) or other surgery (47%), in patients under 50 years of age (61%) and in some types of secondary glaucoma. In aphakia/pseudophakia the success rate was 33%. The posterior capsule was intact only 13% of this category at the time of surgery, in 56% previously unsuccessful filtering surgery had been performed, and the age at operation was relatively young (53 yr). These factors have an unfavorable influence on the results of filtering surgery. The success rate in phakic primary open angle glaucoma was 85% and in phakic primary angle closure glaucoma 73%. The combination with a cataract extraction (in 28%) and a peripheral iridectomy, if this had not been performed previously, (in 31%) may have contributed to the relatively favorable surgical results in phakic primary angle closure glaucoma. Relatively high intraocular pressures were found in the early postoperative period; the peak of the pressure-curve was between 20 and 25 mm Hg, 10 mm Hg higher than at the end of follow-up. Postoperative progression of glaucomatous visual field defects was noted in 7%. The most disturbing complication was flat anterior chamber, causing or enhancing cataract formation (in 4 out of 8 phakic patients) and corneal dystrophy (in 2 out of 12 patients). A review of literature is given concerning methods of improving filtration, when the surgical prognosis is poor.

Evaluation Studies as Topic↗
PubMed1976

[Effect and complications of Vogt perforating cyclodiathermy in various forms of glaucoma].

In 178 eyes 223 perforating cyclodiathermies (PCD) have been performed. The technique described by Vogt was modified by additional coagulations around the insertions of the recti-muscles. This procedure was done if one or repeated glaucoma procedures (fistulas, iridectomies or trabeculotomies) were not successful of if these surgical methods were not reasonable because of the morphological conditions of the iris and the chamber angle. If one compares in this retrospective study the average diurnal curves of 60 eyes preoperatively and 7 days postoperatively the PCD has lowered the curve and removed the morning peak that was visible preoperatively. In 153 eyes (86%) the intraocular pressure could be lowered at least for some time. A new increase was seen in most cases during the first 6 months postoperatively. 116 eyes had a postoperative follow-up of 6 months up to 3 years. 45 (39%) of these eyes were controlled without and another 31 eyes (27%) with additional medical therapy (single measurement or average of the diurnal curve less than or equal to 21 mmHG). In some eyes a repetition of the PCD was necessary to be successful. The best results had been achieved in primary glaucoma, in secondary glaucoma after uveitis and in aphacic eyes. In congenital glaucoma only 12 out of 25 eyes could be controlled and this was similar in secondary glaucoma of the vascular type. There is no influence of the preoperative pressure level on the rate of success. But the effect correlates with the preoperative visual acuity: the worse the visual function, the lower the percentage of controlled eyes. The intra-operative complications are not important. The most important postoperative complication is a phthisis bulbi which was seen in at least 10 out of 178 eyes. Most of these eyes were suffering from a secondary glaucoma of the vascular type with high preoperative pressure. All eyes had a visual acuity of 1/50 or less. To repeat the PCD after a few weeks is another factor that facilitates this serious complication. After at least 3 months the repetition of a PCD seems to be without a special risk of phthisis bulbi.

Adolescent↗
PubMed1992

Surgical results and complications of goniosynechialysis.

Goniosynechialysis (GSL) was performed in 70 eyes with primary angle-closure glaucoma in which the intraocular pressure (IOP) could not be controlled with laser or surgical iridectomy. Following GSL, the IOP was maintained at below 20 mmHg, with and without eye drops, in 34 (87%) of 39 aphakic eyes and in 13 (42%) of 31 phakic eyes. In 8 of 10 eyes, all of which were phakic and the first GSL procedure was not effective, IOP could be controlled by a second GSL procedure combined with lens extraction. Life-table analysis showed a significant difference between the probable success rate, after 5 years, between the phakic and aphakic groups. Postoperative tonographic C values showed improvement in outflow facility. However, frequently encountered complications were exudation of fibrin and minor hemorrhage. Our results suggest that a combination of GSL and extraction of the lens may be necessary to control refractory angle-closure glaucoma.

Adult↗
PubMed1991

Glaucoma and Peters' anomaly. A clinicopathologic case report.

A 26-year-old black woman with Peters' anomaly who had been followed since early childhood developed an open-angle form of glaucoma, which required filtering surgery. Light and electron microscope studies of the trabeculectomy specimen, which was obtained by en bloc resection of the trabecular meshwork and iridectomy specimen, revealed that the structures of the anterior-chamber angle were grossly normal aside from evidence of premature aging on the basis of abundant broad-banded collagen fibers in the trabecular lamellae.

Adult↗