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At least 649 records · Page 36Linked to original sources
PubMed2005

[Glaucoma in the young patient. Therapeutic problems].

Achieving an adequate intraocular pressure (IOP) is critical to the successful management of children affected with juvenile glaucoma, in whom medical therapy is often insufficient to control IOP. Anti-glaucoma eyedrops are usually not approved for use in children but, however, are frequently used in pediatrics. Although ocular hypotensive eyedrops may be well tolerated in young patients, their chronic use is often problematic because of systemic side effects or noncompliance. Glaucoma filtering surgery with adjunctive antifibrosis therapy (particularly with mitomycin C), aqueous shunt surgery and cyclodestructive procedures are currently undertaken in patients with juvenile glaucoma. Filtration surgery is usually less successful in patients with juvenile glaucoma: the higher failure rate stems from the excessive wound healing response in younger patients, resulting in subconjunctival fibrosis.

Adolescent↗
PubMedDate not supplied

Intraoperative management of nonfunctioning Ahmed glaucoma valve implant.

A 62-year-old woman with neovascular glaucoma underwent filtering surgery with the Ahmed glaucoma valve (New World Medical, Inc., Rancho Cucamonga, CA). Intraoperative hypotony secondary to a defective valve was noted and managed by excising the valve mechanism. The implant was then treated as if it was non-valved by placement of an obturator suture. The postoperative course was unremarkable for a non-valved implant. This case demonstrates how intraoperative hypotony secondary to overfiltration of an Ahmed glaucoma valve implant can be successfully managed by converting to a non-valved implant.

Female↗
PubMed1990

Evaluation of antiproliferative agents using a cell-culture model.

Chinese hamster ovarian (CHO) cells in culture were used to evaluate the relative antiproliferative potential of drugs. These agents have been used to improve the clinical response after glaucoma filtering surgery. The following drugs were evaluated: 5-fluorouracil (5-FU) as the benchmark, 5-fluorouridine (FUR), 5-fluorodeoxyuridine (FUDR), 5'-deoxy-5-fluorouridine (DFUR), bleomycin, and cytarabine (ARA-C). In addition to cell counting, a colorimetric assay based on the tetrazolium salt, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) was used to follow growth response. The MTT assay was found to be extremely convenient and an indirect measure of cell activity, offering an alternate or addition to a measure of cell number. All agents tested were shown to inhibit cellular proliferation. Dose-response curves for each agent indicate the following absolute potency: FUDR greater than FUR greater than ARA-C greater than 5-FU = bleomycin greater than DFUR. Besides absolute potency, an evaluation of the effects of equivalent inhibitory concentrations of each drug on growth rate was assessed. Several agents affected the proliferation rate patterns differently. Based on these studies, it is suggested that the in vitro model can identify potential agents through an assessment of their overall activity profile in CHO cells, which includes not only their potency based on dose response, but their onset of activity, duration of effect, and potential for toxicity.

Animals↗
PubMed1991

A prospective evaluation of anterior retinal cryoablation in neovascular glaucoma.

We report a prospective evaluation of the effect of anterior retinal cryopexy on 62 eyes with neovascular glaucoma. Pain was relieved and anterior chamber inflammatory reaction regressed dramatically in 95%. Iris neovascularization was reduced or regressed in 93.5%. Control of intraocular pressure was clinically significant in 82.3% 1 year after the procedure, especially in patients with pretreatment pressures less than 40 mm Hg on maximal medical therapy. Anterior retinal cryopexy is recommended in eyes with media opacities and as a preliminary procedure for filtering surgery in eyes with neovascular glaucoma.

Adolescent↗
PubMedDate not supplied

[Repeat argon laser trabeculoplasty in the treatment of primary open-angle glaucoma].

Twenty-one eyes of eighteen patients with clinically uncontrolled open angle glaucoma, 3 to 49 months after the initial laser treatment underwent repeat argon laser trabeculoplasty. Retreatment was successful in eleven eyes (52%). Ten eyes (48%) has marked increases in intraocular pressure, necessitating urgent filtering surgery. Repeat argon laser trabeculoplasty was effective for these patients who show a prolonged response to their initial treatment.

Glaucoma, Open-Angle↗
PubMed1991

The effects of the fluorinated pyrimidines FUR, FUdR, FUMP, and FdUMP on human Tenon's fibroblasts.

5-Fluorouracil (5-FU) has effectively inhibited fibroblast proliferation to prevent scar formation and bleb failure after glaucoma filtering surgery. To identify more potent but less toxic antiproliferative drugs, the authors studied cell attachment and proliferation of 5-FU metabolites: 5-fluorouridine (FUR), 5-fluorodeoxyuridine (FUdR), 5-fluorouridine-5'-monophosphate (FUMP), and 5-fluorodeoxyuridine-5'-monophosphate (FdUMP) on human Tenon's fibroblasts in vitro.

Adenosine↗
PubMed1991

[Experimental study of the inhibitory effect of daunorubicin and doxorubicin in conjunctival fibroblast proliferation].

Both daunorubicin and doxorubicin were found effective in inhibiting proliferation of rabbit conjunctival fibroblasts in vitro. The 50% inhibition dose for daunorubicin was 0.14 micrograms/ml, and 0.46 micrograms/ml for doxorubicin, the former being stronger. The authors were hopeful that these drugs would prove useful in preventing cicatrization after glaucoma filter surgery.

Animals↗
PubMed1991

The effects of glaucoma medications on Tenon's capsule and conjunctiva in the rabbit.

Glaucoma filtering surgery fails most frequently due to fibrosis at the episcleral-conjunctival/Tenon's capsule interface. Sherwood et al have suggested that chronic topical antiglaucoma medications increase conjunctival inflammatory cells, which could increase the likelihood of fibrosis and subsequent bleb failure. In a pilot study in a rabbit model, we placed timolol, pilocarpine, and epinephrine, or a combination of all three, in one eye of 24 animals twice daily for 7 months. The fellow eye received distilled water. Microscopic examination revealed no statistically significant change in the number of acute or chronic inflammatory cells, fibroblasts, or goblet cells in the treated as compared with the control eyes. A longer duration of drug administration, or drug administration followed by surgical intervention, may be required to produce an effect on the conjunctiva and Tenon's capsule, if such an effect exists.

Administration, Topical↗
PubMed1990

The effect of 5-fluorouracil and cytarabine on human fibroblasts from Tenon's capsule.

The in vitro cellular inhibitory effects of two pyrimidine antimetabolites, 5-fluorouracil (5-FU) and cytarabine (ara-C), on the attachment and proliferation of human Tenon's capsule fibroblasts after 1, 2, 3, 5, 7, and 10 days of growth were measured with a Coulter counter, a colorimetric method using the endogenous enzyme hexosaminidase, and 3H-thymidine uptake. Neither 5-FU nor ara-C affected cell attachment. The 50% inhibitory dose (ID50) for 5-FU, as measured by the Coulter counter and hexosaminidase assay, was 0.2 and 0.4 micrograms/ml, respectively, at day 5 and decreased to 0.01 and 0.10 micrograms/ml, respectively, on later days. The ID50 for ara-C as measured by the Coulter counter and hexosaminidase assay was 0.01 and 0.1 micrograms/ml at day 3 and remained constant over time. Much lower ID50s were measured by thymidine uptake for both drugs. These findings may indicate that 5-FU has a delayed effect on cellular proliferation due to conversion into more active metabolites. The ara-C has a direct and constant inhibitory effect on cellular proliferation and is ten times more potent than 5-FU as an antiproliferative drug. Thus ara-C may have clinical utility in preventing failure of glaucoma filtering surgery.

Anterior Eye Segment↗
PubMedDate not supplied

[Indications and results of Sonocare (ultrasound) in the treatment of ocular hypertension. A preliminary study of 395 cases].

The Sonocare system CST 100 provides high-intensity focused ultrasound to lower the intraocular pressure by three different mechanisms: partial destruction of the ciliary epithelium, scleral thinning allowing transcleral outflow of aqueous humor, and mainly the ciliary body separation from the sclera. Initially it was used to treat blind eyes with painful elevated intraocular pressure; now the indications are gradually extended to eyes with good vision. This technique takes place between laser trabeculoplasty and filtering surgery. The first 395 cases which were treated with ultrasound these two last years in the Quinze-Vingts Hospital, are displayed in this report.

Glaucoma↗
PubMed1987

Increased intraocular pressure following endarterectomy.

Two patients are presented with neovascularization of the iris due to ischemia secondary to decreased blood flow through the carotid arteries. Panretinal photocoagulation was followed by regression of the new iris blood vessels to a greater extent in one patient than in the other. Following carotid endarterectomy, intraocular pressure increased, and, in one case, filtering surgery was required. Possible mechanisms for the rise in intraocular pressure following carotid endarterectomy are discussed.

Carotid Artery Diseases↗
PubMed1987

Surgical management of the secondary glaucomas: Part I.

Surgical approaches to the secondary glaucomas vary depending on the pathogenesis and stage of the disease. In this first part, neovascular glaucoma management is reviewed. Panretinal ablation by laser or cryopexy and goniophotocoagulation used to reverse neovascularization are helpful, but not permanently curative. Filtering surgery is not as successful for neovascular glaucoma as it is for the primary adult glaucomas. Therefore, modifications using 5-fluorouracil, carbon dioxide lasers, and alloplastic implants have been investigated. Although ciliary body ablation using cryotherapy or photocoagulation may reduce intraocular pressure, vision may still deteriorate.

Ciliary Body↗
PubMed1989

The cytotoxic effect of 5-fluorouracil on cultured human conjunctival cells.

5-fluorouracil (5-FU) has been recently injected subconjunctivally following glaucoma filtering surgery to prevent scar formation. We studied the effect of short time exposure of 5-FU on cultured human conjunctival cells. Thirty second exposure to 5-FU more than 100 micrograms/ml caused significant inhibition of cell growth and morphological changes such as decrease of mitotic cells, increase of vacuoles in the nucleus and cytoplasm, chromatin clumping against the nuclear membrane and formation of white-yellowish granules in the cytoplasm and scanning electron microscopy showed reduction of microvilli and filopodia. Although cell growth 48 hrs after the passage of cells exposed to 100 micrograms/ml 5-FU was restored, morphological changes were remained.

Cell Division↗
PubMed1989

An evaluation of three surgical approaches for coexisting cataract and glaucoma.

Seventy-eight eyes of 69 patients with coexisting cataract and glaucoma underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation by one surgeon. A combined guarded filtering procedure was performed in 22 of these cases, and a two-stage procedure filtering surgery followed by cataract extraction was performed in 22 more. Cataract surgery alone was performed in the remaining 34. Since different criteria were used for selecting one of these three surgical approaches, and since baseline values in the three groups were not comparable, the significance of the results is limited. Observations of possible clinical significance, however, include the following: there were fewer early postoperative intraocular pressure rises associated with the combined procedures than were associated with cataract surgery alone, but there was an otherwise relatively lower complication rate in the latter group. All three groups had similar final intraocular pressures, although eyes undergoing the two-stage procedure, having had higher baseline pressures than those in the other two groups, had a higher percentage pressure reduction.

Adult↗
PubMed1989

A modification of the use of the glaucoma tamponade shell.

Filtering surgery may be complicated by excessive filtration or bleb leak in the postoperative period, resulting in a shallow or flat anterior chamber and choroidal detachment. A glaucoma tamponade shell with a raised inner platform increases the resistance to flow through the fistula, deepening the anterior chamber. Some surgeons apply a pressure patch over the shell to increase the tamponading effect and to prevent rotation of the shell. Nevertheless, the shell may still rotate, resulting in less than adequate tamponade. We describe a technique that prevents rotation of the shell.

Bandages↗
PubMed1989

[Effect of short-time exposure of 5-fluorouracil on cultured conjunctival cells].

5-fluorouracil (5-FU) has recently been injected subconjunctivally after glaucoma filtering surgery to prevent scar formation at filtration sites. We studied the effect of short time exposure to 5-FU on cultured human conjunctival cells. Thirty-second exposure to more than 100 microns/ml 5-FU caused significant inhibition of cell growth and morphological changes such as decrease of mitotic cells, and scanning electron microscopy showed reduction of filopodia and microvilli. Although cell growth 24 hr after the cell passage exposed to 100 microns/ml 5-FU was restored, morphological changes remained.

Cell Division↗
PubMed1989

Laser sclerostomy ab interno using a continuous wave Nd:YAG laser.

We report the use of a continuous wave Nd:YAG (CW-YAG) laser focused through a sapphire crystal to create a filtering bleb by ab-interno sclerostomy. A 2-mm clear corneal incision was made in each eye of five anesthetized Dutch Belted rabbits, and the 30-mm-long sapphire crystal with a 0.2-mm focal tip was passed across the anterior chamber until it came in contact with the opposite angle. Between two and three pulses of 0.8 J were required to produce a filtering bleb in each of the 10 eyes. The overlying conjunctiva was not damaged; the procedure time was under five minutes. Histological examination revealed a surrounding area of scleral melting that extended an average of 0.06 mm from the sclerostomy. These data suggest that the CW-YAG laser may be useful in performing glaucoma filtering surgery with minimal damage to surrounding ocular tissues.

Animals↗
PubMed1989

[Medium-term tonometric results of trabeculectomies performed after trabeculoretraction using an argon laser in chronic primary open-angle glaucoma].

Following unsuccessful Argon Laser Trabeculoplasty (ALT), 93 eyes were tracked for periods of 6 to 42 (mean: 24 months). The total failure rate of 20% is similar to the generally known failure rate of the trabeculectomies. However, failures are more frequent (37%) when trabeculectomy is performed between the second and third month after ALT. This may suggest not to operate on too soon after ALT or to perform filtering surgery with 5 Fluoro-uracil.

Adult↗