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Results for “primary angle-closure glaucoma”

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At least 73 records · Page 4Linked to original sources
PubMed1991

Uncontrolled primary angle closure glaucoma: results of early intercapsular cataract extraction and posterior chamber lens implantation.

In this study we retrospectively evaluated the effect of intercapsular or extracapsular cataract extraction and posterior chamber lens implantation in 67 eyes of 57 patients with different types of primary angle closure glaucoma (PACG) in combination with cataract. We subdivided this patient population into three groups, based on the preoperative methods of intraocular pressure (IOP) control. The best results were obtained in patients with acute PACG (55% IOP reduction) and in patients with uncontrolled PACG (44% IOP reduction). In the other PACG groups an IOP reduction of between 20 and 33% was achieved. A long-term postoperative IOP of less than 21 mmHg was established in 63 eyes or 94%. In 91% the glaucoma medication was reduced, 65% of all eyes needed no glaucoma medication postoperatively. We conclude that an intercapsular cataract extraction with PC-IOL implantation should be considered in both controlled and uncontrolled PACG in patients with cataract, instead of filtering surgery or combined procedures. Even in eyes with relatively good visual acuity, cataract extraction might be considered as a means of achieving glaucoma control.

Acute Disease↗
PubMed1990

Choroidal detachment, flat anterior chamber, and hypotony as complications of neodymium: YAG laser cyclophotocoagulation.

Severe hypotony, flat anterior chamber, and serous choroidal detachment after transscleral neodymium: YAG laser cyclophotocoagulation (Nd:YAG-CPC) for three cases of intractable glaucoma are reported. The three patients had failed previous filtering surgery and were receiving maximal medical therapy. The types of glaucomas treated were two cases of primary open-angle and one chronic-angle closure. The complications were noted between 1 and 2 weeks from the time of treatment. One patient improved spontaneously after 1 week of observation. Another patient required drainage of the choroidal effusion and anterior chamber reformation. The last patient remains under observation with a low intraocular pressure (IOP) and a slowly resolving serous choroidal detachment. Though the incidence of shallow anterior chambers is three cases (0.5%) in this series of 750 Nd:YAG-CPCs, it represents a serious problem that had not been reported previously.

Aged↗
PubMed1991

The oval pupil.

The dynamics of pupillary dilation induced by Phenylephrine 10% and Cyclopentolate 1% have been examined by flash photography. A correlation between anterior chamber depth and the pupil shape on dilation with Phenylephrine Hydrochloride 10% is described. It is postulated that these pupillary dilation dynamics support a sympathetic abnormality as a trigger for acute primary angle closure glaucoma.

Adolescent↗
PubMed1991

Glaucoma. A primer for primary care physicians.

Glaucoma is best detected by examination of the optic disk, since intraocular pressure is not always elevated in patients with the condition. A large, vertically oval cup within the optic disk is strong evidence for glaucoma. Open-angle glaucoma, the most common form of the disorder, often is not detected until the disease is advanced. It can usually be treated successfully with topical medications, but systemic absorption of these can result in serious side effects. If medical treatment fails, laser therapy or filtering surgery may be helpful. Acute angle-closure glaucoma has a sudden onset marked by alarming elevations in intraocular pressure. It is treated immediately with topical pilocarpine and systemic osmotic agents, and an iridectomy should be performed as soon as possible. Congenital glaucoma can be cured with goniotomy.

Family Practice↗
PubMed1991

Trabeculectomy with 5-fluorouracil.

The effect of subconjunctival injection of 5-fluorouracil (5-FU) after trabeculectomy was studied retrospectively in 205 eyes of 168 patients. A life table analysis of the surgical outcome was based on the type of glaucoma and age related differences, and a comparison was made with patients who had trabeculectomy without subconjunctival 5-FU. The success rate at 30 months after trabeculectomy with 5-FU therapy was considerably higher in primary open-angle glaucoma at 93.6% (72.7%), secondary glaucoma at 88.9% (72.4%), and refractory glaucoma at 72.2% (32.5%) with (or without) the use of ocular hypotensive drops when compared with historical control groups treated without 5-FU (60.0% (41.7%), 35.5% (24.0%), and 18.0% (8.0%), respectively). In patients aged over 70 years, no statistically significant improvement could be demonstrated with the use of 5-FU after trabeculectomy in primary open-angle glaucoma. Our study may provide data on the appropriate dosage and indications for the use of this drug after glaucoma surgery.

Aged↗
PubMed1991

Does the pilocarpine phenylephrine provocative test help in the management of acute and subacute angle closure glaucoma?

The pilocarpine phenylephrine provocative test (PPPT) has been described as a highly sensitive method to identify eyes suffering from or at risk of angle closure glaucoma (ACG). This paper reports on average 10 years follow-up of the outcome of cases of primary acute ACG and subacute ACG in which the management was determined by the result of the PPPT--a positive result indicating the need for a peripheral iridectomy, a negative result conservative treatment. In spite of a negative PPPT the fellow eyes of cases of acute ACG treated conservatively had a high rate (40%) of development of ACG. Similarly, in eyes with a history of subacute ACG with a negative PPPT, ACG developed at some stage during the follow-up in 60%. Peripheral iridectomy alone resulted in normal intraocular pressure in 63% of eyes that had suffered an attack of acute ACG. In hypertensive eyes that presented with subacute ACG, however, only one eye became normotensive following peripheral iridectomy alone. In the subacute ACG group a positive PPPT was closely related to the presence of glaucomatous optic disc damage. These results indicate that the PPPT lacks sensitivity in detecting eyes at risk of angle closure glaucoma, and a positive result is likely in eyes with damaged outflow that will not respond to peripheral iridectomy.

Adult↗
PubMed1990

Soap gets in your eyes.

We present a previously unreported series of five cases of acute angle closure glaucoma associated with watching the Australia soap opera "Neighbours". Two cases were bilateral and associated with watching two episodes of "Neighbours" on the same day. The pathogenesis, and possible role of watching soap operas in the causation of primary angle closure glaucoma is discussed.

Aged↗
PubMed1992

[YAG laser treatment in anterior segment disease of the eye].

Three hundred and fifty-two eyes (230 patients) with various diseases were treated with the first China-made YAG laser therapy instruments. The success rate was 100%. Two hundred and seventy-six eyes with primary angle closed glaucoma were treated by peripheral iridotomy. Postoperatively, the IOP was lowered by 0.267 kPa (2.43 mmHg). The dose and frequency of medication could then be lowered. The closed chamber angle index improved. Forty-nine eyes with membranous cataract were treated by posterior capsulotomy: Visual acuity was improved by 95%. The main complications during or immediately after operation were as follows: transient elevation of IOP, hyphema, anterior uveitis and corneal edema. All of these were well controlled.

Adult↗
PubMed1992

The selective effects of elevated intraocular pressure on temporal resolution.

Twenty-seven eyes of 27 patients with normal tension glaucoma (NTG), 68 eyes of 68 patients with primary open-angle glaucoma (POAG), and 11 eyes of 11 patients with special forms of high-tension glaucoma (SHTG) including (pigmentary glaucoma, angle-closure glaucoma, secondary glaucoma, etc.), were examined by automated light-sense and temporal resolution perimetry. Light-sense perimetry was performed with the Humphrey Field Analyzer, using program 30-2. Temporal resolution perimetry was conducted with a system developed by Lachenmayr. Global field indices were calculated for all visual fields and modalities: mean defect (MD) for light-sense perimetry and mean flicker defect (FD) for flicker perimetry. For each of the three glaucoma groups there was a significant linear correlation of FD over MD. The slope of the regression line (regression coefficient a) increased with increasing maximal pressure level of the glaucomatous group: for NTG a = 0.6671, for POAG a = -1.2413, and for SHTG a = -2.235. The differences of the regression coefficients between NTG and POAG and between NTG and SHTG were statistically significant (P = 0.0366 and P = 0.0046, respectively). The results of the present study provide evidence that the relative amount of damage to flicker compared to light-sense perimetry increases with increasing maximal pressure level of a glaucomatous population. Thus, flicker perimetry may be a tool for the identification of eyes with pressure-produced damage.

Adult↗
PubMedDate not supplied

[Effectiveness of laser treatment of narrow-angle glaucoma].

Forty-eight patients with narrow-angle glaucoma were treated with M-900 argon laser (Coherent Radiation, USA). Reduction of intraocular pressure as low as 20 +/- 1.82 mm Hg on an average was achieved. Fluid discharge efficacy coefficient has improved. The authors claim that laser cyclotrabeculospasis a sufficiently effective method for the treatment of primary narrow-angle glaucoma.

Adult↗
PubMedDate not supplied

[Clinical evaluation of the hypotensive effectiveness of Betoptic preparation].

Clinical trials of the hypotensive effect of 0.5% betoptic, an antiglaucoma drug manufactured by Alcon (USA), were carried out at three ophthalmologic hospitals. Similar results obtained in all the trials permit a conclusion on a high hypotensive efficacy of this drug in patients with primary open-angle glaucoma. The drug was well tolerated by the patients.

Aged↗
PubMed1991

Awan's syndrome (primary orbital hypertelorism, narrow-angle glaucoma and lean physique) in two women.

Awan's syndrome, characterized by a lean physique, orbital hypertelorism and angle-closure glaucoma, is a distinct clinical entity which should be more widely recognized. The patients, usually women in their sixth decade, may suffer several self-limiting and misdiagnosed episodes of angle-closure before a definite diagnosis is made. The general physical appearance and hypertelorism in two women, one aged 56 and the other 59 years, with Awan's syndrome aroused the suspicion of angle-closure glaucoma. The timely confirmation of diagnosis and proper management prevented further visual loss in both patients. Some patients with Awan's syndrome may show advanced damage to the optic nerve without ever having had an acute attack of glaucoma or any other symptoms, which makes it important that all patients with orbital hypertelorism and suspected glaucomatous optic discs should undergo gonioscopic evaluation to rule out glaucoma.

Body Constitution↗
PubMedDate not supplied

Argon laser iridoplasty: a primary mode of therapy in primary angle closure glaucoma.

Argon laser iridoplasty was performed in 40 eyes of 33 patients of primary angle closure glaucoma. There were 12 male and 21 female patients. The mean ages of the male and female patients were 51 years and 48.4 years respectively. Forty eyes were divided into two groups. Group I consisted of ten eyes of subacute angle closure glaucoma and group II included thirty eyes of chronic angle closure glaucoma. Argon laser iridoplasty was performed with Coherent 9000 model using laser settings of spot size 200 micron, duration 0.2 second and power 0.7 watt. A total of 80 spots were applied over 360 degree circumference. The intraocular pressure control (below 22 mm Hg) was achieved after iridoplasty in all the eyes (100%) in group I, where as in group II the intraocular pressure was controlled in 70% eyes. The follow up period varied from 3 months to one year with a mean of eight months. The success rate with iridoplasty was directly related to the extent of peripheral anterior synechiae, optic disc cupping and presence of visual field changes.

Acute Disease↗
PubMed1991

A preliminary study of short-term efficacy of Nd:YAG laser peripheral iridotomy in patients with primary angle closed glaucoma.

Q-switched Nd:YAG laser was used for the peripheral iridotomy in 68 cases (80 eyes) of primary angle closed glaucoma. The average number of laser shots is 20.5 (1-127 shots), and the average shot energy is 2.5 mJ (0.9-5.6 mJ). The successful rate of iris penetration is about 97.6%. The size of the iris hole is not smaller than 0.2 mm2. The kind of the iris is the most important factor that causes the marked variation in laser shots and in laser shot energy. The main complications of Nd:YAG laser iridotomy present as transient IOP elevation and iris bleeding. Increase in IOP most occurs within two hours after the laser therapy. The iris bleeding was seen in about 39% of the patients, but this iris bleeding is slight and very minor and tend to stop spontaneously. On the other hand, no correlation was found among the IOP elevation, laser shot, and laser shot energy. The causes and management of the IOP elevation after Nd:YAG laser iridotomy was discussed in detail. The authors believe that this newer treatment has immediate benefit for the patients with narrow-angle or angle-closure glaucoma, but many problems still remain to be investigated.

Female↗
PubMed1991

[The partner eye in unilateral malignant glaucoma].

The fellow eyes of 9 Patients suffering of unilateral classical malignant glaucoma have been throughly examined short after the onset of malignant glaucoma. In 3 cases they were apparently normal, in other 3 cases they exhibited an intermittent primary angle closure glaucoma and in the remaining 3 ones an absolute glaucoma. The therapeutic options of these fellow eyes are discussed.

Adult↗
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↗
PubMedDate not supplied

[Primary malignant glaucoma].

The authors present two cases of classical unilateral malignant glaucomas, having at the congeneric eye, a chronic primary glaucoma with extremely advanced blocked angle. The evolution of these two cases might indicate the possibility of transforming the chronic primary glaucoma with blocked angle into a primitive malignant glaucoma (spontaneous). The probable dynamics of these changes is described.

Acute Disease↗
PubMed1990

Migraine versus glaucoma--a diagnostic dilemma.

Episodic headaches associated with ocular symptoms is a frequent complaint in clinical practice. In the medical and medical related field of neurology, one of the most often considered diagnosis is that of classical migraine, whilst in ophthalmology, the condition of intermittent primary angle closure glaucoma must be entertained. This paper reports three cases in which the two conditions were confused, and follows with a discussion on the essential differentiating features that can help in the diagnosis.

Adult↗