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At least 829 records · Page 46Linked to original sources
PubMed2000

Anterior chamber flare after trabeculectomy and after phacoemulsification.

AIMS: To evaluate and compare prospectively the anterior chamber inflammatory response after phacoemulsification cataract surgery and after trabeculectomy with peripheral iridectomy. METHODS: Anterior chamber inflammation was measured using the Kowa FM-500 laser flare meter in 131 patients undergoing trabeculectomy and 148 patients undergoing phacoemulsification cataract extraction with intraocular lens implantation. Flare was measured before surgery and on each postoperative visit up to 12 months. RESULTS: Before surgery there was no significant difference in flare readings between the two groups. Following trabeculectomy flare returned to baseline levels 4 weeks after surgery, while following phacoemulsification cataract extraction it remained significantly higher at week 6 (p<0.006) and month 3 (p<0.05). CONCLUSIONS: Anterior chamber inflammation is more prolonged after cataract surgery than after trabeculectomy. This may have implications for the timing of trabeculectomy in relation to cataract surgery.

Aged↗
PubMed2001

Factors associated with elevated intraocular pressure in eyes with iris melanoma.

AIM: To identify clinical factors associated with secondary elevated intraocular pressure (IOP) in eyes with iris malignant melanoma METHODS: A retrospective case series of 169 consecutive patients with microscopically confirmed iris malignant melanoma. The main outcome measure was the presence of tumour induced secondary elevated IOP. Cox proportional regression models were used to calculate the relation of clinical features to elevated IOP. RESULTS: Of 169 patients with microscopically proved iris melanoma, 50 (30%) presented with tumour induced secondary elevated IOP. The mean pressure in those eyes with elevated IOP at diagnosis was 33 mm Hg (median 31 mm Hg, range 23-65 mm Hg). The tumour configuration was nodular in 23 (46%) and diffuse in 27 (54%) with a mean base dimension of 7.4 mm and thickness of 2.0 mm. Invasion of the angle structures by melanoma seeds was visible for a mean of 7 clock hours (median 7, range 0-12 clock hours). The mechanism of elevated IOP was judged to be outflow obstruction from tumour invasion into the trabecular meshwork. There were no cases of neovascular glaucoma. The tumour was ultimately managed with enucleation in 30 patients (60%), local resection (iridectomy, iridocyclectomy, or iridocyclogoniectomy) in 11 (22%), and plaque radiotherapy in five (10%). In four cases (8%), observation of cytologically low grade tumour was the patient's preference. Using multivariate analysis, the clinical factors at initial evaluation associated with tumour induced secondary elevated IOP from iris melanoma included increasing extent of tumour seeding in the anterior chamber angle (p=0.01) and poor visual acuity at presentation (p=0.02). CONCLUSIONS: Microscopically confirmed iris melanoma demonstrates tumour related elevated IOP in 30% cases at the time of presentation, usually secondary to tumour involvement of the trabecular meshwork obstructing aqueous outflow. Enucleation is necessary in the majority of these patients (60%) as opposed to those cases without elevated intraocular pressure (18%).

Adolescent↗
PubMed2003

Therapeutic penetrating keratoplasty in severe fungal keratitis using cryopreserved donor corneas.

AIMS: To investigate whether cryopreserved donor cornea could be used for therapeutic penetrating keratoplasty (PKP) to eradicate the infection, obviate complications, and preserve anatomical integrity in severe fungal keratitis. METHODS: In this retrospective, consecutive case series, 45 eyes of 45 patients with severe fungal keratitis, which exhibited anterior chamber collapse, corneal perforation, and/or large suppurative corneal infiltrate, received therapeutic PKP after removal of the infected corneal tissue, irrigation of the anterior chamber by 0.2% fluconazole solution, iris dissection of fibrinoid membrane, and iridectomy and therapeutic PKP using corneas cryopreserved at -20 degrees C. RESULTS: Among 45 eyes, 39 eyes (86.7%) were successfully eradicated the fungal infection without recurrence and maintained their anatomical integrity without any complication. Four of 45 eyes (8.9%) showed postoperative rise of intraocular pressure, of which three were controlled with subsequent antiglaucoma surgeries, whereas one eye needed additional antiglaucoma medications. Two of 45 eyes (4.4%) were enucleated because of uncontrollable fungal infection and secondary retinal detachment, respectively. 23 eyes received subsequent optical PKP and, among them, 21 maintained clear corneal grafts and two suffered from graft failure due to allograft rejections. CONCLUSION: Cryopreserved donor corneas are effective substitutes in therapeutic PKP to control severe fungal corneal infection and preserve the global integrity, and may offer additional advantages over conventional PKP in reducing allograft rejection, eradicating fungal infection during the postoperative period, and improving the success of optical PKP for visual rehabilitation.

Administration, Oral↗
PubMed1998

Accommodation dynamics in aging rhesus monkeys.

Accommodation, the mechanism by which the eye focuses on near objects, is lost with increasing age in humans and monkeys. This pathophysiology, called presbyopia, is poorly understood. We studied aging-related changes in the dynamics of accommodation in rhesus monkeys aged 4-24 yr after total iridectomy and midbrain implantation of an electrode to permit visualization and stimulation, respectively, of the eye's accommodative apparatus. Real-time video techniques were used to capture and quantify images of the ciliary body and lens. During accommodation in youth, ciliary body movement was biphasic, lens movement was monophasic, and both slowed as the structures approached their new steady-state positions. Disaccommodation occurred more rapidly for both ciliary body and lens, but with longer latent period, and slowed near the end point. With increasing age, the amplitude of lens and ciliary body movement during accommodation declined, as did their velocities. The latent period of lens and ciliary body movements increased, and ciliary body movement became monophasic. The latent period of lens and ciliary body movement during disaccommodation was not significantly correlated with age, but their velocity declined significantly. The age-dependent decline in amplitude and velocity of ciliary body movements during accommodation suggests that ciliary body dysfunction plays a role in presbyopia. The age changes in lens movement could be a consequence of increasing inelasticity or hardening of the lens, or of age changes in ciliary body motility.

Accommodation, Ocular↗
PubMed1998

Histopathological study of the effect of phacoemulsification-aspiration on iris muscles.

Phacoemulsification-aspiration (PEA) followed by peripheral iridectomy was performed in 10 patients, and the dissected iris fragments were examined by electron microscopy. Organic changes such as cytoplasmic vacuolation and lamellar formation were observed in both the sphincter and dilator muscles of the pupil. No changes in the axons were detected. The same findings were observed when a simian eye was examined after PEA. These results indicate that PEA causes injury to iris muscles.

Aged↗
PubMedDate not supplied

Phacoemulsification and intraocular lens implantation for angle closure glaucoma after the relief of pupillary block.

PURPOSE: We studied the surgical outcomes of phacoemulsification and intraocular lens (IOL) implantation for cataract and/or uncontrolled intraocular pressure (IOP) in eyes with angle closure glaucoma. SETTING: Department of Ophthalmology, National Nagasaki Medical Center, Nagasaki, Japan. METHODS: Eighteen eyes from 15 patients after laser iridotomy (17 eyes) or peripheral iridectomy (1 eye) had undergone surgery and were studied. We used an iris retractor in 7 eyes due to insufficient mydriasis and a capsular tension ring in 2 eyes due to phacodonesis during the operation. The patients were followed up for at least 6 months (13.8 +/- 7.2 months; range: 6-36 months). RESULTS: The mean IOP significantly decreased from 17.4 +/- 8.1 to 13.5 +/- 3.3 mm Hg at 6 months after surgery. The IOP was below 21 mm Hg in all eyes. The visual acuity was not worsened in any eyes and became better than 2 Snellen lines in 14 eyes. The corneal endothelial cell count decreased from 2,365 +/- 517 to 1,960 +/- 661/mm2 (18.3 +/- 17.2%). CONCLUSIONS: Phacoemulsification and IOL implantation is useful in IOP control for angle closure glaucoma after relief of pupillary block. However, we should take care of operative complications because of a shallow anterior chamber, poor mydriasis and zonular weakness.

Aged↗
PubMed1976

Bullous keratopathy following lens extraction in eyes with acute glaucoma due to intumescent cataract.

Nine cases are presented, six of them in detail, which suggest that there is a high risk of bullous keratopathy developing when the lens is removed for the treatment of acute glaucoma due to an intumescent cataract. In some cases the keratopathy is due to detachment of Descemet's membrane from the cornea. Acute glaucoma due to an intumescent cataract should be treated medically or by peripheral iridectomy. The lens should be removed only after the intraocular pressure has been normal and the cornea free of edema for at least 6 weeks.

Acute Disease↗
PubMed1977

Response to experimental implantation of autologous iris tissue and to iris injuries.

Autoimmune disease has been suspected in some cases of human uveitis. The initiating event has been thought to be injury and/or infection. To investigate the effect of injury on the uvea and on the immune apparatus rabbits and guinea pigs were subjected to various repeated iris insults, including implantation of autologous iris tissue into the anterior chamber of the contralateral eye. Of the procedures employed only iridectomy and insertion of iris produced some anterior chamber clouding, which was only slightly increased on repetition of the procedure; 76% of these animals failed to produce circulating CF antibodies. No local CF antibodies in the anterior chamber fluid nor increases in fluorescent antibodes in sections of the eyes could be detected. None of the animals tested developed skin hypersensitivity to homologous uveal antigen. None of the other traumatic procedures, which included repeated insertions of plastic into the anterior chamber, produced uveitis manifested clinically or by histological examination, circulating or local humoral antibodies, nor increases in fluorescent antibodies in the tissues of the eye. Introduction of antiuveal antibody into the anterior chamber also failed to produce uveitis. It can be concluded from these experiments that simple, repeated injury to the iris is not sufficient to elicit an autoimmune response under the conditions tested.

Animals↗
PubMed1980

Angioma of the iris.

The clinical and anatomopathological features of angioma of the iris are described and the relevant literature is briefly reviewed. A personal case in a 47-year-old woman is presented. Reference is made to the fact that, unlike many of the cases in the literature, histological confirmation of the diagnosis was obtained. Mention is also made of the importance of fluorescein angiography in the differential diagnosis of other forms, particularly melanoma. Fluorescein angiography, for the first time applied to angioma of the iris in the present case, enabled a satisfactory result (follow-up of 8 months) to be obtained by conservative iridectomy, in line with the recent approach to the management of this form.

Female↗
PubMed1980

Complications of intraocular injections of silicone combined with vitrectomy.

Observation with long follow-up of the first 200 cases of intraocular injection of silicone combined with vitrectomy led us to discover three major complications: cataract, keratopathy and hypertonia, the last two found only in aphakic eyes. No toxic action of silicone could be proved to explain these complications. They seem to be related to physical properties of the silicone which we use, and in particular its gravity lower than one. This density is responsible for noxious mechanical phenomena. They can be partially kept back by preserving the lens in the first stages, avoiding segmentary iridectomy in aphakic eyes, nocturnal procubitus position and silicone ablation in failed cases.

Aphakia↗
PubMed1982

Microsurgery of persistent hyperplastic primary vitreous.

6 patients with persistent hyperplastic primary vitreous (PHPV) were operated on using microsurgical techniques. There were 5 boys and 1 girl, all with normal birth weight and good general health. PHPV was present in the left eye in 4 patients, in the right eye in 1, and 1 patient had bilateral PHPV. The operative management consisted of a primary large-sector iridectomy (in 4 cases) and suction of the lens, combined with removal of the hyperplastic vitreous using a Klöti Vitreous Stripper in 5 patients, and small anterior chamber scissors in 1 patient. No major operative complications were experienced. The fundus was fully visible in 5 cases while in 1 eye remaining and new proliferations prevented visualization of the fundus. Postoperative visual acuity varied from light perception to 0.2 and the intraocular pressure was within normal limits. It was felt that a useful reserve eye was obtained, with marked improvement of the ocular cosmesis.

Female↗
PubMed2003

Four years later: a clinical update on latanoprost.

PURPOSE: Almost five years have elapsed since the introduction of latanoprost on several markets and considering the large number of publications dealing with it, the authors felt that it was worth re-evaluating the drug. METHODS: The criterion used to select trials for inclusion in the review was: all articles mentioning the drug in common electronic data-bases; these were then screened and considered, on the basis of methodological quality. RESULTS: Experimental data suggest that latanoprost acts by remodeling the extracellular matrix in the ciliary muscle, thus increasing the flow of aqueous humor through the ciliary muscle bundles of the uveoscleral pathway. POAG: Latanoprost persistently improves the pulsatile ocular blood flow in primary open angle glaucoma (POAG). Recent trials confirmed the greater IOP-lowering efficacy of latanoprost vs. timolol, dorzolamide, brimonidine and unoprostone. Trials lasting up to 24 months showed that latanoprost is effective in long-term treatment of POAG and ocular hypertension (OH), with no signs of loss of efficacy when compared to timolol or dorzolamide. Latanoprost provides better control of circadian IOP. Non-responders to beta-blockers should preferably be switched to latanoprost monotherapy before a combination therapy is started. The possibility of a fixed combination of latanoprost and timolol has been explored, with promising results. NTG: Latanoprost is effective in normal tension glaucoma (NTG), lowering IOP, improving pulsatile ocular blood flow and increasing ocular perfusion pressure. OTHER GLAUCOMAS: Latanoprost may provide effective IOP control in angle-closure glaucoma after iridectomy, in pigmentary glaucoma, glaucoma after cataract extraction and steroid-induced glaucoma. However, latanoprost was effective in only a minority of pediatric cases of glaucoma and is contraindicated in all forms of uveitic glaucoma. SAFETY: In the articles reviewed, new or duration-related adverse events were reported.

Antihypertensive Agents↗
PubMedDate not supplied

Malignant melanoma of the iris. A 25-year analysis of Danish cases.

This study examined malignant melanoma of the iris in Denmark over a 25-year period on the basis of the files of the Eye Pathology Institute. From 1961 to 1985 a total of 80 cases were found (41 males, 39 females; median age 53 years, range 8-83). This means an average of 3.2 cases/year with an average population of 4.9 million. In contrast to malignant melanoma of the choroid, an increase was observed. The reason is not known, although exposure to actinic rays may be a factor. More than a third of cases were close to the pupil, a little less than a third invaded the chamber angle/ciliary body. Ten cases were ring melanomas. Half of the tumours were spindle-celled, a quarter mixed and a few epithelioid or naevoid in cell morphology. Iridectomy was performed in 28 cases, primary enucleation in 27 and secondary enucleation in ten. Iridocyclectomy was performed in 15 cases. All patients could be traced. At the date of follow-up (Dec. 1, 1991) eight had died with metastases; four of these were patients with ring melanoma and four with tumours invading the ciliary body. After iridocyclectomy, only one metastatic death was recorded--a case of incomplete resection. The grave prognosis of a ring melanoma is highlighted.

Adolescent↗
PubMed1988

Developmental changes of the proliferative response of mouse epidermal melanocytes to skin wounding.

A cut was made on the middorsal skin of mice of various ages of strain C57BL/0J 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. When the dorsal skins of 1.5-day-old mice were wounded, the melanocyte population positive to the dopa reaction as well as the melanoblast-melanocyte population positive to the combined dopa-premelanin reaction increased dramatically in the epidermis adjacent to a skin wound. Pigment-producing melanocytes in mitosis were frequently found in the vicinity of a wound immediately after wounding. When the dorsal skins of 4.5-day-old mice were wounded, the increase in the melanocyte and melanoblast-melanocyte populations was smaller than that of 1.5-day-old mice. The increase in number of pigment-producing melanocytes in mitosis was reduced and delayed as compared to 1.5-day-old mice. When the dorsal skins of 8.5-, 20.5-, and 60.5-day-old mice were wounded, the increase in the melanocyte and melanoblast-melanocyte populations was much smaller than the newborn mice. Moreover, pigment-producing melanocytes in mitosis were never found. These results indicate that the proliferative response of mouse epidermal melanocytes to skin wounding becomes delayed and diminished with development.

Animals↗
PubMed2000

Auto iris pigment epithelial cell transplantation in patients with age-related macular degeneration: short-term results.

Autologous iris pigment epithelial cell transplantation was performed on patients with exudative age-related macular degeneration (AMD). Autologous IPE cell culture was performed using autologous serum after iridectomy in 7 patients with AMD. The cell suspensions (2 approximately 20 x 10(4) cells) were transplanted into the submacular lesion of individuals after removal of neovascular membranes. Subsequent ophthalmological examinations, including best corrected visual acuity and fluorescein or indocyanine green angiography, were performed. In addition, 15 patients with AMD, who underwent removal of neovascular membrane without transplantation, were evaluated as non randomized controls. Varying degrees of atrophy or defects of choriocapillaris and retinal pigment epithelium were observed in all of the patients. No cystoid macular edema or fluorescein leakage was observed after treatment, but window defects were present. No patient had decreased visual acuity. One treated patient developed mild subretinal fibrosis and an other patient developed mild preretinal fibrosis, however no difference was significant when compared with the control. In conclusion, the treatment resulted in no significant improvement in macular function, as compared with the control; however, no rejection or deterioration in visual acuity occurred up to the 13 month follow up.

Aged↗
PubMed1979

The treatment of glaucoma: role of beta-blocking agents.

The sudden development of a red painful eye with blurred vision may be an acute attack of angle closure glaucoma which requires emergency attention. Once the attack is controlled with medication, surgical intervention with a peripheral iridectomy is indicated to relieve relative pupillary block. Eyes subject to angle closure glaucoma are anatomically different with 'crowded' anterior segments. In contrast, open angle glaucoma (the more common form) may progress to near blindness without symptoms. Routine screening of intraocular pressure is, therefore, necessary to make the diagnosis before extensive irreparable damage has occurred. Surgery for open angle glaucoma carries risks of cataract and infection, and is unpredictable. Open angle glaucoma patients are usually treated chronically with specific medications. Beta-Adrenoceptor blocking agents appear to provide a significant new addition to the currently available antiglaucoma medications.

Administration, Topical↗
PubMed1996

Intraocular hemorrhage developing during interferon therapy.

A 43-year-old man with chronic active hepatitis C was treated with interferon-beta (IFN-beta) at a dosage of 6 x 10(6) IU/day for a planned 6-week period. Ocular hyperemia, ophthalmalgia, and increased intraocular pressure in the right eye developed 20 days after the start of treatment. Intraocular pressure remained high, even after discontinuation of IFN therapy, laser therapy, and iridectomy. Two days later, the right eye was removed because perforation had occurred. The ocular symptoms that developed in this case were thought to have been caused and exacerbated by IFN administration.

Adult↗