[On the effect of clonidine on ocular and brachial pressure with normal intraocular pressure, with glaucoma simplex chronicum and with juvenile].
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The aim of the paper was to evaluate intraocular pressure changes that follow the implantation of posterior intraocular lens. In two examined groups of patients (I group--sulcus ciliaris, II group--intracapsular implantation) the decrease of average intraocular pressure values was observed in the early days after surgery, then during 3 months, it gradually returned to the initial values. This decrease was less marked in the first group of patients. Long-term observation showed the stabilization of intraocular pressure at a level similar to the mean values before surgery.
The influence of different vasodilatators on blood pressure and intraocular pressure has been tested in animal experiments. For that purpose substances with alphasympathicolytic effect (Hydergin, Trental) have been tested as well as substances which are of direct influence on the muscles. In all cases a decrease of the blood pressure was noticed. Furthermore in most of the cases an increase of the intraocular pressure could be seen. This is due to a direct dilatation of ocular vessels. The effects were short-lived and reversible. We tried to find an explanation for the variations of intraocular pressure during the decrease of blood pressure. The low transmural pressure (PTM) and the corresponding low starting point of the muscle tonus seemed to be responsible for this phenomenon. Without doubt the starting point of the blood pressure, the dose, and the cardiac ability for compensation are of great influence in the development of the curve. Only a sufficiently high blood pressure is able to dilate the ocular vessels, so that one has to draw therapeutic conclusions from the constellation blood pressure/intraocular pressure before deciding on treatment.
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PURPOSE: To evaluate intraocular pressure (IOP) after phacoemulsification and intraocular lens (IOL) implantation in nonglaucomatous eyes with and without exfoliation. SETTING: Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland. METHODS: One hundred ninety-six eyes that had phacoemulsification with IOL implantation were examined. Eyes with a history of intraocular disease or surgery that could affect IOP were excluded. The study comprised the remaining 160 eyes: 23 with exfoliation (EXF group) and 137 without exfoliation (non-EXF group). Follow-up data were available for 136 eyes. The same surgeon performed all surgeries. Patients were examined on the first postoperative day and after 1 week, 4 months, and 1.0 to 2.7 years. RESULTS: One day postoperatively, IOP rose in the EXF group from a mean preoperative level of 16.3 mm Hg +/- 2.7 (SD) to 21.0 +/- 8.5 mm Hg, a 28.4% increase (P =.0061). In the non-EXF group, mean IOP rose from 16.2 +/- 3.4 mm Hg to 20.5 +/- 5.7 mm Hg, a 29.9% increase (P =.001). In 4 eyes (17.4%) in the EXF group and 8 eyes (5.8%) in the non-EXF group, IOP increased to 30 mm Hg or higher at 1 day. After this, significant IOP decreases occurred in both the EXF and non-EXF group, respectively, as follows: 14.2 +/- 3.0 mm Hg (12.0% decrease from preoperative value; P =.001) and 15.0 +/- 2.9 mm Hg (5.9%; P =.001) 1 week postoperatively; 12.8 +/- 2.7 mm Hg (20.2%; P =.0002) and 13.8 +/- 2.7 mm Hg (13.2%; P =.001) after 4 months; and 12.3 +/- 2.6 mm Hg (23.2%; P =.0001) and 12.7 +/- 2.7 mm Hg (21.2%; P =.001) after 1.0 to 2.7 years. There was no significant difference between the 2 groups. CONCLUSION: After phacoemulsification with IOL implantation, IOP decreased significantly and remained lower than preoperatively in eyes with and without exfoliation. One day postoperatively, transient pressure peaks were more common in eyes with exfoliation. One eye without exfoliation developed glaucoma.
Elevated intraocular pressure after keratoplasty is a well-recognized phenomenon both in aphakia and in combined lens extraction and penetrating keratoplasty. Ninety-two consecutive cases of penetrating keratoplasty procedures were studied. These were randomly assigned to group A or B. Group A received a donor transplant 0.5 mm larger than the recipient bed. Group B received donor buttons equal in size to the recipient bed. Intraocular pressure was measured preoperatively and daily until the patients were discharged. Group A, which had aphakic penetrating keratoplasty or the combined procedure (0.5-mm larger button), also had significantly lower intraocular pressures (P less than .001) than group B (same size button). There was no difference in postoperative intraocular pressure between groups A and B for those who had phakic penetrating keratoplasties. A larger donor size can alleviate induced "aphakic keratoplasty glaucoma."
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By means of the continuous contemporary recording of arterial blood pressure and intraocular pressure, the relationship between the two parameters was analyzed following the intravenous administration of adrenergic drugs. The aim was that of determining if during a change in systemic blood pressure the behaviour of intraocular pressure may indicate an active or passive participation to such a change. In the present studies the most important representatives of the different adrenergic groups (adrenalin, dibenamin, ergotamin, propranolol and isoproterenol) were taken in consideration. The results in normal eyes and in eyes with experimental hypertension showed that the adrenergic drugs affect the intraocular presure through a primary vasomotorial effect. An active vasodilatation of the intraocular vessels could not be demonstrated, whereas an active (adrenalin, ergotamin) as well as a passive (propranolol, isoproterenol) vasoconstriction was evidenced. The present studies allow an interpretation of the ocular hypotonizing mechanism of action of adrenergic drugs.
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The association of intraocular pressure with age, sex, race, iris pigmentation, systemic blood pressure, and family income was evaluated using data from the Health and Nutrition Examination Survey of 1971-1972. In general, mean intraocular pressure was highest for blacks with brown irides and progressively lower for whites with brown irides, whites with neither brown nor blue irides, and whites with blue irides. Multilinear regression analysis showed positive associations of intraocular pressure with systolic blood pressure (p less than 0.0001), age (p less than 0.0001) and amount of iris pigmentation (p less than 0.0001). The association with iris pigmentation held for both a combined race/iris color variable and for iris color among white persons. When race rather than iris pigmentation was used in the regression equation, it was a weaker (p less than 0.03) but still significant risk factor for higher levels of intraocular pressure. Intraocular pressure was negatively associated with family income (p less than 0.004). Despite the significant associations, the proportion of variance in intraocular pressure that was explained by these variables was small (R2 = 0.06).
Intraocular pressure was measured with a MacKay-Marg tonometer in eight horses following auriculopalpebral nerve block and topical application of lignocaine. Measurements were recorded before and after xylazine, 1.1 mg/kg intravenously, every two minutes for 16 minutes after administration of ketamine, 2.2 mg/kg intravenously, and after recovery from anaesthesia. Before xylazine, intraocular pressure was 17.1 +/- 3.9 and 18.4 +/- 2.2 mm Hg in the left and right eyes, respectively. Intraocular pressure tended to decrease after administration of xylazine and ketamine, with a significant decrease in one eye six minutes after injection of ketamine.
A 0.1 mg (base) dose of prazosin, a postsynaptic alpha- (alpha 1) adrenoceptor antagonist, in rabbits effected an early decrease in arterial blood pressure, normal intraocular pressure (IOP) and IOP artificially elevated by water loading. The late drug effects suppressed elevated IOP, but not normal IOP. The IOP effects of prazosin seem largely independent of the effect on blood pressure.
OBJECTIVE: To determine the effect of positive end-expiratory pressure (PEEP) on intraocular pressure. DESIGN: Prospective, controlled, longitudinal, dual center study. In one group, patients served as their own control. In the second group, isolated determinations of intraocular pressure were made in mechanically ventilated patients receiving PEEP. SETTING: Adult intensive care units of two university hospitals. PATIENTS: Intraocular pressures were measured serially in eight patients during the recovery phase of different clinical conditions and in 22 patients receiving mechanical ventilation with PEEP > or = 10 cm H2O for > 24 hrs. INTERVENTIONS: Group A) In eight patients, a PEEP dose-response curve was established (PEEP 0, 5, 10, 15, and 0 cm H2O every 15 mins). Intraocular pressures were measured at the end of each period. Group B) In 22 patients, measurement of intraocular pressures were done while the patients received mechanical ventilation with PEEP > or = 10 cm H2O for at least > 24 hrs. MEASUREMENTS AND MAIN RESULTS: In both groups, there was a positive correlation between the PEEP level and the central venous pressure (p < .05 in group A, and p < .03 in group B). No relationships between intraocular pressure and PEEP or central venous pressure were observed. However, there was a correlation between intraocular pressure and length of PEEP therapy (p < .03). We found ocular hypertension in only one patient (right eye intraocular pressure = 26 mm Hg; left eye intraocular pressure = 24 mm Hg). CONCLUSIONS: Short-term therapy with PEEP of < or = 15 cm H2O does not present a clinically important significant risk for intraocular pressure increase in a population with normal basal ocular tonometry. During prolonged mechanical ventilation with PEEP, increments in intraocular pressure may occur, but these increments appear to not be of a clinically relevant magnitude.
We studied the intraocular pressure response to short-term maximal aerobic exertion before and after exercise conditioning in ten healthy sedentary volunteers. Before exercise conditioning, mean intraocular pressure +/- S.E.M. decreased by 5.9 +/- 0.6 mm Hg after short-term maximal aerobic exercise, returning to baseline in a mean of 37 +/- 4 minutes. After four months of exercise conditioning, this ocular hypotensive response was significantly dampened, with a mean intraocular pressure reduction of only 1.6 +/- 0.4 mm Hg after short-term maximal aerobic exercise (P less than .01). Additionally, a significant reduction in baseline intraocular pressure occurred, with a mean intraocular pressure of 14.3 +/- 0.7 mm Hg before exercise conditioning, declining to a mean intraocular pressure of 13 +/- 0.9 mm Hg (P less than .02) after four months of physical training. Exercise conditioning may significantly reduce baseline intraocular pressure and attenuate the hypotensive response to short-term maximal aerobic exercise.
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