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Results for “Filtering Surgery”

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At least 1,081 records · Page 60Linked to original sources
PubMed2006

[Childhood glaucoma associated with Sturge-Weber syndrome --the efficacy of cyclofotocoagulation and other therapeutic methods].

PURPOSE: Sturge-Weber syndrome is a rare congenital neurooculocutaneous disorder. Ocular involvement can include glaucoma and vascular malformations of the conjunctiva, episclera, choroid and retina. MATERIAL AND METHODS: 16 children (16 eyes) with Sturge-Weber syndrome associated with glaucoma (mean age--34 month, mean follow up 8.87 years) treated in our institution, were reviewed. In retrospective analysis were assessed: IOP and postoperative complications after diode laser cyklophotocoagulation (16 eyes), after trabeculectomy (6 eyes) and trabeculectomy with MMC (3 eyes). RESULTS: In ten eyes (62.5%) good result (IOP 6-22 mmHg) post cyclophotokoagulation--(3x) was recorded, as well as in 3 eyes (50%) post trabeculectomy and in 3 eyes (100%) post trabeculectomy with MMC 0.2/4 min. No postoperative complications occured in cyclophotocoagulation group. Complications after trabeculectomy were the following: 3 cases of hypotony, 4 cases with shallow anterior chamber and 5 with choroidal effusions. CONCLUSIONS: Diode laser cyclophotocoagulation combined with topical medication is an effective and safe treatment of glaucoma in children with Sturge-Weber syndrome.

Adolescent↗
PubMedDate not supplied

Spontaneous extrusion of a stainless steel glaucoma drainage implant (Ex-PRESS).

PURPOSE: To report a case of spontaneous extrusion of a stainless steel glaucoma drainage implant (Ex-PRESS). METHODS: An Ex-PRESS was implanted under the conjunctiva in a 76-year-old man with primary open-angle glaucoma. RESULTS: Two years after implantation, the Ex-Press extruded spontaneously. Despite this adverse event, there was no increase in intraocular pressure. CONCLUSIONS: This is the first report of spontaneous extrusion of an Ex-PRESS device. Implanting the device under a scleral flap should be considered to avoid adverse events such as extrusion or conjunctival erosion.

Aged↗
PubMedDate not supplied

[A new method for microdrainage using a porous titanium nickelide endoprosthesis in resurgery of uncompensated glaucoma].

Experimental (23 rabbits) and clinical (42 patients with operated glaucoma) studies were conducted to evaluate the effect of a titanium nickelide implant on ocular tissue in modified deep sclerectomy in order to normalize intraocular pressure. Scleral morphological studies in the area of implant placement revealed the formation of a capsule with "fissures" and vessels. Clinically, there was intraocular pressure compensation in 92.8% of the patients operated on.

Alloys↗
PubMed1990

Subconjunctival THC: YAG laser limbal sclerostomy Ab externo in the rabbit.

A chromium-sensitized, and thulium and holmium-doped YAG laser (THC:YAG laser) was used to create bilateral limbal sclerostomies in six Dutch pigmented rabbits. The laser is a long-pulsed (300 microseconds) [corrected], compact, self-contained, solid-state laser operating in the near infrared (2.1 microns). A 1-mm conjunctival stab incision was made 12 mm away from the sclerostomy site to allow entry of a specially designed 26-gauge (480 microns) optic probe that delivers energy at right angles to the long axis of the fiber. Probe insertion minimally disturbed the conjunctiva. Pulse energies of 60 to 150 mJ were used with a repetition rate of 5 pulses/s. Energy levels ranging from 1.35 to 6.6 J produced full-thickness sclerostomies. Histopathology showed a sharply defined perforating limbal wound at all energy levels. The overlying conjunctiva was intact, with swelling of the adjacent cornea. A peripheral iridectomy was intentionally created with the laser through the peripheral limbus, resulting in a sharply defined perforating tract through the iris/ciliary body. This technique may simplify filtering sclerostomy surgery, without anterior chamber instrumentation and with minimal conjunctival trauma.

Animals↗
PubMedDate not supplied

Ocular motility defects in patients with the Krupin valve implant.

To determine the prevalence of ocular motility defects following placement of a Krupin valve with disk and adjunctive mitomycin-C in glaucoma patients, a retrospective case series of all patients receiving a Krupin valve with disk and intraoperative mitomycin-C in a university-based referral practice was conducted. Each of the seven consecutive patients undergoing placement of a Krupin valve with disk in one eye because of uncontrolled glaucoma, developed significant primary position heterotropia or limitation of ocular rotations. One patient had significant postoperative diplopia. We conclude that the Krupin valve with disk used with intraoperative mitomycin-C can be associated with the development of ocular motility defects. The limitation of rotations appears to relate to the combined mechanisms of implant and cyst bulk and the displacement of the oculorotary muscles by the encapsulating cyst.

Adult↗
PubMed1994

Protein quantification and electrophoresis in aqueous humor of pseudoexfoliation eyes.

PURPOSE: Pseudoexfoliation (PSX) eyes frequently show clinical signs of blood-aqueous barrier impairment. To analyze these alterations, the authors examined aqueous humor of human eyes with and without PSX. METHODS: After aqueous humor samples had been obtained during cataract or filtering glaucoma surgery, a modified Pierce-bicin choninic acid assay was used to quantify total aqueous protein concentration in 27 PSX eyes and 37 eyes without clinical signs of PSX (12 cataract eyes and 25 eyes with primary open-angle glaucoma). In addition, aqueous protein composition was analyzed by sodium dodecylsulfate polyacrylamide gel electrophoresis, silver staining, and laser densitometry in 27 PSX eyes and 59 eyes without PSX. RESULTS: Aqueous protein concentration was significantly higher in PSX (mean 0.42 +/- 0.16 mg/ml) than in normal cataract eyes (0.22 +/- 0.08 mg/ml, P < 0.0001) and in eyes with open-angle glaucoma (0.26 +/- 0.09 mg/ml, P < 0.0001, Wilcoxon-Mann-Whitney test). Electrophoresis revealed a characteristic increase of a 12.5-kDa band in 15 of 27 PSX eyes but in only 1 of 59 eyes without PSX (P < 0.00001, chi-square test). CONCLUSIONS: These results substantiate increased aqueous protein concentration and aqueous barrier impairment in PSX. The additional finding of an increased 12.5-kDa band in 56% of PSX eyes may be related to the pathogenesis of PSX in the anterior ocular segment.

Aged↗
PubMed1996

Effects of intraoperative mitomycin-C on the function of Baerveldt glaucoma drainage implants in rabbits.

PURPOSE: The purpose of this study was to assess the effects of intraoperative mitomycin-C (MMC) on the function of Baerveldt glaucoma implants in rabbits. METHODS: Bilateral implantations of 200 mm2 Baerveldt drainage devices were performed in 30 normal albino rabbits. One eye, randomly selected, received intraoperative application of MMC at the site of the implant plate for 5 min, via a 6 x 4 x 2 mm cellulose sponge saturated with 0.5 mg/ml of MMC. The opposite eye served as a control. MMC-treated and control eyes (five animals each group) were compared for intraocular pressure (IOP), resistance to flow, flow rates through the implant and histopathological findings at 2, 4, 6, 12, and 24 weeks postoperatively. Resistance to flow and flow rates through the implants were studied after opening the cornea and connecting the drain tube to a micromanometric system. RESULTS: Preoperative IOP did not differ between groups. MMC-treated eyes had lower levels of IOP than did controls at all postoperative times. The differences in IOP were statistically significant up to 8 weeks postoperatively. Resistance to flow was lower in MMC-treated eyes at all times studied, but the differences were statistically significant only at the time points of 2, 4, and 6 weeks. Flow rates through the implant bleb were always higher in MMC-treated eyes, and statistically significant differences were seen at 2, 4, 6, and 24 weeks. Histopathologically, MMC-treated eyes had thinner implant capsules with delayed maturation and less inflammatory infiltrate. CONCLUSION: MMC causes lower IOP and higher perfusion rates through the implant capsule at 2, 4, and 6 weeks postoperatively. Wound dehiscence, bleb leaks, and extraocular muscle injury were observed only in MMC-treated eyes.

Administration, Topical↗
PubMed1996

Injection of autologous blood for bleb leaks in New Zealand white rabbits.

PURPOSE: Bleb leaks after trabeculectomy with antimetabolites can be recalcitrant to therapy. Peribleb autologous blood injections are a moderately successful new treatment modality for such leaks. However, it is unclear what mechanism the injections work to achieve leak resolution. METHODS: A randomized, prospective study in the rabbit model was undertaken to evaluate further the clinical and histologic effects of peribleb autologous blood injection after leak induction in mitomycin-C exposed blebs, compared to controls that received only peribleb balanced salt solution injections. RESULTS: In the blood-treated eyes, all bleb leaks healed. Control eyes either demonstrated persistent bleb leaks with shallow anterior chambers or failed blebs that were Seidel negative. Histologic results were remarkable for increased peribleb cellularity and collagen deposition in the blood-treated eyes, compared to controls. CONCLUSIONS: Peribleb autologous blood injections are associated with bleb leak resolution, increased peribleb cellularity, and collagen deposition in the rabbit model.

Animals↗
PubMed1996

Corneal incision phacoemulsification and internal bleb revision.

BACKGROUND AND OBJECTIVE: Cataract extraction in filtered eyes often leads to decreased outflow and, eventually, to bleb failure. The authors describe a surgical technique that promotes preservation of the filtering bleb. PATIENTS AND METHODS: The authors retrospectively reviewed 19 eyes of 19 consecutive patients who underwent corneal incision phacoemulsification and simultaneous internal revision of the previous filtering bleb. RESULTS: The mean follow-up time was 13.6 +/- 7.6 months. Visual acuity improved in all patients (89.4 percent achieved 20/40 or better). No significant difference was noted between preoperative and postoperative intraocular pressures and astigmatism. The bleb was preserved in 89.4 percent of the eyes at the time of the last follow-up. CONCLUSIONS: This surgical technique proved to be safe and yielded good results.

Adult↗
PubMed1996

Ultrastructural features of filtration blebs with different clinical appearances.

The authors studied two functioning filtration blebs to evaluate a possible transconjunctival route of aqueous humor flow and describe potential differences between thin cystic and thick opaque functioning filtration blebs. The specimens were prepared for light and electron microscopy immediately after surgical excision because of filtration bleb discomfort. Both blebs had normal collagen in the substantia propria. The collagen, however, was widely spaced and subepithelial connective tissue loosely arranged. Clear spaces were seen in the superficial substantia propria. Epithelial cells were focally acantholytic, separated by clear spaces. Consequently, clinically distinct blebs demonstrated similar histologic and ultrastructural features. The epithelial intercellular spaces observed in this study provide anatomic evidence that aqueous could move transconjunctivally as a mechanism for filtration bleb function.

Aged↗
PubMed1996

Resiting Molteno implant tubes.

The authors describe a surgical technique for resiting Molteno implant tubes. The indications for this intervention are a blockage of the tube that cannot be resolved by other means; erosion of the scleral flap and conjunctiva by the tube; and pediatric cases in which enlargement of the eye causes retraction of the tube from the anterior chamber.

Filtering Surgery↗
PubMed1996

[Surgical effects of trabeculotomy combined with sinusotomy in advanced glaucoma patients controlled in normal intraocular pressure of 15 mmHg or higher].

Trabeculotomy combined with sinusotomy was performed in 30 eyes with advanced open angle glaucoma, whose intraocular pressure (IOP) had been controlled in their high teens with only topical medications. The mean pre- and postoperative IOP levels were 18.2 +/- 1.2 mmHg (mean +/- standard deviation) and 13.2 +/- 1.2 mmHg and the pressure reduction was 4.6 +/- 2.4 mmHg. Average pressure reduction was 28.8 +/- 9.3% and pressure reduction of 30% or more was obtained in 45% of the treated eyes. The pre- and postoperative medication scores were 4.47 +/- 1.50 and 3.07 +/- 1.17, respectively. There was statistically significant difference between the pre- and postoperative medication score. We had no cases in which the IOP reduction was greater than 9 mmHg and postoperative IOP was 9 mmHg or less. A 3-line drop in visual acuity was seen in only one eye. Twenty two of 30 eyes (73%) were controlled at 14 mmHg or less with medications at the last examination. These results show that trabeculotomy combined with sinusotomy in effective, and this procedure can be considered as an alternative choice for surgical treatment in advanced glaucoma.

Aged↗