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At least 127 records · Page 7Linked to original sources
PubMed1981

Iridectomy with scleral cautery.

I have described modifications that have evolved over the years in doing iridectomy with cautery and have reviewed some of my experiences with the method. All filtering operations leave a great deal to be desired. Each technique has certain advantages and disadvantages. A great advantage of the cautery procedure is its safety and simplicity. It is as effective in lowering pressure as most other procedures. Even if the operation fails to control pressure, little harm is done to the eye, and it can be repeated. One of the great advances in management of open-angle glaucoma in recent years has been the adoption of stringent indications for surgery. Surgery should not be advised until a thorough trial of maximal medical therapy has been made. In many instances, however, the pendulum has been allowed to swing too far. When medical treatment has failed, and the patient is faced with progressive loss of vision if control of pressure is not achieved, the ophthalmic surgeon should resist the temptation to procrastinate. Surgery should be done promptly and deterioration should not be allowed to occur. Should a cataract occur, it can be removed. Endophthalmitis can be prevented or cured by antibiotic therapy. Although filtering operations leave a great deal to be desired, when effective, they will preserve a functioning optic nerve.

Cautery↗
PubMed1987

Persistent symptoms after peripheral iridectomy for angle-closure glaucoma.

Symptoms that persist after operations for angle-closure glaucoma arise from different causes. In the presence of open peripheral iridectomies miotics may be beneficial or may close angles; wide pupil dilatation by phenylephrine used to diminish posterior synechiae may close angles; cycloplegic mydriatics will close some angles and open others. Unexpected bizarre reactions to eye drops may occur. Persistent chronic glaucoma will be more common after laser iridotomy than after correctly assessed filtering operations. The importance of gonioscopy in diagnosis and management is emphasised.

Acute Disease↗
PubMed1977

Bilateral cataract: extraction in classic haemophilia with retrobulbar anaesthesia and peripheral iridectomy.

A 47-year-old factor VIII deficient haemophiliac successfully underwent bilateral cataract extraction. The use of cryoprecipitates to achieve haemostasis permitted retrobulbar anaesthesia and a peripheral iridectomy without complication. We consider that the use of cryoprecipitated factor VIII concentrate allows safe elective ocular surgery in patients with classic haemophilia.

Anesthesia, Conduction↗
PubMed1982

Evaluation of laser iridectomy in angle-closure glaucoma: provocative tests.

An argon laser iridectomy was performed on 18 eyes of 14 patients with closed-angle glaucoma. The intraocular pressure (IOP) was controlled in all but one eye within normal limits. Variable amounts of pigment were found on gonioscopy in all cases. The mydriasis test was positive in one eye (5.5%) after homatropine and in 5 eyes (28%) after tropicamide drops. 80% of the positive results occurred in lightly pigmented irides. The dark-prone position test was positive in 7 eyes (38%), 71% of the positive results occurring in heavily pigmented irides. Tomography was also performed; the possibility of trabecular damage is discussed.

Eye Color↗
PubMed1997

A randomised prospective comparison of operative peripheral iridectomy and Nd:YAG laser iridotomy treatment of acute angle closure glaucoma: 3 year visual acuity and intraocular pressure control outcome.

AIM: To compare visual acuity and intraocular pressure outcomes 3 years after treatment of acute angle closure glaucoma (AACG) by operative peripheral iridectomy (PI) or Nd:YAG laser iridotomy (YAG PI). METHODS: A prospective study of consecutive patients presenting to one ophthalmology department with uniocular AACG during a 2 year period. Following informed consent patients were randomised to bilateral PI or bilateral YAG PI. Three years after treatment the mean Snellen visual acuity converted to logMAR scores of the two groups was compared using the unpaired Student's t test. The number of patients with normal intraocular pressure with no further treatment in each group was compared using the chi 2 test with Yates's correction. RESULTS: 21 patients underwent bilateral PI and 27 bilateral YAG PI. Three years after treatment visual acuity was 0.30 (SD 0.28) log MAR units for PI eyes and 0.57 (0.67) logMAR units for YAG PI eyes (p = 0.08, NS). 15 (70.4%) PI eyes and 19 (71.8%) YAG PI eyes had an intraocular pressure less than 21 mm Hg with no further treatment (NS). CONCLUSIONS: There was no significant difference in visual acuity or intraocular pressure control 3 years after treatment of AACG with PI or YAG PI.

Aged↗
PubMed1997

[The relation of the changes of SOD and PGE2 in aqueous humor with the transient rise of intraocular pressure after argon laser iridectomy].

OBJECTIVE: To study the mechanism of transient rise of the intraocular pressure (IOP) after argon laser iridectomy (ALI). METHODS: The rabbit changes of IOP, the activity of superoxide dismutase (SOD) and the concentration of prostaglandin E2 (PGE2) in aqueous 15 min, 60 min, 6 hr, 24 hr, 48 hr after ALI, the relationships of these changes with the transient rise of IOP, and the effects of using indomethacin, cortisone, vitamin E and C before ALI on the transient rise of IOP were observed. RESULTS: After ALI, the transient rise of IOP took place within postoperative 6 hr. Following the postoperative transient rise of IOP, the concentration of PGE2 in the aqueous was markedly increased, but the activity of SOD in the aqueous markedly decreased. When indomethacin, cortisone, vitamin E and C were used before ALI, the concentration of PGE2 was not markedly increased, the activity of SOD was not markedly decreased and the postoperative transient rise of IOP did not take place. CONCLUSIONS: The transient rise of IOP after ALI is related to the increase of concentration of PGE2 and the decrease of activity of SOD in the aqueous. Using indomethacin, cortisone, vitamin E and C before ALI can effectively prevent the postoperative transient rise of IOP.

Animals↗
PubMedDate not supplied

Outpatient argon laser iridectomy for angle closure glaucoma: a two-year study.

A technique for iridectomy in the the treatment of angle-closure glaucoma utilizing laser beams has been developed. The operation is performed in two steps. In step 1 a partially penetrating burn of the iris is made to produce an iris hump. In step 2 a penetrating burn is used to pierce the crown of the previously produced hump. Tables 1, 2, and 3 summarize current recommendations and the detailed steps that must be followed (without exception) to achieve success with this technique. Of 22 phakic eyes, fellow eyes, or eyes with narrow-angle glaucoma, instantaneous, permanent iris perforation was produced in all except two. In these two, a second treatment on the following day produced a permanent perforation. Serious complications were encountered in only one patient who received treatment at a greater energy level than we now recommend. In that patient striate keratopathy became apparent, as well as a decrease in vision which has lasted five months. No significant complication was encountered in any eye treated with the currently recommended procedure.

Ambulatory Care↗
PubMed1975

[Transtrabecular iridectomy - a new surgical technique in the treatment of chronic narrow-angle glaucoma (author's transl)].

A new surgical technique in the treatment of chronic narrow-angle glaucoma is described. After forming a scleral flap and opening of Schlemm's canal a probe is inserted into the canal. We dissect the sclera and the outer wall of Schlemm's canal by an oblique cut. The probe being retracted again, the trabecular meshwork is cut and a basal iridectomy is performed. Then the scleral cut and the trabecular window are closed tightly. Postoperative pressure behaviour and gonioscopy indicate, that the outflow of aqueous humour occurs via trabecular cleft and the collector channels in the operating field; obviously with this technique the intrascleral outflow channels can be saved to a great extend.

Chronic Disease↗
PubMed1975

[Angle block glaucoma and prophylactic iridectomy in the eye without symptoms (author's transl)].

58% of 114 patients who had been treated stationarily with an angle block glaucoma in one eye and who had had conservative therapy got an attack in the second eye in the course of 5 years from 1960 onwards till 1970. From 1970 onwards 77 patients were treated by prophylactic iridectomy in the eye without symptoms with a narrow chamber angle; no patient has an acute attack since then received.

Glaucoma↗
PubMedDate not supplied

[Influence of surgical technic in cataract operation. (Postoperative astigmatism, type of iridectomy)].

The authors have made a statistical study of the influence of surgical technique on the anatomical (astigmatism) and functional results in cataract surgery. They have taken into consideration whether the incision is made under a conjunctival flap or not, with a keratome or Gillette blade, with a sector or peripheral iridectomy. Their conclusions are that when performed by the same surgeon the different surgical techniques do not give rise to significant variations in astigmatism or in the eventual functional result.

Aged↗
PubMed1991

Corneal decompensation after argon laser iridectomy--a delayed complication.

We report six eyes in six patients in which corneal decompensation developed 18 or more months after argon laser iridectomy (ALI). In addition to the level of laser energy used, other risk factors included performing ALI during an attack, diabetes, and a cornea damaged by glaucomatous attack. The interval between the ALI and corneal decompensation ranged from 18 months to 3 1/2 years.

Adult↗
PubMedDate not supplied

[Charleux's method of basal iridectomy].

Retrograde transcorneal iridectomy suggested by Charleux and Etienne was used in 27 eyes (20 patients) suffering from glaucoma with closed angle (in 12 eyes with acute attack and in 15 congeneric eyes) (prophylactic). The post- or intrasurgical complications were absent. The operation was simple and had good results. The hospitalization period was of 2-3 days.

Aged↗
PubMed1990

A modified iris fixation suture utilizing a peripheral iridectomy.

To help ensure proper placement of an iris fixation suture, a peripheral iridectomy can be performed to allow visualization of the superior haptic of a posterior chamber intraocular lens (PC-IOL). In cases where support for the PC-IOL is in question, an iris fixation suture using this technique provides an easy way of ensuring adequate support.

Aged↗
PubMedDate not supplied

[Chandler's basal iridectomy. Our observations on surgical indications, technic and value].

Basal iridectomy is a pupillary bypass having a prophylactic role, when made on an eye with potential glaucoma, and a curative role when performed on an eye with primary narrow angle glaucoma in the reversible stage of the disease. The authors present their experience on 37 eyes, using Charleux-Etienne's technique that, compared with Chandler's technique is more advantageous: the limb remains intact for a possible future operation, it is simple, rapid, without risks, efficient and elegant.

Evaluation Studies as Topic↗
PubMed1989

Posterior synechiae after laser iridectomy.

Eighty-six eyes of 46 patients were studied retrospectively to determine the incidence of posterior synechiae after laser iridectomy. All eyes were dilated and studied with a slit lamp. The incidence of permanent posterior synechiae in the eyes in this study (37%) is much higher than that previously reported. There was a strong positive correlation between the use of miotic agents postoperatively and the finding of posterior synechiae. The probable pathogenesis of this complication is discussed, and methods to decrease the incidence of this complication are given.

Cicatrix↗
PubMed1988

[Surgical peripheral iridectomy and argon laser iridotomy in primary closed-angle glaucoma. Comparative statistical study].

The subject is to compare the middle term efficiency of surgical peripheral iridotomy and Argon laser iridotomy for primary closed angle glaucoma. We have considered reopened angles on 360 degrees after a crisis of closed angle; eyes with a positive "neosynephrine - pilocarpine" test; the second eye of a primary closed angle glaucoma and primary mixed glaucoma. Sixty affected eyes have been divided in two groups in a randomized study. Group A: Thirty eyes requiring a bilateral surgical peripheral iridectomy, Group B: Thirty eyes requiring a bilateral Argon laser iridotomy. The patients are regularly followed at intervals of: one week, three months, six months, one year and two years. Four parameters have been researched: 1. Intraocular pressure between 9 h-12 h a.m. Intraocular pressures lower or equal to 22 mmHg were considered to be successes. 2. Far visual acuity with correct lenses. 3. Opacity of the crystalline lenses: normal or sclerosed (0, +/-, +) cataract (++, ). 4. Post-operative complications. Some cases have required several periods of Argon laser photocoagulation (colorless iris, older patients) but we prefer a proper result immediately in order not to take any risks with pupillary blocking-up. The statistical analysis gives the following results: Same tonometric results according to the different technics even if the treatment has been prophylactic (positive provocation test; second eye) or curative (primary closed-angle glaucoma with solvable crisis; mixed glaucoma). No significant difference of visual acuity between the two groups after two years. Similarly, we have not found a significant difference between both techniques in each considered age group two years after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Sector iridectomy in the management of prolonged attacks of acute congestive glaucoma.

Clinicians still encounter patients suffering from prolonged episodes of primary angle-closure glaucoma. These patients often have been misdiagnosed or neglected initially. While laser iridotomies have proven most effective in the treatment of acute angle-closure glaucoma, there is a diversity of opinion regarding the treatment of chronic forms, in particular when the congestive phase has been of long duration (e.g., 3 to 14 days). The fact that ophthalmologists must still contend with the dreaded complication of malignant glaucoma attests to the difficulty of treating this condition. A series of cases have been collected during the past 15 years, all having prolonged episodes of primary angle-closure glaucoma, where the anterior-chamber angles could not be opened medically before surgery. We found that laser iridotomy is not efficacious in this situation, and indeed often impossible to perform due to corneal edema. Our patients were treated surgically with sector iridectomies, with an extremely high degree of success, and a minimal complication rate. The results are presented in tabular form. The mechanism of action is described, and the reasons for the success of this procedure explained.

Acute Disease↗
PubMed1986

Long-term gonioscopy follow-up of eyes with posterior chamber lens implants and no iridectomy.

One hundred eyes which had undergone extracapsular cataract extraction with no iridectomy followed by insertion of a posterior chamber lens were examined gonioscopically 1 to 4.7 years postoperatively to determine the prevalence of asymptomatic angle closure from pupillary block. Since no peripheral anterior synechiae (PAS) characteristic of pupillary block were found, there seems to be little risk that these eyes will develop angle-closure glaucoma. During the study small PAS were noted adjacent to many haptics implanted in the ciliary sulcus.

Cataract Extraction↗