1/16. A slit-lamp needling filtration procedure for uncontrolled glaucoma in pseudophakic and aphakic eyes.In one aphakic and one pseudophakic patient without previous filtration surgery, a transconjunctival needling procedure similar to that used for failed filtration procedures was performed to create a filtering bleb. In both cases, intraocular pressure was successfully lowered for 6 months until the occurrence of bleb encapsulation, which was relieved by transconjunctival needling. There were no complications. In selected cases, this minimally invasive slit-lamp needling procedure provides successful filtration.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/16. Cystoid macular edema associated with latanoprost therapy in a case series of patients with glaucoma and ocular hypertension.OBJECTIVE: To identify coexisting ocular diagnoses in a case series of eyes that developed cystoid macular edema (CME) associated with latanoprost therapy. DESIGN: Retrospective observational case series. PARTICIPANTS: Seven eyes of seven patients who developed CME possibly associated with latanoprost treatment were studied. INTERVENTION: When these patients, all of whom were treated with latanoprost in addition to other glaucoma medications, described blurred vision or eye irritation, ocular examination revealed CME, which was confirmed by fluorescein angiography. Latanoprost was discontinued, and in three cases topical corticosteroids and nonsteroidal anti-inflammatory agents were used to treat the CME. MAIN OUTCOME MEASURES: visual acuity and intraocular pressure were determined before latanoprost use began, during therapy, and after latanoprost use ceased. In these cases, resolution of CME was documented clinically after discontinuing latanoprost. RESULTS: Clinically significant CME developed after 1 to 11 months of latanoprost treatment, with an average decrease of 3 lines in Snellen visual acuity. intraocular pressure decreased an average of 27.9% during treatment. Cystoid macular edema was confirmed in all cases by fluorescein angiography. In these seven patients, the following coexisting ocular conditions may have placed these eyes at risk for prostaglandin-mediated blood-retinal barrier vascular insufficiency: history of dipivefrin-associated CME, epiretinal membrane, complicated cataract surgery, history of macular edema associated with branch retinal vein occlusion, history of anterior uveitis, and diabetes mellitus. In all cases, the macular edema resolved following discontinuation of latanoprost, in some instances with concomitant use of steroidal and nonsteroidal anti-inflammatory agents. CONCLUSIONS: In this case series of pseudophakic, aphakic, or phakic eyes, the temporal relationships between the use of latanoprost and developing CME, and the resolution of CME following cessation of the drug, suggest an association between latanoprost and CME. In all cases, coexisting ocular conditions associated with an altered blood-retinal barrier were present.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
3/16. Treatment of traumatic cyclodialysis with vitrectomy, cryotherapy, and gas endotamponade.An aphakic patient with severe chronic hypotony had an alternative treatment of a traumatic cyclodialysis cleft: a 3-port pars plana vitrectomy, cryotherapy of the cleft, and fluid-gas exchange with subsequent supine positioning. The therapeutic principle was mechanical apposition of the detached ciliary muscle to the scleral spur by the gas bubble and scar induction by cryotherapy. intraocular pressure increased to within normal ranges, and visual acuity improved over a 15 month follow-up.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/16. Management of glaucoma drainage implant tube kink and obstruction with Pars Plana Clip.Increased intraocular pressure after glaucoma drainage implant surgery may be caused by obstruction of the tube. A case of obstruction of an Ahmed glaucoma valve tube after pars plana insertion due to kinking of the tube was treated with a Pars Plana Clip (New World Medical, Rancho Cucamonga, CA).- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/16. Ab interno laser sclerostomy in aphakic patients with glaucoma and chronic inflammation.Five patients with aphakia, glaucoma, and chronic inflammation were treated with ab interno sclerostomy by using the continuous wave Nd:YAG laser focused through a sapphire probe. After a follow-up period of 24 to 28 months, three of five patients had good intraocular pressure control. The sclerostomy failed in one patient when it was occluded by vitreous. The second failure was attributed to closure of the sclerostomy because of chronic intraocular inflammation.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/16. Delayed nonexpulsive suprachoroidal hemorrhage after trabeculectomy.Five cases of delayed nonexpulsive suprachoroidal hemorrhage after trabeculectomy in aphakic eyes are reported. Four cases were done under general anesthesia and in three there was straining and bucking at extubation. The most common presentation was sudden severe ocular pain one day postoperatively, associated with marked decrease in vision and low intraocular pressure. The prognosis was related to the extent of the hemorrhage; where suprachoroidal hemorrhage was extensive, surgical drainage appeared to help. Our last two patients, both with massive postoperative nonexpulsive suprachoroidal hemorrhage, underwent surgical drainage of suprachoroidal blood and recovered preoperative visual acuity.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/16. Acute glaucoma following vitrectomy and silicone oil injection.Three cases are described of acute glaucoma following vitrectomy and silicone oil injection in proliferative vitreous retinopathy. The first case developed silicone-induced pupillary block in a phakic eye. Cases 2 and 3 developed elevated pressure in aphakic eyes with deep anterior chambers. Cases 1 and 3 were treated by laser iridectomy. Case 2 was treated by removal of silicone. The pathogenesis and treatment of these problems are discussed.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/16. Prevention and management of delayed suprachoroidal hemorrhage after filtration surgery.We report two new cases of massive delayed nonexpulsive suprachoroidal hemorrhage (DNSH) following a filtering operation in the aphakic eyes of elderly patients with glaucoma. A timely surgical drainage resulted in full recovery of preoperative visual acuity in both of our patients. As we combine our cases with a series of 18 similar cases of others in the literature, the following conclusions emerge. Limited DNSH does not require surgical intervention for a favorable visual outcome. Massive DNSH, however, requires timely and appropriate surgical intervention to achieve a favorable visual outcome and to avoid persistent hypotony. The most effective surgical intervention is drainage of the suprachoroidal hemorrhage and re-formation of the anterior chamber, but without concomitant vitrectomy. In both limited and massive DNSH, the final visual outcome is not determined by the worst vision at the time of DNSH. Some of the known and suspected risk factors of DNSH following filtering surgery are old age, aphakia, postoperative hypotony, a history of vitreous manipulation or complication, general anesthesia, increased venous pressure, use of fluorouracil, and high myopia. In view of these risk factors, we recommend several preventive measures for decreasing the incidence of DNSH following filtering surgery.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/16. Acute glaucoma following Nd: YAG laser membranotomy.A 65-year-old aphake with a functioning filtration bleb underwent neodymium:YAG laser membranotomy. Shortly thereafter, he acutely developed pain, nausea, and visual blur with an intraocular pressure of 42 mm Hg. The mechanism of the acute glaucoma is believed to be occlusion of the fistula by herniated vitreous.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/16. Contraindications for mannitol in aphakic glaucoma.When prescribing mannitol to decrease intraocular pressure, the physician must be alert to potential complications. A 72-year-old woman suffered obtundation, intractable pulmonary edema, acidemia, and irreversible renal insufficiency despite vigorous hemodialysis. When renal function is compromised, careful monitoring of electrolyte levels, daily urine output, and renal function is necessary with mannitol therapy.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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