1/47. Treatment of fibrinous pupillary membrane occlusion following cataract surgery with microruptor laser.A 79-year-old female with rheumatoid arthritis suffered from severe induced iritis with dense fibrinous pupillary membrane occlusion and high intraocular pressure (57 mmHg) following cataract surgery. We used a Nd:YAG laser technique to dissect and move the dense pupillary membrane away and avoid invasive surgical procedures. Postoperatively, we recorded IOP 14 mmHg and visual acuity 20/30.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/47. Long-term outcome of aqueous shunt surgery in ten patients with iridocorneal endothelial syndrome.PURPOSE: To report the long-term outcome of ten patients with iridocorneal endothelial (ice) syndrome who underwent aqueous shunt surgery for uncontrolled glaucoma. DESIGN: Noncomparative, retrospective case series. PARTICIPANTS: The authors reviewed charts of ten patients with ice syndrome-related glaucoma who underwent aqueous shunt surgery at one institution between 1987 and 1996. MAIN OUTCOME MEASURES: intraocular pressure (IOP), number of glaucoma medications, and further surgical interventions were measured. RESULTS: With a median follow-up of 55 months, four eyes had adequate IOP control (IOP <21 mm Hg) with one or two medications after the initial aqueous shunt surgery. An additional three eyes achieved adequate IOP control after one or more tube repositionings or revisions of the initial aqueous shunt. In this series, the aqueous shunt surgery most often failed because of blocking of the tube ostium by iris, ice membrane, or membrane-induced tube migration. CONCLUSION: Aqueous shunt surgery appears to be an effective method for IOP lowering in some eyes with ice syndrome-related glaucoma when medical treatment or conventional filtration surgeries fail, but additional glaucoma procedures and/or aqueous shunt revisions and tube repositionings are not uncommon.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/47. Histopathological findings of X-linked retinoschisis with neovascular glaucoma.BACKGROUND: X-linked retinoschisis (XLRS) is rarely complicated by neovascular glaucoma. Only a few reports of XLRS histopathological findings with neovascular glaucoma have been published. methods: A 41-year-old man with XLRS complicated by neovascular glaucoma in his left eye was examined with electroretinography, B-scan, ultrasound biomicroscopy and computed tomography. He was examined by ophthalmoscopy and fluorescein angiography in the other eye. An enucleation was performed in his left eye due to uncontrollable high intraocular pressure and persistent ocular pain. We examined the enucleated eye histopathologically. RESULTS: Examination of the enucleated eye showed nuclear sclerosis of the lens, pigmented retrolental membrane and retinoschisis which separated the inner layer of the retina and made a large space in the vitreous cavity without any apparent detachment of the outer layers of the retina. Sclerotic vessels were present histopathologically in both the inner and outer layers of the retina. There was a peripheral anterior synechia, ectropion uveae and a fibrovascular membrane, which contained many lumina of neovascularization, indicating marked rubeosis iridis. Small cystic spaces were observed in both the schitic retina in the peripheral region and the foveal schisis at the outer layer of the retina. The photoreceptor cells had become markedly atrophied and multiple regions of calcification were observed. The optic nerve showed severe atrophy with gliosis, but the central retinal artery and vein were still open within the nerve. CONCLUSIONS: These histopathological findings suggest that rubeosis iridis may have developed secondarily to retinal ischemia due to occlusion of the retinal blood vessels.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/47. Laser iridocystotomy for bilateral acute angle-closure glaucoma secondary to iris cysts.PURPOSE: To report laser iridocystotomy for bilateral acute angle-closure glaucoma secondary to peripheral iris cysts. METHOD: Case report. RESULTS: In a 55-year-old man with increased bilateral intraocular pressure, gonioscopy revealed varied angle narrowing. Bilateral angle-closure glaucoma secondary to peripheral iris cysts was diagnosed by ultrasound biomicroscopy. The peripheral iris cysts could not be seen in mydriasis by gonioscopy. Therefore, we decided to perform laser iridocystotomy with argon and Nd:YAG laser. Collapse of the cysts after laser treatment was demonstrated by ultrasound biomicroscopy. At follow-up, 9 months after laser treatment, intraocular pressure had dropped below 20 mm Hg in both eyes without further therapy. The iris cysts did not recur, which was demonstrated by ultrasound biomicroscopy. CONCLUSIONS: Peripheral iris cysts may produce angle closure and may cause secondary angle-closure glaucoma. If transpupillary laser cystotomy is not possible, laser iridocystotomy may produce collapse of the iris cysts and correction of secondary angle closure.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
5/47. Successful goniosynechialysis for angle-closure glaucoma after vitreoretinal surgery.PURPOSE: To describe 2 cases of long-term successful clinical outcome after goniosynechialysis for secondary angle-closure glaucoma after vitreoretinal surgery. methods: case reports. Goniosynechialysis was performed bilaterally in 1 patient and unilaterally in another for uncontrolled angle-closure glaucoma after vitreoretinal surgery. RESULTS: Angle reopening was performed 2 to 4 months after initial closure. After follow-up of between 3 and 5 years, intraocular pressure has remained below 21 mm Hg without medication in all three eyes. CONCLUSION: Goniosynechialysis should be considered a viable therapeutic alternative to filtration surgery in selected patients with a recent history of angle-closure glaucoma after vitreoretinal surgery.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/47. Latanoprost-induced iris heterochromia and open-angle glaucoma: a clinicopathologic report.PURPOSE: To report the histopathologic and immunohistochemical findings from the iridectomy specimen of a patient with acquired unilateral iris heterochromia due to latanoprost. PATIENT AND methods: A 45-year-old woman with open-angle glaucoma and unilateral iris heterochromia was evaluated for uncontrolled intraocular pressure increase. Subsequently, the patient underwent trabeculectomy with mitomycin C and an iridectomy specimen was obtained for analysis. RESULTS: The histopathologic analysis of the iridectomy specimen did not reveal any nuclear atypia, nuclear crowding, or mitotic figures. Immunohistochemical studies showed that the iris melanocytes were negative for HMB45 and S-100, and weakly positive for Melan A. CONCLUSION: Latanoprost-associated iris color change may exhibit a diffuse, uniform, dark velvet-brown appearance, thereby simulating diffuse iris melanoma. Histopathologic and immunohistochemical analysis confirmed the benign characteristics of the affected iris melanocytes.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/47. Acquired anterior ocular melanocytosis following cataract extraction.The right eye of a 59-year-old man was the subject of extracapsular cataract extraction and posterior chamber lens implantation. He gradually developed superior sectoral scleral and diffuse iris hyperpigmentation within 7 years postoperatively. The iris was also uniformly thickened. He sustained 20/20 visual acuity in the pseudophakic eye. Despite marked pigmentation of the angle, his right intraocular pressure remained within normal limits. We use the term acquired anterior ocular melanocytosis because the pigmentary changes were confined to the anterior segment and the choroid was not involved. We conclude that surgical injury in the form of cataract extraction can induce episcleral/scleral hyperpigmentation and iris hyperchromia.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/47. iris synechia after laser goniopuncture in a patient having deep sclerectomy with a collagen implant.neodymium:YAG (Nd:YAG) goniopuncture is an efficient and safe treatment for low filtration through the trabeculo-Descemet's membrane after deep sclerectomy with a collagen implant (DSCI). The only reported complication of this procedure is choroidal detachment. However, we found an iris synechia in a patient whose intraocular pressure (IOP) was elevated again 1 month after Nd:YAG goniopuncture. Synechiolysis and peripheral iridectomy with Nd:YAG and argon lasers effectively removed the iris synechia, and IOP immediately dropped to the normal range. We believe that iris synechia is a potential complication that may cause elevated IOP after laser goniopuncture in patients having DSCI.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/47. Phakic posterior chamber intraocular lens pupillary block.A 49-year-old woman developed bilateral pupillary block after implantation of a phakic posterior chamber intraocular lens despite patent-appearing but nonfunctional peripheral iridotomies. This case serves as a basis to identify clinical signs that distinguish this diagnosis from other causes of elevated intraocular pressure and types of pupillary block.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/47. iris prolapse at the surgical site: a late complication of nonpenetrating deep sclerectomy.To investigate the occurrence and management of late-onset iris prolapse through the surgical wound after nonpenetrating deep sclerectomy. Two cases of iris prolapse that presented 8 and 10 months, respectively, after surgery for glaucoma were reviewed. One of the cases was associated with mild trauma. The postoperative follow-up was 5 and 24 months, respectively. The iris tissue bulge did not progress and there were no other complications. The visual acuity was not affected and the intraocular pressure was controlled with medical therapy. These cases demonstrate that the eye is weaker than normal at the surgical site after nonpenetrating deep sclerectomy, allowing iris protrusion. iris prolapse should be added to the list of late postoperative complications of nonpenetrating deep sclerectomy.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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