1/34. Management of traumatic cyclodialysis cleft associated with ocular hypotony.BACKGROUND AND OBJECTIVE: To evaluate the efficacy of direct cyclopexy for treatment of traumatic cyclodialysis cleft associated with ocular hypotony. patients AND methods: Eyes with traumatic cyclodialysis cleft were treated with direct cyclopexy or 1.0% atropine eyedrop. RESULTS: Five eyes with a large cyclodialysis cleft were treated with direct cyclopexy. Postoperatively, these eyes obtained normal intraocular pressure. Four of the 5 eyes had good visual acuity, and 1 eye that had preoperative subretinal hemorrhage in the macula had poor visual acuity. Of the 3 eyes treated with 1.0% atropine eyedrops, 1 had good visual acuity, and 2 with retinal folds had fairly good and poor visual acuity. CONCLUSION: The present study showed that direct cyclopexy is useful for the treatment of traumatic cyclodialysis cleft associated with ocular hypotony, and that the cyclodialysis should be surgically treated before irreversible retinal folds develop.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/34. 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) |
3/34. ciliary body detachment caused by capsule contraction.A 74-year-old woman developed capsule contraction associated with hypotony and choroidal effusion 18 months after uneventful phacoemulsification with 3-piece poly(methyl methacrylate) intraocular lens implantation. Ultrasound biomicroscopy revealed ciliary body detachment and stretched zonules. A radial neodymium: YAG anterior capsulotomy was performed, resulting in the resolution of the ciliary body detachment and choroidal effusion as well as in normal intraocular pressure over 4 days.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/34. Treatment of a cyclodialysis cleft by means of ophthalmic laser microendoscope endophotocoagulation.PURPOSE: To report on the repair of a cyclodialysis cleft by means of endolaser photocoagulation. METHOD: Case report. We describe treatment of a cyclodialysis cleft by means of endolaser photocoagulation with a diode laser. RESULTS: In a 8-year-old boy with pseudophakia and secondary glaucoma in the right eye, combined trabeculectomy/trabeculotomy was performed. Ten months later, the patient was seen with persistent hypotony with a flat filtration bleb. The hypotony was unresponsive to all forms of medical therapy. Reformation of the anterior chamber along with synechialysis revealed a 2.5 clock-hour cyclodialysis cleft by means of gonioscopy. A laser microendoscope probe was used and laser was applied to both the internal scleral and external ciliary body surfaces within the depths of the cleft. Within 3 weeks after treatment, intraocular pressure increased to 15 mm Hg and has remained at that level as of 9 months after the endolaser photocoagulation procedure. CONCLUSION: Endolaser photocoagulation with the ophthalmic laser microendoscope may be an appropriate procedure, after failure of medical therapy, for the diagnosis and repair of a cyclodialysis cleft, especially in the pediatric population.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/34. intraocular pressure -- all that is raised is not glaucoma.Increased intraocular pressure invariably sets our mind in the direction of either establishing or ruling out the diagnosis of glaucoma and in the process, sometimes, certain hidden factors may escape our attention, leading to some delay in delivering the specific treatment to the patient. We present a case whose underlying pathology remained obscured for more than 10 years before we examined this patient and discovered the hidden secret.- - - - - - - - - - ranking = 5keywords = pressure (Clic here for more details about this article) |
6/34. Angle-closure glaucoma in association with orbital pseudotumor.PURPOSE: To describe the pathophysiology of angle-closure glaucoma secondary to idiopathic inflammatory orbital pseudotumor. DESIGN: Retrospective, small noncomparative case series. PARTICIPANTS: Three patients with angle-closure glaucoma and orbital pseudotumor. methods: The pathophysiology of this entity was investigated using magnetic resonant imaging (MRI) and ultrasound biomicroscopy (UBM). MAIN OUTCOMES MEASURES: Clinical features, anterior chamber angle configuration, and intraocular pressure. RESULTS: Angle closure from anterior rotation of the ciliary body caused by choroidal effusions secondary to pseudotumor was demonstrated using MRI and UBM. Two of the three cases resolved after treatment for orbital pseudotumor. CONCLUSIONS: Idiopathic orbital pseudotumor is a cause of secondary angle-closure glaucoma. The mechanism of angle closure is anterior rotation of the ciliary body secondary to choroidal effusions resulting from the orbital inflammation.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/34. Expulsive hemorrhage before phacoemulsification.A 65-year-old white man who was scheduled for cataract extraction experienced a sudden increase in intraocular pressure (IOP) with flattening of the anterior chamber immediately after the anterior capsule incision. The eye was sutured, and because no decrease in pressure was noted, surgery was postponed. The presence of the cataract prevented ophthalmoscopic examination. Echographic examination revealed a hemorrhagic choroidal detachment with involvement of the ciliary body. The patient was examined regularly until the choroidal detachment disappeared 4 weeks later. He then had uneventful phacoemulsification and intraocular lens implantation.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
8/34. Angle-closure glaucoma in teenagers.OBJECTIVE: To report the occurrence of angle-closure glaucoma in 2 teenagers. DESIGN: Observational case reports, review of literature. methods: review of case histories, examinations, biometries, visual fields, and ultrasound biomicroscopy findings in 2 teenagers with angle-closure glaucoma. MAIN OUTCOME MEASURES: intraocular pressure, gonioscopy, Humphrey 24-2 visual field (SITA Standard), and ultrasound biomicroscopy. RESULTS: The first case involved a 15-year-old white male who presented with an intraocular pressure of 60 mm Hg in the right eye and 24 mm Hg in the left eye and 360-degree appositional closure in both eyes. Ultrasound biomicroscopy revealed prominent bilateral ciliary pigment epithelial cysts pushing the iris anteriorly towards the angle. The second case involved a 14-year-old white male with a strong family history of primary angle-closure glaucoma. The patient had pupillary block and an intraocular pressure of 24 mm Hg in the right eye and 40 mm Hg in the left eye on routine eye examination. gonioscopy and ultrasound biomicroscopy revealed appositional closure of the angle in all 4 quadrants bilaterally. CONCLUSION: Primary angle-closure glaucoma is uncommon in younger individuals. Therefore, the finding of angle-closure glaucoma in a young individual should alert the physician to the possibility of a secondary cause of angle closure, such as iris pigment epithelial cysts. In addition, special attention to family history is important as the configuration of an occludable anterior chamber angle may, in some instances, be inherited.- - - - - - - - - - ranking = 3keywords = pressure (Clic here for more details about this article) |
9/34. Chronic angle closure glaucoma secondary to frail zonular fibres and spherophakia.PURPOSE: We describe a 39-year-old Japanese woman with chronic angle closure glaucoma secondary to spherophakia and frail zonular fibres. The patient was 143 cm in height with short fingers and had no family history of eye problems. High intraocular pressure, total optic disc cupping and severe visual field constriction were found in the right eye. methods: The patient was treated successfully with trabeculectomy in the right eye and laser iridotomy in the left eye. CONCLUSION: The clinical findings imply that this was a borderline case of Weil-Marchesani syndrome.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/34. Transscleral diode laser therapy for cyclodialysis cleft induced hypotony.In order to evaluate the efficacy of transscleral diode laser therapy for treatment of cyclodialysis cleft associated with ocular hypotony, transscleral diode laser therapy was used in two patients with cyclodialysis cleft. It was applied over the cleft area in two rows of 14 applications in a post-traumatic patient and of 8 applications in a post-trabeculectomy patient at a power setting of 2500 mW and duration of 2000 msec. The clefts were closed with restoration of normal intraocular pressure and recovery of visual function in both patients. Transscleral diode laser therapy seems to be a safe, simple and non-invasive method for closure of the cyclodialysis clefts, especially in patients inappropriate for argon laser photocoagulation and those with opaque cornea.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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