scholarly journals Anterior 360° Synechiolysis in a Case of Late Iridocorneal Adhesions after 25-G Vitrectomy: Surgical and Physiopathogenetic Aspects

2017 ◽  
Vol 8 (1) ◽  
pp. 170-172 ◽  
Author(s):  
Raffaele Nuzzi ◽  
Francesca Monteu
Keyword(s):  
Intraocular Pressure ◽  
Corneal Edema ◽  
Endothelial Damage ◽  
Angle Closure ◽  
Anatomy And Physiology ◽  
Elevated Intraocular Pressure ◽  
Surgical Iridectomy ◽  
Single Opening ◽  
To Receive

We describe the case of an 86-year-old patient, pseudophakic in both eyes and with high myopia, who had previously had a 25-G vitrectomy with 20% C3F8 used as a tamponade due to a total retinal detachment with choroidal hemorrhages and macular hole. At the postoperative 4-month follow-up, we found 360° iridocorneal synechiae with elevated intraocular pressure due to angle closure in all sectors, with an adherent retina and in the absence of choroidal hemorrhage/detachment and of corneal edema or endothelial damage. The patient was, therefore, hospitalized to receive 360° anterior synechiolysis with a single opening to the corneal limbus, like in paracentesis, with topical anesthesia. We have tried to study the possible causes of this case history. However, it should be recognized that the development of iridocorneal synechiae and the rise of intraocular pressure can be a possible complication of air/C3F8 vitrectomy, which cannot be managed with medical therapy. It will be essential to monitor the situation and to hospitalize the patient for surgical synechiolysis to restore the normal anatomy and physiology and to correct the ocular hypertension. During the vitrectomy, we will have to introduce in advance an adequate amount of viscoelastic material in the anterior chamber and to perform a preventive surgical iridectomy, even if the iridocorneal angle is open in all sectors.

scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

scholarly journals Minimally Invasive Surgery for Intraocular Lens Removal and Intrascleral Intraocular Lens Fixation with Trabeculectomy in a Patient with Dislocated Intraocular Lens and Elevated Intraocular Pressure

2021 ◽  
pp. 538-542
Author(s):  
Yuko Mano ◽  
Kei Mizobuchi ◽  
Tomoyuki Watanabe ◽  
Akira Watanabe ◽  
Tadashi Nakano
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Combined Therapy ◽  
Swept Source ◽  
Needle Technique ◽  
Elevated Intraocular Pressure ◽  
Anterior Segments ◽  
The Right ◽  
End Stage

A 88-year-old female who was being treated for end-stage pseudoexfoliation syndrome was referred to our hospital for treatment of dislocated intraocular lens (IOL) and the elevated intraocular pressure (IOP) and in the right eye (RE). At the first visit to our hospital, best-corrected visual acuity (BCVA) was 0.2 in the RE and 0.02 in the left eye (LE). IOP was 47 mm Hg in the RE and 21 mm Hg in the LE. Slit-lamp examination showed no abnormalities in anterior segments and dislocated IOL in the RE. Fundus photograph showed optic disc pallor in both eyes. We performed the combined therapy of flanged intrascleral IOL fixation with the double-needle technique and trabeculectomy. Throughout the follow-up period, BCVA slightly improved from 0.2 to 0.4 in the RE. The angle of tilt of the IOL was 6.6, 7.9, and 8.7° as measured by swept-source optical coherence tomography at 1, 4, and 6 months after the surgery, respectively. The IOP remained less than 10 mm Hg without having to administer any other glaucoma medications. Furthermore, any complications associated with the surgery were not confirmed.

scholarly journals Iridoplasty for plateau iris syndrome: a systematic review

2019 ◽  
Vol 4 (1) ◽  
pp. e000340
Author(s):  
Hugo Bourdon ◽  
Vittoria Aragno ◽  
Christophe Baudouin ◽  
Antoine Labbé
Keyword(s):  
Systematic Review ◽  
Intraocular Pressure ◽  
Retrospective Studies ◽  
Scientific Evidence ◽  
Argon Laser ◽  
Angle Closure ◽  
Current Evidence ◽  
Iridocorneal Angle

Plateau iris syndrome (PIS) is a frequent cause of angle closure. Argon laser peripheral iridoplasty (ALPI) has been proposed in PIS to widen the iridocorneal angle. The objective of the present study was to perform a systematic review of the available studies evaluating the efficacy of ALPI on intraocular pressure (IOP), iridocorneal angle opening and the number of medications in patients with chronic angle-closure associated with PIS. One prospective and seven retrospective studies with a minimum 1 month of follow-up were included. Although ALPI seemed to lower IOP, to decrease the number of topical antiglaucoma medications and widen the iridocorneal angle shortly after the procedure, there is no current evidence of long-term efficacy. To date, there is no robust scientific evidence to advocate ALPI as a treatment for chronic angle-closure caused by PIS.

scholarly journals Effect of Cataract Surgery on Intraocular Pressure in Glaucoma Patients

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Shua Azam ◽  
Abdul Hameed Talpur ◽  
Mahak Shaheen ◽  
Sadia Bukhari
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Angle Closure ◽  
Inclusion Criteria ◽  
Primary Angle Closure Glaucoma ◽  
Closed Angle ◽  
Operative Assessment

Purpose:  To determine the change in intraocular pressure after cataract surgery in patients diagnosed with glaucoma. Study Design:  Interventional case series. Place and Duration of Study:  Glaucoma Clinic. Al-Ibrahim Eye Hospital (AIEH) Karachi, Pakistan from May to October, 2019. Methods:  Thirty-eight patients diagnosed with glaucoma and cataract and registered in glaucoma clinic were recruited for this study. Inclusion Criteria was age > 41 years and patients diagnosed with primary open/closed angle glaucoma and cataract. Patients with secondary glaucoma, history of trabeculectomy and any other ocular diseases were excluded from the study. Pre-operative assessment was done for phacoemulsification. In post-operative examination, first and second follow-up IOP was measured. Data analysis was done on statistical package for social science (SPSS) version 20.0. Statistical changes were present in the form of bar chart, frequency and graphs. The mean standard deviation for pre-operative, post-operative 1st and 2nd follow-up IOP was calculated. Results:  A total of 38 participants and 48 eyes satisfied the inclusion criteria. Out of 48 eyes, 39 (81.3%) eyes were diagnosed with Primary open angle glaucoma and 9 (18.8%) eyes with Primary Angle Closure Glaucoma. The pre-operative mean IOP was 16.56 ± 6.67 mm Hg and post-operative mean IOP at first follow-up was 13.39 ± 4.04 mm Hg. At second follow-up at one-month mean IOP was 12.14 ± 2.28 mm Hg. Conclusion:  Phacoemulsification produces a useful decrease in IOP in glaucoma patients. Key Word:  Glaucoma, Cataract, Phacoemulsification, Intraocular Pressure.

scholarly journals Clinical Outcome of Hypertensive Uveitis

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Deborah Lewkowicz ◽  
François Willermain ◽  
Lia Judice Relvas ◽  
Dorine Makhoul ◽  
Sarah Janssens ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Clinical Outcome ◽  
Topical Corticosteroid ◽  
Retrospective Review ◽  
Corticosteroid Treatment ◽  
First Episode ◽  
Elevated Intraocular Pressure ◽  
Unilateral Disease

Purpose. To review the clinical outcome of patients with hypertensive uveitis.Methods. Retrospective review of uveitis patients with elevated intraocular pressure (IOP) > 25 mmHg and >1-year follow-up. Data are uveitis type, etiology, viral (VU) and nonviral uveitis (NVU), IOP, and medical and/or surgical treatment.Results. In 61 patients, IOP values are first 32.9 mmHg (SD: 9.0), highest 36.6 mmHg (SD: 9.9), 3 months after the first episode 19.54 mmHg (SD: 9.16), and end of follow-up 15.5 mmHg (SD: 6.24). Patients with VU (n=25) were older (50.6 y/35.7 y,p=0.014) and had more unilateral disease (100%/72.22%  p=0.004) than those with NVU (n=36). Thirty patients (49.2%) had an elevated IOP before topical corticosteroid treatment. Patients with viral uveitis might have higher first elevated IOP (36.0/27.5 mmHg,p=0,008) and maximal IOP (40.28/34.06 mmHg,p=0.0148) but this was not significant when limited to the measurements before the use of topical corticosteroids (p=0.260and 0.160). Glaucoma occurred in 15 patients (24.59%) and was suspected in 11 (18.03%) without difference in viral and nonviral groups (p=0.774).Conclusion. Patients with VU were older and had more unilateral hypertensive uveitis. Glaucoma frequently complicates hypertensive uveitis. Half of the patients had an elevated IOP before topical corticosteroid treatment.

scholarly journals Comparison of the efficacy and safety of bimatoprost (0.03 %) and travoprost (0.004 %) in patients with primary open angle glaucoma

2013 ◽  
Vol 5 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Ashish Chander ◽  
H Kapoor ◽  
S Thomas
Keyword(s):  
Intraocular Pressure ◽  
Side Effect ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Efficacy And Safety ◽  
Once Daily ◽  
The Mean ◽  
To Receive

Purpose: To compare the efficacy and safety of bimatoprost (0.03 %) and travoprost (0.004 %) in patients with primary open angle glaucoma (POAG). Subjects and methods: Patients with POAG were randomized to receive either bimatoprost or travoprost once daily. Detailed ocular examination was done and intraocular pressure (IOP) was measured at 9.00 am, 1.00 pm and 4.00 pm at the baseline and at 1, 2, 4, 6 and 12 weeks of therapy. Results: A total of 31 patients were analysed. The patients were randomly divided into two groups (Bimatoprost group = 16; Travoprost group = 15). Both the groups had a statistically significant reduction from the baseline IOP at all follow up visits at 9.00 am, 1.00 pm and 4.00 pm. The mean IOP decreased from a baseline of 25 ± 2.32 mm Hg to 15.93 ± 1.79 mm Hg after 12 weeks in the bimatoprost group (p < 0.001), and from 24.2 ± 1.60 mm Hg to 16.53 ± 1.56 mm Hg in the travoprost group (p < 0.001). A better mean reduction of IOP was obtained with bimatoprost than with travoprost at the end of the study at 12 weeks (p = 0.03). Mild ocular redness was the commonest side effect in both the groups but was not significant in either group. Conclusion: Both drugs lowered IOP effectively but bimatoprost showed a greater reduction in the mean IOP than did travoprost at 12 weeks and both are safe for ocular use. Nepal J Ophthalmol 2013; 5(9):75-80 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7831

Selective Laser Trabeculoplasty for Primary Angle Closure With Persistently Elevated Intraocular Pressure After Iridotomy

2009 ◽  
Vol 18 (7) ◽  
pp. 563-566 ◽  
Author(s):  
Ching Lin Ho ◽  
Jimmy S. M. Lai ◽  
Mario V. Aquino ◽  
Prin Rojanapongpun ◽  
Hon Tym Wong ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Angle Closure ◽  
Selective Laser Trabeculoplasty ◽  
Primary Angle Closure ◽  
Laser Trabeculoplasty ◽  
Elevated Intraocular Pressure

scholarly journals Potential effects of angiogenesis-related factors on the severity of APAC and surgical outcomes of trabeculectomy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Wang ◽  
Ming-shui Fu ◽  
Min-wen Zhou ◽  
Bi-lian Ke ◽  
Zhi-hua Zhang ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Aqueous Humor ◽  
Family Members ◽  
Angle Closure ◽  
Related Factors ◽  
Acute Primary Angle Closure ◽  
Failure Group ◽  
Primary Angle Closure

Abstract Background EPO (erythropoietin) and PDGF (platelet derived growth factor) families are thought to be associated with angiogenesis under hypoxic condition. The sharp rise of intraocular pressure in acute primary angle closure (APAC) results in an inefficient supply of oxygen and nutrients. We aimed to measure the expression of EPO and PDGF family members in APAC eyes and demonstrate their associations with APAC’s surgical success rate. Methods Concentrations of EPO, PDGF-AA, -BB, -CC and -DD collected in aqueous humor samples of 55 patients recruited were measured. Before operations, correlations between target proteins and IOP (intraocular pressure) were detected between APAC (acute primary angle closure) and cataract patients. Based on the post-operative follow-up, the effects of EPO and PDGF family members on the successful rate of trabeculectomy were tested. Results The levels of EPO, PDGF-CC and -DD were significantly elevated in the APAC group compared to the cataract group. During the post-operative follow-up, EPO, PDGF-CC and -DD showed significant differences between the success and failure groups. In multivariable linear regression analyses, failed filtration surgery was more likely in APAC eyes with higher EPO level. The Kaplan-Meier survival plot suggested that the success rate in eyes with low EPO level was significantly higher than that in eyes with high EPO level. Conclusion The levels of EPO, PDGF-CC and -DD were significantly elevated in failure group. EPO level correlated with preoperative IOP and numbers of eyedrops, and higher EPO level in aqueous humor is a risk factor for trabeculectomy failure. It can be a biomarker to estimate the severity of APAC and the success rate of surgery. The investigation of mechanism of EPO in APAC a may have potential clinical applications for the surgical treatment of APAC.

scholarly journals What was Glaucoma Called before the 20th Century?

2015 ◽  
Vol 7 ◽  
pp. OED.S32004 ◽  
Author(s):  
Christopher T. Leffler ◽  
Stephen G. Schwartz ◽  
Francesca M. Giliberti ◽  
Matthew T. Young ◽  
Dennis Bermudez
Keyword(s):  
Intraocular Pressure ◽  
Optic Neuropathy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
The Other ◽  
Angle Closure ◽  
Open Angle ◽  
Poor Vision ◽  
Elevated Intraocular Pressure

Glaucoma involves a characteristic optic neuropathy, often with elevated intraocular pressure. Before 1850, poor vision with a normal eye appearance, as occurs in primary open-angle glaucoma, was termed amaurosis, gutta serena, or black cataract. Few observers noted palpable hardness of the eye in amaurosis. On the other hand, angle-closure glaucoma can produce a green or gray pupil, and therefore was called, variously, glaucoma (derived from the Greek for glaucous, a nonspecific term connoting blue, green, or light gray) and viriditate oculi. Angle closure, with palpable hardness of the eye, mydriasis, and anterior prominence of the lens, was described in greater detail in the 18th and 19th centuries. The introduction of the ophthalmoscope in 1850 permitted the visualization of the excavated optic neuropathy in eyes with a normal or with a dilated greenish-gray pupil. Physicians developed a better appreciation of the role of intraocular pressure in both conditions, which became subsumed under the rubric “glaucoma”.

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