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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We compared 15 patients who had undergone Holmium laser sclerostomy ab externo with 15 who had had trabeculectomy. In the short term, laser sclerostomy led to adequate control of intraocular pressure, but in the longer term it compared unfavourably with trabeculectomy in terms of efficacy, complications and reoperation rate. At 1 year follow-up, 8 patients in the laser group had had to undergo a second operation compared with none in the control trabeculectomy group, and 7 were still on glaucoma medication compared with 2 in the control group. Iris prolapse into the internal sclerostomy ostium within 2 months accounted for most failures, and was only partially amenable to Nd:YAG peripheral iridectomy. This common complication seems to be related to anterior chamber depth. There also appears to be a tendency for blockage of the sclerostomy with cellular or fibrinous debris. Recent literature is reviewed and modifying strategies discussed.
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PMID:A comparison of the efficacy of Holmium laser sclerostomy ab externo versus trabeculectomy in the treatment of glaucoma. 782 60

Square scleral corneal, square clear corneal, and rectangular clear corneal incisions were constructed in six cadaver eyes that had no previous intraocular surgery. The 3.2 mm or smaller wounds had sutureless closures. To determine their relative abilities to resist leakage and iris prolapse, eyes were tested at external pressures of up to 525 pounds per square inch (psi) at one of two intraocular pressure (IOP) ranges: 10 to 15 mm Hg or 20 to 25 mm Hg. The square scleral corneal (3.2 mm x 3.2 mm) and square clear corneal wounds (3.2 mm x 3.2 mm, 2.0 mm x 2.0 mm, 1.0 mm x 1.0 mm) withstood external pressure without effect at both IOP ranges, up to the maximum 525 psi. This level of external pressure was far greater than pressures withstood by rectangular clear corneal wounds, especially the wound usually constructed in clinical practice (3.2 mm x 2.0 mm), which leaked and demonstrated iris prolapse at 13 psi at the lower IOP. The square clear corneal wounds that were stable at 525 psi, however, are either clinically impractical (visual axis encroachment from 3.2 mm x 3.2 mm wound) or not technologically feasible until the size of phacoemulsification tips and intraocular lenses can be further reduced. Thus, of the procedures for small incision cataract surgery presently in use, the square scleral corneal incision with 1.5 mm internal corneal lip appears to offer greater stability and safety than the conventional rectangular clear corneal incision (3.2 mm x 2.0 mm).
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PMID:Relative strength of scleral corneal and clear corneal incisions constructed in cadaver eyes. 783 73

A 12-month period was reviewed to identify the incidence of iris prolapse following cataract surgery, and any predisposing factors. Of 1408 routine manual extracapsular cataract extractions, 29 eyes (2.06%) sustained an iris prolapse. Iris prolapse was commoner in Asian patients and when less experienced surgeons were operating. Twenty-five per cent of cases occurred in patients with obstructive airways disease or post-operative cough. Thirty-four per cent of iris prolapses were identified on the first post-operative day and 86% within 2 weeks. Prolapse probably occurs because of raised intraocular pressure in association with poor wound construction or closure. More emphasis should be given to wound construction and closure during surgical training, with extra diligence when operating on patients likely to cough postoperatively. Clinicians must ensure non-English speaking patients understand about ocular aftercare following cataract surgery.
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PMID:Iris prolapse; who? When? Why? 822 9

A 55-year-old man reported a severe headache of 3 days' duration, left ptosis and left lid swelling before examination. The ocular examination revealed left eye proptosis, severe edema of the left bulbar conjunctiva and lid, increasing intraocular pressure of the left eye and ptosis on the left side with decreased extraocular movement. The right eye was normal. Hematologic studies indicated mild inflammation. An enhanced computed tomography scan revealed proptosis of the left globe and enlargement of the superior ophthalmic vein and cavernous sinus of the left side. Angiography revealed an area of interrupted blood flow in the left cavernous sinus. Enhanced magnetic resonance imaging (MRI) with Gd-DTPA revealed a low-intensity area that was suspected to be a blood clot in the enlarged left cavernous sinus. This case indicates the efficacy of enhanced MRI examination in the early diagnosis of cavernous sinus thrombosis.
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PMID:Magnetic resonance imaging in the early diagnosis of cavernous sinus thrombosis. 857 Jan 57

A Boston Terrier puppy presented with a full-thickness peripheral corneal defect, iris prolapse and anterior lens capsule tear in the left eye (OS). Phacofragmentation and primary repair of the corneal laceration was performed. At surgery, subluxation of the lens was also apparent. One day postoperative, there was severe corneal edema, diffuse hyphema, an intraocular pressure (IOP) of 65 mmHg and a small amount of vitreous that protruded from the corneal incision OS. Malignant glaucoma or pupillary block glaucoma were suspected. Intravenous mannitol was administered preoperatively and had no effect. An anterior vitrectomy was performed on the vitreous within the anterior chamber and pupil. One day postoperative the IOP was 16 mmHg in the right eye (OD) and 20 mmHg OS. Postoperative iridocyclitis was managed medically, and additional elevations in IOP were not recorded. Resolution of the elevated IOP following anterior vitrectomy was supportive of pupillary block or malignant glaucoma. Vision returned 3 weeks after the initial surgery. Two years after the initial injury, the eye is visual and comfortable with infrequent topical anti-inflammatory therapy.
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PMID:Anterior lens capsule disruption and suspected malignant glaucoma in a dog. 1207 63

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.
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PMID:Iris prolapse at the surgical site: a late complication of nonpenetrating deep sclerectomy. 1266 29

This technique manages vitreous prolapse associated with posterior capsule rupture during phacoemulsification by performing small-gauge pars plana vitrectomy with a sutureless, self-sealing incision performed in a closed chamber, maintaining normal intraocular pressure. A high-speed cutter exerts minimal traction on the vitreous. Accessibility to the vitreous through the pars plana is better, ensuring more complete removal of the vitreous and restoration of normal anatomy.
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PMID:Small-gauge, sutureless pars plana vitrectomy to manage vitreous loss during phacoemulsification. 1551 56

This retrospective case series describes ocular side-effects associated with imatinib mesylate (Gleevec) and the clinical characteristics of these adverse reactions. A chart review of 104 patients on imatinib mesylate therapy from Oregon Health & Science University's Cancer Center were studied with regard to ocular side-effects. In addition, spontaneous reports from the Food and Drug Administration, the World Health Organization, and the National Registry of Drug-Induced Ocular Side-Effects databases were reviewed, including a Medline literature search. Seventy-three (70%) of the patients at OHSU developed periorbital edema and 19 patients (18%) developed epiphora after receiving imatinib mesylate. Average dose was 407.5+/-60 mg. Periorbital edema occurred an average of 68+/-48 days after initiation of therapy. WHO classification of side-effects is as follows: certain: periorbital edema; probable: epiphora; possible: extraocular muscle palsy, ptosis, blepharoconjunctivitis; unlikely: glaucoma, papilledema, retinal hemorrhage, photosensitivity, abnormal vision, and increased intraocular pressure. Periorbital edema and epiphora are the two most common ocular side-effects related to imatinib mesylate therapy. Clinical characteristics of imatinib mesylate induced periorbital edema are described. Management of ocular side-effects is conservative except in very rare cases of visually significant periorbital edema.
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PMID:Ocular side-effects associated with imatinib mesylate (Gleevec). 1296 61

We report a case of surprachoroidal hemorrhage (SCH) that occurred during cataract surgery in a previously vitrectomized eye. The only sign of SCH was a progressive shadow obscuring the red reflex. There was no increase in intraocular pressure (IOP), shallowing of the anterior chamber, or iris prolapse. Postoperatively, the SCH gradually resolved without complications, leaving a series of subretinal pigmentary lines. Surgeons should be aware that the signs normally expected in SCH may not develop in vitrectomized eyes. Obscuration of the red reflex may be the only sign of the hemorrhage, and when this happens, it may be prudent to keep the IOP elevated and suture the incision at the end of the procedure.
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PMID:Suprachoroidal hemorrhage during cataract surgery in a vitrectomized eye. 1603 5

Non-penetrating trabeculectomy (NPT) is effective in preventing numerous postoperative complications encountered with trabeculectomy. Recently, NPT has been modified to further reduce intraocular pressure (IOP) by combining other techniques. However, these modified NPT methods would make the globe even weaker than NPT alone. Here, we report a case of iris prolapse caused by blunt ocular trauma after NPT with sinusotomy and mitomycin C treatment. A 68-year-old man, who underwent NPT with sinusotomy and mitomycin C treatment, suffered from blunt ocular trauma to his left eye 28 days after surgery. The iris prolapsed from the sinusotomy site. Iridectomy, scleral suturing, and pars plana vitrectomy were performed. The bleb was absent post-re-operatively. Iris prolapse occurs uncommonly following simple NPT. However, additional sinusotomy and mitomycin C treatment render the globe weaker, and iris prolapse might occur. Iris prolapse increases risks in developing secondary infections and a loss of the filtration bleb. Thus, precautions are needed postoperatively.
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PMID:Iris prolapse after non-penetrating trabeculectomy with sinusotomy and mitomycin C. 1786 33


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