Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ninety-six patients who had undergone single-plate Molteno implantation for glaucomas with poor surgical prognoses were re-evaluated for long-term results. Control of intraocular pressure was achieved with one single-plate implant to a level less than 22 mmHg (but greater than 5 mmHg) without reoperation or devastating complications in 46% of the aphakic/pseudophakic eyes, 25% of eyes after failed filters, 25% of eyes with neovascular glaucomas, and 26% of eyes in patients younger than 13 years of age (life-table analysis at 5 years). Five-year success rates improved to 53%, 71%, 40%, and 56%, respectively, when data from second plates were included. Visual acuities improved or remained the same after one or two plates were implanted in 47% of aphakic/pseudophakic eyes, 17% of eyes after failed filters, 65% of eyes with neovascular glaucomas, and 63% of eyes in patients younger than 13 years of age on whom Snellen acuity was available. The most frequent overall complications after implantation of one or two plates included: corneal edema (19%), corneal graft decompensation (13%), and cornea-tube touch, retinal detachment, and cataract (8% each).
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PMID:Clinical experience with the single-plate Molteno implant in complicated glaucomas. Update of a pilot study. 159 11

Clinical features of capsular glaucoma during a recent 15-year period were compared with those of primary open-angle glaucoma (POAG). Out of 1623 new glaucoma patients, 263 patients (16.2%) were capsular glaucoma and 268 (16.5%) were POAG. The patients with capsular glaucoma were older than the patients with POAG. The former had higher intraocular pressure, lower visual acuity, more advanced visual field change and heavier trabecular pigmentation than POAG patients at the time of initial examination. These findings suggest that capsular glaucoma is more difficult to manage than POAG and that the prognosis is poorer than for POAG. Pseudoexfoliative material was found on the pupillary border in 98.3%, on the central lens surface in 46.1%, and on the peripheral lens surface in 72.3%. Though 190 of 263 patients with capsular glaucoma (73.9%) were unilateral cases, 38.9% of the fellow eyes had some abnormalities related to glaucoma. Phakodonesis was found in 10% of patients with capsular glaucoma. This finding suggests that the presence of capsular glaucoma might be a risk factor in cataract surgery.
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PMID:Clinical features of capsular glaucoma in comparison with primary open-angle glaucoma in Japan. 160 70

Twenty-five eyes (23 patients) with inflammatory cystoid macular edema (CME) (11 after cataract surgery and 14 eyes (12 patients) with uveitis) were followed in a prospective open study. The aim was to determine the efficiency of a combined treatment of Diamox (acetazolamide), Voltaren Ophtha (diclofenac, a NSAID) and Ultracortenol (prednisolone acetate) and in the case of treatment failure, the usefulness of posterior subtenon's injections of corticosteroids (Kenacort 40 mg (triamcinolone)). Seven eyes (all pseudophakic CMEs) responded successfully to the initial therapy. Their mean visual acuity improved from 0.31 +/- 0.13 to 0.93 +/- 0.08 after 18 +/- 5 days (p less than or equal to 0.001). Of the sixteen of 18 evaluable eyes that were additionally treated with a mean of 3.28 +/- 1.07 three-weekly posterior subtenon's injections, 15 eyes including all uveitis CME responded to treatment. Their mean visual acuity improved from 0.49 +/- 0.20 to 0.96 +/- 0.31 (p less than or equal to 0.001). Two patients were excluded; in 22/23 eyes the sequential treatment was successful with an overall success rate of 95% of cases (improvement of five lines on the Snellen chart or final visual acuity of 0.8 or better). Initial angiographic cystoid macular edema was comparable and significantly improved after therapy in the two treatment groups. No mean intraocular pressure rise was noted after steroid injections. Measurement of anterior chamber inflammation with the laser flare-cell meter (Kowa FC-1000) showed elevated flare in all cases which significantly decreased in both treatment groups and represented a good follow-up parameter for the effect of antiinflammatory treatment and restoration of blood-ocular barrier.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Differential treatment of postoperative and uveitis-induced inflammatory cystoid macular edema]. 161 2

The authors evaluated the systemic and ocular hypotensive effects of nicardipine hydrochloride (Perdipine:NH) in 31 cases with acute hypertension (over 160/95 mmHg) during cataract surgery. All cases received an intravenous bolus injection of NH 30 micrograms/kg. Blood pressure and intraocular pressure were compared with level at rest, a preoperatively and 5 minutes after the administration of NH. Blood pressure significantly elevated from 136.9 +/- 10.6/73.4 +/- 10.2 mmHg at rest to 187 +/- 11.5/98 +/- 13.1 mmHg preoperatively (p less than 0.001), but it significantly reduced to 125.6 +/- 13.1/67.1 +/- 8.3 mmHg 5 minutes after the administration of NH (p less than 0.001). On the other hand, in the same way an blood pressure changed, intraocular pressure significantly elevated from 13.3 +/- 2.8 mmHg at rest to 19.8 +/- 2.9 mmHg preoperatively (p less than 0.001), but significantly reduced 17.1 +/- 3.0 mmHg 5 minutes after administration of NH (p less than 0.001). The hypotensive effect of NH continued for over 90 minutes. There were no side effects apart from mild tachycardia in all cases. NH is safe, easy to administer and useful for control of acute hypertension during limited-period surgery such as cataract surgery.
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PMID:[Control of blood pressure by a calcium antagonist during cataract surgery]. 162 96

Eighty-one eyes which had had trabeculectomy with a mean follow-up period of 9.2 years (range 7 to 10 years) were studied retrospectively for their subsequent pattern of intraocular pressure. Of 43 chronic open-angle glaucoma eyes, 29 (67%) had their pressures maintained below 21 mmHg by trabeculectomy alone over a 7-10-year period. On the other hand, 25 of 38 (65%) eyes with other types of glaucoma required an average of 1.5 different antiglaucoma medications post-op for the control of their intraocular pressures. Fifteen of 69 (22%) phakic eyes required cataract extraction at a mean of 5.1 years post-op. Two of 43 (5%) chronic open-angle glaucoma eyes suffered blinding complications attributable to the procedure. Seventeen percent: of eyes gained visual field at a mean of 7% of the pre-op field per year following trabeculectomy. Fifty percent lost field at a mean rate of 2.3% per year.
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PMID:Long-term post trabeculectomy intraocular pressures. 163 89

In seven eyes of four patients, retinal hemorrhages were observed following trabeculectomy under both local and general anesthesia. The hemorrhages were diffuse, both deep and superficial, and many had white centers when first observed. Two patients were young healthy male myopes undergoing primary trabeculectomy. The third patient was a young man with chronic uveitis. The fourth patient was an elderly man with primary open angle glaucoma who had an acute rise in intraocular pressure following cataract extraction. Intraocular pressure and visual results appeared unaffected by the hemorrhages. Retinal hemorrhages associated with ocular decompression appear to be relatively benign.
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PMID:Complications of glaucoma surgery. Ocular decompression retinopathy. 163 82

In the present prospective study, we compared the results of cataract surgery in two groups with or without exfoliation syndrome; 210 eyes were studied. The preoperative pupillary dilatation was smaller in the group with exfoliation syndrome (SE). We noticed a higher incidence of complications during planned extracapsular cataract extraction in patients with SE. A pupillary diameter smaller than 6 mm increases the incidence of capsulozonular rupture (22.5%) in these patients. After surgery, an inflammatory reaction and a transient increase in intraocular pressure were more frequent and the visual results were less favourable in the group with SE. The exfoliation syndrome is a major risk factor for cataract surgery. We recommend extracapsular extraction associated with a sector iridectomy when the pupillary diameter measures less than 6 mm.
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PMID:[Exfoliative syndrome and cataract surgery]. 164 74

The results achieved in the treatment of secondary traumatic cataract using either Nd-YAG laser or surgical discussion in 41 patients at the Department of Ophtmhalmology, School of Medicine, University of Zagreb in the period between 1987 and 1989 are presented. Good visual acuity was achieved in 60% of the patients who were treated by Nd-YAG laser, and in 28% of those who had surgical discussion. Transitory increase of intraocular pressure measured 2 hours after Nd-YAG laser application was observed in 90% of the subjects. Transitory increase of IOP correlated negatively with the total amount of the applied laser energy. In 24 hours following surgical discussion no increase of IOP was noted. Postoperative complications of vitreous prolapse and bullous keratopathy were found in 4 patients treated by surgical discussion.
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PMID:[The neodymium YAG laser and surgical discission in traumatic cataracts]. 166 30

To prevent vitreous body prolapse in cataract extraction, intraocular pressure is reduced by means of beta-adrenoblockers instillation (timolol 0.5% solution) in the evening and 2 hours before surgery in the morning. Intraocular pressure was followed up in 59 patients with senile and 12 with complicated cataract subjected to cataract cryoextraction by the same surgeon. The pressure decreased by 5.6 +/- 1.3 mm Hg. Prolapse of the vitreous body occurred in 1 case.
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PMID:[Use of beta adrenergic blockaders in the prevention of vitreous body prolapse in cataract extraction]. 167 3

This article reviews standard treatment modalities for patients with glaucoma and describes 3 classes of drugs which are undergoing development: apraclonidine (aplonidine, ALO 2145), an alpha 2-adrenergic agonist which has been released for clinical use; topical carbonic anhydrase inhibitors, a modification of the systemic carbonic anhydrase inhibitors currently in use; and prostaglandins (PGs), a new class of drugs with topical ocular hypotensive activity. Standard treatment modalities include parasympathomimetic agents such as pilocarpine, carbachol, and phospholine iodide, which lower intraocular pressure (IOP) by increasing aqueous outflow through the trabecular meshwork. A newer form of pilocarpine as a gel produces a longer action. Adrenergic agonist medications, such as epinephrine (adrenaline) and its prodrug dipivefrine (dipivalyl epinephrine), function by increasing uveoscleral outflow and trabecular outflow facility. A decrease in aqueous formation by the ciliary processes is thought to be the mechanism of action of beta-adrenoceptor antagonists, but the physiological basis for this action has not been clearly demonstrated. A newer beta-blocker, betaxolol, has relatively selective beta 1-blocking activity. Carbonic anhydrase inhibitors are nonbacteriostatic sulphonamide derivatives which decrease aqueous formation by the ciliary body. Almost 50% of patients taking these medications are unable to tolerate them because of their adverse effects, and there is thus much interest in the development of a topical carbonic anhydrase inhibitor with the potential for fewer adverse effects. MK 507 is the most recent and most potent compound in the series of topically active carbonic anhydrase inhibitors. Apraclonidine hydrochloride is a derivative of clonidine hydrochloride, an alpha 2-adrenergic agonist. Clonidine has previously been shown to lower IOP significantly, but has the potential to produce marked lowering of both systolic and diastolic blood pressures. Its major ocular effect appears to be a decrease in aqueous production. The structural modification to apraclonidine decreases corneal absorption and the drug's ability to cross the blood-brain barrier, minimising the risk of centrally mediated cardiovascular side effects. Apraclonidine may also influence secondary avenues of aqueous outflow, such as uveoscleral outflow, and may also affect conjunctival and episcleral vascular flow. It produces a mean decrease in IOP of 25% for as long as 12 hours. Adverse effects include blanching of the conjunctiva, minimal mydriasis and eyelid retraction. This drug has been approved in the US for use in prevention of elevated IOP after argon laser trabeculoplasty and iridotomy, and has potential uses in preventing an IOP rise after YAG laser posterior capsulotomy and cataract surgery in patients already on other antiglaucomatous medications.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:New developments in the drug treatment of glaucoma. 171 57


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