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Query: UMLS:C0595921 (intraocular pressure)
 11,750 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Aniridia is an uncommon disorder that may be associated with glaucoma that is usually refractory to conventional medical and surgical therapy. In this study, we report our experience with the surgical management of glaucoma in aniridia in 17 eyes of 10 patients. A total of 45 surgical procedures were performed. The mean preoperative intraocular pressure was 38 mm Hg. The intraocular pressure was ultimately controlled successfully in 11 eyes (intraocular pressure range, 8 to 20 mm Hg) with a mean of 2.8 surgical procedures required in successful cases. Trabeculectomy controlled the intraocular pressure in one eye, but it was successful in only 9% of cases in which it was performed. Cyclocryotherapy was successful in five eyes (25% of cases in which it was performed), although complications of phthisis bulbi and progressive cataract occurred. We detail our experience with the Molteno implant, which was successful in five eyes (83% of cases in which it was performed). We have found this type of drainage device to be effective in controlling intraocular pressure in aniridic eyes when previous attempts at control have failed.
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PMID:The results of glaucoma surgery in aniridia. 156 57

Fifty-five eyes of 51 patients with different forms of refractory glaucoma (15 aphakic, 12 neovascular, 9 postpenetrating keratoplasty, 8 congenital, 5 secondary to uveitis, 4 associated with aniridia, 1 pseudophakic, and 1 traumatic) underwent antiglaucomatous surgery using a modified 90 degrees Schocket implant. In 25 eyes (45.4%), this was the first surgical procedure. Follow-up ranged from 3 to 27 months (mean, 10.3 +/- 5.4 months). The mean preoperative intraocular pressure (IOP) was 39.5 +/- 8.6 mmHg (range, 22 to 66 mmHg). The mean postoperative IOP was 17.8 +/- 7.6 mmHg (range, 4 to 50 mmHg). Intraocular pressure remained less than 21 mmHg in 50 eyes (90.9%) during the follow-up period. In 13 of these eyes (26.0%), IOP remained under control without any medication. Complications were observed in 13 eyes (23.6%) and were successfully treated in 11 of them. Complications included iris-tube block (5.4%), vitreous-tube block (3.6%), early postoperative flat anterior chamber (1.8%), choroidal effusion (3.6%), tube exteriorization from anterior chamber (3.6%), tube displacement from silicone band (1.8%), retinal detachment (1.8%), tube-cornea touch (1.8%), vitreous hemorrhage (1.8%), infectious endophthalmitis (1.8%), and phthisis bulbi (1.8%). Modified 90 degrees Schocket implants are an effective technique in the management of refractory glaucoma.
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PMID:Modified Schocket implant for refractory glaucoma. Experience of 55 cases. 200 79

We report on our results of transscleral Nd-YAG-cyclophotocoagulation on 27 eyes with refractory glaucoma. Cyclophotocoagulation was performed with similar parameters according to our findings of morphological investigation in normal human donor eyes. 9 eyes had hemorrhagic glaucoma, 10 eyes had secondary glaucoma after intraocular silicone oil tamponade because of proliferative diabetic retinopathy or because of complicated retinal detachment with proliferative vitreoretinopathy. None of the patients in this group had silicone oil in the anterior chamber, silicone oil emulsification and only one eye had rubeosis iridis. The third group of 8 eyes had glaucoma with aniridia, post-traumatic or postinflammatory glaucoma, glaucoma after extraction of a congenital cataract and one eye with an absolute painful pseudoexfoliation glaucoma. The effects were applied coaxially through the conjunctiva at 1 to 1.5 mm distance from the limbus. The energy was between 3.8 and 4.2 Joules, the exposure time was 10 ms. The focus of the laser beam was placed 3.6 mm posteriorly with a focus adjustment of 9 at the LASAG Microruptur 2. The mean postoperative observation period was 7.5 months. Among the group of hemorrhagic glaucomas the intraocular pressure could in 78% be lowered below 22 mmHg, in 60% among the secondary glaucomas after intraocular silicone oil application and in 50% among the heterogenous third group. In eyes with preceding cyclocryocoagulation 82% fulfilled this criterion. The intraocular pressure stayed stable after 4 weeks at a mean level of 40% below the preoperative values. In all cases the intraocular pressure was at least lowered by 14 mmHg. Vision was reduced in three eyes by the underlying disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical use and results of trans-scleral Nd-YAG cyclophotocoagulation in therapy-refractory glaucoma]. 205 34

Presented are the results of surgical treatment glaucoma in congenital aniridia (10 eyes), in the syndrome of closed anterior chamber (7 eyes), in Sturge-Weber's syndrome (7 eyes) in marfan's disease (2 eyes), in Lowe's disease (2 eyes) and Recklinghausen's disease (1 eye). Trabeculectomy was performed in this majority of cases; in cleavage syndrome it was connected with cataract extraction. In Marfan's disease with lensectomy of a luxated lens. Cyclocryopexy and cyclodiathermy were applied as secondary surgical interventions. In general--44 operations were performed obtaining normalization of the intraocular pressure in 82% of eyes.
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PMID:[Treatment of glaucoma in children in congenital pathologic syndromes]. 262 43

An automated trephine (trabecuphine) was used to perform an internal sclerectomy in seven glaucoma patients who were aphakic or had undergone previous filtering surgery that had failed or both. A patent fistula was achieved intraoperatively in all seven eyes. Postoperatively, six patients received subconjunctival injection of 5-fluorouracil (5-FI) once daily for an average of 8 days. Five of seven patients have retained a functional bleb and a controlled intraocular pressure (IOP) after surgery (follow-up, 4-24 months). The only intraoperative complication was hemorrhage from the sclerectomy site in a patient with aniridia that resulted in a 20% hyphema. The hyphema cleared quickly, and the bleb has remained functional with a pressure of 12 mmHg for 9 months. The trabecuphine makes it possible to perform a glaucoma filtering operation safely from within the anterior chamber. This technique minimizes conjunctival trauma in the filtration area. The absence of a conjunctival incision overlying the fistula simplifies the adjunctive use of antimetabolites such as 5-FU.
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PMID:Internal sclerectomy with an automated trephine for advanced glaucoma. 321 73

A massive impalement injury to a 46-year-old man led to corneoscleral laceration, partial aniridia, traumatic cataract and rupture of the orbiculus ciliaris of more than one third of the circumference with extreme hypotony and practically blinding. In addition there was a massive circular haemorrhage into the suprachorioidal space. The course of the operative intervention leading to complete replantation of the ciliary body and so finally to normalisation of the intraocular pressure is described. The gratifying course could have been favoured by the diffuse retrochorioidal haemorrhage.
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PMID:Replantation of one third of the ciliary body after severe impalement injury. 682 8

Thirty-eight eyes were treated by adding timolol to the medical regimen. After a suitable trial, attempts were made to reduce other glaucoma medications. Fifteen eyes with infantile glaucoma treated surgically at birth, experienced elevated intraocular pressure later in life. Another 15 eyes had glaucoma associated with congenital anomalies such as aniridia, Sturge-Weber syndrome, and mesodermal malformations. The group with infantile glaucoma demonstrated an average drop in pressure of 24% and 22% after one and three months, respectively. Six of the 15 eyes were controlled at 22 mm Hg or less. In the other group, intraocular pressure fell 30% after one month and 12% after three months. Five of the 15 eyes were controlled. Adverse effects occurred in five patients, timolol therapy was discontinued in two (7%). The IOP was not controlled in any of the eyes with timolol alone.
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PMID:Timolol and pediatric glaucomas. 723 13

A case of aniridia associated with a membranous cataract and glaucoma in a 52-year-old woman was reported. Bilateral ocular findings included marked hypoplasia of the iris, goniodysgenesis, corneal opacification with superficial vascularization, macular hypoplasia and glaucoma. A membranous cataract was found in the right eye. The intraocular pressure was abnormally high. Since trabeculectomy on the right eye was ineffective, a seton procedure was carried out. During the follow-up period, the membranous cataract in the right eye spontaneously moved from its original position and floated in the vitreous, maintaining its shape.
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PMID:Membranous cataract in association with aniridia. 829 72

Zeiss Visulas YAG I Nd:YAG laser (Opton, Germany) was used in the treatment of 70 patients with three forms of secondary posttraumatic glaucoma (adhesive glaucoma with anterior-chamber adhesions and goniosynechias, adhesive glaucoma with aphakia-aniridia symptom complex, and aphakic malignant glaucoma). Laser synechiolysis was highly effective in patients with the first of the listed forms of glaucoma if the operation was performed as early as possible. The efficacy of hyaloidotomy, particularly peripheral, is confirmed; this modality in combination with drug therapy helps normalize intraocular pressure. The place of transpupillary laser hyaloidotomy in the treatment of aphakic malignant glaucoma is defined.
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PMID:[Laser surgery for some forms of secondary posttraumatic glaucoma]. 950 46

A 17-year-old male patient was referred for poorly controlled glaucoma on maximal medication, congenital aniridia, cataract, nystagmus, and hypoplasia of the macula. A bilateral filtering procedure was performed to control the glaucoma. Three months later, a slow motion phacoemulsification and implantation of a brown diaphragm intraocular lens (IOL) was attempted. Despite the presence of nystagmus and hypoplasia of the macula, the visual acuity improved from 20/300 to 20/100 in the right eye and from 20/400 to 20/150 in the left eye. Both aniridia IOLs were well centered, the anterior segment was quiet with normal intraocular pressure without medication, and all of the patient's glare symptoms disappeared. A single-piece iris diaphragm and optical lens offer a safe alternative for patients who previously had no viable options for iris reconstruction. The most serious postoperative problem, glaucoma, should be addressed before the cataract and lens implantation is performed to avoid a possible acceleration of the glaucoma progression by the large aniridia IOL.
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PMID:Bilateral cataract surgery combined with implantation of a brown diaphragm intraocular lens after trabeculectomy for congenital aniridia. 1244 32


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