To evaluate the effects of mitomycin C(MMC) on the fibrous capsule of the anterior chamber tube shunt to a surgical membrane(ACTSSM) surgery, 0.04% MMC solution was applied on the episclera for 5 minutes before ACTSSM surgery(group A, 9 rabbits). At postoperative 2, 4 and 8 weeks, 6 eyes of the 3 rabbits from each group were enucleated and light microscopic examinations of the fibrous capsules were done. In group A, fibrous capsules had many microcystic spaces and fibrous tissues between twofold surgical membranes were scanty. But in control group(group B, 9 rabbits), fibrous capsules showed higher density of fibroblast and less microcystic spaces than group A, suggesting low permeability of the fibrous capsule to aqueous humor. These results suggest that MMC may increase the success rate of the ACTSSM surgery.
Anterior Chamber* ; Aqueous Humor ; Capsules ; Fibroblasts ; Membranes* ; Mitomycin* ; Permeability ; Rabbits*

Cyclodialysis and ciliochoroidal detachment was performed in one eye of three rabbits and in one eye of another three rabbits respectively. 0.1 ml of 10% sodium fluorescein was injected intracamerally after aspiration of aqueous humor and the eyeball was enucleated between 30 minutes and one hour after sodium fluorescein injection and prepared for fluorescence microscopy. Sodium fluorescein concentration in supraciliary space was much greater in group with cyclodialysis or ciliochoroidal detachment than in normal control group. These results suggest that in the eye with cyclodialysis, aqueous humor may gain access freely to supraciliary space through the cleft between anterior chamber and supraciliary space and then is removed rapidly and in the eye with ciliochoroidal detachment, aqueous humor may pass through uveoscleral outflow pathway.
Anterior Chamber ; Aqueous Humor* ; Fluorescein ; Microscopy, Fluorescence ; Rabbits

PURPOSE: The aim of this study is to determine the soluble Fas (sFas) levels in both sera and aqueous humor in patients with uveitis and compare them to the uveitis severity. METHODS: We measured the sFas levels in both sera and aqueous humor (AH) of patients (n=40) with uveitis and non-uveitis controls (n=27). The patients with uveitis comprised 24 Behcet's disease, 6 panuveitis, 5 anterior uveitis, 2 lens induced uveitis, 1 Vogt-Koyanagi-Harada-disease, 1 sarcoidosis, and 1 retinal vasculitis. The severity of uveitis was determined by the Hogan's grading method (0~4 grade) at the time of sampling. RESULTS:The concentration of aqueous sFas in uveitis patients was significantly higher than that in nonuveitis controls, while there was no difference in the serum concentration of sFas between the two groups. In the paired samples of serum and AH, obtained simultaneously, the aqueous sFas levels were higher than serum Fas levels in patients with uveitis, whereas the non-uveitis controls displayed significantly lower sFas levels in AH than in the serum. The sFas levels in AH or serum were not different between Behcet's uveitis and non-Behcet's uveitis. However, in patients with Behcet's uveitis, circulating sFas strongly correlated with aqueous sFas, which was not so in those with non-Behcet's uveitis. Patients (n=29) with more active (grade> or =2) uveitis had significantly higher levels of aqueous sFas than those (n=11) with less active (grade<2) uveitis. After treatment with steroid and/or immunosuppressive agents, aqueous sFas levels were decreased in parallel with a reduction in the number of inflammatory cells in the anterior chamber. CONCLUSIONS: The levels of sFas were elevated in patients with uveitis and correlated well with uveitis severity.
Anterior Chamber ; Aqueous Humor ; Humans ; Immunosuppressive Agents ; Panuveitis ; Retinal Vasculitis ; Sarcoidosis ; Uveitis* ; Uveitis, Anterior

We observed the breakdown of the blood-aqueous barrier after trabeculectomy with mitomycin C by using laser flaremeter. There were 20 patients (25 eyes) of which 9 patients(11 eyes) were applied 0.02% MMC for 3minutes during the trabeculectomy and 11 patients (14 eyes) were not applied MMC. All patients were diagnosed as primary open angle glaucoma and underwent trabeculectomy. The preoperative, postoperative 1 day and 3 months aqueous flare intensity were 10.8+/- 5.05, 15.6+/- 5.32, 10.1+/- 4.55(photon count/msec)in group with MMC and 10.6+/-4.04,15.9+/-3.30, 9.2+/-3.94(photon count/msec) in group without MMC Anterior chamber flares were highest on the first postoperative day, declining rapidly in the first week with more gradual recovery to preoperative level by 1 month postoperatively, which shows the breakdown of blood-aqueous barrier by surgery. There was no statistically significant difference between the two groups in postsurgical aqueous flare intensity. 0.02% MMC does not appear.
Anterior Chamber ; Aqueous Humor ; Blood-Aqueous Barrier* ; Glaucoma, Open-Angle ; Humans ; Mitomycin* ; Trabeculectomy*

Iridescent cholesterol crystals in the anterior chamber are unusual finding. Although the clinical picture of phacolytic glaucoma is well recognized, the nature of the iridescent or hyperrefringent crystals is not well understood. A 70 years old womon presented with the acute onset of monocular pain and redness. The examination revealed a high intraocular pressure (42 mmHg), conjunctival hyperemia, and diffuse corneal edema. The heavy flare and pseudohypopyon were seen in the anterior chamber associated with iridescent or hyperrefringent particles. The anterior chamber aspirate obtained at operation was subsequently examined by wet field microscopy. Wet field microscopy showed that macrophages identified histologically in the aspirate corresponded to regular round cells about two to three times the size of an leukocyte. And, notched rectangular platelike crystals were typical morphologically of cholesterol, varied in size, and contacted each other. We found cholesterol crystals in aqueous humor of the eye with phacolytic glaucoma.
Aged ; Anterior Chamber ; Aqueous Humor* ; Cholesterol* ; Corneal Edema ; Glaucoma* ; Humans ; Hyperemia ; Intraocular Pressure ; Leukocytes ; Macrophages ; Microscopy

PURPOSE: To investigate the morphologic changes of anterior chamber angle and trabecular meshwork during development in human fetal eyes, 77 eyes was enrolled in this study. METHODS: The sequential development of iridocorneal angle and trabecular meshwork were examined using light microscopy in 77 eyes with a gestational age ranged from 7 to 40 weeks. RESULTS: It was found that the presence of openings in the anterior chamber angle lining and aqueous humor drainage was effective by 20~22 weeks of fetal life and intercellular gaps become larger and more frequent as development progresses. During the gestational age(28~30 week), the anterior ahamber was located at the middle of the trabecular meshwork. During the gestational age(32~38 week), the intertra-becular space was widen with the apparent presence of the Schlemm's canal. CONCLUSIONS: The arrest or abnormal differetiation during the gestational period may cause the dysfunction of aqueous humor outflow, to develop congenital glaucoma.
Anterior Chamber* ; Aqueous Humor ; Drainage ; Fetus ; Gestational Age ; Glaucoma ; Humans* ; Microscopy ; Trabecular Meshwork*

Alteration of the chemical composition of aqueous humor may be closely related to the occurrence of glaucoma. Comparison of chemical composition of aqueous humor in glaucoma patients with that of the normal eyes is thought to be helpful in searching the pathogenesis and treatment modality of glaucoma. Concentration of 8 chemical components in the aqueous humor of cataract eyes as well as glaucoma eyes was analyzed and the differences between the two groups were searched by the authors. Subjects were 47 eyes of 47 cataract patients and 35 eyes of 32 glaucoma patients. During the operation 0.1-0.2cc of aqueous humor was collected by anterior chamber paracentesis and 10cc of blood was also drawn. In cataract patients, the mean values were Na+;145.2, K+;4.0, Cl-;123.7, HCO3-; 22.9 mEq/l, Ca++;6.6, Mg++;1.7, glucose; 48.2 mg/100 ml and ascorbic acid; 245.5 microgram/ml. In glaucoma patients, the mean values were Na+;142.1, K+;4.0, Cl-;126.0, HCO3-;17.6 mEq/I, Ca++;6.3, Mg++;1.9, glucose; 59.4 mg/100 ml and ascorbic acid; 227.5 microgram/ml. Aqueous glucose concentration was 55% of blood glucose level, and aqueous ascorbic acid concentration was 62 times higher than that in blood. Regarding the eight components in aqueous humor, no significant difference was found between cataract and glaucoma patients. Lack of significant difference in ascorbic acid levels between the two groups was thought to be due to the use of carbonic anhydrase inhibitors prior to glaucoma surgery.
Anterior Chamber ; Aqueous Humor* ; Ascorbic Acid ; Blood Glucose ; Carbonic Anhydrase Inhibitors ; Cataract* ; Glaucoma* ; Glucose ; Humans ; Paracentesis

PURPOSE: To report the results of anterior vitrectomy for obstruction of the aqueous outflow shunt by prolapsed vitreous strands after trabeculectomy. CASE SUMMARY: Trabeculectomy was performed on a pseudophakic primary open angle glaucoma patient with uncontrolled intraocular pressure under maximum tolerable medical therapy. Three months after trabeculectomy, the bleb flattened and the intraocular pressure elevated. On gonioscopic examination, vitreous strands prolapsed through the iridectomy site obstructing the inner ostium. The maximum tolerable medical therapy and Nd:YAG laser vitreolysis were attempted, but the intraocular pressure was not controlled. Anterior vitrectomy was performed to remove the prolapsed vitreous strands. After anterior vitrectomy, the bleb regained filtering function and the intraocular pressure was stabilized. CONCLUSIONS: In a case with a prolapsed vitreous into the anterior chamber obstructing the outflow shunt of the aqueous humor after trabeculectomy, anterior vitrectomy showed therapeutic effects.
Anterior Chamber ; Aqueous Humor ; Blister ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Iridectomy ; Prolapse ; Trabeculectomy ; Vitrectomy

PURPOSE: To report the results of anterior vitrectomy for obstruction of the aqueous outflow shunt by prolapsed vitreous strands after trabeculectomy. CASE SUMMARY: Trabeculectomy was performed on a pseudophakic primary open angle glaucoma patient with uncontrolled intraocular pressure under maximum tolerable medical therapy. Three months after trabeculectomy, the bleb flattened and the intraocular pressure elevated. On gonioscopic examination, vitreous strands prolapsed through the iridectomy site obstructing the inner ostium. The maximum tolerable medical therapy and Nd:YAG laser vitreolysis were attempted, but the intraocular pressure was not controlled. Anterior vitrectomy was performed to remove the prolapsed vitreous strands. After anterior vitrectomy, the bleb regained filtering function and the intraocular pressure was stabilized. CONCLUSIONS: In a case with a prolapsed vitreous into the anterior chamber obstructing the outflow shunt of the aqueous humor after trabeculectomy, anterior vitrectomy showed therapeutic effects.
Anterior Chamber ; Aqueous Humor ; Blister ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Iridectomy ; Prolapse ; Trabeculectomy ; Vitrectomy

During filtration surgery for glaucoma, the conjunctival incision site is sutured watertightly with a suture material like 10-0 nylon. However, this suture material may cause the infiltration of inflammatory cells, and the proliferation and migration of fibroblasts and collagen fibers at the junction of the conjunctiva and episclera. Subsequently, the arrangement of collagen fiber in episclera would be disrupted and the outflow of aqueous humor could be occluded. In the search for a more suitable suture material, the fibrin glue(Tisseel(R)) was introduced recently. It is claimed to be simple to use and safe, causes less damage and less inflammatory reaction than nylon. The authors used 10-0 nylon(control group) on the right eye and fibrin glue(Tisseel(R))(experimental group) on the left eye of a white rabbit's conjunctival suture. We compared and evaluated the clinical and histological effects of the suture material on the suture site as well as on the intraocular region. The results were as follows; 1. In the experimental group, conjunctival injection and chemosis were mild and disappeared rapidly. 2. The filtering bleb was macroscopically well formed and maintained from the third postoperative day in both groups, but, thereafter, it decreased in size in two cases of the control group. 3. There was no difference in the inflammatory reaction in anterior chamber in both groups postoperatively. 4. In the experimental group, there was loosening of the fibroblasts proliferation and lesser infiltration of inflammatory cells at the postoperative second and fourth week. And the arrangement of collagen fibers in episclera was intact. The above findings strongly suggest fibrin glue(Tisseel(R)) as a suture material in the filtration surgery of glaucoma is clinically promising.
Anterior Chamber ; Aqueous Humor ; Blister ; Collagen ; Conjunctiva ; Fibrin* ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma ; Nylons ; Rabbits* ; Sutures