No Abstract Available.
Silicones*

This study was conducted to establish glaucomatous diagnostic criteria and to investigate its sensitivity and specificity with the confocal scanning laser ophthalmoscope(TopSSTM) on the basis of the normal values of the optic disc parameters in previous study. Abnormal ratio of optic disc parameters were analysed in 80 primary open angle glaucoma eyes - the subjects were divided into three groups according to visual field defects, each group of mild, moderate, and severe. and then glaucomatous diagnostic critera was established. According to this diagnostic criteria, we calculated its sensitivity and specificity. We established the glaucomatous diagnostic criteria with high sensitive five parameters(1/2 depth area, C/D ratio, neuroretinal rim area(NRRA), volume above, and notching), the established criteria are 1) If NRRA is decreased, one of the four parameters is abnormal. 2) If NRRA is normal, notching and one of the other three parameters are abnormal. Notching was defined as decreased neuroretinal area at either 6 o/c or 12 o/c sector. With this criteria, the sensitivity was 89.7% in mild group and 100% in moderate and severe groups and the specificity was 89.1% in normal groups. This criteria showed high sensitivity and specificity in the diagnosis of glaucoma, so as to be useful in the early detection of glaucomatous spticdisc changes.
Diagnosis ; Glaucoma ; Glaucoma, Open-Angle ; Ophthalmoscopes* ; Reference Values ; Sensitivity and Specificity* ; Visual Fields

An attempt was made to observe the possibility of controlling intraocular pressure (IOP) without hypotony and ocular motility disorder by installing an experimentally designed glaucoma implant through a small conjunctival incision with the aid of a stylet and maintaining the aqueous reservoir using mitomycin C (MMC). The implant was made of silicone tube, of which one end was occluded by glue and on the same end 4 check-valve-like slits were made. Thirty-five healthy white rabbits were used and subdivided into 4 groups. In groups I to III, implants having 2.0, 2.5, 3.0 mm slit lengths, respectively, were installed with MMC application in one eye of each of the 10 rabbits. In group IV, a 2 mm slit-length implant was installed without MMC in one eye of each of the 5 rabbits. Pneumatonometry and ultrasonography were performed to check the IOP and the formation of aqueous reservoir in the implanted eyes for 8 weeks. In group I through III, there was a statistically significant 4-5 mmHg pressure-lowering effect in the implanted eyes compared to the contralateral control eyes for 8 weeks. The aqueous reservoirs were observed throughout the follow-up period. In group IV, we could observe neither a pressure-lowering effect nor aqueous reservoir formation in the implanted eyes after 2 weeks postoperatively. Hypotony did not occur in implanted eyes in any of the groups. This study shows the possibility of IOP control by installing a specially designed glaucoma implant with application of MMC.
Animals ; Anterior Eye Segment/ultrasonography ; Antibiotics, Antineoplastic/*therapeutic use ; Aqueous Humor/secretion ; Chemotherapy, Adjuvant ; Glaucoma/*therapy ; Intraocular Pressure ; Mitomycin/*therapeutic use ; Ocular Hypotension/prevention & control ; Ocular Motility Disorders/prevention & control ; *Prostheses and Implants ; Rabbits ; *Silicone Elastomers ; Tonometry, Ocular

We attempted to observe the expression of stromelysin, which regulates the extracellular matrix of trabecular meshwork and is one of the family of the matrix metalloproteinases, in the trabecular cells after transfection of replication deficient recombinant adenovirus vector containing stromelysin cDNA. Stromelysin cDNA was produced by RT-PCR with total RNA extracted from cultured human trabecular cells after induction with interleukin-1 alpha, and cloned by inserting the cDNA into the TA vector. Adenovirus vector that contains stromelysin cDNA was constructed by cotransfection of pJM17 and p delta A. CMV. PA-str into the 293 cells. The expression of stromelysin in the trabecular cells was assayed by Western blot and zymography. The sequence of stromelysin cDNA was consistent with that previously reported. The constructed adenovirus vector had stromelysin cDNA but had no E1 region. The expression of stromelysin in the trabecular cells by this vector was detected in 4 days and peaked in 7 days after transfection. In conclusion, this study showed the possibility of gene therapy in the glaucoma treatment by transfecting the trabecular cells with the replication deficient recombinant adenovirus vector containing stromelysin cDNA.
Adenoviridae* ; Blotting, Western ; Clone Cells ; DNA, Complementary ; Extracellular Matrix ; Genetic Therapy ; Glaucoma ; Humans* ; Interleukin-1alpha ; Matrix Metalloproteinase 3 ; Matrix Metalloproteinases ; RNA ; Trabecular Meshwork ; Transfection

Although adjunctive use of Mitomycin C(MMC)increased the success rate of trabeculectomy, intractable bleb leakage-related complications increased. As a consequence, demand for MMC related bleb leakage repair is increasing. We attempted to observe whether the cultured autologous fibroblast injected into the subconjunctival space of rabbit may be used as a new treatment modality in the MMC related bleb leakage. Similar situation to extensive bleb leakage after trabeculectomy with MMC was prepared by repeated injections of 0.1cc of 0.05% MMC into subconjunctival space in 30 eyes of 15 New Zealand white rabbits weekly for 3 times and devided them into control, autologous blood injection and autologous fibroblast injection groups. Then, we observed the change of conjunctiva and enucleated it for histopathologic study at 1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks, respectively. In control group, the conjunctiva was thin and transparent. Subconjunctival fibroblasts were hardly visible and collagen fibers were arranged coarsely. In contrast, cultured autologous fibroblast injection group showed thickened and less transparent conjunctiva along with packed fibroblasts and collagen fibers. In autologous blood injection group, the transparency of conjunctiva and the density of fibroblast and collagen fiber arrangement were between those of the other two groups. The cultured autologous fibroblast injection may be a feasible and an effective treatment modality in intractable bleb leakage after trabeculectomy with MMC.
Blister ; Collagen ; Conjunctiva ; Fibroblasts* ; Mitomycin* ; Rabbits ; Trabeculectomy

A 60-year-old man visited our clinic with a sudden blurred vision and ocular pain in his right eye occurring 15 years after cataract surgery. The intraocular pressure (IOP) was 55 mmHg in the right eye and gonioscopy revealed a wide open angle with white cortical lens material in the inferior angle. Since the IOP was unable to be controlled with medical therapy, removal of the lens material was performed by irrigation and aspiration. Following surgery, the IOP was decreased to 18 mmHg without medication and the patient's vision recovered to 20/20. The pathology of the aqueous humor showed macrophages with engulfed lens particles.
Aqueous Humor/*cytology ; Case Report ; Cataract Extraction/*adverse effects ; Glaucoma/*etiology/*pathology ; Human ; Lens, Crystalline/*pathology ; Macrophages/pathology ; Male ; Middle Age

PURPOSE: To evaluate the clinical manifestations and the factors associated with prognosis of the traumatic cyclodialysis patients who underwent direct cyclopexy. METHODS: The authors retrospectively analyzed the data of 23 eyes of 22 patients who underwent consecutive direct cyclopexy for the hypotonous cyclodialysis between 1997 and 2002 at the authors' institution. Perioperative A-scan and ultrabiomicroscopy were performed to evalaute correlation between the parameters and postoperative visual prognosis. RESULTS: Postoperatively, the mean increase of intraocular pressure was 11.1mmHg and the mean improvement of visual acuity was four lines of Han's Korean visual acuity chart. As the preoperative hypotony period was shorter, postoperative visual prognosis was better (p<0.05). Anterior chamber depth (p<0.0001), axial length (p<0.01), spherical equivalent (p<0.05), and intraocular pressure (p<0.0001) were increased, whereas lens thickness (p<0.0001) was decreased postoperatively. Transient postoperative ocular hypertension was controlled by adequate medication, and the patients' intraocular pressure were controlled below 20 mmHg without medications at the average of 19 days after the cyclopexy. Post-operative visual acuity was not significantly correlated with pre-operative intraocular pressure, pre-operative visual acuity, age, or sex. Preoperative extent of cyclodialysis was not significantly correlated with visual prognosis, postoperative development of cataract, intraocular pressure, or the cause of trauma. CONCLUSIONS: Direct cyclopexy is one of a successful method for the treatment of the hypotonous cyclodialysis cleft, and the early diagnosis and treatment are thought to be necessary for the improvement of visual prognosis.
Anterior Chamber ; Cataract ; Early Diagnosis ; Humans ; Intraocular Pressure ; Ocular Hypertension ; Prognosis ; Retrospective Studies ; Visual Acuity

No abstract available.
Education, Medical*

We analyzed the outcome of primary trabeculectomy performed with intraoperative 5-fluorouracil(5-FU) sponge application on episclera and under lamella scleral flap in seventeen uncomplicated glaucoma eyes. The mean preoperative intraocular pressure(IOP) was 36.8+/-11.0mmHg. The mean postoperative IOP was 14.2+/-3.5mmHg after mean follow-up of 11.4 months. Two eyes required additional anti-glaucoma medications. Compliations included chronic hypotony(1 eye), shallow anterior chamber(2 eyes), and hyphema (1 eye). No eye showed corneal problems, hypotonic maculopathy, and bleb leakage. This study suggests that a single intraoperative use of 5-FU in primary trabeculectomy is an effective way of improving IOP control and of decreasing complications in eyes with uncomplicated glaucoma.
Blister ; Fluorouracil* ; Follow-Up Studies ; Glaucoma ; Hyphema ; Porifera ; Trabeculectomy*

There are many factors affecting the outflow facility. Structural changes of aqueous outflow channel by ciliary muscle contraction play major role in the control of outflow facility. Although many studies on the physiology of outflow facility have been done by many authors, the lens effect on the ciliary muscle contractability has not been reported. We performed clear corneal phacoemulsification and foldable intraocular lens implantation in 42 cataract patients and measured intraocular pressure(IOP) pre and postoperatively by Goldmann applanation tonometer and determined outflow facility with and without 2% pilocarpine before and after cataract surgery, respectively. We analysed IOP changes after surgery, and assessed ciliary muscle contractability by analysing outflow facility changes. Statistical analysis was done by Wilcoxon`s signed rank test. IOP decreased by 2.4+/-0.4mmHg(mean+/-SEM)(P<0.001): outflow facility with and without pilocarpine increased by 0.080+/-0.012microliter/min/mmHg(P<0.001) and 0.045+/-0.006microliter/min/mmHg(P<0.01), respectively after lens extraction: outflow facility increased 2.8+/-0.4 times by pilocarpine itself after lens extraction(P<0.001). The lens connected to the ciliary muscle muscle by zonnule may have an influence on ciliary muscle contractability.
Cataract ; Humans ; Lens Implantation, Intraocular ; Muscle Contraction ; Phacoemulsification ; Physiology ; Pilocarpine