The pattern and morphology of cellular infiltration of iris melanocytes implanted into the corneal stroma were studied with a rabbit corneal model. Iris melanocytes are transformed into fibroblast-like cells with a loss of pigment granules, which may reflect the in vivo characteristics of iris melanocytes under pathologic conditions. The metaplastic chararter of iris melanocytes appears to be related to the formation of retrocorneal pigmentation and fibrous membrane.
Animals ; Cell Division ; Cornea/*cytology/pathology/surgery ; Iris/*cytology ; Melanocytes/*cytology/physiology/transplantation ; Metaplasia/pathology ; Rabbits

We report a case of ciliary body melanocytoma in a Korean patient, which presented as an intermittently painful pigmented iris mass and was successfully managed by iridocyclectomy. A 52-year-old healthy man presented with an irregularly-shaped and heavily-pigmented mass at the iris root of his right eye. Visual acuity of the right eye was 20/20 with normal intraocular pressure. Ultrasound biomicroscopy showed a 1.5x1.3-mm ciliary-body mass with extension into the iris root. Iridocyclectomy with scleral resection under a lamellar scleral flap was performed, and the histopathologic features of the resected tissue were consistent with melanocytoma of the ciliary body. The patient's visual acuity remained 20/20 with good postoperative cosmesis. During one year of follow-up, no signs of tumor recurrence were seen, and the patient reported resolution of the intermittent ocular pain in the involved eye.
*Ciliary Body/surgery ; Humans ; Iris/*pathology/*physiopathology/surgery ; Male ; Middle Aged ; Neoplasm Invasiveness/*pathology/physiopathology ; Nevus/*pathology/surgery ; Pain/*physiopathology ; Uveal Neoplasms/*pathology/surgery

To report on an epithelial inclusion cyst of the iris that was successfully treated with needle aspiration and Ab externo laser photocoagulation. A 6-year-old boy was treated for a 6.0 mm fluid-filled cyst in the anterior chamber of the right eye. Thirteen months previously, he had undergone primary closure of a 6 mm full-thickness corneal laceration. The subsequent cyst was diagnosed as an epithelial inclusion cyst of the iris. His vision decreased to finger-count at 30 cm as the cyst grew over the pupil. We performed needle aspiration of the cyst and Ab externo laser photocoagulation of the cyst wall. The treated lesion was completely removed. The patient's visual acuity recovered to 20/40 without complications. There was no recurrence as determined by slit lamp examination up to 6 months after treatment. Needle aspiration and Ab externo laser photocoagulation can be used to effectively treat epithelial inclusion cysts of the iris.
Biopsy, Fine-Needle ; Child ; Cornea/injuries ; Cysts/etiology/*pathology/surgery ; Epithelial Cells/*pathology ; Eye Injuries, Penetrating/complications/surgery ; Humans ; Iris Diseases/etiology/*pathology/surgery ; Lacerations/complications/surgery ; Laser Coagulation ; Male ; Play and Playthings/injuries

Iris neovascularization was produced in rabbits by hypotony following repeated aspiration of the vitreous. The hypotony was produced after 0.3 ml of vitreous fluid was aspirated using a 25-gauge needle through the pars plana of 10 rabbits. For the histochemical study, horseradish peroxidase(HRP) was injected through the ear lobe vein. After fixation of the iris tissue, the tissue was treated with diaminobenzidine and examined with both light microscopy and transmission electron microscopy. The newly-formed vessel was abundant, particularly on the upper stroma of the iris. The new vessel formation was evident due to the proliferation of endothelial cells, which may have been derived from preexisting iris vessels. The endothelial cells of the newly-formed vessels revealed prominent villous processes into the vascular lumen, formation of the marginal flap, numerous fenestrations in the endothelial junction, and reaction product onto extravascular space by the cytochemical electron microscopy. These results suggest that hypotony in the rabbit produces the disruption of the blood-iris barrier and the balance between angiogenesis-antiangiogenesis modulation.
Animals ; Biological Transport, Active ; Disease Models, Animal ; Horseradish Peroxidase/diagnostic use ; Iris/*blood supply/*ultrastructure ; Iritis/*pathology ; Neovascularization, Pathologic/*pathology ; Rabbits ; Vitreous Body/surgery

PURPOSE: To evaluate the characteristics of peripheral anterior synechiae (PAS) in primary angle-closure glaucoma (PACG). METHODS: We reviewed the charts of 155 patients (244 eyes) with PACG. We divided these patients into one of four clinical subtypes: acute angle-closure glaucoma (ACG), chronic ACG, angle-closure hypertension, and ACG suspect. The prevalence, extent, and location of PAS were evaluated according to PACG subtypes. Correlation analysis was used to evaluate relationships between the highest IOP level without treatment and the extent of PAS. RESULT: The average degree of angle-closure with PAS was 14.6+/-9.1 in eyes that were classified as ACG suspect, 83.8+/-48.3 in angle-closure hypertension, 140.5+/-31.3 in acute ACG, and 180.3+/-31.9 in chronic ACG (ANOVA test, P<0.05). PAS was most frequently found in the superior part of the eye, especially from 12 to 1 o'clock. The incidence of broad PAS (PAS over 30 degrees in width) was highest in superior part, but the medium and narrow PAS (PAS limited to within 30 degrees in width) was distributed throughout all 12 sectors relatively equally. Prior to a laser iridotomy (LI) and other medical treatments, a positive correlation was found between the highest IOP (intraocular pressure) levels and the extent of PAS in chronic ACG (r=0.423, P<0.0001). However, statistically significant relationships were not found between the highest IOP levels before treatment and the extent of PAS in any of the other clinical subtypes. CONCLUSIONS: Our results suggest that acute and chronic ACG patients are most likely to have a greater extent of PAS than patients in the angle-closure hypertension or ACG suspect subtypes. PAS may be narrower in earlier stages and broader in later stages. PAS was also found most frequently in the superior part of the eye. The extent of synechial closure of the angle may play a role in raising IOP levels in later stages of the disease rather than early on.
Severity of Illness Index ; Retrospective Studies ; Male ; Laser Surgery/methods ; Iris/surgery ; Intraocular Pressure ; Humans ; Gonioscopy ; Glaucoma, Angle-Closure/*pathology/physiopathology/surgery ; Follow-Up Studies ; Female ; Anterior Chamber/*pathology ; Aged

PURPOSE: In Asian countries, laser iridotomy for the treatment of angle-closure glaucoma is a common cause of bullous keratopathy, which may be associated with a shallow anterior chamber and dark iris pigmentation in Asians. Several cases of corneal decompensation after argon laser iridotomy have been reported. In the present study, we evaluated the harmful effects of argon laser iridotomy on the corneal endothelium. METHODS: Argon laser iridotomy was performed on the right eyes of pigmented rabbits. Changes in corneal thickness and endothelial cell density after laser iridotomy were evaluated. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) was performed for assessment of corneal endothelial cell apoptosis. Combined staining with alizarin red and trypan blue, as well as a live/dead cell assay, were performed for evaluation of damage to the corneal endothelium induced by laser iridotomy. RESULTS: Corneal thickness did not change immediately after laser iridotomy; however, a significant increase was observed 24 hours after iridotomy (p = 0.001). The endothelial cell density of laser-treated eyes four days after laser iridotomy was significantly decreased compared with control eyes (p < 0.001). TUNEL staining showed many TUNEL-positive cells in the corneal endothelium and corneal stroma. No endothelial trypan blue-stained cell nuclei were observed after laser iridotomy; however, several large endothelial cells with damaged membrane integrity were observed. The live/dead cell assay clearly showed a large number of dead cells stained red in several areas throughout the entire corneal button 24 hours after iridotomy. CONCLUSIONS: Argon laser iridotomy induces corneal endothelial cell apoptosis in pigmented rabbit eyes, resulting in decreased endothelial cell density.
Animals ; Apoptosis ; Corneal Diseases/pathology/*surgery ; Disease Models, Animal ; Endothelium, Corneal/*pathology ; In Situ Nick-End Labeling ; Iris/*surgery ; Laser Therapy/*methods ; Lasers, Gas/*therapeutic use ; Ophthalmologic Surgical Procedures/*methods ; Rabbits

PURPOSE: In Asian countries, laser iridotomy for the treatment of angle-closure glaucoma is a common cause of bullous keratopathy, which may be associated with a shallow anterior chamber and dark iris pigmentation in Asians. Several cases of corneal decompensation after argon laser iridotomy have been reported. In the present study, we evaluated the harmful effects of argon laser iridotomy on the corneal endothelium. METHODS: Argon laser iridotomy was performed on the right eyes of pigmented rabbits. Changes in corneal thickness and endothelial cell density after laser iridotomy were evaluated. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) was performed for assessment of corneal endothelial cell apoptosis. Combined staining with alizarin red and trypan blue, as well as a live/dead cell assay, were performed for evaluation of damage to the corneal endothelium induced by laser iridotomy. RESULTS: Corneal thickness did not change immediately after laser iridotomy; however, a significant increase was observed 24 hours after iridotomy (p = 0.001). The endothelial cell density of laser-treated eyes four days after laser iridotomy was significantly decreased compared with control eyes (p < 0.001). TUNEL staining showed many TUNEL-positive cells in the corneal endothelium and corneal stroma. No endothelial trypan blue-stained cell nuclei were observed after laser iridotomy; however, several large endothelial cells with damaged membrane integrity were observed. The live/dead cell assay clearly showed a large number of dead cells stained red in several areas throughout the entire corneal button 24 hours after iridotomy. CONCLUSIONS: Argon laser iridotomy induces corneal endothelial cell apoptosis in pigmented rabbit eyes, resulting in decreased endothelial cell density.
Animals ; Apoptosis ; Corneal Diseases/pathology/*surgery ; Disease Models, Animal ; Endothelium, Corneal/*pathology ; In Situ Nick-End Labeling ; Iris/*surgery ; Laser Therapy/*methods ; Lasers, Gas/*therapeutic use ; Ophthalmologic Surgical Procedures/*methods ; Rabbits

We report a case of recurrent occlusion of laser iridotomy (LI) sites after a Visian ICL (Implantable contact lens version 4, Staar Surgical AG, Nidau, Switzerland) implantation. A 45-year-old woman had bilateral ICL implantation after placement of two peripheral LI sites in each eye to prevent pupillary block. At one month after the operation, severe narrowing or occlusion of four LI sites occurred. After this, although she received four additional LIs at postoperative months 1, 6, 9 and 10 in both eyes, the narrowing or occlusion recurred. Mild chronic anterior chamber inflammation was observed intermittently throughout the follow-up period. We performed clear lens extraction in both eyes (at postoperative month 11 in the left eye and month 26 in the right eye) due to recurrent occlusion of the LI sites and excess trabecular meshwork pigment deposition presumably caused by the four repeated LIs. Recurrent obstruction of LI sites can occur after ICL implantation. These problems were unresolvable despite four repeated laser iridotomies. The risks associated with anterior uveitis must be considered when planning an ICL implantation.
Female ; Humans ; Iridectomy/*methods ; Iris/*surgery ; *Laser Therapy ; Lasers, Solid-State ; Lens Implantation, Intraocular/*adverse effects ; Middle Aged ; *Phakic Intraocular Lenses ; Pigment Epithelium of Eye/pathology ; *Postoperative Complications ; Recurrence ; Reoperation ; Trabecular Meshwork/pathology ; Uveitis, Anterior/etiology

PURPOSE: To compare conventional laser peripheral iridotomy (LPI) and LPI combined with laser peripheral iridoplasty in eyes with primary angle closure suspect (PACS) by assessment of anterior chamber dimensional changes using a Pentacam. METHODS: Forty-eight eyes of 24 subjects with bilateral PACS were recruited consecutively. Each eye was randomly allocated to treatment with conventional LPI, argon LPI only, or LPI plus iridoplasty, which consisted of simultaneous argon LPI and peripheral iridoplasty. Anterior chamber measurements were performed on each eye using a Pentacam, both before and after treatment. Mean anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle were measured, and topographic ACD analysis was performed. Results were compared between the two treatment groups. RESULTS: After treatment with either conventional LPI or LPI plus iridoplasty, the mean ACD and ACV increased significantly. Topographic ACD analysis revealed that the mid-to-peripheral ACD increase was significantly greater in the LPI plus iridoplasty group than in eyes treated with conventional LPI. Intraocular pressure changes and post-LPI complications did not differ between the groups. CONCLUSIONS: Compared with conventional LPI, our study showed that LPI plus iridoplasty improved the mid-to-peripheral ACD increase. This procedure may have a role as an adjunct for reducing angle closure by simultaneously eliminating pupillary and non-pupillary block components.
Adult ; Aged ; Anterior Chamber/*pathology/surgery ; Diagnostic Techniques, Ophthalmological/*instrumentation ; Equipment Design ; Female ; Follow-Up Studies ; Glaucoma, Angle-Closure/pathology/physiopathology/*surgery ; Gonioscopy ; Humans ; Intraocular Pressure ; Iridectomy/*methods ; Iris/pathology/*surgery ; Laser Therapy/*methods ; Lasers, Solid-State ; Male ; Middle Aged ; Prospective Studies ; Tonometry, Ocular