Adolescent ; Cysts ; surgery ; Humans ; Iris Diseases ; surgery ; Keratoplasty, Penetrating ; Male

BACKGROUNDFor some high myopic patients with posterior iris bowing, laser periphery iridectomy should be performed pre-operation to prevent pupil block glaucoma if these patients would have phakic intraocular lens implantation to correct high myopia. So we had the opportunity to analysis the influence of laser iridectomy on posterior iris bowing.

METHODSEighteen high myopic patients with posterior iris bowing (11 males and 7 females) were involved in the study in Beijing Tongren Eye Center from March 2008 to July 2008. Phakic intraocular lens were implanted to correct their ametropia. The mean age was (32 ± 6) years (range, 25 - 40 years). The center anterior chamber depth, the pupil diameter, the posterior iris bowing depth and the anterior chamber angle were measured with anterior segment coherence tomography (AS-OCT) under the normal condition, myosis condition induced by 2% pilocarpine, laser periphery iridectomy after myosis, and 2% pilocarpine eluting condition respectively.

RESULTSThere was no significant difference of center anterior chamber depth under the four conditions (P = 0.512). The pupil constricted after pilocarpine (P = 0.001). After laser iridectomy performed and pilocarpine eluted, posterior iris bowing depth reduced more than that in normal condition (P = 0.003). The anterior chamber angle reduced significantly after laser periphery iridectomy and pilocarpine eluted (P = 0.012).

CONCLUSIONLaser periphery iridectomy can reduce the posterior iris bowing, which might be due to the change in aqueous circulate pathway.

Adult ; Female ; Humans ; Iridectomy ; methods ; Iris Diseases ; surgery ; Male ; Myopia ; surgery

To determine the factors which can increase the failure after glaucoma filtering surgery and to evaluate the affect of Mitomycin C(MMC) on filtering surgery. We evaluated 249 eyes who underwent glaucoma filtering surgery consecutively during last 2 years in Catholic University Medical College hospitals. 129 eyes had risk factors and 68 eyes of them were treated with MMC during operation. The success rate of the group with risk factors was significantly lower (P=0.001) than that of the group without risk factors. In the risk group, MMC has increased the sucess rate (P=0.07). Previous cataract surgery, neovascularization of iris (NVI) , re-trabeculectomy, young age under 40, uveitis and diabetes were significant risk factors for surgical failure. After adjustment of each factors, previous cataract surgery, NVI, retrabeculectomy and young age still increased the failure rate significantly. Among them we were able to make reduse the effect of re-trabeculectomy and youth by using MMC during surgery. The outcome of glaucoma surgery may increase the success rate in some high risk cases.
Adolescent ; Cataract ; Filtering Surgery* ; Glaucoma* ; Humans ; Iris ; Mitomycin* ; Risk Factors* ; Uveitis

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

PURPOSE: To investigate the efficacy and postoperative complications of nonpenetrating deep sclerectomy(NDS) with 0.02% Mitomycin C(MMC) in primary open-angle glaucoma(POAG). METHODS: After 5 x 5 mm scleral flap was made externally, 0.02% MMC was applied under and above the scleral flap for 2 to 5 minutes. A rectangular internal scleral flap was dissected down to remove Schlemm's canal and juxtacanalicular trabecula. RESULTS: Eleven patients(16 eyes) with POAG underwent the filtering surgery of NDS. The mean follow-up was 10.7(range 6 to 12) months. The mean preoperative intraocular pressure(IOP) was 25.6+/-1.7mmHg(SEM, standard error of mean). The mean postoperative IOP was 12.3+/-1.4, 15.8+/-1.8, 15.5+/-0.9, 16.3+/-1.3, and 18.3+/-1.7 mmHg(SEM) at 1, 3, 6, 9, and 12 months, respectively. Success rate defined as an IOP lower than 21 mmHg without medication was 93.8%, 87.5% and 80.8% at 3, 6 and 12 months, respectively. Complications included two shallow anterior chambers, three wound leakages, two hypotonies and two iris adhesions to sclerectomy site. CONCLUSION: Deep sclerectomy with 0.02% MMC may contribute to a satisfactory result of effect of IOP reduction with fewer complication in management of POAG but has tendency to increase the IOP gradually as time elapsed.
Anterior Chamber ; Filtering Surgery ; Follow-Up Studies ; Iris ; Mitomycin* ; Postoperative Complications ; Wounds and Injuries

Persistent pupillary membranes are common congenital disorders. To reduce the surgical complications, we used vitreous scissors instead of conventionally used Vannas scissors to remove the membrane and reviewed the surgical results. Five eyes of 4 children with persistent pupillary membrane were treated by surgery. Through the 1.5 mm limbal incision, the membrane was removed by using vitreous scissors after intracameral sodium hyaluronate. After 22.6 months follow-up, all pupils of operated eyes were round and no complications associated with the surgery were found. Three eyes showed improved visual acuities after the operation. We suggest that the surgery with vitreous scissors is better than with Vannas scissors.
Anterior Chamber ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Hyaluronic Acid/administration & dosage ; Infant ; Injections ; Iris/*abnormalities ; Iris Diseases/*congenital/*surgery ; Male ; Pupil ; Surgical Instruments ; Treatment Outcome

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

BACKGROUNDMany studies indicated that short-term and long-term intraocular pressure (IOP) fluctuations in primary open angle glaucoma patients might lead to glaucomatous progression. However, seldom study has evaluated the long-term fluctuation of IOP in primary chronic angle closure diseases. The objective of this study was to investigate the long-term IOP fluctuation of primary angle closure diseases and its associations following laser peripheral iridotomy (LPI) with or without laser peripheral iridoplasty.

METHODSA total of 158 patients with primary angle closure suspect (PACS, n = 21), primary angle closure (PAC, n = 81) and primary angle closure glaucoma (PACG, n = 55) had been treated by LPI with or without laser peripheral iridoplasty and followed up for more than 12 months. IOP was measured with Goldman applanation tonometer. Multivariate linear regression with generalized estimating equation (GEE) regression models was used to evaluate the association of long-term IOP fluctuation (maximum IOP minus minimum IOP) with gender, age, baseline IOP, baseline peripheral anterior synechia (PAS), baseline vertical cup/disc ratio (VCDR), baseline mean deviation (MD), need for IOP-lowering medications.

RESULTSIOP fluctuation during follow-up in PACS, PAC and PACG groups were (4.83 ± 2.90), (5.67 ± 3.35), and (9.40 ± 7.14) mmHg, respectively. IOP fluctuation was strongly correlated with baseline IOP (r = 0.356, P < 0.001), PAS (r = 0.374, P < 0.001). IOP fluctuation was higher in patients with higher baseline IOP (0.18 mmHg per unit increase, 95%CI: 0.05 - 0.31 mmHg).

CONCLUSIONSLong-term IOP fluctuation in PACG group was larger than that in PACS or PAC group. Eyes with higher baseline IOP were observed to have larger long-term IOP fluctuation.

Follow-Up Studies ; Glaucoma, Angle-Closure ; physiopathology ; therapy ; Humans ; Intraocular Pressure ; Iridectomy ; Iris ; surgery ; Laser Therapy ; Middle Aged

An 0.1 mm thin polyethylene sheet was used as an iris protector in posterior chamber intraocular lens implantation. An experiment using rabbits was done to determie the applicability of a polyethylene sheet as a glaucoma seton. The polyethylene sheet had 0.1 mm thickness and was cut into 5 mm X 8 mm. In the subconjunctival space, one end of the implant was at the corneoscleral limbus or introduced into the anterior chamber through a sclerectomy opening, and the other end was allowed to extend to the posterior surface of the sclera. The eyes with an implant showed a more prominent and larger filtering bleb than the control eyes without an implant. Postoperative foreign body inflammatory change was minimal on both grossly and light microscopically. Fibroconnective capsule lining the polyethylene sheet was 0.2 mm - 0.3 mm thick, and had a small amount of collagen, and fibroblasts, and a few lymphocytes. Number and configuration of histiocytes on the inner surface of the fibroconnective tissue lining the implants were different, according to the sclerectomy or bleb size. The major complications were extrusion of the implant and dislocation into the anterior chamber. Above results suggested that the polyethylene sheet was suitable as a glaucoma seton, but more flexible products were expected.
Anterior Chamber ; Blister ; Collagen ; Dislocations ; Fibroblasts ; Filtering Surgery* ; Foreign Bodies ; Glaucoma* ; Histiocytes ; Iris ; Lens Implantation, Intraocular ; Lymphocytes ; Polyethylene ; Rabbits ; Sclera

Iridocorneal endothelial(ICE) syndrome is charaterized by unilateral glaucoma, abnormal corneal endothelium with proliferation, and iris stromal abnormalities. Uncontrolled glaucoma in ICE syndrome has been treated with filtering surgery, but the late failures occurred frequently. The medical records of nine patients with ICE syndrome that underwent glaucoma surgery were retrospectively reviewed. 6 eyes were progressive iris atrophy, and 3 eyes were Cogan-Reese syndrome. The success rates of primary trabeculectomy at 1 and 2 years were 57.1% and 33.3%, respectively. Ahmed glaucoma valve implant oeprations were performed on 6 eyes with failed previous filtering operation. 4 of 6 eyes resulted in controlled IOP until last follow up visit(mean ; 18.8 months). Overall, 1.9 times operations were needed to control IOP. Operations were performed only one time in 4 patients and two times in 3 patients to control IOP.
Atrophy ; Endothelium, Corneal ; Filtering Surgery ; Follow-Up Studies ; Glaucoma* ; Humans ; Ice ; Iridocorneal Endothelial Syndrome* ; Iris ; Medical Records ; Retrospective Studies ; Trabeculectomy