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

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

PURPOSE: Several articles have been published on the successful elimination of iridolenticular synechiae after cataract extraction with a neodymium YAG laser (Nd:YAG laser) and surgical synechiolysis during cataract surgery, but the indications recommending which method is proper to use for specific kinds of adhesions have not yet been established. METHODS: We retrospectively reviewed the medical records of 106 patients who had undergone Nd:YAG laser or surgical synechiolysis between January 2002 and December 2007 in our clinic. Laser synechiolysis was performed in the synechiae not exceeding the extent of one clock hour and reaching only to the iris sphincter, whereas surgical synechiolysis was performed in other diffuse and/or thick synechiae. RESULTS: Surgical synechiolysis was performed in 93 eyes, and YAG laser synechiolysis was done in 21 eyes. Increases in best-corrected visual acuity (BCVA) were observed in 61 eyes (53.51%). Intraocular pressure spikes after the procedure were present in only 4 eyes, and all of them were transient except for 1 eye, which needed additional glaucoma eyedrops. CONCLUSIONS: With suitable indications, laser or surgical synechiolysis can be performed safely, and a small rise in visual acuity may also be expected.
Adult ; Aged ; Aged, 80 and over ; Cataract Extraction ; Female ; Humans ; Iris Diseases/*surgery ; Lasers, Solid-State/*therapeutic use ; Lens Capsule, Crystalline/*surgery ; Lens Diseases/*surgery ; Male ; Middle Aged ; Postoperative Complications/*surgery ; Retrospective Studies ; Tissue Adhesions/surgery ; Visual Acuity

Rieger's syndrome is a rare autosomal dominant developmental anomaly characterized by ocular and systemic abnomalities. These disorders are typically bilateral and usually diagnosed at birth or in the childhood. The most common ocular defects are hypoplasia of the iris, a prominent Schwalbe's line with iris strands and corectopia. A large number of patients have glaucoma due to devel-opmental defects of the anterior chamber angle structure. The authors experienced a case of Rieger's syndrome which was found in 31-year-old female, who had characteristic ocular and other systemic abnormalities. Associated glaucoma was well controlled by filtering surgery.
Adult ; Anterior Chamber ; Atrophy ; Edema ; Female ; Filtering Surgery ; Frontal Lobe ; Glaucoma* ; Glioblastoma ; Humans ; Intracranial Pressure ; Iris ; Neurofibromatoses ; Optic Atrophy ; Optic Nerve ; Optic Nerve Diseases* ; Parturition ; Skin

The Foster Kennedy syndrome is ipsilateral optic disc atrophy and contralateral optic disc edema that is caused not only frontal lobe tumor but also another intracranial tumors and non tumorous conditions. In this case, suspected neurofibromatosis by the skin and ocular manifestations, there are glioblastoma multiforme in left temporoparietal lobe and undefined mass with bony destruction of the ipsilateral sphenoidal wing ridge. Authors asserted that ipsilateral optic atrophy was caused by direct compression of the undefined mass on sphenoidal wing ridge to the optic nerve and the contralateral disc edema was result from high intracranial pressure caused by glioblastoma multiforme.
Adult ; Anterior Chamber ; Atrophy ; Edema ; Female ; Filtering Surgery ; Frontal Lobe ; Glaucoma* ; Glioblastoma ; Humans ; Intracranial Pressure ; Iris ; Neurofibromatoses ; Optic Atrophy ; Optic Nerve ; Optic Nerve Diseases* ; Parturition ; Skin

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

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