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14 eyes of 11 patients with chronic angle-closure glaucoma(CACG) undergoing extracapsular cataract extraction(ECCE) with posterior chamber intraocular lens(PCIOL) implantation(group 1) and 14 eyes of 12 patients without glaucoma undergoing ECCE/PCIOL(group 2) were studied to assess the effect on anterior chamber depth, anterior chamber angle, and intraocular pressure (IOP). We measured the anterior chamber depth and angle using the EAS-1000 Scheimpflug camera. Following ECCE/PCIOL in group 1, the anterior chamber depth increased 1.00 +/- 0.25mm(p=0.0001), the anterior chamber angle widened 15.36 +/- 5.61 degrees(p=0.0001), and the postoperative IOP drop of 4.7mmHg(23.9%) showed statistical significance. Group 2 showed the increase of anterior chamber depth 0.22 +/- 0.44mm(p=0.0964), the widening of anterior chamber angle 2.51 +/- 2.65 degrees(p=0.0047), and the decrease of IOP 0.9mmHg(6.2%, p=0.0933). The effects on anterior chamber depth, anterior chamber angle, and rap were statistically significant between the two groups. Based on these results, we recommend that eyes with cataract and CACG may be considered for ECCE/PCIOL implantation as a first procedure rather than combined cataract and filtering surgery.
Anterior Chamber ; Cataract Extraction* ; Cataract* ; Filtering Surgery ; Glaucoma ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure

Generally, the postoperative failure of glaucoma filtrationsurgery(GFS) is caused by scarring of filtering site. Mitomycin C(MMC) has been commonly used for preventing the scarring of filtering site. Though the antifibroblastic effect of this drug is approved clinically, its cytotoxic side effect cannot be overlooked,. alpha-tocopherol is known to inhibit proliferation of fibroblast without cytotoxic complications. In this study, we used alpha-tocopherol in GFS of rabbits and investigated the maintenance of bleb formation, complications and inhibition of fibroblast proliferation compared with MMC. Thirty six rabbits were divided into 6 groups Negative control groups were the balanced salt solution soaked group and the 19% ethanol soaked group and positive control group was soaked with 0.2mg/ml MMC during GFS. As experimental groups, group I, II, III were soaked with 100micrometer, 1mM and 10mM alpha-tocopherol. The results were as follows: For the maintenance of bleb formation, at postoperative 2 weeks, all extinguished in negative control groups and each experimental groups from I to III showed 16.7%, 33.3%, 50%, with highest rate of 66.7% in MMC soaked group, but at 2 months, group III and MMC soaked group showed 33.3% equally. Various complications were present in MMC soaked group but rare in alpha-tocopherol soaked groups. On histologic examinations, proliferation of fibroblast and infiltration of lymphocyte in group II, III and MMC soaked group except group I were much less than those of negative control groups and the degree of inhibition was proportional to concentration of tocopherol. There was no statistic difference(P>0.05) in area of reticulin fibers between group III and MMC soaked group and antifibroblastic effects were also similar between these two groups. These result suggest when directlyconcentration(1mM<) as much as MMC. Moreover, it is expected to be used more safely during GFS withous serious cytotoxic complications. However, application method, dosageand possible long term complications.
alpha-Tocopherol* ; Blister ; Cicatrix ; Ethanol ; Fibroblasts* ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Lymphocytes ; Mitomycin ; Rabbits* ; Reticulin ; Tocopherols

We reviewed 39 consecutive cases of extracapsular cataract extraction and with or without posterior chamber intraocular lens implantation combined with trabeculectomy in 35 glucoma patients. In 26 (66.7%) of the 39 cases, intraocular lens was implanted. The mean preoperative intraocular pressure was 26.3mmHg on glaucoma medications Postoperatively, the average intraocular pressure was 15.5mmHg which was 1O.8mmHg(41.5%) lower than the preoperative level. Visual acuity improved in 37 eyes (94.9%) with an average improvement of 4.3 lines at postopertive 6 months. The postoperative complications are hyphema (5 yeyes. 12.8%), shallow anterior chamber (3 eyes, 7.7%), fibroexudative membrane (3 eyes, 7.7%) and endophthalmitis(1 eye, 2.6%).
Anterior Chamber ; Cataract Extraction ; Cataract* ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Membranes ; Postoperative Complications ; Trabeculectomy ; Visual Acuity

We reviewed 39 consecutive cases of extracapsular cataract extraction and with or without posterior chamber intraocular lens implantation combined with trabeculectomy in 35 glucoma patients. In 26 (66.7%) of the 39 cases, intraocular lens was implanted. The mean preoperative intraocular pressure was 26.3mmHg on glaucoma medications Postoperatively, the average intraocular pressure was 15.5mmHg which was 1O.8mmHg(41.5%) lower than the preoperative level. Visual acuity improved in 37 eyes (94.9%) with an average improvement of 4.3 lines at postopertive 6 months. The postoperative complications are hyphema (5 yeyes. 12.8%), shallow anterior chamber (3 eyes, 7.7%), fibroexudative membrane (3 eyes, 7.7%) and endophthalmitis(1 eye, 2.6%).
Anterior Chamber ; Cataract Extraction ; Cataract* ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Membranes ; Postoperative Complications ; Trabeculectomy ; Visual Acuity

Failure of a glaucoma filtering operation mainly results from scarring at the filtering wound, and postoperative proliferation and migration of fibroblasts play an important role histologically in the formation of scar tissue. As an inhibitory agent for fibroblast proliferation, gamma-interferon has been introduced, and the application of gamma-interferon following filtering surgery is now being made on a trial basis. We studied the effect of gamma-interferon histologically on the fibroblast proliferation and collagen synthesis occurring at the filtering site by comparing the effect of gamma-interferon on the experimental group with that of 5-fluorouracil on the control group, using 10 rabbits (20 eyes) after posterior lip sclerectomy. Both groups showed similar flat and diffused bleb grossly and also showed a similar inhibitory effect on fibroblast proliferation and collagen fiber synthesis histologically. Our findings seem to justify the clinical use of gamma-interferon. Further studies on adequate dosage, method of administration, and local and systemic complications would be desired.
Animals ; Anterior Chamber/drug effects ; Cell Division/drug effects ; Collagen/*biosynthesis ; Fibroblasts/drug effects ; Fluorouracil/pharmacology ; Glaucoma/pathology/*surgery ; Interferon-gamma/*pharmacology ; Rabbits ; Sclera/pathology ; *Sclerostomy

Human lens capsules(basement membrane of lens epithelium) were isolated from surgically removed cataractous lenses of diabetic and nondiabetic patients with senile cataracts. Basement membranes were purified from lens capsules, using the detergent Triton X-100 and the extent of glycosylation was determined with a colorimetric reaction that detected carbohydrates in ketoamine linkage with proteins. Furthermore, the level of glycosylation of lens capsule basement membrane from diabetics was significantly higher than that in their nondiabetic counterparts and capsule basement membranes were confirmed to be glycosylated.
Basement Membrane ; Capsules ; Carbohydrates ; Cataract ; Detergents ; Diabetes Mellitus* ; Glycosylation* ; Humans* ; Membranes ; Octoxynol

The diurnal variation of introcular pressure was measured in 40 eyes of 20 healthy Koreans and in 50 eyes of 25 patients with chronic open angle glaucoma and ocular hypertension with and without levobunolol and dipivefrine. The intraocular pressure was measured every 1 hour from 8:00 o'clock by the same examiner using with Goldmann applanation tonometry. The levobunolol, a new beta-adrenoceptor antagonist effective in the long-term treatment of glaucoma and the dipivefrine, a prodrug of epinephrine which is alpha-and beta-adrenergic agonist, both decrease intraocular pressure despite of opposite pharmacologic actions. Several clinical studies have demonstrated additional effect when an epinephrine compound is added to timolol, a beta-blocker antagonist, theraphy. It is the most important issue that determination of the time of instillatiolt related to the time of maximum effec: of the drugs and the time of the highest intraocular pressure in a day in every each patient. The authors obtained the following results; 1) In the control group, the mean intraocular pressure was 15.3 +/- 1.377 mmHg, the highest was 17.3 +/- 0.924 mmHg at 10 o'clock AM and the lowest was 13.7 +/- 1.764 mmHg at 3 o'clock PM. The diurnal variation was 3.60 +/- 1.743 mmHg.(p=0.002). 2) In the patient group, the mean intracular pressure was 28.5 +/- 1.606 mmHg, the highest was 31.4 +/- 2.986 mmHg at 10 o'clock AM and the lowest was 26.1 +/- 0.836 mmHg at 4 o'clock PM. The diurnal variation was 5.31 +/- 1.101 mmHg.(p=0.0001). 2) The lowering effect of intraocular pressure by the instillation of 0.5% levabunolol and 0.1% dipivefrine was statistically significant(p=0.0001) both in the control group and patient group. In the patient group, the maximum effect was made at 5 hours after instillation of the drugs with 28% decrease. 4) The distribution of the highest intraocular pressure in the patient group was as following: 23 eyes at 10 o'clock AM, 11 eyes at 9 AM, 9 eyes at 11 AM, 3 eyes at 8 AM, 3 eyes at noon and 1 eye at 4 o'clock PM.
Adrenergic beta-Agonists ; Epinephrine ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Levobunolol* ; Manometry ; Ocular Hypertension ; Pharmacologic Actions ; Timolol

Aphakic or pseudophakic glau-oma is known to be at high risk for failure after filtration surgery. The authors retrospectively investigated the results of trabeculectomy in 14 eyes of 14 patients with glaucoma, seven aphakic and seven pseudophakic eyes, which were followed from six months to three years with an average ot 16.5 months. A conventional trabeculectomy without using antifibrotic agents was performed in all the eyes. The site of conjunctival incision was prepared on the virgin area of the conjunctiva; 8 superonasal, 4 inferonasal and 2 inferotemporal approaches. An average postoperative intraocular pressure reduction was 13.4 mmHg. The number of medications decreased in 11 eyes. A spontaneously developed functioning bleb was found in seven eyes. In other four eyes, the filtering bleb was formed with an aid of massage or needling. The remallllllg three eyes did not show a functioning bleb. Postoperative complications included hyphema in 3 eyes, overfiltration in 2 eyes, choroidal detachment in 1 eye, corneal edema in 1 eye and endophthalmitis in 1 eye.
Aphakia* ; Blister ; Choroid ; Conjunctiva ; Corneal Edema ; Endophthalmitis ; Filtering Surgery* ; Glaucoma ; Humans ; Hyphema ; Intraocular Pressure ; Massage ; Postoperative Complications ; Pseudophakia* ; Retrospective Studies ; Trabeculectomy

Postoperative endophthalmitis has been greatly improved over the past decade by the use of improved medical therapy and the use of vitrectomy. However, the appropriate use of the different treatment modalities and the appropriate time of vitrectomy in the treatment of postoperative endophthalmitis remains controversial. We have experienced consecutive endophthalmitis following 2 cases of cataract surgery, 1 case of glaucoma filtering surgery with cataract operation and 1 case of secondary posterior chamber intraocular lens (PCL) implantation. We report the presumed cause of endophthalmitis and its therapeutic results. 1. Four of five patients who underwent cataract and combined glaucoma surgery were detected Pseudomonas aeruginosa and its infective cause presumed to be the I and A Kit of phacoemulsifier (Cavltron Kelman 8000). 2. More severe 3 of 4 patients who developed postoperative endohthalmitis were treated with vitrectomy and mild 1 patient was treated medically. 3. At the time of follow-up (mean, 11 months), the final corrected average visual acuity of 20/30 was achieved.
Cataract ; Endophthalmitis* ; Filtering Surgery ; Follow-Up Studies ; Glaucoma ; Humans ; Lenses, Intraocular ; Pseudomonas aeruginosa ; Visual Acuity ; Vitrectomy