OBJECTIVETo evaluate the impact of hyphema secondary to high intraocular pressure on corneal pathology in rabbits.

METHODSThirty adult New Zealand rabbit were randomized into 3 equal groups, and in each rabbit, one eye served as the experimental eye with the other as the control eye. In the experimental eye, autoblood was injected into the anterior chamber to induce high intraocular pressure maintained for 3, 5, or 8 days. Only saline was injected into the control eye. After the injections, the cornea was observed with slit-lamp microscopy, and at 3, 5, or 8 days, the experimental and control eyes were taken from the 3 groups for microscopic examination of the corneas to detect the occurrence of cornea bloodstain with prolonged high intraocular pressure. Corneal edema, elastic fibers changes, growth of new blood vessels, changes of eosinophils, fibroblasts, lymphocytes and plasma cells, as well as the pathological changes of the corneal layers were observed and compared between the experimental and control eyes.

RESULTSMaintenance of high intraocular pressure for 8 days resulted in the most severe corneal edema and thickening, and histopathologically, the corneal stroma showed widened space between the elastic fibers and obvious fiber distortion. Neovascularization was seen in the marginal cornea where eosinophil infiltration occurred with a small number of lymphocytes, plasma cells and fiber cells. All the three groups showed more obvious edema in the posterior than in the anterior cornea.

CONCLUSIONProlonged hyphema with ocular hypertension results in aggravation of corneal edema, and corneal blood staining does not occur until 8 days of high intraocular pressure but corneal elastic fiber disruption can be seen, suggesting the impending irreversible pathological changes of cornea.

Animals ; Cornea ; pathology ; Edema ; pathology ; Female ; Hyphema ; complications ; pathology ; Male ; Ocular Hypertension ; complications ; pathology ; Rabbits ; Random Allocation

PURPOSE: To evaluate the advantages and complications of triamcinolone acetonide (TA)-assisted pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: We retrospectively examined 110 eyes with vitreous hemorrhage or tractional retinal detachment resulting from a PDR after surgery. The TA-assited PPV [TA(+)] consisted of 58 eyes, and the conventional PPV[TA(-)]group consisted of 52 eyes. The improvement in vision, residual vitreous cortex (VC) pattern, and postoperative complications were studied. RESULTS: The residual VC pattern was divided into 3 groups: the focal type in 34 eyes (58.6%): the diffuse type in 22 eyes (37.9%): and no residual VC, seen in 2 eyes (3.4%). The TA (+) group had a lower incidence of rebleeding (p=0.0149) and of a preretinal membrane (p=0.0138) than the TA (-) group. No apparent persistant ocular hypertension occurred in any eyes. CONCLUSIONS: Triamcinolone-assisted PPV appears to be potentially useful to remove residual VC and to protect from postoperative complications.
Diabetic Retinopathy* ; Incidence ; Membranes ; Ocular Hypertension ; Postoperative Complications ; Retinal Detachment ; Retrospective Studies ; Traction ; Triamcinolone Acetonide ; Vitrectomy* ; Vitreous Hemorrhage

PURPOSE: To investigate the efficacy and safety of selective laser trabeculoplasty (SLT) in pregnant and lactating women who have primary open-angle glaucoma and ocular hypertension. METHODS: From January 2006 to August 2006 SLT was performed in fertile female patients with primary open-angle glaucoma and ocular hypertension. Intraocular pressure (IOP) was measured at 1 hour, 1 day, 1 week, 1 month, 3 months, and 6 months after SLT. Anterior chamber reaction and ocular pain were checked on postoperative day 1. Peripheral anterior synechia was examined at postoperative 6 months. Any anti-glaucoma drug was discontinued after SLT procedure, and restarted when needed. RESULTS: 22 patients (40 eyes) of primary open-angle glaucoma (40 eyes) and ocular hypertension (10 eyes) were included. The mean baseline intraocular pressure was 31.6 mmHg. The mean IOP was 15.7 mmHg and the mean number of anti-glaucoma drug was 1.3+/-0.6 preoperatively. There was successful IOP decrease at postoperative 1 day (17.9 mmHg), 1 week (16.3 mmHg), 1 month (17.7 mmHg), 3 months (18.4 mmHg), and 6 months (19.0 mmHg). The mean number of anti-glaucoma drug was 0.43+/-0.7 (p=0.000) postoperatively. There were no significant postoperative complications in the 6-month follow-up period. CONCLUSIONS: SLT seems to be a safe and effective procedure for fertile female patients who need to discontinue or reduce the anti-glaucoma drugs.
Anterior Chamber ; Female ; Fertility ; Follow-Up Studies ; Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Lactation ; Ocular Hypertension* ; Postoperative Complications ; Pregnancy ; Trabeculectomy*

We report a case of Descemet's membrane detachment, a rare complication of viscocanalostomy. During the operation, the injection cannula was directed slightly oblique to the Schlemm's canal rather than parallel to it. Localized corneal whitening developed adjacent to the injection site during viscoelastic injection. One week postoperatively, corneal edema decreased and Descemet's membrane detachment was noted. Nine months after surgery, the cornea was clear while the Descemet's membrane detachment remained. And IOP was 19 mmHg without any medications. We think that improper cannula positioning during viscoelastic injection may cause Descemet's membrane detachment, a rare complication of viscocanalostomy.
Aged ; Case Report ; Corneal Diseases/*etiology ; *Descemet's Membrane ; Human ; Hyaluronic Acid/administration & dosage ; Injections/adverse effects ; Intraoperative Complications ; Male ; Ocular Hypertension/*surgery

No abstract available.
Chronic Disease ; Cryopyrin-Associated Periodic Syndromes/*complications/diagnosis ; Gonioscopy ; Humans ; *Intraocular Pressure ; Male ; Microscopy, Acoustic ; Middle Aged ; Ocular Hypertension/diagnosis/*etiology/physiopathology ; Rare Diseases

PURPOSE: To evaluate the surgical outcomes on the combined procedures of phacoemulsification, intraocular lens (IOL) implantation, and vitrectomy, and to compare clinical results with sequential surgery results in Korean patients with idiopathic epiretinal membrane. METHODS: The present retrospective study included 20 eyes of 19 patients with idiopathic epiretinal membrane who underwent combined phacoemulsification, IOL implantation, and pars plana vitrectomy (combined surgery), and 18 eyes of 18 patients who underwent phacoemulsification and IOL implantation subsequent to vitrectomy (sequential surgery). Postoperative clinical results and intra- and postoperative complications were compared between the 2 groups. RESULTS: Postoperative best corrected visual acuity (BCVA) (logMAR) was 0.41 +/- 0.42 in the combined group, and 0.35 +/- 0.37 in the sequential group. There was no significant difference in BCVA between the 2 groups (p = 0.675). The mean refractive prediction error was -0.46 +/- 0.88 diopters (D) in the combined group, and -0.06 +/- 0.68 D in the sequential group, showing no statistically significant difference between the 2 groups (p = 0.147). The present study showed no major differences between the 2 groups in complications such as intraoperative mild corneal edema, postoperative ocular hypertension, and lens capsular opacity. CONCLUSIONS: Combined phacoemulsification, IOL implantation, and pars plana vitrectomy as well as the two-step procedure are safe and effective for treating patients with idiopathic epiretinal membrane.
Corneal Edema ; Epiretinal Membrane ; Eye ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Ocular Hypertension ; Phacoemulsification ; Postoperative Complications ; Retrospective Studies ; Visual Acuity ; Vitrectomy

INTRODUCTIONPrimary angle-closure glaucoma (PACG) is a major cause of blindness among Asians. A better understanding of the disease will improve the treatment and outcome of this condition.

METHODSA literature review of all recent publications on PACG was carried out. Articles were retrieved using a key word search of MEDLINE, PubMed and Science Citation Index databases.

RESULTSFollowing laser peripheral iritodomy for acute angle-closure, Asians were found to have a higher tendency to develop a subsequent rise in intraocular pressure compared to Caucasians. Furthermore, the extent and severity of visual field damage was more severe in Asians than Caucasians, particularly in eyes that presented insidiously with chronic PACG. Prophylactic laser iridotomy in the contralateral eye was found to be highly effective in preventing acute angle-closure attacks.

CONCLUSIONPACG is more difficult to manage and is associated with more severe long-term visual morbidity in Asians than Caucasians. Regular follow-up of patients with PACG is important for the early detection of progression of the disease and visual field deterioration.

Asian Continental Ancestry Group ; European Continental Ancestry Group ; Glaucoma, Angle-Closure ; complications ; physiopathology ; surgery ; Humans ; Intraocular Pressure ; Iridectomy ; adverse effects ; Ocular Hypertension ; etiology ; Visual Fields

To investigate the risk factors for glaucoma, we reviewed the clinical record of 361 primary open-angle glaucoma (POAG) patients, 178 ocular hypertensives (OH), and 927 controls without POAG or OH, randomly selected from an urban medical center eye clinic. Old age defined as > or = 55 year, (odds ratio ratio (OR) = 3.13 95% confidence interval (CI): 2.06-4.76, P < .0001), black race (OR = 2.58, 95% CI: 1.79-3.74, p < .0001), hypertension (OR = 1.709, 95% CI: 1.15-2.51, P < .0108), and diabetes mellitus (OR = 1.83, 95% CI: 1.08-3.09, P = .0308) were identified as significant risk factors in POAG compared to OH. Old Age (OR = 4.94, 95% CI: 3.62-6.76, p < .0001), and black race (OR = 2.04, 95% CI: 1.59-2.61, P < .0001), HTN (OR = 1.63, 95% CI: 1.26-2.11, P = .0002), and DM (OR = 1.40 95% CI: 1.02-1.92 P = .0450) were also significant risk factors when compared to normal controls. However, when the 361 POAG patients were compared to 361 controls matched with respect to age, race, and sex, hypertension and diabetes mellitus did not appear to be independent risk factors. Family history of glaucoma was found to be a risk factors more significantly for OH (OR = 6.79, 95% CI: 4.39-10.50, P < .0001) than for POAG (OR = 2.83, 95% CI: 1.90-4.21, P < .0001) compared to the matched control subjects. The apparent importance of hypertension and diabetes as risk factors for POAG may therefore be due at least in part to a higher prevalence of hypertension and diabetes mellitus in the elderly than the young and also in the black race as risk factors for glaucoma may be in part due to an increased prevalence of hypertension and diabetes mellitus in the elderly and blacks. Positive family history of glaucoma appears to be a risk factor more specifically for elevated intraocular pressure than for glaucomatous visual field defects.
African Continental Ancestry Group ; Age Factors ; Aged ; Aged, 80 and over ; Diabetes Complications ; Female ; Glaucoma, Open-Angle/ethnology/*etiology ; Humans ; Hypertension/complications ; Male ; Middle Aged ; Ocular Hypertension/ethnology/*etiology ; Odds Ratio ; Prevalence ; Random Allocation ; Risk Factors

Glaucoma is characterized by loss of retinal ganglion cells (RGCs) and their axons. Retrograde axoplasmic transport blockade and excitotoxicity were proposed to be a major cause of RGC apoptosis. We conducted this study to characterize the episcleral vessel cauterization glaucoma model in the rat with respect to decreased retrograde axoplasmic flow and subsequent apoptotic RGC death. After episcleral vessels were cauterized in Sprague-Dawley rats, Fluorogold was injected into their superior colliculi by stereotactic method. Retrograde axoplasmic flow and TUNEL-stained apoptotic dead cells were observed microscopically. Elevated intraocular pressure was maintained for up to 6 weeks during follow-up. Retrograde axoplasmic flow to the rat retina was significantly decreased. Apoptotic RGC was selectively TUNELstained in the retina, especially at the ganglion cell layers. We concluded that elevated intraocular pressure caused apoptotic RGC death through retrograde axoplasmic flow blockage. Further studies will elucidate the neuroprotection strategies in glaucoma patients.
Animals ; *Apoptosis ; Axonal Transport ; Disease Models, Animal ; In Situ Nick-End Labeling ; *Intraocular Pressure ; Male ; Ocular Hypertension/*complications ; Rats ; Rats, Sprague-Dawley ; Retinal Ganglion Cells/*pathology ; Retrograde Degeneration/etiology ; Sclera/blood supply

We performed a randomized, prospective study to evaluate the effect of intraoperative, intracameral carbachol or acetylcholine on early postoperative intraocular pressure(IOP) after extracapsular cataract extraction(ECCE) and posterior chamber lens(PCL) implantation. Fifty-six eyes of 56 patients scheduled for routine ECCE and PCL implantation were randomly assigned into three groups: (1)carbachol infusion (19 eyes) (2) acetylcholine infusion (15 eyes) (3)balanced salt solution (BSS) infusion (control, 22 eyes). We compared the preoperative IOP, early postoperative IOP, postoperative 24 hours IOP and postoperative 1 week IOP. In the measurement of early postoperative IOP, IOP was measured at least twice at 3, 6 or 9 hours postoperatively. There was no significant difference in IOP between the three groups preoperatively, at postoperative 3 hours, and 1 week. At postoperative 6 hours, both the carbachol infusion group and acetylcholine infusion group were significantly different from the BSS infusion group. At postoperative 9 and 24 hours, only carbachol infusion group had a significant difference from BSS infusion group in suppression of postoperative IOP increase. Our results suggest that intraoperative, intracameral administration of carbachol or acetylcholine prevents early postoperative IOP increase, and that carbachol has a more lasting effect.
Acetylcholine/administration & dosage/*pharmacology ; Adult ; Aged ; Anterior Chamber/drug effects ; Carbachol/administration & dosage/*pharmacology ; Cataract Extraction/*adverse effects ; Female ; Humans ; Intraocular Pressure/*drug effects ; Lenses, Intraocular ; Male ; Middle Aged ; Ocular Hypertension/etiology/*prevention & control ; Postoperative Complications ; Prospective Studies