PURPOSE: To evaluate the change of axial length (AL), intraocular pressure (IOP), and corneal astigmatism after scleral shortening with scleral invagination in the rabbit eye. METHODS: The authors performed scleral shortening (3 mm) with scleral invagination in two groups of 6 eyes each: 180 degrees (group 1) and 360 degrees (group 2). RESULTS: Average AL shortening was more prominent in group 2 (0.5 +/- 0.17 mm) than in group 1 (0.37 +/- 0.29 mm), but the difference was not statistically significant. IOP increased immediately after the procedure and was maintained at a high level through 2 months postoperatively. Induced corneal astigmatism was more prominent in group 1 than in group 2. The difference was statistically significant in group 1 (p< 0.05) but not in group 2. CONCLUSIONS: In the scleral shortening with scleral invagination procedure, a large amount of scleral invagination resulted in more shortening of axial length, but there was more corneal astigmatism in 180-degree invagination of the sclera than in 360-degree. Further research is required to determine the effect of the extent of scleral invagination on the change of these values.
Animals ; Astigmatism/*etiology ; Corneal Diseases/*etiology ; Eye/*pathology ; *Intraocular Pressure ; Postoperative Period ; Rabbits ; Sclera/*surgery

Preoperative aqueous humor, known to inhibit the growth of fibroblasts in tissue culture assay, was used as an adjunct to filtering surgery in rabbits to determine its effect in vivo on the outcome of filtering surgery. Fifteen rabbits underwent a posterior-lip sclerectomy in both eyes. In experimental eyes 1.4 ml preoperative aqueous humor and in fellow eyes 1.4 ml balanced salt solution were injected intracamerally. Gross and histopathological differences of bleb were observed. In this animal experiment, although there was no statistical significance or late postoperative effect, the rabbit eyes refilled with preoperative aqueous humor intracamerally just after filtering surgery, had a larger bleb and less fibroconnective tissue on the bleb than the control eyes in the early postoperative period.
Animals ; Anterior Chamber/*pathology ; Aqueous Humor/*physiology ; Connective Tissue/pathology ; Fibroblasts/pathology ; Isotonic Solutions ; Rabbits ; Sclera/surgery

In the process of closing scleral wounds caused by various conditions, incarceration of conjunctiva, Tenon's capsule, or vitreous in the wound can occur unexpectedly. We created such conditions experimentally in order to discover their intraocular complications. The experimental materials consisted of 12 albino rabbits (24 eyes) divided into two groups (Groups I & II). Vitrectomy was performed in the Group I rabbits (12 eyes) but not in the Group II rabbits (12 eyes). Flaps of conjunctiva and Tenon's capsule were made and inserted into the vitreous cavity through the sclerotomy site, which was soon closed. Fundal examination of the rabbits was carried out using an indirect ophthalmoscope at intervals after the procedure; first at 3 days, then at 1, 3, and 6 weeks, and then at 3 months and 6 months, respectively. Enucleation of the rabbits' eyes 4 from two different rabbits at each of these intervals was carried out, and the extracted eyes were examined under a light microscope at each interval. The results are summarized as follows: 1. All rabbit eyes studied showed intraocular fibrovascular proliferation. 2. The extent of tissue proliferation, which was proportional to the amount of vitreous hemorrhage, was greater in Group II than in Group I. 3. The proliferated tissue developed to "band" by three weeks postexperiment, after which it gradually regressed. 4. The fibrovascular band was made of fibroblasts, stromal matrix, and capillaries.
Animals ; Cell Division ; Conjunctiva/pathology ; Eye Injuries/surgery ; Fundus Oculi ; Postoperative Complications ; Rabbits ; Retinal Diseases/pathology ; Retinal Vessels/*pathology ; Sclera/*surgery ; Vitrectomy ; Vitreous Hemorrhage/pathology

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

In adjustable strabismus surgery, a satisfactory final result would be achieved with delayed adjustment. However, the postoperative adhesions following strabismus surgery make delayed adjustment impossible. We evaluated the efficacy of mitomycin C in reducing the severity of postoperative adhesions following strabismus surgery and in delaying the time adjustment after surgery. Experimental rabbits underwent a hang-back recession procedure in the superior rectus muscle. A topical application of mitomycin C was made between the conjunctiva and the sclera for 5 minutes during the operation. We then studied the possible time of delayed adjustment and estimated the minimal forces required for the adjustment. The topical application of 0.1 mg/ml mitomycin C between the conjunctiva and sclera allowed for a 2-week delayed adjustment after surgery, and 0.2 mg/ml mitomycin C prevented the adhesions between these tissues and the muscle 5 weeks after surgery. These results suggest that topical mitomycin C may enhance the success rate of strabismus surgery with delayed adjustment and reduce postoperative adhesions.
Administration, Topical ; Animals ; Chemotherapy, Adjuvant ; Conjunctiva/drug effects ; Mitomycin/administration & dosage/*pharmacology ; Oculomotor Muscles/drug effects/pathology/*surgery ; Ophthalmic Solutions ; Postoperative Complications/prevention & control ; Rabbits ; Sclera/drug effects ; Strabismus/drug therapy/pathology/*surgery ; Suture Techniques ; Tissue Adhesions/prevention & control

Axenfeld-Rieger syndrome (ARS) is associated with ocular and systemic anomalies. PITX2 is known to be a major controlling gene in the pathogenesis of ARS and is associated with differentiation in both the neural crest and mesoderm during eye development. A 4-year-old girl with bilateral ARS had 20 prism diopters (PD) of exotropia with 30PD of A- pattern deviation, more than 20PD of dissociated vertical deviation (DVD), and severe superior oblique overaction (SOOA). During surgery we observed that the SO inserted more posteriorly than normal. We believe this finding is one of the abnormal manifestations of the development of the extraocular muscles in ARS.
*Abnormalities, Multiple ; Anterior Eye Segment/*abnormalities ; Child, Preschool ; Eye Abnormalities/*diagnosis/surgery ; Eye Movements ; Female ; Follow-Up Studies ; Humans ; Oculomotor Muscles/*abnormalities/surgery ; Ophthalmologic Surgical Procedures/*adverse effects ; Optic Nerve/abnormalities ; Postoperative Complications ; Sclera/*pathology/surgery ; Syndrome ; Tooth Abnormalities/*genetics

We compared the success rate of filtering surgery of a single 5-minute intraoperative application of mitomycin-C (MMC) or 5-fluorouracil (5-FU). Animal experiment and clinical study were done. In animal study, thirty pigmented rabbits (60 eyes) weighing 2.0 to 2.5 Kg were enrolled. We divided into 4 groups, such as BSS, 5-FU 50 mg/ml, MMC 0.2 mg/ml and MMC 0.4 mg/ml subconjunctival soaked group. Each group consisted of 15 eyes. In each group, 10 eyes was for examination of bleb survival and complications, 3 eyes for light microscopic examination and 2 eyes for electron microscopic examination. Bleb was survived 6.1 days (3 to 13 days) for BSS treated group, 16.3 days (9 to 23 days) for 5-FU 50mg/ml treated group, 32.7 days (17 to 55 days) in MMC 0.2 mg/ml treated group, and 64.4 days (49 to 84 days) in MMC 0.4 mg/ml treated group. Duration of bleb survival was significantly prolonged in 5-FU, MMC 0.2 mg/ml and MMC 0.4 mg/ml group respectively. In clinical study, fifty-five eyes of 40 patients were enrolled. 29 eyes of 21 patients were treated with MMC 0.2 mg/ml and 26 eyes of 19 patients were treated with 5-FU 50 mg/ml. The success rate was 89.7% in MMC 0.2 mg/ml treated group and 84.6% in 5-FU 50 mg/ml treated group at postoperative 3 months, and postoperative 6 months 89.7% in MMC 0.2 mg/ml treated group and 76.9% in 5-FU 50 mg/ml treated group. There was no statistical significance at postoperative 3 months (P > 0.05), but statistical significance at postoperative 6 months (P < 0.05). There was no serious complications using a MMC 0.2 mg/ml or 5-FU 50mg/ml.
Adult ; Aged ; Animals ; *Filtering Surgery ; Fluorouracil/*administration & dosage/pharmacology ; Glaucoma, Angle-Closure/*surgery ; Glaucoma, Open-Angle/*surgery ; Humans ; Intraoperative Care ; Middle Aged ; Mitomycin/*administration & dosage/pharmacology ; Ostomy ; Rabbits ; Sclera/pathology ; Sclerostomy

We compared the success rate of filtering surgery of a single 5-minute intraoperative application of mitomycin-C (MMC) or 5-fluorouracil (5-FU). Animal experiment and clinical study were done. In animal study, thirty pigmented rabbits (60 eyes) weighing 2.0 to 2.5 Kg were enrolled. We divided into 4 groups, such as BSS, 5-FU 50 mg/ml, MMC 0.2 mg/ml and MMC 0.4 mg/ml subconjunctival soaked group. Each group consisted of 15 eyes. In each group, 10 eyes was for examination of bleb survival and complications, 3 eyes for light microscopic examination and 2 eyes for electron microscopic examination. Bleb was survived 6.1 days (3 to 13 days) for BSS treated group, 16.3 days (9 to 23 days) for 5-FU 50mg/ml treated group, 32.7 days (17 to 55 days) in MMC 0.2 mg/ml treated group, and 64.4 days (49 to 84 days) in MMC 0.4 mg/ml treated group. Duration of bleb survival was significantly prolonged in 5-FU, MMC 0.2 mg/ml and MMC 0.4 mg/ml group respectively. In clinical study, fifty-five eyes of 40 patients were enrolled. 29 eyes of 21 patients were treated with MMC 0.2 mg/ml and 26 eyes of 19 patients were treated with 5-FU 50 mg/ml. The success rate was 89.7% in MMC 0.2 mg/ml treated group and 84.6% in 5-FU 50 mg/ml treated group at postoperative 3 months, and postoperative 6 months 89.7% in MMC 0.2 mg/ml treated group and 76.9% in 5-FU 50 mg/ml treated group. There was no statistical significance at postoperative 3 months (P > 0.05), but statistical significance at postoperative 6 months (P < 0.05). There was no serious complications using a MMC 0.2 mg/ml or 5-FU 50mg/ml.
Adult ; Aged ; Animals ; *Filtering Surgery ; Fluorouracil/*administration & dosage/pharmacology ; Glaucoma, Angle-Closure/*surgery ; Glaucoma, Open-Angle/*surgery ; Humans ; Intraoperative Care ; Middle Aged ; Mitomycin/*administration & dosage/pharmacology ; Ostomy ; Rabbits ; Sclera/pathology ; Sclerostomy

Scleral necrosis and infection are serious late complications of pterygium treatment and are difficult to manage. We describe a 70-year-old Chinese male who presented with scleral necrosis and Pseudomonas aeruginosa infection 15 years after the excision of a pterygium. The infection was treated early and aggressively with intensive topical and intravenous antibiotics and the thin necrotic sclera was reinforced with a donor scleral patch graft when the scleral infection was clinically controlled. The integrity of the globe was maintained by a thin layer of sclera anterior to the graft after the graft gradually shrunk in size and retracted posteriorly. The eye was saved from possible scleral perforation and endophthalmitis. This case is reported to highlight the importance of early aggressive treatment of infection and the value of prophylactic repair of scleral necrosis in the management of these late complications of pterygium treatment.
Administration, Topical ; Aged ; Anti-Bacterial Agents ; Drug Therapy, Combination ; administration & dosage ; therapeutic use ; Humans ; Injections, Intravenous ; Male ; Necrosis ; Pseudomonas Infections ; drug therapy ; Pseudomonas aeruginosa ; Pterygium ; surgery ; Sclera ; pathology ; transplantation ; Scleral Diseases ; drug therapy ; microbiology ; Surgical Wound Infection ; drug therapy ; etiology