Adherence syndrome may be due to fibrofatty proliferation creating adherence between infeiror orbital tissue, sclera, or inferior rectus muscle capule and inflammatory reaction initiated by the rupture of the Tenon's capsule and invasion of the extraconal fat. We report 4 cases of adnerence syndrome after weakening procedure of inferior oblique muscle in the cases of overacting inferior oblique muscle.
Orbit ; Rupture ; Sclera ; Tenon Capsule

PURPOSE: To investigate the effect of Gelrite (Gelrite gellan gum), a natural gelling agent, on the viability and proliferation of human Tenon's capsule fibroblasts in tissue culture. METHODS: We studied the effect of two common preservatives, Gelrite and pure benzalkonium chloride (BAK) on the proliferation of primarily cultured human Tenon's capsule fibroblasts. After treatment of Gelrite and BAK with various serial dilutions, proliferation was assessed by MTT assay and the morphologic changes were evaluated with by inverted phase contrast microscopic examination after 24 hours and 1 week respectively. RESULTS: Gelrite did not affect the proliferation of fibroblasts and revealed no apparent morphologic change or viability of the fibroblasts in tissue culture. Also BAK did not affect the proliferation but inhibited the proliferation of the fibroblasts with toxic effects on cell morphology. CONCLUSIONS: Gelrite showed no apparent effect on the proliferation and morphology of the primarily cultured human Tenon's capsule fibroblasts.
Benzalkonium Compounds ; Fibroblasts* ; Humans* ; Tenon Capsule*

The prior long-term use of topical anti-glaucoma medications has been suggested as an adverse factor for the outcome of trabeculectomy. The mechanism of action is still unclear. This study investigates the effect of Trusopt and Xalatan on the proliferation and viability of human Tenon`s capsule fibroblasts in tissue culture. We examined the effect of two commercial drugs, Trusopt and Xalatan, and pure benzalkonium chloride, at various dilution, on the proliferation as assessed by MTT assay and assessed micro-scopically the viability of human Tenon's capsule fibroblasts in tissue culture. None of the tested compounds stimulated proliferation of fibroblasts in tissue culture and inhibited proliferation. All had toxic effects on cell morphology. These results show an antiproliferative and toxic effect of Trusopt and Xalatan on the fibroblasts in tissue culture and no direct stimulation of fibroblast proliferation.
Benzalkonium Compounds ; Fibroblasts ; Humans ; Tenon Capsule ; Trabeculectomy

The efficacy and safety of mitomycin C(MMC) trabeculectomy was tested in patients with uncomplicated glaucoma(low-risk group) and the result was compared with that in patients with refractory glaucoma(high-risk group). Subjects included 37 eyes of 26 consecutive patients in low-risk group and 36 eyes of 26 patients in high-risk group. The mean preoperative IOP was 32.9 +/- 9.7 mmHg and 31.9 +/- 8.7 mmHg, respectively(p=1.45). The mean number of preoperative medications was 2.8 +/- 0.8 and 2.0 +/- 0.9, respectively(p<0.05). MMC(0.25 mg/ml or 0.5 mg/ml) was applied between Tenon's capsule and the sclera during trabeculectomy for 3 minutes in low-risk group, for 5 minutes in high-risk group. Scleral-flap was closed with tight releasable sutures. Eyes followed longer than 3 months were included(mean of 14.1 +/- 8.0 months vs 11.9 +/- 6.8 months, p=0.23). The low-risk group had better postoperative results including: a lower IOP at last follow-up(13.7 +/- 3.2 vs 17.2 +/- 8.4 mmHg, p=0.02), a better success rate(94% vs 83% with or without medications, p=0.23: 83% vs 55% without medications, p=0.02), a lower postoperative need for glaucoma medications(0.2 +/- 0.4 vs 0.6 +/- 08, p=0.005). Overall complications were similar between both groups. One of 37 eyes(3%) in the low-risk group developed a hypotony(p=0.51) and one of 36 eyes(3%) in the high-risk group developed a hypotony maculopathy(p=0.49). This study suggests that MMC trabeculectomy with tight releasable scleralflap sutures is safe and effective in controlling IOP not only in refractory glaucoma but also, more successfully, in uncomplicated glaucoma.
Glaucoma* ; Humans ; Mitomycin* ; Sclera ; Sutures ; Tenon Capsule ; Trabeculectomy*

In the process of closing a scleral wound caused by various conditions, incarceration af the conjunctiva, Tenon's capsule or vitreous in the wound can occur unexpectedly. We created such conditions experimentally to determine their intraocular complications. The experimental, materials were 12 albino rabhits(24 eyes) and the rabbits were divided into two groups(I and II). Group I rabbits(12 eyes) received no vinectormy and group II rabbits(12 eyes) received a vitrectormy. After the conjunctiva and Tenon's capsule flap was made, the tissue flap was inserted into the vitreous cavity through the sclerotomy site- Fundus examination with an indirect ophthalmoscope and enucleation for histology were performed at 3 days, 1 week, 3 weeks, 6 weeks, 3 months and 6 months after the experiment. The results were as follows: 1, Intraocular fibrovascular proliferation developed in all experimental rabbit eyes. 2. The more vitreous hemorrhage developed, the greater was the fibrovascular proliferation and the degree of fibrovascular proliferation was more marked in group II than group I. 3. The fibrovascular proliferation developed to a band in 3 weeks, then regressed gradually. 4. The fibrovascular band was composed of fibroblasts, stromal matrix and few vessels.
Conjunctiva ; Fibroblasts ; Ophthalmoscopes ; Rabbits ; Tenon Capsule ; Vitreous Hemorrhage ; Wounds and Injuries*

In the process of closing a scleral wound caused by various conditions, incarceration af the conjunctiva, Tenon's capsule or vitreous in the wound can occur unexpectedly. We created such conditions experimentally to determine their intraocular complications. The experimental, materials were 12 albino rabhits(24 eyes) and the rabbits were divided into two groups(I and II). Group I rabbits(12 eyes) received no vinectormy and group II rabbits(12 eyes) received a vitrectormy. After the conjunctiva and Tenon's capsule flap was made, the tissue flap was inserted into the vitreous cavity through the sclerotomy site- Fundus examination with an indirect ophthalmoscope and enucleation for histology were performed at 3 days, 1 week, 3 weeks, 6 weeks, 3 months and 6 months after the experiment. The results were as follows: 1, Intraocular fibrovascular proliferation developed in all experimental rabbit eyes. 2. The more vitreous hemorrhage developed, the greater was the fibrovascular proliferation and the degree of fibrovascular proliferation was more marked in group II than group I. 3. The fibrovascular proliferation developed to a band in 3 weeks, then regressed gradually. 4. The fibrovascular band was composed of fibroblasts, stromal matrix and few vessels.
Conjunctiva ; Fibroblasts ; Ophthalmoscopes ; Rabbits ; Tenon Capsule ; Vitreous Hemorrhage ; Wounds and Injuries*

PURPOSE: Resveratrol exerts cytoprotective or cytotoxic effects according to cell type. This study was performed to evaluate the effects of resveratrol on the survival of cultured human Tenon's capsule fibroblasts (HTFBs). METHODS: Primarily cultured HTFBs were exposed to 0, 10, or 100 microM resveratrol for 3 days. Cellular survival was assessed using the MTT assay and degree of apoptosis was analyzed with flow cytometry using annexin-V/propidium iodide double staining. RESULTS: Resveratrol decreased the survival of HTFBs after exposure to 10 microM (p = 0.04). In flow cytometric analysis, 10 microM resveratrol did not affect the degree of apoptosis (p = 0.89), but 100 microM resveratrol increased the degree of apoptosis (p = 0.003). Both 10 and 100 microM resveratrol did not affect the degree of necrosis (p = 0.74, 0.33). CONCLUSIONS: Resveratrol decreased cellular survival of cultured HTFBs and induced apoptosis. Thus, resveratrol may exert antiproliferative effects on HTFBs.
Apoptosis ; Fibroblasts* ; Flow Cytometry ; Humans* ; Necrosis ; Tenon Capsule

Convergent strabismus fixus is a rare condition in which one or both eyes are anchored in a position of extreme adduction. The involved eye is fixed in this position and cannot be moved, and the forced duction test will confirm the immobility of the eye. This condition generally is thought to be congenital and caused by fibrosis and loss of elasticity of the medial rectus muscle. However Villaseca postulated that fibrosis of the medial rectus muscle is the consequence of contracture following a lateral rectus paralysis rather than a primary anomaly. The authors experienced two cases of monocular convergent strabismus fixus of left eye in a 51 year old female patient and a 63 year old male patient. In the latter case, we performed complete disinsertion of medial rectus muscle combined with recession of conjunctiva and Tenon's capsule and temporary fixation of the globes with traction sutures in a position of abduction on left eye. The result of that surgery, however, was not satisfactory. So we performed 11mm resection of lateral rectus muscle of left eye about 8 weeks after the first surgery and followed up for months in satisfactory result.
Conjunctiva ; Contracture ; Elasticity ; Esotropia* ; Female ; Fibrosis ; Humans ; Male ; Middle Aged ; Paralysis ; Sutures ; Tenon Capsule ; Traction

PURPOSE: We report a case of infraduction limitation improvement and orthotropia at primary position in a patient with traumatic isolated inferior rectus muscle rupture after immediate repair surgery of the ruptured muscle. CASE SUMMARY: A 47-year-old man came to our emergency department complaining of right eyelid contusion and conjunctival laceration after trauma due to the metal part of a high pressure hose. Right hypertropia of 20 prism diopters was observed at primary gaze and right hypertropia of 30 prism diopters was observed at down gaze. The right eye showed a -4 infraduction limitation. We sutured the distal part of the ruptured inferior rectus muscle with surrounding tissue, including the Tenon's capsule and the part of the muscle stump, to its original insertion. Orthotropia at primary position and 8-prism-diopters of right hypertropia on down gaze was observed one day after surgery. At 40 days after surgery, the patient had orthotropia at primary position and 4-prism-diopter right hypertropia on down gaze. Infraduction limitation of the right eye improved to -1. CONCLUSIONS: Immediate repair of complete traumatic isolated inferior rectus muscle rupture can correct the limitation of extraocular movement and achieve orthotropia at primary position.
Contusions ; Emergency Service, Hospital ; Eyelids ; Humans ; Lacerations ; Middle Aged ; Rupture* ; Strabismus ; Tenon Capsule

PURPOSE: To report a patient with adsence of the superior oblique (SO) muscle of the right eye, who showed improvement after surgery for hyperdeviation and exotropia. METHODS: A four-year-old girl who presented with 14 PD exotropia, and 25 PD hypertropia of the right eye had a history of myectomy of the right inferior oblique (IO) muscle for bilateral SO palsy as a two-year-old. At the time of surgery, severely fibrotic pseudotendon of IO and Tenon's capsule attached to the insertional area of the inferior rectus muscle was found. IO was remyectomized with adhesiolysis. Lateral rectus and superior rectus (SR) muscles were recessed 6.5mm and 7mm, respectively. After exposure of SR, the absence of SO was found. MRI taken at postoperative one day showed definite SO absence. RESULTS: Three weeks after surgery, 4 PD of left hyperphoria at distant and 5 PD of left hyperphoria at near were observed. Right hyperdeviation was not detected. At postoperative 7 months, 4 PD of exophoria, 6 PD of right dissociated vertical deviation (DVD) and 10 PD of left DVD were seen at distant. A small left hyperdeviation was intermittently noted at upgaze and was cautiously followed. CONCLUSIONS: Absence of the superior oblique muscle is rare. However, such absence should be suspected when apparent superior oblique palsy accompanies with severe hyperdeviation and horizontal deviation. MRI or CT is helpful in the diagnosis of this condition and direct confirmation is needed.
Diagnosis ; Exotropia ; Female ; Humans ; Magnetic Resonance Imaging ; Muscles ; Paralysis ; Strabismus ; Tenon Capsule