This prospective observational case series study included 6 eyes of 6 consecutive glaucomatous patients. Each patient underwent trabeculectomy with mitomycin C, and received a 1.25 mg of subconjunctival bevacizumab injection at completion of the trabeculectomy. Study eyes included two with neovascular glaucoma, three with uveitic glaucoma, and one with secondary glaucoma following vitrectomy. All eyes had undergone failed glaucoma laser/surgical treatment or an intraocular surgical procedure. Intraocular pressure (IOP) at the following postoperative visits: preoperative, 1 week, 1 month, 2 months, 3 months, and 6 months, was measured. We also evaluated postoperative bleb findings and complications. IOP measured at each visit was 37.5+/-14.4 mmHg, 6.2+/-3.4 mmHg, 8.3+/-7.2 mmHg, 12.0+/-4.4 mmHg, 10.8+/-3.1 mmHg, and 12.2+/-3.3 mmHg, respectively, for each visit. All eyes had functioning blebs with normal IOP at postoperative 6 months with no additional IOP-lowering medication.
Adult ; Aged ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Conjunctiva ; Female ; Glaucoma/*drug therapy/etiology/*surgery ; Glaucoma, Neovascular/drug therapy/surgery ; Humans ; Injections, Intraocular ; Male ; Middle Aged ; Prospective Studies ; Trabeculectomy/*methods ; Uveitis/complications ; Vascular Endothelial Growth Factor A/*antagonists & inhibitors ; Vitrectomy/adverse effects

PURPOSE: To evaluate the refractive outcomes using 5 different IOL power calculation formulas (SRK II, Holladay I, Hoffer Q, SRK T, Binkhorst II) in pediatric cataract patients. METHODS: A retrospective analysis of biometric and refractive data was performed on 63 eyes of 44 pediatric patients, who successfully underwent primary and secondary IOL implantation. For analysis, the eyes were divided into three groups: those with axial length <22.0 mm (group S); > or =22 mm but <24.5 mm (group M); and > or =24.5 (group L). And also divided into another three groups: those with mean keratomery value <42.5D (group I); > or =42.5D but <44.5D (group II); and > or =44.5D (group III). The postoperative refractive outcome was taken as a spherical equivalent of the refraction at 1 week and 2 to 3 months after surgery. The 'predictive error' was defined as absolute error between the target and actual postoperative refraction. RESULTS: SRK II had a best predictive error but there was no statically significant in short eye group and medium eye group at 1 week and 2 to 3 months after the surgery. And SRK II also had a best predictive error but there was no statically significant in group I, II, and III at 1 week and 2 to 3 months. CONCLUSIONS: In our study, theoretical formulas did not outperform the regression formula in pediatric IOL implantation. This may be related to the variability of the relationship between axial length and corneal curvature in pediatric eyes and to dependent variables inherited in the formulas.
Cataract ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Models, Theoretical ; Retrospective Studies

BACKGROUND: Several investigations have studied hypoxic pulmonary vasoconstriction (HPV) during endotoxemia and there is an increase in nitric oxide (NO) in pulmonary vessels. However, these studies yielded conflicting or at times contradictory results, since reference has been made to both enhancement and inhibition of HPV. Our objective was to determine the changes of hypoxic pulmonary vasoconstriction on the isolated blood-perfused lung of endotoxemic rats. METHODS: Pulmonary arterial pressure (PAP) was measured in a blood-perfused lung preparation from Sprague-Dawley rats in normoxia (21% O2, 5% CO2, balanced N2) and hypoxia (5% O2, 5% CO2, balanced N2). We studied the effect of normoxia and hypoxia in a control group, Escherichia coli lipopolysaccharide group (LPS) and LPS with N omega-nitro-L-arginine methyl ester group (L-NAME). RESULTS: The Baseline PAP was higher in LPS (15.0+/-4.0 mmHg) compared with control group (10.9+/-2.9 mmHg) and L-NAME (11.1+/-3.6 mmHg). In hypoxia, HPV was higher in L-NAME (109.6+/-100.2%) compared with control group (59.9+/-31.6%) and LPS (58.8+/-33.8%)(P<0.05). CONCLUSIONS: We conclude that NO is an important factor to impair HPV during endotoxemia.
Animals ; Anoxia ; Arterial Pressure ; Endotoxemia ; Escherichia coli ; Lung* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Rats* ; Rats, Sprague-Dawley ; Vasoconstriction*

PURPOSE: A diagnosis of wooden intraorbital foreign bodies is common and their removal is often necessitated after complications become manifested. In case of operation, it is difficult to find and remove wooden foreign bodies completely. We have experienced a case of retained multiple intraorbital foreign bodies removed by the secondary operation. We report this case with a literature review. METHODS: A 39-year-old man visited our clinic complaining of diplopia, exophthalmos, and limitation of eyeball movement. He had fallen down and had a lacerated wound. Right after primary closure, he experienced strabismus, orbital cellulitis, and abscess. Several months later, he had a soft mass in the operated lower lid, and two wooden intraorbital foreign bodies were found. MRI detected granuloma and cellulitis near the cavernous sinus. RESULTS: More than ten intraorbital wooden foreign bodies were surgically removed. After the surgery exophthalmos and diplopia were improved, and limitation of eyeball movement disappeared. The MRI findings were also improved. CONCLUSIONS: Intraorbital wooden foreign bodies should be diagnosed with a thorough history taking and radiologic exam, due to a number of potential complications, such as orbital cellulitis, abscess, and diplopia. Furthermore, they should be removed in consideration that they can move spontaneously into the deep interior of the orbit.
Abscess ; Adult ; Cavernous Sinus ; Cellulitis ; Diagnosis ; Diplopia ; Exophthalmos ; Foreign Bodies* ; Granuloma ; Humans ; Magnetic Resonance Imaging ; Orbit ; Orbital Cellulitis ; Strabismus ; Wounds and Injuries

PURPOSE: To analysis the epidemiology, distribution of age, and social welfare statue of low vision patients. METHODS: A retrospective analysis of age, visual acuity, underlying ocular disease, and optical aids of 102 patients who visited our clinic from March 2004 to March 2006. We had an interview with patients about their educational background, jobs and registration of legal blindness. RESULTS: The mean age was 40.87+/-22.72 years old and the patients in their forties were most common. The most frequent cause of low vision included optic atrophy (16.7%), macular degeneration (15.7%), retinitis pigmentosa (11.8%), congenital cataract (10.8%), glaucoma (6.9%), amblyopia (6.9%). 42 patients had already got the registration for legal blindness but, 41 patients were newly registered during this study. Under 20 years old, there were 17 general school students, 4 special school students, and 1 preschool child. Over 20 years old, there were only 14 patients who got regular job and all patients have educational attainment under high school graduate except 10 patients. CONCLUSIONS: The epidemiology of low vision has been changed to the aging society. And the registration of legal blindness criteria and understanding of low vision need to be changed. Moreover, understanding how low vision impacts lives is important to be able to provide better social services in the future.
Aging ; Amblyopia ; Blindness ; Cataract ; Child, Preschool ; Epidemiology ; Glaucoma ; Humans ; Macular Degeneration ; Optic Atrophy ; Retinitis Pigmentosa ; Retrospective Studies ; Social Welfare* ; Social Work ; Vision, Low* ; Visual Acuity ; Young Adult

PURPOSE: To report two cases of trabeculectomy with biodegradable collagen material conducted on two post-vitrectomy patients. CASE SUMMARY: The first patient was a 43-year-old woman with uncontrolled increased intraocular pressure (IOP) after pars plana vitrectomy with scleral buckling for diabetic retinopathy and vitreous hemorrhage. Another patient, a 28-year-old woman with aphakia, also had uncontrolled increased IOP after pars plana vitrectomy with encircling scleral buckling for retinal detachment. For both of these patients, we performed trabeculectomy using mitomycin C and recently developed biodegradable collagen matrix. In the first case, the IOP was increased three months after the surgery, for which needling was done. After needling, the IOP was well controlled in the range of 16 to 19 mmHg up to eight months postoperatively with stilling anti-glaucomatous eyedrops (Cosopt(R), Xalatan(R)). In the second case, IOPwas increased one week after the surgery, but it was well controlled between 14 to 21 mmHg up to nine months postoperatively with anti-glaucomatous eye drops (Combigan(R)). CONCLUSIONS: Biodegradable collagen matrix can possibly reduce the surgical failure of trabeculectomy and it is especially suitable for high risk patients when combined with anti-metabolic agents like MMC.
Adult ; Aphakia ; Collagen ; Diabetic Retinopathy ; Female ; Humans ; Intraocular Pressure ; Mitomycin ; Ophthalmic Solutions ; Retinal Detachment ; Scleral Buckling ; Trabeculectomy ; Vitrectomy ; Vitreous Hemorrhage ; Wound Healing

Hibernoma is a rare slowly growing painless subcutaneous neoplasm, and predominates in the scapular and interscapular region, mediastinum, and upper thorax. Microscopically, hibernomas display a distinct lobular pattern and are composed of cells with varying degrees of differentiation, ranging from uniform, round to ovoid, granular eosinophilic cells to multivacuolated cells with multiple, small lipid droplets and centrally placed nuclei. We report a case of hibernoma occurred on the right scapular region in a 33-year-old man.
Adult ; Eosinophils ; Humans ; Lipoma* ; Mediastinum ; Thorax

PURPOSE: To report a case of ab interno trabeculotomy with Trabectome(R) (NeoMedix Corp., CA, USA) conducted on a refractory primary open angle glaucoma (POAG) patient. CASE SUMMARY: Trabectome(R) has microelectrocautery with simultaneous infusion and aspiration of debris and ablates a segment of trabecular meshwork and the inner wall of Schlemm's canal. The patient, a 54-year-old man had uncontrolled intraocular pressure (IOP) with topical anti-glaucoma medications after trabeculectomy and Ahmed valve implantation for POAG. For the patient, ab interno trabeculotomy with Trabectome(R) was performed. There were no other postoperative complications except for microhyphema immediately after surgery. The IOP was controlled between 14 to 24 mm Hg up to 3 months postoperatively with topical anti-glaucoma medications (Cosopt(R), Alphagan-P(R), Lumigan(R)). CONCLUSIONS: Ab interno trabeculotomy with Trabectome(R) appears to offer a newer method of lowering IOP in POAG than conventional trabeculectomy and glaucoma drainage device surgery.
Drainage ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Middle Aged ; Postoperative Complications ; Trabecular Meshwork ; Trabeculectomy

PURPOSE: To compare conventional laser peripheral iridotomy (LPI) and LPI combined with laser peripheral iridoplasty in eyes with primary angle closure suspect (PACS) by assessment of anterior chamber dimensional changes using a Pentacam. METHODS: Forty-eight eyes of 24 subjects with bilateral PACS were recruited consecutively. Each eye was randomly allocated to treatment with conventional LPI, argon LPI only, or LPI plus iridoplasty, which consisted of simultaneous argon LPI and peripheral iridoplasty. Anterior chamber measurements were performed on each eye using a Pentacam, both before and after treatment. Mean anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle were measured, and topographic ACD analysis was performed. Results were compared between the two treatment groups. RESULTS: After treatment with either conventional LPI or LPI plus iridoplasty, the mean ACD and ACV increased significantly. Topographic ACD analysis revealed that the mid-to-peripheral ACD increase was significantly greater in the LPI plus iridoplasty group than in eyes treated with conventional LPI. Intraocular pressure changes and post-LPI complications did not differ between the groups. CONCLUSIONS: Compared with conventional LPI, our study showed that LPI plus iridoplasty improved the mid-to-peripheral ACD increase. This procedure may have a role as an adjunct for reducing angle closure by simultaneously eliminating pupillary and non-pupillary block components.
Adult ; Aged ; Anterior Chamber/*pathology/surgery ; Diagnostic Techniques, Ophthalmological/*instrumentation ; Equipment Design ; Female ; Follow-Up Studies ; Glaucoma, Angle-Closure/pathology/physiopathology/*surgery ; Gonioscopy ; Humans ; Intraocular Pressure ; Iridectomy/*methods ; Iris/pathology/*surgery ; Laser Therapy/*methods ; Lasers, Solid-State ; Male ; Middle Aged ; Prospective Studies ; Tonometry, Ocular

We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*