Adolescent ; Ciliary Body ; pathology ; surgery ; Cysts ; surgery ; Glare ; Humans ; Male ; Neodymium ; chemistry ; Yttrium ; chemistry

OBJECTIVE: To explore the risk factors, the ciliary body anatomy structures, the therapeutic methods and the prognosis for malignant glaucoma through retrospectively collecting the clinical data from primary angle-closure glaucoma (PACG) patients. METHODS: Clinical data in 1183 patients (1456 eyes) with PACG were collected between July, 2010 and May, 2014 from Xiangya Hospital, Central South University. Thirty patients (38 eyes) were diagnosed as malignant glaucoma. According to symptom, these patients were divided into a PACG group (1418 eyes) and a malignant glaucoma group (38 eyes); according to age, they were divided into a 3-40 years old group (171 eyes), a 41-70 years old group (1016 eyes) and a ≥71 years old group (269 eyes); according to therapeutic methods, they were divided into a drug therapy group (5 eyes), a lens extraction group (6 eyes) and a vitrectomy surgery group (27 eyes); according to the different method of surgery, they were divided into a vitrectomy group (27 eyes), a nonvitrectomy group (11 eyes). The age, sex, anterior chamber depth (ACD), axial length (AL), lens thickness (LT), visual acuity, intraocular pressure, therapeutic methods and surgery history were recorded. Meanwhile, the ciliary body thickness (CBT), trabecular ciliary process angle (TCA) and lens diameter were measured by ultrsound biomicroscopy (UBM). RESULTS: Male and female ratio was 1:2 in the malignant glaucoma group. The average age [(51.87±12.92) years] in the malignant glaucoma group was less than that in the PACG group [(57.87±8.78) years](P<0.05). Malignant glaucoma was more likely to occur in the first 3 months after PACG trabeculectomy with a rate of 85.7%. The LT [(4.33±0.67) mm], AL[(21.44±1.18) mm] and ACD [(2.12±0.41) mm] in the malignant glaucoma group were less than those in the PACG group [(4.81±0.50), (22.17±0.97) and (2.49±0.48) mm, respectively](all P<0.05). The CBT0, CBT1, CBTmax, TCA and lens diameter in the malignant glaucoma group were less than those in the PACG group (all P<0.05). CONCLUSION Female PACG patients, with short axial length, shallow anterior chamber, thin lens, thin ciliary body, small trabecular ciliary process angle and short lens diameter, are more likely to suffer from malignant glaucoma. Vitrectomy can significantly reduce intraocular pressure.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Ciliary Body ; anatomy & histology ; Female ; Glaucoma, Angle-Closure ; drug therapy ; surgery ; Humans ; Intraocular Pressure ; Lens, Crystalline ; anatomy & histology ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Tonometry, Ocular ; Trabeculectomy ; Visual Acuity ; Vitrectomy ; Young Adult

PURPOSE: In this study, we examined the stability of the lens-angle supporter (LAS) for accommodation restoration by comparing intraocular lens (IOL) location, after-cataract and ciliary body damage after cataract surgery in rabbits. METHODS: Eight rabbits were divided into experimental and control groups of four rabbits each. Phacoemulsification and irrigation and aspiration were performed in all rabbits. This was followed by an LAS and IOL insertion in the four experimental rabbits. In the four control rabbits, only an IOL insertion was performed. Six months after the surgery, the location of the IOL, the conditions of the lens capsule and ciliary body were evaluated using a slitl-amp examination and Miyake-Apple view. RESULTS: For the experimental group, the ultrasound biomicroscope results showed normal LAS and IOL positioning in all four cases. According to the slitlamp examination and Miyake-Apple view, the IOL was positioned at the center, with less after-cataract and damage to the ciliary body. For the control group, ultrasound biomicroscope results indicated a higher IOL position than normal, as well as a single case of IOL decentering. According to the slit-lamp examination and Miyake-Apple view, the IOL was decentered with more severe after-cataract and ciliary body damage. CONCLUSIONS: The LAS has the potential to maintain a stable IOL position while producing less after-cataract when used in lens-angle reconstruction for correction of presbyopia. Moreover, LAS implantation incurs less damage to the ciliary body.
Accommodation, Ocular/physiology ; Animals ; Anterior Eye Segment ; Ciliary Body/injuries ; Disease Models, Animal ; Eye Injuries/*surgery ; Lens Capsule, Crystalline/*surgery ; *Lens Implantation, Intraocular ; Microscopy, Acoustic ; *Phacoemulsification ; Rabbits ; *Reconstructive Surgical Procedures

We report a case of ciliary body melanocytoma in a Korean patient, which presented as an intermittently painful pigmented iris mass and was successfully managed by iridocyclectomy. A 52-year-old healthy man presented with an irregularly-shaped and heavily-pigmented mass at the iris root of his right eye. Visual acuity of the right eye was 20/20 with normal intraocular pressure. Ultrasound biomicroscopy showed a 1.5x1.3-mm ciliary-body mass with extension into the iris root. Iridocyclectomy with scleral resection under a lamellar scleral flap was performed, and the histopathologic features of the resected tissue were consistent with melanocytoma of the ciliary body. The patient's visual acuity remained 20/20 with good postoperative cosmesis. During one year of follow-up, no signs of tumor recurrence were seen, and the patient reported resolution of the intermittent ocular pain in the involved eye.
*Ciliary Body/surgery ; Humans ; Iris/*pathology/*physiopathology/surgery ; Male ; Middle Aged ; Neoplasm Invasiveness/*pathology/physiopathology ; Nevus/*pathology/surgery ; Pain/*physiopathology ; Uveal Neoplasms/*pathology/surgery

BACKGROUNDCiliary body tumors are usually difficult to diagnose and treat in early stages. However, treatment of such tumors has trended toward ocular conservation instead of enucleation. Local excision of ciliary body tumors has become effective with the development of the modern vitrectomy, but long-term outcomes are still not clear. Therefore, we reported the outcome of locally excised ciliary body tumors after long-term follow-up.

METHODSTwenty-two patients (22 eyes), who had been diagnosed with ciliary body tumors in Beijing Tongren Hospital from January 1996 to June 2001, were enrolled in this prospective cohort study. Localized lamellar sclera-ciliary excisions were performed. In some cases, vitrectomies, scleral graft transplantations, and further excisions of the anterior choroid were performed. Diagnoses were confirmed by histopathologic examination. Patients were followed from five to eleven years after surgery. Their visual acuity, intraocular pressure and local recurrence were recorded with descriptive percentages.

RESULTSAfter surgery, all patients maintained normal eyeball appearances. Six patients maintained circular pupils. The final best corrected visual acuities (BCVA) varied from 0.02 - 1.00, including 18 patients (81.82%) who had BCVA equal to or better than that before surgery. Fifteen patients (68.18%) had BCVA better than 0.3. Only two patients had intraocular pressure (IOP) of less than 10 mmHg and the other patients maintained normal IOP. Nine cases (40.91%) were given confirmed diagnosis of malignant melanoma, four (18.18%) of melanocytoma, six (27.27%) of nonpigmented ciliary epithelial adenoma, two (9.09%) of neurofibroma, and one (4.55%) of neurinoma. Twenty patients (90.91%) had no recurrence during the follow-up period. In one case melanocytoma recurred seven years after surgery and enucleation was performed. One patient, whose operation removed a malignant melanoma with a diameter of 16 mm, died of hepatic metastasis five years after the operation.

CONCLUSIONFor some ciliary body tumors, especially in the early stages, local excision is an effective and safe method to save the vision and the eyeball.

Adolescent ; Adult ; Ciliary Body ; Cohort Studies ; Female ; Humans ; Intraocular Pressure ; Male ; Melanoma ; surgery ; Middle Aged ; Prospective Studies ; Uveal Neoplasms ; diagnosis ; pathology ; surgery ; Visual Acuity

OBJECTIVETo evaluate the therapeutic effect of laser photocoagulation of ciliary processes after pars plana vitrectomy in aphakic glaucoma.

METHODSTwenty patients (20 eyes) of aphakic glaucoma underwent vitrectomy plus laser treatment. During the surgery, after conventional 3-incision pars plana vitrectomy, a probe of semi-conductor diode laser (532 nm) was inserted through the sclera incision, the ciliary processes were then photocoagulated under direct visualization for 180 degree range. Before and after the surgery, the visual acuity, the intraocular pressure (IOP) as well as the outer appearance of the anterior segment were evaluated. The mean follow-up period was 13 months.

RESULTSThe IOP at the last visit was (21.35 +/-2.52) mmHg, which was significantly lower than that before the surgery [(39.75 +/-6.27) mmHg, P=0.000]. Atrophy of the ciliary processes was observed 1-3 months after the surgery.

CONCLUSIONPars plana vitrectomy combined with laser coagulation of ciliary processes reduces the IOP in patients with aphakic glaucoma effectively.

Adult ; Aphakia ; complications ; Ciliary Body ; surgery ; Female ; Glaucoma ; complications ; physiopathology ; surgery ; Humans ; Intraocular Pressure ; Laser Coagulation ; methods ; Male ; Middle Aged ; Treatment Outcome ; Visual Acuity ; Vitrectomy ; methods

PURPOSE: Ahmed glaucoma valves were implanted into the ciliary sulcus of two patients diagnosed with neovascular glaucoma with favorable outcomes. METHODS: The study patients presented to our hospital with ocular pain caused by increased intraocular pressure (IOP). A thorough history was taken, and an ophthalmic examination was performed. RESULTS: A 71-year-old male patient and a 57-year-old female patient visited our hospital for ocular pain and persistent, elevated IOP. Each were diagnosed with neovascular glaucoma and underwent an Ahmed glaucoma valve implantation to the sulcus. After surgery, the patients maintained stable IOPs without major complications. CONCLUSIONS: The method of Ahmed glaucoma valve implantation into the ciliary sulcus could reduce complications caused by implantation to the anterior chamber. It is thought to be an efficient method for the maintenance of appropriate IOP after surgery.
Aged ; Ciliary Body/*surgery ; Female ; Follow-Up Studies ; *Glaucoma Drainage Implants ; Glaucoma, Neovascular/physiopathology/*surgery ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Prosthesis Design ; Prosthesis Implantation/*instrumentation ; Visual Acuity

This study was performed to demonstrate the ultrasound, biomicroscopic and dimensional changes of angle structure after laser iridotomy (LI) and primary trabeculectomy (PT) in primary angle-closure glaucoma (PACG). Angle-opening distance at a point 500 (m from the scleral spur (AOD500), trabecular-iris angle (theta1), trabecular ciliary process distance (TCPD), ciliary process-iris angle (CPI), iris thickness (ID1, ID3), length of iris-lens contact distance (ILCD) and anterior chamber depth (ACD) were assessed before and after each procedure. Thirteen patients with LI and 16 with PT were prospectively enrolled. There were statistically significant increases in AOD500, theta1, and ILCD in both groups. CPI was decreased in both groups. ACD, TCPD, and iris thickness were not changed significantly. The changes in angle configuration after LI or PT may result more from alterations in aqueous pressure gradients across the iris and the changes of configuration were greater in the iris roots without rotation of ciliary body. However, we didn't find any significant differences in the changes of parameters between the two procedures.
Acute Disease ; Aged ; Aged, 80 and over ; Ciliary Body/surgery/*ultrasonography ; Female ; Glaucoma, Angle-Closure/surgery/*ultrasonography ; Humans ; Iridectomy/*methods ; Iris/surgery/*ultrasonography ; Laser Surgery ; Male ; Middle Aged ; Prospective Studies ; Trabecular Meshwork/surgery/*ultrasonography ; Trabeculectomy/*methods

Mitomycin C(MMC) is one of the alkylating agents, which is commonly used adjunctively to inhibit the over-growth of the fibroblasts in high-risk filtering surgery. However, it increases the incidence of the complications including persistent postoperative hypotony. The hypotony may be caused by the toxic effect of MMC on the ciliary epithelium. The morphological changes of the ciliary epithelium were evaluated using transmission electron microscope four and twelve weeks after the application of balanced salt solution(BSS) and MMC on the exposed sclera against the ciliary body in the rabbit eyes. There was no specific change in the ciliary epithelium four and twelve weeks after the application of BSS. Four weeks after the application of 0.2mg/ml of MMC, the mitochondria in the nonpigmented epithelium of the applied region were swollen mildly. The mitochondria of both pigmented and nonpigmented epithelia were swollen moderately in the region applied with 0.5mg/ml of MMC. Twelve weeks after the application of either 0.2 or 0.5mg/ml of MMC, the mitochondria were swollen markedly, the nuclear membranes in the pigmented and nonpigmented epithelia were wrinkled, and the heterochromatins of the nuclei faded in both applied and contralateral ciliary epithelia. These findings indicate that mitomycin C causes degenerative changes in the ciliary epithelium decrease aqueous production.
Alkylating Agents ; Ciliary Body ; Epithelium* ; Fibroblasts ; Filtering Surgery ; Heterochromatin ; Incidence ; Mitochondria ; Mitomycin* ; Nuclear Envelope ; Sclera

This study was performed to investigate the toxicity of mitomycin C(MMC) on the iris and ciliary body of the cat. After anesthesia, MMC in 0.1, 0.2, or 0.4 mg/ml concenration was injected intracamerally and the equal volume of balanced salt solution(BSS) was injected intracamerally to the contralateral eye as a control. There were no significant difference between 0.1 mg/ml of MMC and BBS injection except for the enlargement of endoplasmic reticulum and destruction of cristae of ciliary body 14 days after MMC injection. Iris vessel was congested and mitochondria of ciliary body was enlarged and cristae was disrupted 7 days after 0.4 mg/ml of MMC injection. There were infiltration of inflammatory cell on the iris and increased cellular damage at the nonpigmented epithelium of ciliary body 21 days after 0.4 mg/ml of MMC injection. These results suggest that the caution is necessary to prevent high concentration of MMC from getting into the anterior chamber at the time of glaucoma filtering surgery in human.
Anesthesia ; Animals ; Anterior Chamber ; Cats* ; Ciliary Body* ; Endoplasmic Reticulum ; Epithelium ; Estrogens, Conjugated (USP) ; Filtering Surgery ; Glaucoma ; Humans ; Iris* ; Mitochondria ; Mitomycin*