1/71. Long-term outcome of aqueous shunt surgery in ten patients with iridocorneal endothelial syndrome.PURPOSE: To report the long-term outcome of ten patients with iridocorneal endothelial (ice) syndrome who underwent aqueous shunt surgery for uncontrolled glaucoma. DESIGN: Noncomparative, retrospective case series. PARTICIPANTS: The authors reviewed charts of ten patients with ice syndrome-related glaucoma who underwent aqueous shunt surgery at one institution between 1987 and 1996. MAIN OUTCOME MEASURES: intraocular pressure (IOP), number of glaucoma medications, and further surgical interventions were measured. RESULTS: With a median follow-up of 55 months, four eyes had adequate IOP control (IOP <21 mm Hg) with one or two medications after the initial aqueous shunt surgery. An additional three eyes achieved adequate IOP control after one or more tube repositionings or revisions of the initial aqueous shunt. In this series, the aqueous shunt surgery most often failed because of blocking of the tube ostium by iris, ice membrane, or membrane-induced tube migration. CONCLUSION: Aqueous shunt surgery appears to be an effective method for IOP lowering in some eyes with ice syndrome-related glaucoma when medical treatment or conventional filtration surgeries fail, but additional glaucoma procedures and/or aqueous shunt revisions and tube repositionings are not uncommon.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/71. persistent hyperplastic primary vitreous with myopia: a case study.BACKGROUND: persistent hyperplastic primary vitreous (PHPV) is a congenital disorder that manifests a range of ocular anomalies, including leukocoria, microphthalmia, cataract, and a retrolental fibrovascular membrane. In general, the prognosis for visual acuity with PHPV has been poor. A recent report on six patients who have myopia associated with PHPV showed that these patients were not microphthalmic, did not manifest leukocoria, and showed a mean visual acuity at final followup of 20/160. CASE REPORT: The case of a 3-year-old boy with myopic PHPV of the left eye is presented. Full-time wear of the cycloplegic refraction, combined with patching of the non-amblyopic eye, resulted in an improvement in visual acuity. RESULTS: PHPV with myopia may constitute a distinct subtype of PHPV. patients with myopic PHPV tend to seek treatment later than patients with anterior or posterior PHPV as a result of the lack of microphthalmia and leukocoria. These individuals do not show the long-term complications, such as secondary glaucoma and intraocular hemorrhages, associated with PHPV. CONCLUSION: The acuity improvement in this case of myopic PHPV suggests that a more conservative approach to its surgical management may be appropriate while pursuing refractive correction and amblyopia therapy to attain the best acuity possible.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
3/71. tissue plasminogen activator to treat impending pupillary block glaucoma in patients with acute fibrinous HLA-B27 positive iridocyclitis.PURPOSE: To report the use of intracameral tissue plasminogen activator to dissolve fibrinous membranes and break posterior synechiae in patients with acute HLA-B27-positive iridocyclitis with impending pupillary block. methods: Two patients with severe acute fibrinous iridocyclitis and seclusio pupillae were identified. Because of the concern of impending pupillary block, intracameral tissue plasminogen activator (12.5 microg in 0.1 ml, Activase; Genentech, Inc, South san francisco, california) was injected with a 25-gauge needle through the corneal limbus. RESULTS: Both patients showed complete dissolution of fibrin with disruption of posterior synechiae. There were no adverse events after injection. Neither patient required further invasive intervention, and both fully recovered with medical management. CONCLUSIONS: Intracameral tissue plasminogen activator is a safe and effective agent for patients with severe acute iridocyclitis and pupillary seclusion. patients with clinical signs suggestive of impending pupillary block glaucoma may be considered for tissue plasminogen activator injection to avoid the possible need for emergency surgical iridectomy and synechiolysis.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
4/71. corneal opacity and congenital glaucoma associated with massive heparan sulfaturia: report of one case.A four month-old male infant was noted to have had severe corneal opacity since birth. Buphthalmos, increased intraocular pressure and corneal opacity with neovascularization were noted during physical examination. There was neither dysmorphic face nor hirsutism and the liver and spleen were impalpable. In addition, hypotonia, poor head control, and absence of Moro and grasping reflexes were also noted. There was no evidence of congenital infection by TORCH study. Tests of both urine and plasma amino acids were within normal limits. However, excessive urinary excretion of heparan sulfate was detected by thin-layer chromatography. corneal transplantation was performed at 6 months old. Histopathological examination of the corneal button showed homogeneous thickening of Bowmen's membrane and intracytoplasmic pinkish substances in corneal stroma. The alcian blue stain was positive, which was consistent with mucopolysaccharidosis of cornea. The manifestation of this case may be a clinical variant of Sanfilippo's syndrome (Mucopolysaccharidosis type III).- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
5/71. Pre-Descemet's hematoma in a patient of congenital glaucoma with Descemet's detachment: a unique form of hemorrhage.A unique form of anterior segment hemorrhage called Pre-Descemet's hematoma is a previously unreported type of hemorrhage in which blood collects in the narrow space between the corneal stroma and detached Descemet's membrane, which in our case was because of congenital glaucoma associated with Haab's straie.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
6/71. In vivo confocal microscopy in primary congenital glaucoma with megalocornea.PURPOSE: To report the microscopic findings of congenital glaucoma-related megalocornea using in vivo confocal microscopy. patients AND methods: Two consecutive adult patients presenting the typical features of glaucomatous megalocornea underwent a complete ophthalmologic examination. The first patient presented with progressive glaucoma with bilateral megalocornea. The second patient's left eye was affected by megalocornea without actual evidence of glaucoma, whereas the right eye was healthy. Both patients were examined using a new-generation scanning slit corneal confocal microscope. RESULTS: In both patients, confocal microscopy revealed a mild reduction of keratocyte density in the mid and rear stroma, a particular abnormal "clew-shaped" morphology of stromal nerves, and the presence of discontinuous hyperreflective structures overhanging the endothelial layer at the level of the descemet membrane. The endothelium showed severe polymegethism, pleomorphism, and a markedly decreased cell density, and focal cellular lesions were noted. CONCLUSION: Confocal microscopy is a diagnostic tool used to evaluate microscopic aspects of Haab striae and endothelial morphologic changes in glaucomatous megalocornea. Unsuspected alterations, such as nerves abnormalities and focal endothelial tractions by scar tissue, were observed.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
7/71. Amniotic membrane graft for late-onset glaucoma filtering leaks.PURPOSE: To evaluate the effectiveness and safety of amniotic membrane graft in the management of late-onset filtering bleb leaks after trabeculectomy with mitomycin C. DESIGN: Prospective, noncomparative, interventional case reports. methods: Two eyes of two patients with late-onset filtering bleb leak received an amniotic membrane graft. RESULTS: In both patients, bleb leaks were closed successfully with amniotic membrane graft, and bleb function was maintained during the follow-up period of 34 and 14 months, respectively. CONCLUSION: Amniotic membrane graft may be considered an alternative method for treating late-onset filtering bleb leaks while maintaining bleb function. As the number of cases was small, more cases need to be accumulated to verify the usefulness of this technique.- - - - - - - - - - ranking = 4keywords = membrane (Clic here for more details about this article) |
8/71. Repair of Descemet's membrane detachment after viscocanalostomy.We report an alternative descemetopexy technique in a case of Descemet's membrane detachment after viscocanalostomy, possibly caused by high-molecular-weight viscoelastic material.- - - - - - - - - - ranking = 2.5keywords = membrane (Clic here for more details about this article) |
9/71. Diffuse congenital hemangiomatosis with infantile glaucoma.A white male infant was born with multiple hemangiomas of the skin and mucous membrane. At 7 months of age he exhibited the signs and symptoms of infantile glaucoma in each eye, but goniotomy was not possible because of vascularity in the angles. Cyclocryotherapy was used on multiple occasions to control intraocular pressure until a goniotomy could be done safely in one eye. The other eye has had good control of intraocular pressure without operation.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
10/71. phenotype of cytochrome P4501B1 gene (CYP1B1) mutations in Japanese patients with primary congenital glaucoma.AIM: To investigate the phenotypes associated with cytochrome P4501B1 gene (CYP1B1) mutations in Japanese patients with primary congenital glaucoma (PCG). methods: 66 Japanese patients with PCG were screened for sequence mutations in the CYP1B1 gene using single strand conformation polymorphism analysis followed by automated dna sequencing. 11 cases had a CYP1B1 mutation in both alleles (the mutation group) and 21 cases did not have a CYP1B1 mutation (the "no mutation" group). The clinical features, such as age of onset, sex, intraocular pressure, and Descemet's membrane rupture, of the two groups were compared. RESULTS: The clinical symptoms and signs did not differ for the two groups. The mean age at onset was 1.7 months in the mutation group and 3.1 months in the no mutation group, and the male:female ratio was 6:5 in the mutation group and 19:2 in the no mutation group. Both of these differences were statistically significant. CONCLUSIONS: In clinically diagnosed cases of PCG, a subgroup shows a CYP1B1 gene mutation. Age at onset was earlier in PCG patients with CYP1B1 mutations than in patients without mutations. women were more prevalent among patients with mutations than those without mutations.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
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