Cases reported "Glaucoma, Open-Angle"

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1/9. Transient intraocular pressure elevation after trabeculotomy and its occurrence with phacoemulsification and intraocular lens implantation.

    PURPOSE: To elucidate the characterization of intraocular pressure (IOP) spike after trabeculotomy, and after the combined procedure of phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. methods: Included in this study were 39 patients (53 eyes) with primary open-angle glaucoma with IOPs uncontrolled even with anti-glaucoma medication. We conducted a retrospective study for the following two groups: patients who underwent trabeculotomy alone (25 eyes) and patients undergoing trabeculotomy combined with PEA and implantation of an IOL (28 eyes). RESULTS: In 7 (28%) of the 25 eyes after trabeculotomy alone and 7 (25%) of the 28 eyes after the combined procedure, transient IOP elevation was found postoperatively. The incidence of hyphema-related IOP spike was significantly higher in eyes after trabeculotomy alone (16%) than after the combined procedure (0%). After removal of the blood present in the anterior chamber in eyes with hyphema-related IOP spikes, the IOP levels were well controlled. CONCLUSIONS: hyphema-related IOP spike is one of the common complications in eyes after trabeculotomy alone, and the combined procedure decreases the incidence of this complication. It is thought that removal of prolonged massive hyphema is effective as treatment for hyphema-related IOP spike.
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ranking = 1
keywords = hyphema
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2/9. Non-penetrating deep sclerectomy in unilateral open-angle glaucoma secondary to idiopathic dilated episcleral veins.

    PURPOSE: To investigate the efficacy of non-penetrating deep sclerectomy (NPDS) in a secondary open-angle glaucoma case due to dilated episcleral veins, on intraocular pressure and retrobulbar hemodynamics. methods: NPDS was done on a 32-year-old male unilateral open-angle glaucoma secondary to idiopathic dilated episcleral veins. RESULTS: Except for hyphema and shallow anterior chamber on the first post-operative day, no other complications were observed. intraocular pressure was 18-20 mmHg during the first six months, without medication or visual loss. Retrobulbar color Doppler imaging showed normal mean and end-diastolic velocities and pulsatility indices of the posterior ciliary and central retinal arteries at end of the first post-operative year. CONCLUSIONS: NPDS may be an alternative to trabeculectomy in open-angle glaucoma secondary to dilated episcleral veins.
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ranking = 0.25
keywords = hyphema
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3/9. Bleeding during gonioscopy after deep sclerectomy.

    PURPOSE: To show a new complication after deep sclerectomy (DS). methods: We described two eyes of two patients with open-angle glaucoma and cataract who were operated on of an uneventful phacoemulsification and DS with SK-gel implantation. RESULTS: Bleeding during gonioscopic examination occurred in both eyes 7 and 8 months after combined surgery. The blood originated from the vessels around the Descemet window, and was probably due to manipulation or rocking of the goniolens. Pressure was immediately applied to the gonioscopic lens and the hyphema was interrupted. CONCLUSION: These cases show the presence of new vessels around the Descemet window after DS with SK-gel. Bleeding from the Descemet window vessels can occur during gonioscopy even months after DS. We recommend conducting a careful gonioscopic examination in patients who have undergone DS to avoid this complication.
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ranking = 0.25
keywords = hyphema
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4/9. hyphema occurring during selective laser trabeculoplasty.

    The first case of hyphema occurring during selective laser trabeculoplasty in an eye without neovascularization is described. A 77-year-old man with uncontrolled open-angle glaucoma received selective laser trabeculoplasty in both eyes for high intraocular pressure with maximally tolerated medical treatment. hyphema occurred during selective laser trabeculoplasty in the left eye. This resolved spontaneously without sequelae. Successful intraocular pressure control was achieved. hyphema and bleeding can happen during selective laser trabeculoplasty. Although this was transient and uneventful in one patient, careful monitoring of intraocular pressure and anterior chamber reaction is advised.
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ranking = 0.25
keywords = hyphema
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5/9. Late hyphema after filtering surgery for glaucoma.

    Four eyes of three patients developed spontaneous hyphemas eight months to three years after uncomplicated glaucoma filtering surgery. In two of the four eyes abnormal vessels could be seen at the internal margin of the trabeculectomy opening. argon laser photocoagulation was successfully used to treat the bleeding, although one eye required multiple sessions.
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ranking = 1.25
keywords = hyphema
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6/9. intraocular pressure elevation caused by massive and prolonged hemorrhage after trabeculotomy ab externo.

    A case with postoperative elevated intraocular pressure levels caused by massive and prolonged hemorrhage after trabeculotomy ab externo is presented. In this case, intraocular pressure was controlled by removal of the hemorrhage, but the transient elevation resulted in progression of visual field defect. Thus, resorption of hyphema and intraocular pressure levels should be monitored closely after trabeculotomy, and surgical removal of the hemorrhage appears to be an effective treatment for this rare complication.
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ranking = 0.25
keywords = hyphema
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7/9. postoperative complications of subconjunctival THC-YAG (holmium) laser sclerostomy.

    BACKGROUND: The THC-YAG (holmium) laser is currently being used to create thermal sclerostomies, an alternate method of intraocular pressure control with poorly regulated glaucoma. A significant advantage of this procedure is the ab externo approach, which utilizes a small fiberoptic laser probe that is advanced subconjunctivally to the limbus. Surgical intraocular trauma is minimized, decreasing the amount of scarring and ultimate bleb failure. Complications may be seen with the THC-YAG sclerostomy and include: conjunctival burn, filtration bleb leak, posterior corneal striae, peaked pupil, iris incarceration, infection, hyphema, cataracts and ocular hypotony. methods: This paper presents four glaucoma patients, co-managed at the illinois eye Institute, who developed complications following THC-YAG laser sclerostomy. A discussion of other possible postoperative complications and their management is included. RESULTS: While the holmium laser has shown positive results in lowering intraocular pressure in patients with uncontrolled refractory glaucoma, complications are inherent in this procedure. The most common are posterior corneal striae, iris incarceration with secondary peaked pupil, and ocular hypotony. Conjunctival burn with secondary filtration bleb leak, limbal pigment deposition and hyphema may also be seen. CONCLUSION: early diagnosis and treatment of postoperative complications may help in maintaining the long term filtration ability of the sclerostomy.
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ranking = 0.5
keywords = hyphema
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8/9. Intracameral tissue plasminogen activator: management of a fibrin clot occluding a Molteno tube.

    We report the use of intracameral tissue plasminogen activator to dissolve a fibrin clot occluding a Molteno tube in the immediate postoperative period. This technique is an effective alternative to awaiting clot lysis or reoperation with minimal risk. The only complication was a small, layering hyphema.
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ranking = 0.25
keywords = hyphema
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9/9. iris cavernous hemangioma in a patient with recurrent hyphema.

    A 41-year-old woman presented with a hyphema in her right eye. Clinical examination revealed a vascular lesion of the iris that had enlarged over a 6-month period. The patient had no other evidence of ocular or cutaneous vascular malformations. Subsequently she experienced recurrent episodes of spontaneous hyphema, and there was objective evidence of growth of the lesion. Consequently, the lesion was excised by means of a sector iridectomy. Histopathological examination showed several large vascular compartments separated by thin, fibrous septa and lined by endothelium, consistent with a cavernous hemangioma. A benign iris melanocytic lesion was identified adjacent to the cavernous hemangioma. The intraocular pressure in the affected eye remained normal after the lesion was removed. After 6 months of follow-up no new hyphemas had developed. iris cavernous hemangioma should be added to the differential diagnosis of recurrent hyphema.
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ranking = 2
keywords = hyphema
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