scholarly journals Modified Descemet’s Stripping Automated Endothelial Keratoplasty: The Use of Ophthalmic Viscoelastic Devices in Hypotonic Eyes That Had Undergone Glaucoma Filtering Surgeries

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Itaru Oyakawa ◽  
Takahiko Hayashi ◽  
Toshiki Shimizu ◽  
Naoko Kato
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
New Method ◽  
Back Surface ◽  
Endothelial Keratoplasty ◽  
Good Adhesion ◽  
Case Presentation ◽  
Filtering Bleb ◽  
One Step

Purpose. Descemet’s stripping automated endothelial keratoplasty (DSAEK) is more difficult in hypotonic eyes with filtering bleb, due to the difficulties in elevating the intraocular pressure (IOP). We report a new method that uses ophthalmic viscoelastic devices (OVDs) to achieve good graft adhesion. Case Presentation. We performed modified DSAEK surgery on 2 eyes of 2 patients, who had previously undergone a trabeculectomy. Both eyes had functioning filtering blebs; the IOP was lower than 10 mmHg without medication. After the graft was inserted into the anterior chamber, the conjunctiva was penetrated, apart from the bleb, using a 30 G needle, and Healon V® was injected into the bleb until the encapsulated space was filled completely. Air was subsequently injected into the anterior chamber to promote the graft attachment to the back surface of the cornea. The IOP was elevated above 40 mmHg in both eyes 1 h after surgery and then decreased to less than 30 mmHg over the subsequent 3 h period. The implanted graft showed good adhesion and no dislocation. Conclusions. Our novel DSAEK procedure that adds one step of OVD injection into the filtering bleb may be useful for hypotonic eyes that had undergone filtering surgeries.

scholarly journals Temporary Filtering Bleb Failure Induced by Anterior Chamber Sulfur Hexafluoride Gas: A Complication after Descemet Membrane Endothelial Keratoplasty

2019 ◽  
Vol 10 (1) ◽  
pp. 120-126
Author(s):  
Philip Enders ◽  
Georgia Avgitidou ◽  
Ludwig M. Heindl ◽  
Thomas S. Dietlein ◽  
Claus Cursiefen
Keyword(s):  
Anterior Chamber ◽  
Sulfur Hexafluoride ◽  
Glaucoma Patient ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Pupillary Block ◽  
Filtering Bleb ◽  
Descemet Membrane ◽  
Gas Tamponade ◽  
Bleb Failure

Herein, we report two clinical cases with acute temporary filtering bleb obstruction by gas tamponade after Descemet membrane endothelial keratoplasty (DMEK) surgery and postoperative intraocular pressure (IOP) peaks. Both patients underwent uncomplicated DMEK surgery with 20% sulfur hexafluoride (SF6) anterior chamber tamponade and had previous trabeculectomy for glaucoma. Prior to surgery, both patients showed patent bleb function with low to normal IOP without antiglaucomatous medication. After uneventful DMEK surgery, both patients showed postoperative IOP peaks of up to 50 mm Hg despite patent inferior iridotomy and no sign of a pupillary block. In both cases, SF6 gas bubbles could be visualized obstructing the bleb. Both patients were treated with IOP-lowering agents topically as well as systemically. In addition, anterior chamber paracenteses were performed to reduce the SF6 volume within the anterior chamber. Under this treatment, IOP normalized within the first 18 h after surgery. We hypothesize that the SF6 gas tamponade from the anterior chamber migrates into the ostium and below the bleb, leading to an acute temporary insufficiency of bleb function and to a consecutive IOP peak after surgery. In contrast to a pupillary block, this mechanism cannot be antagonized by preoperative iridotomy and needs to be taken into account for every glaucoma patient with functional bleb undergoing DMEK surgery.

scholarly journals XEN® stent complications: a case series

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chandni Gupta ◽  
Divya Mathews
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Clinical Decision Making ◽  
Case Series ◽  
Clinical Decision ◽  
Stent Insertion ◽  
Management Options ◽  
Case Presentation ◽  
Subconjunctival Space ◽  
Xen Implant

Abstract Background XEN® gel stent (Allergan, Dublin/Republic of Ireland) is a relatively new microinvasive glaucoma device providing an ab-interno approach to the subconjunctival space for aqueous drainage and reduction of intraocular pressure. It is thought to be less invasive, reduce surgical time and post-operative infection rates compared with traditional glaucoma procedures. Little information however, has been published regarding complications and subsequent management. Case presentation The authors highlight five complicated cases of XEN® stent insertion, how they were managed and key learning points. Cases include: entire stent found at the bottom of the anterior chamber several months after uncomplicated insertion, stent broke into multiple pieces during manipulation within subconjunctiva, XEN45 stent migrated into the anterior chamber 7 months post-operatively and a case of limbal-based conjunctival dissection during open revision which lead to additional scarring around the stent and subsequent raised intraocular pressure. Conclusions We present some new and interesting complications of XEN implant as well as potential management options. This can assist clinical decision-making and enable better pre-operative discussions with patients regarding risks of surgery.

Immediate Postoperative Intraocular Pressure Changes After Anterior Chamber Air Fill in Descemet Membrane Endothelial Keratoplasty

Cornea ◽  
2016 ◽  
Vol 35 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Tisha P. Stanzel ◽  
Lebriz Ersoy ◽  
Wiwan Sansanayudh ◽  
Moritz Felsch ◽  
Thomas Dietlein ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Pressure Changes

scholarly journals Investigation of intraocular pressure of the anterior chamber and vitreous cavity of porcine eyes via a novel method

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Koji Nagae ◽  
Hiromasa Sawamura ◽  
Makoto Aihara
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Pressure Sensor ◽  
Vitreous Cavity ◽  
New Method ◽  
Significant Group ◽  
Physiological Range ◽  
Novel Method ◽  
Porcine Eyes ◽  
Condition Interaction

AbstractTo evaluate a new method of measuring the intraocular pressure (IOP) in the vitreous cavity. IOPs in the anterior chamber and vitreous cavities of 24 porcine eyes (12 eyes with lenses and 12 eyes without lenses) were measured directly, continuously, and simultaneously. We used a needle as a part of the pressure sensor to measure the anterior chamber IOP and a disk-shaped sensor to measure the vitreous cavity IOP. A significant group-by-condition interaction on the vitreous cavity IOP between the two groups (phakia and aphakia) and four conditions of anterior chamber IOP were observed (F[3,258] = 5.8564, p < 0.001). A positive correlation was observed between the vitreous cavity IOP and anterior chamber IOP in both the phakia group (R = 0.96, p < 0.001) and the aphakia group (R = 0.97, p < 0.001). No significant correlation was observed between the ΔIOPv-a (vitreous cavity IOP − anterior chamber IOP) and anterior chamber IOP in either group (phakia group: R =  − 0.18, p = 0.034; aphakia group: R =  − 0.029, p = 0.73). The vitreous cavity IOP measured with the new sensor was well-correlated with the anterior chamber IOP in the physiological range tested.

Coexistante of intraocular eyelashes and anterior chamber cyst after penetrating eye injury: a case presentation

1994 ◽  
Vol 18 (5) ◽  
pp. 309-311 ◽  
Author(s):  
Süheyla Köse ◽  
Özean Kayikçioglu ◽  
Cezmi Akkin ◽  
Ayşe Yagci ◽  
Gülçin Bašdemir
Keyword(s):  
Anterior Chamber ◽  
Eye Injury ◽  
Case Presentation ◽  
Penetrating Eye Injury

scholarly journals Polypharmacy-associated potential contraindications of drug prescriptions in patients with primary angle closure disease in a real-world setting

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Fumiaki Tanaka ◽  
Naoki Shibatani ◽  
Kazumi Fujita ◽  
Hiroaki Ikesue ◽  
Satoru Yoshimizu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Japanese Patients ◽  
Median Number ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Number Of Patients ◽  
Multiple Drugs

Abstract Background Primary angle closure disease (PACD) is a type of glaucoma in which the intraocular pressure (IOP) is increased because of the blockage of the anterior chamber angle. Medications contraindicated for patients with PACD, such as anticholinergics, cause mydriasis, and can elevate IOP. However, anticholinergics are currently contraindicated only for primary angle closure glaucoma (PACG) in Japanese package inserts. In this study, we investigated the prescription status of medications contraindicated for PACD, such as anticholinergics, in patients with PACD scheduled for eye surgeries. Methods Forty-three Japanese patients diagnosed with PACD at Kobe City Eye Hospital, Japan, and scheduled hospitalization for eye surgeries between December 2017 and July 2018, were included. Data, including sex, age, diagnosis, IOP, anterior chamber depth, and patients’ regular medications prior to hospitalization, were collected for each patient from the electronic medical records. Results The number of patients with chronic primary angle closure (CPAC) and acute primary angle closure (APAC) was 35 (81.4%) and 8 (18.6%), respectively. Among all the 43 patients with PACD, 8 (18.6%) received 15 medications that are potentially contraindicated for PACD by non-ophthalmologist. According to medication categories, benzodiazepine hypnotics were the most commonly prescribed. Among the 8 patients with APAC, 2 (25.0%) had routinely received medications contraindicated for PACD. The median number of all kinds of prescriptions on the day of hospitalization was significantly higher for patients who received medications contraindicated for PACD than for those who did not receive them (p = 0.010). Conclusions About 20% of patients with PACD received medications potentially contraindicated for PACD, such as anticholinergics. Attention should be paid to patients prescribed multiple drugs for adverse events, such as increase in intraocular pressure.

scholarly journals Urrets-Zavalia Syndrome Following Cataract Surgery

2021 ◽  
pp. 659-663
Author(s):  
Shimon Kurtz ◽  
Maayan Fradkin
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Inflammatory Reaction ◽  
Intraocular Lens Implantation ◽  
Postoperative Course ◽  
Lens Implantation ◽  
The Right

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.

scholarly journals Intraocular Pressure Reduction after Femtolaser Assisted Cataract Surgery and Its Association with the Use of Ultrasound

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 437
Author(s):  
Hana Abouzeid ◽  
Walter Ferrini ◽  
Murielle Bochud
Keyword(s):  
Intraocular Pressure ◽  
Linear Regression ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Multiple Linear Regression Model ◽  
Study Data ◽  
Department Of Ophthalmology ◽  
Duration Of Surgery ◽  
Ocular Pressure

Background and Objectives: To quantify the change in intraocular pressure (IOP) after phacoemulsification in patients having undergone femtolaser assisted cataract surgery (FLACS), and study the influence of the use of ultrasound on this change. Setting: Jules-Gonin Eye Hospital, University Department of Ophthalmology, Lausanne, Switzerland. Materials and Methods: Interventional study. Methods: All consecutive cases operated with FLACS and with complete data for the studied parameters were selected for inclusion in the study. Data had been prospectively collected and was analysed retrospectively. Linear regression was performed to explore the association of change in IOP with time of measure, ultrasound use, sex, age, and duration of surgery. Results: There was a mean decrease in intraocular pressure of 2.5 mmHg (CI 95% −3.6; −1.4, p < 0.001) postoperatively. No association between the change in intraocular pressure and ultrasound time or effective phaco time was observed when the data were analyzed one at a time or in a multiple linear regression model. There was no association with sex, age, nuclear density, presence of pseudoexfoliation, duration of surgery, and time of ocular pressure measurement. Eyes with preoperative IOP ≥ 21 mmHg had a more significant IOP reduction after surgery (p < 0.0001) as did eyes with an anterior chamber depth <2.5 mm (p = 0.01). Conclusion: There was a decrease in intraocular pressure six months after FLACS in our study similar to that in the published literature for standard phacoemulsification. The use of ultrasound may not influence the size of the decrease, whereas the preoperative IOP and anterior chamber depth do. FLACS may be as valuable as standard phacoemulsification for cases where IOP reduction is needed postoperatively.

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