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Argon Laser Peripheral Iridoplasty and Argon Laser Pupilloplasty: Alternative Management for Medically Unresponsive Acute Primary Angle Closure
摘要： Objective. To introduce the combined laser technique, argon laser peripheral iridoplasty (ALPI) and argon laser pupilloplasty (ALPP), in the management of medically unresponsive acute primary angle closure (APAC). Design. Retrospective study. Methods. We retrospectively reviewed the records of 23 patients (27 eyes) with APAC, who were applied ALPI and ALPP when traditional treatment failed. The visual acuity and intraocular pressure (IOP) were monitored before surgery and at 1, 2, 12, 24, and 48 h after surgery. Additionally, the angle-opening status was monitored before surgery and 48 h after the treatment by using an ultrasonic biological microscope (UBM), and the presurgical and postsurgical cornea edema statuses were observed by using a slit lamp. We also documented the complications of laser treatment. Results. For the ALPI + ALPP laser-effective group, the presurgical IOP was 37.6 ± 10.9 mmHg (1 h), 28.4 ± 12.4 mmHg (2 h), 19.9 ± 9.0 mmHg (6 h), 16.8 ± 7.3 mmHg (12 h), 15.9 ± 5.9 mmHg (24 h), and 14.9 ± 5.0 mmHg (48 h), with statistically significant differences (p < 0.05) in each time point. It was observed in all the patients that the corneal edema alleviated, the angles opened, and visual acuity recovered with varying degrees at 48 h after applying combined laser treatment. For the ALPI + ALPP laser-ineffective group, further interventions were taken. Definitive treatment was given in both groups to maintain the long-term IOP control. Conclusions. Although the combination of ALPI and ALPP is a temporizing therapeutic strategy for APAC, it is effective in relieving pupillary block which is unresponsive to miotic agents, opening the closed angle to a certain extent, restoring the transparency of cornea, and reducing IOP to a safe level for further definitive treatment.
关键词： acute primary angle closure,argon laser peripheral iridoplasty,argon laser pupilloplasty,corneal edema,intraocular pressure
更新于2025-09-11 14:15:04
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Double-session micropulse transscleral laser (CYCLO G6) for the treatment of glaucoma
摘要： This study aims to evaluate the effectiveness and safety of double-session micropulse transscleral (MP3) laser for the treatment of glaucoma. This was a retrospective chart review of all patients who underwent MP3 laser with the standard protocol and were within at least 12 months of their follow-up appointments. Eyes were treated at 2000 mW with 31.3% duty cycle for 80 s per treatment session, with double sessions in each hemifield alternating between upper and lower and upper and lower. Success criterion was defined as a greater than 20% reduction in intraocular pressure (IOP) and an IOP between 6 and 18 mmHg at the end of the follow-up period. Eighty-nine eyes of seventy-six glaucoma patients were included; 31 of which were considered primary, i.e., no previous glaucoma surgery. The average pre-treatment IOP was 29.9 ± 6.4 mmHg. At around 16.7 ± 3.1 months of follow-up, the average IOP was 14.8 ± 4.7 mmHg (p < 0.001) (28.8 ± 7.4 to 15.7 ± 5.3 mmHg, p < 0.001, at 17.0 ± 3.1 months in the primary eyes). The number of topical glaucoma medications was reduced from 3.6 ± 0.5 to 1.9 ± 0.9 at the last evaluation (p < 0.001). The best corrected visual acuity in logMAR ranged from 0.41 ± 0.34 preoperatively to 0.45 ± 0.44 at the last visit (p = 0.2), and also remained stable in primary eyes. Success was obtained in 86.5% of the eyes, with 1.5 ± 0.8 procedures, and in 90.3% with 1.2 ± 0.5 MP3 laser procedures in the primary eye group. MP3 laser in two consecutive 80-s sessions was shown to be safe and effective in the treatment of glaucoma. Primary eyes required lower number of MP3 laser procedures.
关键词： Treatment outcome,Glaucoma,Ciliary body/surgery,Intraocular pressure,Laser surgery
更新于2025-09-11 14:15:04
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Two-Dimensional Plasmonic Grating for Intraocular Pressure Sensing
摘要： Glaucoma is a group of characteristic optic neuropathies that collectively are the leading cause of irreversible blindness globally. Elevated intraocular pressure (IOP) is the major causal risk factor. While the fundamental mechanisms of the IOP elevation and consequent optic neuropathy are not well understood, recent studies have indicated that there may be pressure spikes directed at the optic nerve head during accommodation and that IOP may not be homogeneous throughout the eye. To facilitate the in situ and in vivo measurement of IOP in various locations within the vitreous and facilitate measurement of accommodative IOP spikes at the ONH, here, we report the development of an implantable, biocompatible, and miniaturized IOP sensor using 2-D plasmonic grating that generates structural color. The change of the grating period with pressure between 0 and 50 mmHg results in a change in the visible color, allowing us to observe small changes in pressure without additional electronics.
关键词： glaucoma,intraocular pressure (IOP),Electromagnetic wave sensors,optical nerve head (ONH),surface plasmon
更新于2025-09-11 14:15:04
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Outcomes of Micropulse Transscleral Cyclophotocoagulation in Uncontrolled Glaucoma Patients
摘要： This study aimed at evaluating the intermediate-term efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in cases of uncontrolled glaucoma. Patients with moderate to advanced glaucoma and uncontrolled intraocular pressure (IOP) despite maximally tolerable antiglaucoma medications were selected to undergo MP-TSCPC using the MP3 handpiece with the Iridex Cyclo G6 (IRIDEX Laser Systems). Follow-up examinations took place on a regular basis until 15 months postoperatively. Seventy-five eyes of 69 patients (53.6% male patients) were included. Mean age was 55.5 ± 22.9 years. Primary open-angle glaucoma was the most common diagnosis. Corrected distance visual acuity at baseline ranged between 0 and 2.1 logMAR. Mean prelaser IOP was 26.0 ± 7.91 mm Hg. This was reduced significantly to 13.8 ± 5.6 mm Hg (44.0% reduction, P < 0.001) at week 1, and to 18.0 ± 7.7, 18.4 ± 7.1, 16.7 ± 6.2, 15.1 ± 4.1, 15.7 ± 5.32, and 14.8 ± 5.50 mm Hg at months 1, 3, 6, 9, 12, and 15, respectively. The mean number of antiglaucoma drops decreased significantly up to 12 months of follow-up (P = 0.008) and that of oral acetazolamide tablets decreased significantly up to 15 months (P < 0.001). The success rate decreased progressively with time, reaching 81.4% at 6 months and 73.3% at 1 year. No major postoperative complications were encountered, and no eye lost vision completely. MP-TSCPC is an efficient noninvasive glaucoma treatment that achieves sustained IOP reduction and reduced need for ocular antihypertensive medications for up to 15 months. The optimal laser parameters to achieve the best success rate with the least side effects still need to be determined.
关键词： intraocular pressure,micropulse transscleral cyclophotocoagulation,glaucoma
更新于2025-09-11 14:15:04
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Comparison of variation of intraocular pressure in noncontact tonometry in patients subjected to phacoemulsification and trabeculectomy with phacoemulsification
摘要： Objective: Evaluate the pattern of intraocular pressure (IOP) variations through the pneumatic tonometer, between two specific surgical techniques, and the possible variables that may influence the behavior of this pressure. Methods: Retrospective cross-sectional study carried out through the review of electronic medical records of a private ophthalmological reference hospital in the city of Goiania, Goiás, Brazil, from 2012 to 2016, comprising of a sample of 550 eyes. The analyzed variables were, age, gender, IOP, axis, pachymetry, anterior chamber depth, and axial length. Results: In the end, the study consisted of 231 eyes, represented by 179 patients. Of these, 182 eyes were operated on by isolated cataract surgery, with a mean age of 72.0±9.5 years. The combined surgery represented a total of 49 eyes, 34 patients with a mean age of 71.9±8.14 years. There was statistical significance (P,0.05) in correlating the pre- and postoperative IOP values in the 24-hour, 7-, 15-day, and 12-month postoperative periods. Conclusion: A standard of variation of IOP was found through the pneumatic tonometer in both surgical techniques, but a more significant reduction was observed in combined surgery than in isolated cataract surgery, and further studies with a greater epidemiological impact are required for confirmation of this conclusion.
关键词： pneumatic tonometer,cataract,glaucoma,intraocular pressure
更新于2025-09-10 09:29:36
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A new device to noninvasively estimate the intraocular pressure produced during ocular compression
摘要： To describe a noninvasive instrument that estimates intraocular pressure during episodes of external globe compression and to demonstrate the accuracy and reliability of this device by comparing it to the intraocular pressures simultaneously and manometrically measured in cannulated eyes. A thin fluid-filled bladder was constructed from flexible and inelastic plastic sheeting and was connected to a pressure transducer with high pressure tubing. The output of the pressure transducer was sent to an amplifier and recorded. This device was validated by measuring induced pressure in the fluid-filled bladder while digital pressure was applied to one surface, and the other surface was placed directly against a human cadaver eye or in vivo pig eye. The human cadaver and in vivo pig eyes were each cannulated to provide a manometric intraocular pressure control. The measurements obtained with the newly described device were within ～5% of simultaneously measured manometric intraocular pressures in both a human cadaver and in vivo pig eye model for a pressure range of ～15–100 mmHg. This novel noninvasive device is useful for estimating the intraocular pressure transients induced during any form of external globe compression; this is a clinical setting where no other devices can be used to estimate intraocular pressure.
关键词： ocular compression,tonometer,glaucoma,intraocular pressure
更新于2025-09-10 09:29:36
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The Result of Photorefractive Keratectomy Treated with 0.1% Fluorometholone and Tranilast Eye Drops
摘要： ??: ????????????(photorefractive keratectomy) ? 0.1% ??????? ???? ?? ??? ??? ??, ??????(0.5% tranilast, Krix?, JW pharmaceutical, Seoul, Korea) ??? ?? ??? ???? ??? ?? ?? ??? ??? ??? ????? ???. ??? ??: 2014? 5??? 2015? 5??? ???? ????????????? ?? 0.1% ??????? ??? ?? ?, ? ? 1??? ?? ???? ?????? ?????? ???? ??? ?? 49?(49?)? 2012? 12??? 2013? 10??? ??? ??? ?? ?????? ???? ???? ?? 71?(71?)? ??? ?????. ??: ? ? 6?? ? ??? ?????? ???? ????? ?? logMAR -0.08 ± 0.05, logMAR -0.08 ± 0.04? ? ? ?? ??? ???. 0.1% ??????? ?? ??? ?????? ????? 17.7 ± 3.3?, ????? 20.5 ± 3.7???(p＜0.01). ?????? ?? ??? ?????? ????? ? ? 18.4 ± 3.2?, ????? 20.9 ± 3.7???(p＜0.01). ??: ???????????? ? 0.1% ???????? ?? ?? ??? ??? ??, ?????? ??? ?? ??? ????? ????? 0.1% ???????? ?? ??? ??? ????? ??? ???? ? ?? ????.
关键词： Fluorometholone,Tranilast,Intraocular pressure,Photorefractive keratectomy,Steroid-induced glaucoma
更新于2025-09-10 09:29:36
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Evaluation of optic nerve head blood flow in response to increase of intraocular pressure
摘要： The time course of the changes in the optic nerve head (ONH) blood flow in response to changes in the ocular perfusion pressure (OPP) induced by an artificial elevation of the intraocular pressure (IOP) has not been determined. We measured the blood flow, represented by the mean blur rate (MBR), on the ONH determined by laser speckle flowgraphy. The MBR was determined before, during, and after the IOP was elevated by 20 or 30 mmHg by pressure applied on the eye by an ophthalmodynamometer in a total of 27 healthy eyes. For an IOP elevation of 20 mmHg, the percentage reduction in the MBR-vessel was ?24.7%, and in the MBR-tissue was ?16.0% (P < 0.001). For an IOP elevation of 30 mmHg, the percentage reduction of the MBR-vessel was ?35.3% and the MBR-tissue was ?24.7% (P < 0.001). During the 30 mmHg IOP elevation for 10 minutes, both the MBR-vessel and MBR-tissue began returning to the baseline level from 1 minute after the beginning of the IOP elevation (P < 0.01, P < 0.05, respectively) and continued returning during the 10 minutes IOP elevation (P < 0.001, P < 0.01, respectively). We conclude that the ONH can autoregulate its blood flow in response to experimental changes in OPP induced by IOP elevations.
关键词： optic nerve head,autoregulation,laser speckle flowgraphy,blood flow,intraocular pressure
更新于2025-09-10 09:29:36
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Review: Measurement Techniques for Intraocular Pressure
摘要： The literature on intra-ocular pressure dynamics is reviewed, including tonometer design and calibration, the influence of corneal-scleral mechanics, and scleral rigidity factors. Drugs that influence the outflow facility of the trabecular meshwork (TM) are discussed. Transmural pressure drop across the lamina cribosa (LC) is an important parameter, in terms of quantifying potential glaucoma damage to the optic nerve.
关键词： Glaucoma,Ocular rigidity,Calibration,Intraocular pressure,Tonometer
更新于2025-09-10 09:29:36
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A comparison of NCT, Goldman application tonometry values with and without fluorescein
摘要： Purpose: The aim of the study was to statistically compare intraocular pressure (IOP) values measured using noncontact tonometer (NCT), Goldmann applanation tonometry (GAT) with fluorescein (fGAT), and GAT without fluorescein (nGAT). The study was also performed to test whether the values obtained using each technique change in accordance with the central corneal thickness (CCT) and refractive and keratometric values. Study design: This study was a prospective study of 188 eyes of 94 healthy volunteers. Methods: IOP was measured using fGAT, nGAT and NCT. CCT, refractive values, and keratometric values were measured, and the correlations and differences in the IOP for each tonometer were investigated. Results: The mean IOP values obtained with the NCT, nGAT, and fGAT were 17.5±3.7, 12.3±2.7, and 12.5±2 mmHg. The mean CCT was 538.2±34.4 μm, the mean refractive value was 0.9±1.2 D, and the mean keratometric value was 43.5±1.5 D. NCT was positively correlated with fGAT and GAT values and was significantly higher than both the values. There were no differences between fGAT and GAT values. No correlation was observed between the CCT and keratometric and refractive values and the difference between NCT and nGAT or fGAT. Conclusion: Differences in the measurements obtained using nGAT and fGAT were insignificant (P.0.05). Both values were positively correlated with NCT measurements (r =0.354, P,0.05) and were independent of CCT, keratometry, and refraction values. nGAT appears to be suitable for use in routine clinic practice.
关键词： central corneal thickness,Goldmann applanation tonometry,intraocular pressure,refractive value,noncontact tonometry,fluorescein
更新于2025-09-09 09:28:46