Three-Year Follow-up of a Novel Aqueous Humor MicroShunt.

Aims: An observational study to determine the safety and efficacy of filtering surgery employing a microlumen aqueous drainage device (InnFocus MicroShunt), used intraoperatively with Mitomycin C, implanted alone or in combination with phacoemulsification.

Materials And Methods: Single-site, prospective, nonrandomized study of 23 eyes that had failed maximum tolerated glaucoma medication, followed for 3 years. A MicroShunt was implanted ab externo through a needle tract under the limbus, draining aqueous from the anterior chamber to the scleral surface.

Abnormal movements in first-episode, nonaffective psychosis: dyskinesias, stereotypies, and catatonic-like signs.

Motor abnormalities represent a neurobehavioral domain of signs intrinsic to schizophrenia-spectrum disorders, though they are commonly attributed to medication side effects and remain understudied. Individuals with first-episode psychosis represent an ideal group to study innate movement disorders due to minimal prior antipsychotic exposure. We measured dyskinesias, stereotypies, and catatonic-like signs and examined their associations with: (1) age at onset of psychotic symptoms and duration of untreated psychosis; (2) positive, negative, and disorganized symptoms; (3) neurocognition; and (4) neurological soft signs.

Treatment of late-onset capsular distension syndrome with a neodymium:YAG laser peripheral iridotomy and anterior capsulotomy.

We describe a new approach to treat late-onset capsular distension syndrome in which the fluid in the capsular bag is cloudy and prevents a posterior neodymium:YAG (Nd:YAG) laser capsulotomy. A peripheral laser iridotomy is created through which the anterior lens capsule peripheral to the IOL optic is accessed. This opening in the iris provides an access point through which an anterior Nd:YAG laser capsulotomy can be performed.

Histopathology of the Ex-PRESS Shunt.

The authors report the histopathologic features of a human enucleated eye with an Ex-PRESS shunt (Optonol, Ltd., Neve Ilan, Israel). An 86-year-old man with a blind painful eye underwent enucleation.

Clinicopathologic correlations of poly-(styrene-b-isobutylene-b-styrene) glaucoma drainage devices of different internal diameters in rabbits.

Background And Objective: To assess the biocompatibility and intraocular pressure (IOP) lowering effect of a novel glaucoma drainage implant in rabbits.

Materials And Methods: Sixteen New Zealand white rabbits received one of three glaucoma drainage implants fabricated from poly-(styrene-b-isobutylene-b-styrene [SIBS]) with an internal diameter of the lumen of either 70 (6 eyes), 100 (6 eyes), or 150 (4 eyes) μm. Clinical follow-up examinations were performed during 6 months and postmortem eyes were studied with light microscopy.

Technique for air bubble management during endothelial keratoplasty in eyes after penetrating glaucoma surgery.

Our purpose was to develop a technique for maintaining air within the anterior chamber during endothelial keratoplasty in eyes that have previously undergone trabeculectomy or a glaucoma drainage implant. Whole human globes and rabbits underwent penetrating glaucoma surgery to develop the technique. Without the aid of any additional device or manipulation, continuing to inject air into the anterior chamber as it escapes through the sclerostomy or tube eventually fills the subconjunctival space and allows for back pressure.

Characteristics of optic nerve head drusen on optical coherence tomography images.

Background And Objective: To describe the characteristics of optic nerve head drusen in optical coherence tomography (OCT) images.

Patients And Methods: Cross-sectional images of the optic nerve were obtained in seven patients with optic nerve head drusen with Stratus and spectral-domain OCT (Carl Zeiss Meditec, Dublin, CA). These were compared to optic disc photographs, autofluorescence, and echography images.

Polypropylene suture-guided valve tube for posterior chamber implantation in patients with pseudophakic glaucoma.

We describe a new surgical procedure for implanting a glaucoma drainage tube in the posterior chamber. A needle with a 10-0 polypropylene suture is introduced into the posterior chamber, and a 23-gauge needle is also introduced as the barrel on the polypropylene needle tip. After the 23-gauge needle is withdrawn from the posterior chamber, the polypropylene needle tip is pulled and the suture crosses the anterior and posterior chambers.

Estimation of intraocular pressure in rabbits with commonly used tonometers.

Background And Objectives: To validate accuracy and reproducibility of the Perkins tonometer, pneumatonometer, and Tono-Pen XL (Medtronic Solan, Jacksonville, FL) in estimating intraocular pressure (IOP) in rabbits.

Materials And Methods: IOP was increased from 5 to 50 mm Hg in 5-mm increments. Measurements were compared to readings of two digital manometers simultaneously measuring real IOP in the anterior chamber and vitreous cavity.

A newly designed glaucoma drainage implant made of poly(styrene-b-isobutylene-b-styrene): biocompatibility and function in normal rabbit eyes.

Objective: To report clinical evaluation, flow patency, and histopathological findings of a novel glaucoma drainage implant (GDI) made of poly(styrene-b-isobutylene-b-styrene) (SIBS) in rabbits.

Methods: In 16 normal eyes, the proximal end of the SIBS GDI was inserted into the anterior chamber while the distal end was placed in the subconjunctival space. A control group underwent implantation of a similarly designed silicone GDI.

Validation of the Barraquer tonometer for high intraocular pressure estimation.

Purpose: To compare the pneumatonometer and the Tono-Pen XL in a closed ex-vivo system in human eye bank eyes at high intraocular pressures (IOP) and evaluate the validity of high IOP measurements with the Barraquer tonometer.

Methods: Intraocular pressure was monitored by cannulation of the anterior chamber and vitreous cavity in eight human cadaver eyes (mean donor age: 77.3 +/- 4.

Trabecular meshwork alteration and intraocular pressure change following pulsed near-infrared laser trabeculoplasty in cats.

Background And Objective: To comparatively assess the safety and variation in intraocular pressure (IOP) of two pulsed near-infrared lasers (titanium:sapphire and alexandrite) for laser trabeculoplasty versus conventional blue-green argon laser trabeculoplasty in an animal model.

Materials And Methods: The left eyes of 15 healthy cats received a 180 degree laser trabeculoplasty treatment: 5 with a titanium:sapphire laser, 5 with an alexandrite laser, and 5 with an argon laser. Preoperatively and postoperatively, all animals underwent tonometry, gonioscopy, and slit-lamp examination.

Ex vivo evaluation of Tono-Pen and pneumotonometry in cat eyes.

Purpose: To evaluate the validity and intraobserver reliability of intraocular pressure (IOP) measurements with both pneumotonometry and the Tono-Pen in a closed ex vivo system in cat eyes.

Methods: IOP was increased step by step in 5 enucleated cat eyes, while taking IOP measurements with the Tono-Pen and pneumotonometry. The outcomes were compared to readings of a digital manometer simultaneously measuring the actual pressure in the anterior chamber.

Surgical management of patients with combined glaucoma and corneal transplant surgery.

The reasons for having combined glaucoma and corneal transplant surgery are myriad. Patients with corneal transplants have a high frequency of developing secondary glaucoma. Patients with preexisting glaucoma have even higher risk for developing glaucoma refractory to medical management after penetrating keratoplasty.

Amniotic membrane transplantation for bullous keratopathy in eyes with poor visual potential.

Purpose: To evaluate the long-term outcomes of epithelial debridement and amniotic membrane transplantation (AMT) for pain and discomfort relief in patients with symptomatic bullous keratopathy and poor visual potential.

Setting: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.

Methods: This retrospective study included 18 eyes (18 patients) with bullous keratopathy presenting with intractable pain or discomfort and poor visual potential.

Corneal graft survival and intraocular pressure control after penetrating keratoplasty and glaucoma drainage device implantation.

Objective: To investigate corneal graft survival rates and intraocular pressure (IOP) control in eyes after penetrating keratoplasty (PK) and glaucoma drainage device (GDD) implantation.

Design: Retrospective, comparative, consecutive case series.

Participants: All patients who underwent PK and GDD implantation at the Bascom Palmer Eye Institute between January 1, 1993 and October 31, 1998.

Corneal preparation of eye bank eyes for experimental surgery.

Purpose: To evaluate the efficacy of dextran in balanced salt solution (BSS) as a preparation of eye bank corneas for experimental surgeries.

Methods: We used 12 eye bank eyes that were unsuitable for transplant. The corneas were removed from the globe and affixed to a Hanna artificial anterior chamber.

Combined pars plana vitrectomy and glaucoma drainage implant placement for refractory glaucoma.

Purpose: To report visual acuity and intraocular pressure outcomes among patients who have undergone combined pars plana vitrectomy and placement of a glaucoma drainage implant.

Methods: The medical records of all patients who underwent combined pars plana vitrectomy and placement of a glaucoma drainage implant at the Bascom Palmer Eye Institute by one of the authors between January 1, 1990, and February 28, 1998, were reviewed. Forty patients (40 eyes) were identified, including 14 patients with neovascular glaucoma secondary to proliferative diabetic retinopathy or central retinal vein occlusion, 15 patients with other posterior segment disease, seven patients with secondary angle-closure glaucoma, and four patients with aphakia with ruptured anterior hyaloid face.

Small peripheral anterior continuous curvilinear capsulorhexis.

Cataract surgery is routinely performed using an anterior continuous curvilinear capsulorhexis (CCC). A manual surgical technique is described for performing a small (less than 1.5 mm diameter) anterior CCC.

Synthetic meshwork implant for glaucoma filtering surgery: effect of adjunct heparin and sodium hyaluronate in rabbits.

Background And Objective: To evaluate the efficacy of a novel filtering implant, a synthetic meshwork (MESH), with or without heparin or sodium hyaluronate amendment.

Materials And Methods: Eighteen eyes of 18 rabbits received MESH surgery. The eyes were divided into three subgroups.

Corneal wound healing in monkeys after repeated excimer laser photorefractive keratectomy.

Five rhesus monkey eyes underwent repeated argon fluoride (193 nm) excimer laser myopic photorefractive keratectomy 3 months following an initial ablation that had produced mild subepithelial haze. At 3 months all eyes had development of a dense subepithelial opacity and a thickened epithelium (12 cells, 80 microns) with vacuolization of basal cells, fragmented basement membrane, and a layer of subepithelial fibrosis containing activated fibroblasts. By 6 months the opacity was clearing; epithelium was thinner (50 microns); subepithelial fibrosis was more lamellar.

Healing of excimer laser ablated monkey corneas. An immunohistochemical evaluation.

The healing response of the cornea following excimer laser anterior keratomileusis (a 4-mm-diameter ablation to a depth of 11, 23, or 46 microns) was analyzed immunohistochemically in adult rhesus monkeys. The ablated surface had reepithelialized and the synthesis of type VII collagen (a major component of anchoring fibrils) was evident by 7 days; the reestablishment of a nearly continuous anchoring fibril zone was evident after 12 weeks. Stromal fibroblasts, activated in response to wounding, expressed a fetal antigen for approximately 6 weeks.

Corneal wound healing in monkeys 18 months after excimer laser photorefractive keratectomy.

Excimer laser keratomileusis (photorefractive keratectomy, direct corneal ablation) for myopic corrections of 2.00 diopters (n = 1), 4.00 D (n = 4), and 8.

Wound healing after excimer laser keratomileusis (photorefractive keratectomy) in monkeys.

Laser myopic keratomileusis (photorefractive keratectomy) was performed on 29 rhesus monkey corneas with an argon fluoride (193-nm) excimer laser and a computer-controlled, moving slit delivery system. The 4-mm-diameter central ablation zone ranged in depth from 11 microns (-2 diopters effect) to 46 microns (-8 diopters effect). Corneas were studied for the 9 months postoperatively by clinical slit-lamp microscopy, and periodically with light and transmission electron microscopy.