Preliminary results of femtosecond laser-assisted descemet stripping endothelial keratoplasty.

Objective: To evaluate the preliminary visual results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK).

Methods: We prospectively analyzed results of 20 consecutive patients with Fuchs endothelial dystrophy or aphakic/pseudophakic bullous keratopathy who underwent FS-DSEK. Best spectacle-corrected visual acuity (BSCVA), refraction, corneal topography, and endothelial cell density were measured preoperatively and 3 and 6 months after FS-DSEK.

Graft failure: III. Glaucoma escalation after penetrating keratoplasty.

Glaucoma after penetrating keratoplasty is a frequently observed post-operative complication and is a risk factor for graft failure. Penetrating keratoplasty performed for aphakic and pseudophakic bullous keratopathy and inflammatory conditions are more likely to cause postoperative glaucoma compared with keratoconus and Fuchs' endothelial dystrophy. The intraocular pressure elevation may occur immediately after surgery or in the early to late postoperative period.

Complications of Descemet's stripping with automated endothelial keratoplasty: survey of 118 eyes at One Institute.

Purpose: To compile a survey of complications during and after Descemet's stripping with automated endothelial keratoplasty (DSAEK) in 118 eyes conducted by cornea subspecialists at a single academic center.

Design: Retrospective case series.

Participants: One hundred eighteen eyes undergoing DSAEK in 99 patients.

Late-onset hyaloideocapsular block syndrome.

Purpose: To report an unusual cause of decreased vision in an aphakic patient.

Design: Interventional case report.

Participant: One patient.

The aetiology in paediatric aphakic glaucoma.

Purpose: To investigate the causes of glaucoma in children following removal of cataracts.

Methods: In total, 24 patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma following cataract removal were studied retrospectively. Cataract morphology, surgical technique, postoperative complications, time to glaucoma onset, gonioscopic findings, the presence of microcornea, and the histopathologic characteristics of the filtration angle in one case were the studied parameters.

Artisan lens implantation to correct aphakia after vitrectomy for retained nuclear lens fragments.

Purpose: To report the results of pars plana vitrectomy (PPV) for retained lens fragments with implantation of an Artisan intraocular lens (IOL) (Ophtec) to correct aphakia.

Setting: University-based referral center.

Methods: In this retrospective case-controlled study, patients who had had a PPV to remove dislocated lens fragments and implantation of an Artisan IOL for pseudophakic correction during initial cataract surgery or PPV were reviewed.

Slit-lamp visualization of aqueous flow through an inferior iridectomy.

Purpose: To demonstrate how an inferior iridectomy prevents a pupillary block in aphakic patients with a silicone oil tamponade.

Design: Observational case series.

Methods: Photographs of two patients who had undergone vitrectomy, lensectomy, membrane peeling, silicone oil tamponade, and inferior iridectomy for a complex retinal detachment were evaluated.

Pupil block glaucoma from traumatic vitreous prolapse in a patient with posterior chamber lens implantation.

Background: Angle closure secondary to pupil block is an entity known to occur in aphakic and pseudophakic patients. In aphakic patients, typically the cause of the pupil block is vitreous prolapse (aphakic pupil block). In pseudophakic patients, the typical cause of the pupil block is an anterior chamber lens implant, often in the absence of an iridectomy (pseudophakic pupil block).

Angle closure glaucoma following pupillary block in an aphakic perfluoropropane gas-filled eye.

We report the case of a 35-year-old aphakic patient who developed an intractable secondary glaucoma due to angle closure after pupillary block following the use of perfluoropropane (C3F8) gas at a nonexpansile concentration of 14%.

Uveitis and pupillary block glaucoma in an aphakic dog.

Unilateral uveitis with pupillary occlusion and secondary glaucoma was treated with neodymium:YAG laser iridotomy and iridencleisis in an aphakic 2-year-old male Miniature Schnuauzer. The dog presented 4 months after bilateral phacoemulsification with a complaint of blepharospasm of the left eye. Examination revealed anterior uveitis with pupillary occlusion and iris bombé.

Pupil block glaucoma in phakic and pseudophakic patients after vitrectomy with silicone oil injection.

Purpose: To describe pupil block glaucoma in phakic and pseudophakic patients after vitrectomy with silicone oil injection.

Design: Interventional case series.

Methods: Cases were collected from January 1997 to July 2000 from three tertiary referral centers.

[Improved technology of simultaneous penetrating keratoplasty and second implantation of posterior chamber intraocular lens in complete or extensive absence of the posterior lenticular capsule].

The authors describe in detail improved technology of simultaneous keratoplasty and second (re)implantation of posterior-chamber disc intraocular lens (IOL) into aphakic and artiphakic eyes (103 operations) in cases with complete or extensive absence of the posterior capsule of the lens. Disc Saturn and TIOL IOLs with circulating supporting elements 7.5 mm in diameter were placed into the posterior chamber using a safe supporting suture and then fixed to the posterior surface of the iris in 2-3 sites.

The efficacy of neodymium: YAG laser iridotomy in the treatment of closed peripheral iridotomies in silicone-oil-filled aphakic eyes.

Eighteen patients had a surgical inferior peripheral iridotomy performed to prevent pupil block and silicone oil anterior chamber prolapse. The occlusion of an iridotomy was treated by neodymium: YAG laser therapy and this form of treatment was successful only in 4 cases (22%). The reopening of occluded iridotomies is best performed by surgery as opposed to laser treatment.

Inferior peripheral iridectomy in patients receiving silicone oil. Rates of postoperative closure and effect on oil position.

Background: Silicone oil tamponade is used in treating retinal detachments, but silicone-associated complications remain frequent. Keratopathy and acute pupillary block glaucoma are related to migration of silicone oil into the anterior chamber. Since 1985, many surgeons have created an inferior peripheral iridectomy (PI) at the time of surgery to prevent forward migration of the oil, but the rate of postoperative closure of the PI and the effect on oil position have not been well defined.

[Pupillary blockage after intracapsular cataract extraction in the adult apropos of 4 cases].

Intra capsular extraction is the most employed surgical technics for the treatment of senile cataract in developing countries. Nevertheless complications are usual, among them the pupillary block. The authors notified in 365 intra capsular cataract extractions, executed during 8 months, 4 cases of pupillary block occurred after operation without incident.

[Long-term results of secondary implantation of anterior chamber lenses].

Long-term follow-up of secondary implanted anterior chamber intraocular lenses. The long-term results after secondary implantation of an anterior chamber IOL in aphakic patients are illustrated. After a mean period of 7 years after uneventful intracapsular cataract extraction 45 eyes underwent secondary implantation of an anterior chamber IOL of Symflex-Type.

Complications of secondary surgical capsulotomy in pseudophakic and aphakic eyes.

A retrospective study was conducted to analyze the complications of surgical capsulotomy in 587 eyes--51 aphakic and 536 pseudophakic. Transient or permanent complications occurred in 20 (3.4%).

Neodymium: YAG laser therapy in aphakic pupillary block glaucoma and aphakic malignant (ciliovitreal block) glaucoma.

Aphakic pupillary block glaucoma and malignant glaucoma (ciliovitreal block) are severe complications of the intracapsular cataract extraction, presenting clinically as elevated intraocular pressure, persistent shallow anterior chamber and severe vitreal hernia. Six eyes (four women and two men) with aphakic pupillary block glaucoma and aphakic malignant glaucoma were resolved by Neodymium: YAG laser iridotomy and hyaloidotomy. The laser therapy resulted in immediate deepening of the anterior chamber and reducing of intraocular pressure.

The superior peripheral iridectomy: prevention of pupil block due to silicone oil.

Superior peripheral iridectomy has been performed in 40 patients who have undergone silicone oil surgery for retinal detachment and who are aphakic. Only two developed raised intraocular pressure due to pupil block by liquid silicone and in each case the iridectomies seemed to be closed by proliferative membrane rather than the silicone meniscus. This type of iridectomy is particularly suitable in patients requiring intracapsular cataract extraction after previous vitrectomy and silicone oil surgery.

Treatment of postvitrectomy fibrin pupillary block with tissue plasminogen activator.

We injected 25 micrograms of recombinant tissue plasminogen activator into the anterior chamber or the vitreous cavity in seven aphakic patients for pupillary block caused by a complete fibrin pupillary membrane that formed after vitrectomy with fluid-gas exchange. Progressive fibrin deposition resulted in pupillary block by three days after vitrectomy surgery in six patients, and seven days after vitrectomy in one patient. The pupillary block was associated with increased intraocular pressure in six patients.

Pseudophakic and aphakic pupillary block.

Fifteen eyes of 14 patients who underwent cataract extraction surgery with or without lens implantation developed pupillary block. Six lenses were of the anterior-chamber type, two of the posterior-chamber, and four of the iris-clip Binkhorst type; three were simple aphakic eyes. Ocular hypertension was present in 12 eyes; while in three eyes, the pupillary block was detected by biomicroscopic examination.

Acute glaucoma following vitrectomy and silicone oil injection.

Three cases are described of acute glaucoma following vitrectomy and silicone oil injection in proliferative vitreous retinopathy. The first case developed silicone-induced pupillary block in a phakic eye. Cases 2 and 3 developed elevated pressure in aphakic eyes with deep anterior chambers.

Neodymium-YAG laser posterior capsulotomy for the treatment of aphakic and pseudophakic pupillary block.

We examined five patients who developed pupillary block after extracapsular cataract extraction. One of the patients also had a posterior chamber intraocular lens implanted at the time of cataract operation. In all five patients, pupillary block was promptly relieved by Nd:YAG laser posterior capsulotomy.

Basal iridectomy at 6 o'clock in the aphakic eye treated with silicone oil: prevention of keratopathy and secondary glaucoma.

In the aphakic eye, with intact iris diaphragm, silicone oil has frequently caused a pupillary block. In this situation aqueous humour accumulates behind the iris and forces silicone oil through the pupil into the anterior chamber. An iridectomy at the 6 o'clock position can effectively prevent this pupillary block.