RESUMO
Intraocular pressure (IOP) was measured 4 to 6 hours after surgery and on the first postoperative day in 35 eyes of 35 consecutive patients undergoing initial trabeculectomy. In 27 eyes, the anterior chamber was re-formed at the completion of surgery with balanced salt solution, and in eight eyes it was reformed with hyaluronate sodium. A total of six eyes (17%) had an IOP of 40 mm Hg or greater 4 to 6 hours after surgery. Patients who received hyaluronate to maintain the depth of the anterior chamber had a significantly greater chance of experiencing a marked postoperative IOP rise, both at 4 to 6 hours (P = .005) and on the first postoperative day (P = .0038). There was no correlation between the postoperative IOP rise and the patient's age, sex, glaucoma diagnosis, preoperative IOP, use of 5-fluorouracil, or the number of sutures used to close the scleral flap. Hyaluronate may contribute to an early increase in IOP that could result in further visual field loss in eyes with severe glaucomatous damage. We recommend early monitoring of IOP after trabeculectomy and avoiding the routine use of hyaluronate.
Assuntos
Glaucoma/cirurgia , Pressão Intraocular , Cloreto de Sódio , Trabeculectomia/efeitos adversos , Acetatos/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Câmara Anterior/efeitos dos fármacos , Combinação de Medicamentos , Feminino , Humanos , Ácido Hialurônico/efeitos adversos , Ácido Hialurônico/uso terapêutico , Pressão Intraocular/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Minerais/uso terapêutico , Cuidados Pós-Operatórios , Campos VisuaisRESUMO
We reviewed retrospectively the records of patients referred for retinal examination and found 375 eyes (233 patients) with acquired retinoschisis. Of the 375 eyes, 85 had outer layer retinal breaks, 27 had retinal detachments, and 29 had pigmentary lines. Twenty-five of the 29 pigmentary lines (86.2%) demarcated either retinal detachment or outer retinal layer breaks.
Assuntos
Pigmentação , Perfurações Retinianas/fisiopatologia , Humanos , Pessoa de Meia-Idade , Retina/patologia , Descolamento Retiniano/complicações , Perfurações Retinianas/complicações , Perfurações Retinianas/patologiaAssuntos
Glaucoma/etiologia , Terapia a Laser/efeitos adversos , Suturas , Trabeculectomia/efeitos adversos , Acetazolamida/uso terapêutico , Corticosteroides/uso terapêutico , Feminino , Glaucoma/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Midriáticos/uso terapêutico , Retalhos CirúrgicosRESUMO
An 87-year-old woman, who had undergone cataract surgery and vitrectomy OD two years previously, had a blind, painful right eye secondary to intraocular hemorrhage and glaucoma. At the initial examination, a flat area of darkly pigmented tissue was noted at the wound site of the previous cataract surgery, and uveal prolapse was diagnosed. One year later, pigmented tissue was also seen at the inferior limbus. Intraocular malignant melanoma was considered, and the eye was enucleated. Histologic study revealed areas of hemorrhage and epithelioid malignant melanoma. It is important to recognize that prolapse of tissue at a surgical wound site may represent an extension of an intraocular malignancy.