A comparison of Healon and Amvisc on the early postoperative pressure after extracapsular cataract extraction with implantation of posterior chamber lens.

Two viscoelastic agents, Healon and Amvisc, both hyaluronic acids, were evaluated in two prospective, randomized and masked studies in order to compare the effects of the viscoelastics and timolol (Blocadren ) on the early postoperative intraocular pressure (IOP) after planned extracapsular cataract extraction with implantation of a posterior chamber lens. The study protocols were similar, especially with regard to the sample size, pre-, per- and postoperative management and sampling. The IOP was measured preoperatively, 3-6 and 24 h postoperatively. The testing of Amvisc revealed that aspiration or non-aspiration of Amvisc at the end of surgery was of little importance for the IOP, and that timolol significantly reduced the IOP 3-6 h postoperatively in the order of about 8 mmHg. The postoperative IOP was lower for Amvisc than for Healon only when the viscoelastic material was aspirated and topical timolol was administered. In all the other groups there were no significant differences between the viscoelastics as far as the postoperative pressure was concerned. Multiple regression revealed a marked pressure reducing effect of timolol 3-6 h postoperatively in both groups, but no effect was observed 24 h postoperatively. The two viscoelastic agents showed minor effect on the IOP both 3-6 and 24 h postoperatively.

The quantitative effect of Healon on early postoperative intraocular pressure after extracapsular cataract extraction with implantation of a posterior chamber lens.

In a prospective, randomized and masked study the quantitative effect of sodium hyaluronate (Healon) on early postoperative intraocular pressure after cataract surgery was evaluated. At the end of planned extracapsular cataract extraction with implantation of posterior chamber lens, 0.1 ml or 0.2 ml of Healon was injected into the anterior chamber. The intraocular pressure was measured preoperatively, 3-6 h and 24 h postoperatively. All patients received topical timolol at the end of surgery. The results were compared to eyes operated with identical techniques where Healon was aspirated at the end of surgery. Three to six hours postoperatively a significant drop in mean intraocular pressure from preoperative pressure occurred when Healon was aspirated, but no statistical differences in mean intraocular pressure appeared when 0.1 ml or 0.2 ml of Healon was injected. The frequencies of pressure rise above 30 mmHg show no differences among the groups. Twenty-four hours postoperatively a significant pressure elevation from mean preoperative pressure occurred when 0.1 ml or 0.2 ml Healon was injected compared to the group were Healon was aspirated at the end of surgery. Similar results are seen when pressure rise above 30 mmHg are concerned.

Evaluation of a flexible one-piece open-loop anterior chamber lens 'Symflex 350B' 3-4 years after implantation.

One-piece, open-loop flexible anterior chamber lens, Symflex 350B, was implanted in 90 eyes, 26 after extracapsular cataract extraction (ECCE), and 57 after intracapsular cataract extraction (ICCE), and in 7 cases the operation was done as a secondary implantation. The cohort was followed 3.4-4.4 years, 68 eyes were included in the last examination. At the final examination 7 eyes (10.29%) had developed corneal oedema. 6 eyes had undergone ICCE and one eye had been secondarily implanted. In no case was vaulting or malposition of the intraocular lens (IOL) found. The decompensation appeared shortly after the operation in 2 cases, one case being a secondary implantation between 1 year and 3-4 years after implantation. All extracapsularly operated eyes showed normal corneas, but the difference was not statistically significant. Neither ovalling of the pupils, nor tissue growth over the haptic feet in the anterior chamber angle, nor the visual acuity (VA) changed significantly from the 1-year to the 3-4-years examination. The intraocular pressure (IOP), however, was statistically significantly lowered 3-4 years postoperatively.

The effect of Healon and timolol on early postoperative intraocular pressure after extracapsular cataract extraction with implantation of a posterior chamber lens.

In a prospective, randomized, masked study the effect of sodium hyaluronate (Healon) and timolol on the acute intraocular pressure rise after extracapsular cataract extraction with implantation of a posterior chamber lens were evaluated. Intraocular pressure was measured preoperatively and 3-6 h and 24 h postoperatively. When no timolol was used, a significant rise in intraocular pressure was observed at 3-6 h, whether or not Healon was aspirated. Timolol reduced the intraocular pressure rise, especially during the first 3-6 h after surgery. When timolol was not applied at the end of surgery, IOP exceeded 30 mmHg in 28% 3-6 h postoperatively, compared to only 4% when timolol was applied.

Twelve-hour IOP control obtained by a single dose of timolol/pilocarpine combination eye drops.

The 12 h IOP control achieved by a single application of a newly developed ophthalmic solution containing 0.5% timolol and 2% resp. 4% pilocarpine was compared with that obtained by 1 dose of timolol 0.5% alone in 33 patients with manifest open angle glaucoma or ocular hypertension. The combined solutions gave a significantly better 12 h IOP control, evidenced by both a reduced mean diurnal IOP and a decreased frequency of larger pressure peaks.

Argon laser trabeculoplasty--5 years experience from a local eye department.

Argon Laser Trabeculoplasty (ALT) have been used in the treatment of open angle glaucoma since 1982. During a five-year period, 1982-1986, the annual rate of glaucoma filtering operations has decreased steadily from 65 to 8. The pressure reducing effect is good both in simple and capsular glaucoma. In secondary glaucoma ALT failed to control the intraocular pressure in about 50%. Simple and capsular glaucoma respond well to repeated ALT, but in secondary glaucoma repeated ALT seems to be useless.