Subject(s)
Lacrimal Apparatus Diseases/surgery , Ophthalmologic Surgical Procedures , Orbital Diseases/surgery , Aged , Canada , Delivery of Health Care/trends , Humans , Ophthalmologic Surgical Procedures/methods , Ophthalmologic Surgical Procedures/statistics & numerical data , Ophthalmologic Surgical Procedures/trends , Ophthalmology/organization & administration , Waiting ListsABSTRACT
OBJECTIVE: To determine whether ultrasound biomicroscopic (UBM) appearance can predict successful lowering of the intraocular pressure following trabeculectomy. DESIGN: Blinded prospective study. SETTING: Glaucoma clinic at a tertiary care hospital in Calgary. PATIENTS: Forty-six patients who had undergone trabeculectomy 1 week to 22 years earlier were recruited. In three cases UBM scanning was stopped because of discomfort, and five studies were excluded because the clinical information became known to the ultrasonographer. A total of 44 studies from 46 patients were analysed. OUTCOME MEASURES: Intraocular pressure and need for medication, UBM appearance. RESULTS: In 38 (86%) of the 44 studies there was a positive association between the UBM grade and the clinical findings. UBM had a sensitivity of 91% in predicting a functioning bleb and a specificity of 70% in predicting a nonfunctioning bleb. CONCLUSIONS: UBM is a useful adjunct to the glaucoma surgeon in the management of certain patients following trabeculectomy.
Subject(s)
Eye/diagnostic imaging , Glaucoma/surgery , Trabeculectomy , Aged , Double-Blind Method , Evaluation Studies as Topic , Female , Forecasting , Glaucoma/physiopathology , Humans , Intraocular Pressure , Male , Middle Aged , Postoperative Period , Prospective Studies , Sensitivity and Specificity , UltrasonographyABSTRACT
Due to anatomic distortion or surgical complications, it may be difficult to determine the precise position of an implanted Molteno tube. We performed ultrasound biomicroscopy (high-resolution ultrasound) to test the usefulness of this modality in localizing implanted Molteno tubes in 10 patients with Molteno tubes. A 50-megahertz transducer with a penetration of approximately 4 mm was used to produce a magnified image of the anterior segment. The Molteno tube was visualized without complication in all of these cases.
Subject(s)
Anterior Eye Segment/diagnostic imaging , Molteno Implants , Glaucoma/surgery , Humans , Microscopy , Prosthesis Fitting , Silicone Elastomers , UltrasonographyABSTRACT
Aplastic anemia attributed to medications used in ophthalmology is rare. We report a fatal case that developed in a 73-year-old woman 7 weeks after cataract extraction performed under local anesthesia. Postoperative medications included a chloramphenicol-containing ointment, flurbiprofen sodium drops, prednisone acetate drops and orally given acetazolamide. It was felt that the aplastic anemia was related to therapy with chloramphenicol or acetazolamide or both. We recommend that the course of prophylactic antibacterial therapy after intraocular surgery be kept short, regardless of the preparation used. We urge caution in the choice and use of drugs known to be associated with aplastic anemia and recommend close monitoring of the hemogram.
Subject(s)
Acetazolamide/adverse effects , Anemia, Aplastic/chemically induced , Cataract Extraction , Chloramphenicol/adverse effects , Acetazolamide/administration & dosage , Administration, Oral , Aged , Chloramphenicol/administration & dosage , Female , Humans , Ointments , Ophthalmic Solutions , Postoperative ComplicationsABSTRACT
BACKGROUND: Ultrasound biomicroscopy is a new method of imaging the anterior segment of the eye at microscopic resolution using high frequency ultrasound. METHODS: A prospective study was performed to evaluate the use of ultrasound biomicroscopy in imaging anterior segment tumors. Forty-five patients underwent clinical examination followed by slit-lamp photography, anterior segment B-scan ultrasonography, and ultrasound biomicroscopy according to an established protocol. RESULTS: All lesions were clearly imaged by ultrasound biomicroscopy, while only 17 were detectable by conventional B-scan ultrasound. Ultrasound biomicroscopy allowed precise measurement and visualization of subsurface features in small tumors. Differentiation between solid and cystic lesions was easily achieved. The margins of ciliary body tumors could be more accurately defined. Histopathologic correlation was possible in four cases managed surgically. Ultrasound biomicroscopy images compared favorably with low-power microscopy. No complications were encountered. CONCLUSION: Ultrasound biomicroscopy proved a valuable new noninvasive technique in the evaluation of anterior segment tumors.
Subject(s)
Anterior Eye Segment/diagnostic imaging , Eye Neoplasms/diagnostic imaging , Anterior Eye Segment/pathology , Choroid Neoplasms/pathology , Choroid Neoplasms/ultrastructure , Ciliary Body/diagnostic imaging , Ciliary Body/pathology , Cysts/diagnostic imaging , Cysts/pathology , Eye Neoplasms/pathology , Humans , Iris Neoplasms/pathology , Iris Neoplasms/ultrastructure , Prospective Studies , Ultrasonography , Uveal Neoplasms/pathology , Uveal Neoplasms/ultrastructureABSTRACT
A 48-year-old man presented with longstanding complaints of transient blurring of vision on exposure to cold temperatures. A review of family history was noteworthy in that two of the patient's four sons and the patient's brother had similar complaints. All affected individuals had Raynaud's disease. Results of ophthalmic evaluation showed transient corneal opacities. Slit-lamp video photography under cold stress demonstrated conjunctival vascular changes consistent with Raynaud's phenomenon. An extensive work-up for systemic disease was otherwise negative. To the best of the authors' knowledge, anterior segment changes have not been described previously in idiopathic Raynaud's disease.
