ABSTRACT
A modification of the classical goniotomy technique is described. After complete evacuation of the anterior and posterior chambers, sodium hyaluronate is placed in the anterior chamber and on the cornea. Putting hyaluronate in both locations prevents the formation of air bubbles under the goniotomy lens, provides the same index of refraction on both sides of the cornea, prevents accidental loss of the anterior chamber, and allows maximal depth of the anterior chamber. Diminished intraocular bleeding and lower risk of injury to the corneal endothelium, iris, and lens may be additional advantages of the procedure. Two cases are presented in which five goniotomies were performed on four eyes using this technique. Both patients had one eye controlled with a single goniotomy. The fellow eye of each patient required multiple procedures. Glaucoma was controlled successfully with no medication in all four eyes. No significant complications occurred.
Subject(s)
Hyaluronic Acid/therapeutic use , Trabeculectomy , Female , Glaucoma/congenital , Humans , Infant , Intraocular Pressure/drug effects , Trabeculectomy/methodsABSTRACT
A new technique to obtain patency of the lacrimal drainage system was used in three children with bilateral congenital obstruction of the lacrimonasal duct (six cases) and upper canalicular abnormalities (five cases). The upper canalicular abnormalities prevented bicanaliculonasal intubation.A silicone tube was passed through the lower canaliculus, traversing the lacrimal drainage system and into the nasal fossa. The proximal end of the tube was placed subconjunctival in the inferior fornix and secured. The distal end of the tube was passed through the subcartilaginous nasal septum to the contralateral nasal fossa and tied to a tube similarly passed through the opposite lacrimal system.The procedure was successful in all six cases, with all tubes remaining in place the desired length of time. Postoperative identification and removal of the tubes offered no difficulties and was followed by permanent patency of the lacrimal drainage system in all six cases.
Subject(s)
Intubation/methods , Lacrimal Duct Obstruction/therapy , Nasolacrimal Duct , Child, Preschool , Female , Humans , Infant , Intubation/instrumentation , Lacrimal Duct Obstruction/congenital , Male , Silicone ElastomersABSTRACT
A new occluder to perform the cover test allows visualization of the covered eye through the occluder and direct observation of heterophorias. The occluder is composed of an aluminium-polyester filter mounted on a support in front of a 2.2-V light bulb.
Subject(s)
Ophthalmology/instrumentation , Strabismus/diagnosis , HumansABSTRACT
Four children ranging from 4 to 6 years of age with unilateral aphakia and corneal scarring secondary to penetrating injuries were treated with epikeratophakia. One child had undergone a rotational penetrating keratoplasty to displace the corneal scar from the visual axis prior to the epikeratophakia procedure. In all of the cases, nonlyophilized donor tissue was utilized. The procedure was successful in all four cases. The average best corrected postoperative visual acuity was 20/45. These results confirm prior studies suggesting that epikeratophakia can be performed successfully on partially opaque and scarred corneas in pediatric aphakic eyes.
Subject(s)
Corneal Injuries , Child, Preschool , Corneal Transplantation , Evaluation Studies as Topic , Humans , Male , Postoperative Period , Visual AcuityABSTRACT
A 3-year-old child with posttraumatic aphakia and a corneal scar was treated with a rotational penetrating ipsilateral autokeratoplasty followed by epikeratophakia 2 months later. His final best corrected visual acuity was 20/30, with 1.37D of corneal astigmatism. There were no significant operative or postoperative complications.
