Iris Photocoagulation Research Articles

Effectiveness of multiple therapeutic strategies in neovascular glaucoma patients: A PRISMA-compliant network meta-analysis.

Neovascular glaucoma (NVG) is a severe secondary glaucoma with uncontrolled intraocular pressure that leads to serious eye pain and vision loss. Presently, the therapeutic strategies for NVG are diverse, but the therapeutic effects are still not ideal. We performed a network analysis to assess the effect of multiple therapeutic strategies on the treatment of NVG patients. We searched public electronic databases through April 2017 using the following keywords "neovascular glaucoma," "iris neovascularization," "hemorrhagic glaucoma," and "random" without language restrictions. The outcome considered in the present analysis was treatment success rate. A network meta-analysis and multilevel mixed-effects logistic regression were used to compare regimens. We included 27 articles assessing a total of 1884 NVG patients in our analysis. According to the network analysis, interferon and mitomycin plus trabeculectomy (94.9%), glaucoma valve implantation (86.9%), and iris photocoagulation plus trabeculectomy (81.9%) were the most likely to improve treatment success rate in NVG patients. The multilevel logistic regression analysis showed that glaucoma valve, bevacizumab, interferon, cyclophotocoagulation, trabeculectomy, iris photocoagulation, ranibizumab, and mitomycin had advantages in terms of improving treatment success rate in NVG patients. However, the application of retinal photocoagulation and vitrectomy reduced patient treatment success rate. The regimen including mitomycin, interferon, and trabeculectomy was the most likely to improve the treatment success rate in NVG patients. The application of glaucoma valve and bevacizumab were more beneficial for improving patient treatment success rate as a surgery and as an agent, respectively.

Iris microhaemangioma: a management strategy.

To analyse previous literature and to formulate a management strategy for iris microhaemangiomas (IMH). A review of the literature in English language articles on IMH. Thirty five English language articles fulfilled the criteria for inclusion to the study and based on the contents on these articles a management strategy was formulated. Age at presentation ranged from 42 to 80 years with no sex or racial predisposition. Most patients withIMHhave no systemic disease but a higher incidence had been reported in patients with diabetes mellitus, myotonic dystrophy, chronic obstructive pulmonary disease (COPD) and several other systemic and ophthalmic co-morbidities. Most patients remained asymptomatic until they experienced a sudden blurring of vision due to a hyphaema. Some patients only develop a self-limiting single episode of hyphaema and therefore the laser or surgical photocoagulation of iris should be reserved for the cases complicated with recurrent hyphaema. In some patients, several laser photocoagulation sessions may be needed and the recurrent irisvasculartufts may require more aggressive treatment. Iris fluorescein angiography (IFA) is useful in identifying the true extent of the disease and helps to improve the precision of the lasertreatment. Surgical excision (iridectomy) should only be considered in patients who fail to respond to repeated laser treatment. In some cases IMHs has been initially misdiagnosed as amaurosis fugax, iritis and Posner-Schlossmansyndrome. Owing to its scarcity, there is no good quality scientific evidence to support the management of IMH. The authors discuss the various treatment options and present a management strategy based on the previous literature for the management for this rare condition and its complications.

Effects of Nilvadipine, Nicardipine and Verapamil on Acute Rise of Aqueous Flare Induced by Iris Photocoagulation or Intravenous Lipopolysaccharides in Pigmented Rabbits

The effects of nilvadipine, nicardipine and verapamil on the acute rise of aqueous flare induced by argon laser photocoagulation of the iris or by intravenous injection of lipopolysaccharides (LPS, 0.5 µg/kg) were investigated in pigmented rabbits. Nilvadipine, nicardipine and verapamil were injected intravenously. Aqueous flare was measured with a laser flare cell meter. Following photocoagulation, aqueous flare increased, reached its maximum at 45–75 min and then decreased. After administration of LPS, aqueous flare increased, reached its maximum at 4 h and then returned to baseline levels at about 24 h. Flare reactions were inhibited by nilvadipine in a dose-dependent manner. The elevations were maximally inhibited by nilvadipine 30 min before photocoagulation or intravenous LPS. Two hundred micrograms per kilogram of nilvadipine inhibited 81% of photocoagulation-induced flare elevation, while the same dose of nicardipine and verapamil inhibited 19 and 9% of the elevation, respectively. The same dose of nilvadipine inhibited 51% of LPS-induced flare elevation, while the same dose of nicardipine and verapamil inhibited 6 and 4% of the elevation, respectively. In conclusion, nilvadipine inhibited the experimental elevation of aqueous flare more effectively than did nicardipine and verapamil.

Transient Hypopyon Following Primary or Adjunct Argon Laser Photocoagulation-Reply

In Reply. —We appreciate the comments and additional references provided by Dr Shin. The differential diagnosis in our two cases included microbial endophthalmitis as well as an exaggerated inflammatory reaction related to panretinal laser endophotocoagulation or to contaminants in the silicone oil. Both patients developed marked anterior chamber fibrin as well as a prominent hypopyon following pars plana vitrectomy, laser endophotocoagulation, and silicone oil injection. Neither of these patients had preoperative rubeosis iridis and neither received iris photocoagulation. A common standard of care in presumed microbial endophthalmitis is to obtain intraocular cultures and administer intraocular and periocular antibiotics and steroids. In reviewing the literature on reported endophthalmitis cases following vitrectomy and silicone oil injection, a consistent observation was made of purulent material in front of or below the silicone oil, as well as severe ocular pain. Although ocular pain did occur in one of our two patients, it was not

Argon Laser Iris Photocoagulation to Relieve Acute Angle-Closure Glaucoma

Two patients, a 67-year-old woman and a 24-year-old man, suffered acute attacks of angle-closure glaucoma. After standard treatment methods had failed, argon laser iris photocoagulation was used to relieve the attacks. In one case the argon laser photocoagulation relieved the pupillary block, decreasing the intraocular pressure and permitting successful argon laser peripheral iridotomy. In the second case, argon laser photocoagulation broke up the posterior synechiae, decreasing the intraocular pressure.

Occult Iris Erosion: A Treatble Cause of Recurrent Hyphema in Ins-supported Intraocular Lenses

A 78-year-old man underwent intracapsular cataract extraction with implantation of a Binkhorst four-loop lens. Two years later he developed recurrent hyphema, glaucoma, diffusion of blood into the vitreous, and reduction of visual acuity to 3/200. Iris fluorescein angiography demonstrated a localized network of prominent collateral vessels without fluorescein leakage above the pupil, deflection and compression of, radial iris vessels by the superior lens posts, and a focal area of leakage adjacent to one of the posts. Argon laser photocoagulation obliterated the abnormal vessels in each of these areas, eliminated the recurrent hyphema and glaucoma, and permitted recovery of 20/80 visual acuity. The patient died suddenly three months after iris photocoagulation. Histopathologic study of the eye demonstrated erosion of iris stroma and displacement of iris vessels by the lens posts, as well as the vascular effects of successful photocoagulation therapy.

Argon Laser Photomydriasis

Argon laser photomydriasis was used to enlarge 20 miotic pupils in 18 open-angle glaucoma patients, with beneficial visual results in patients properly selected before treatment. During eight months of observation, significant complications such as persistent iritis and lens changes did not occur. An increase in intraocular pressure occasionally occurred shortly after treatment, but chronic exacerbation of underlying glaucoma was not observed. Argon laser iris photocoagulation in rabbit eyes showed localized atrophy of the iris sphincter and stroma within the treatment zones. Discrete, anterior lens opacities occurred only at high-power levels, and these appeared to be nonprogressive during the eight-week observation period.

Iris photocoagulation therapy of aphakic pupillary block.

Five patients who underwent uneventful cataract extraction developed flat anterior chamber (AC) secondary to pupillary block, 2 1/2 to 4 weeks postoperatively. None had a wound leak. After drug therapy had failed to restore the AC, iris photocoagulation was performed. Four eyes were treated with a xenon-arc photocoagulator, and one with both a portable xenon-arc unit and an argon laser. The AC deepened immediately and permanently in all cases. No complications occurred, and visual acuity was good. Iris photocoagulation with a xenon-arc unit is a valid alternative to intraocular surgery in therapy for flat AC that is caused by aphakic pupillary block in patients in whom medicinal therapy fails and no wound leak is present.

Lens subluxation and surgical aphakia treated with photocoagulation of the iris.

Results of experimental studies of iris photocoagulation in rabbits and clinical observations of iris photocoagulation on 29 eyes of 25 patients with lens subluxation or surgical aphakia have been incorporated into this report. On the basis of this experience, consideration is given to the indications and contraindications for photocoagulation of the iris, the relative advantages and limitations of the procedure and the technique of iris photocoagulation.

Subluxation of the Lens Treated with Iris Photocoagulation

Subluxation of the Lens Treated with Iris Photocoagulation

Photocoagulation of iris and retina.

The eye offers unique opportunities for study of the effects of focused radiant energy because of the transparency of the media. Because radiation affects only those tissues in which it is absorbed (Draper's law), visible and infrared rays pass through the transparent media of the eye and may damage only those tissues which absorb this energy—the pigment layer of the iris and retina. When a high-powered beam from the sun or a carbon arc lamp is focused on one part of the iris, the rays can produce considerable damage to the iris. By the same token, if radiation of sufficient intensity is focused by the dioptric media of the eye, it passes through the transparent media and burns the pigmented layer of the retina, where it is absorbed. Solar chorioretinal burns caused by looking at the sun have been known for years. 1 Many investigators 2-9 have coagulated the iris