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Ophthalmic plaque brachytherapy: choroidal melanoma and retinoblastoma
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Paul T Finger, A Linn Murphree
It is important to note that stage 4 vitreous hemorrhage and large areas of retinal ischemia are associated with a worse prognosis for vision and eye retention (Table 46.2). Vitreous hemorrhage clouds our ability to use laser photocoagulation and to monitor for progression of radiation retinopathy. Patients who present with vitreous hemorrhage often have occult neovascularization and are at risk of developing secondary neovascular or ghost cell glaucoma.41
Secondary Open-Angle Glaucomas
Published in Neil T. Choplin, Carlo E. Traverso, Atlas of Glaucoma, 2014
Jonathan Myers, L. Jay Katz, Anand Mantravadi
After the first week, other factors may lead to glaucoma. Vitreous in the anterior chamber may reduce aqueous outflow. Hyphema, related to wound construction or intraocular lens position, may occur. Ghost-cell glaucoma results from long-standing hyphema or vitreous hemorrhage leading to degenerated erythrocytes, which are less flexible and block trabecular channels. Retained lens particles become hydrated and more prominent, blocking the trabecular meshwork. Postoperative inflammation related to retained lens particles, intraocular lens position, vitreous traction, and surgical trauma may become more manifest. Corticosteroid-induced glaucoma must be considered as a common source of increased IOP in postoperative patients on topical steroids. Discontinuation of steroids or a therapeutic challenge of the fellow eye with topical steroids will often aid in the diagnosis.
A review of techniques and challenges in performing sutureless intrascleral fixation of intraocular lens
Published in Expert Review of Ophthalmology, 2021
Neslihan Sevimli, Remzi Karadag, Özgür Çakıcı
This technique was revised by Prenner et al [12]. and they performed a 270° conjunctival peritomy. They did not use a 24-gauge needle, when forming a scleral tunnel, they made use of a 23-gauge trocar instead. They operated on 24 patients and followed them up for 1 year and published the results[12]. According to this study, they observed that vitreous hemorrhage was the most common short-term complication and spontaneous IOL dislocation was the most common long-term complication. A case using this technique with a ghost cell glaucoma in one eye operated was reported by Thompson et al [13]. In this case, they found that IOL and iris were in contact and had to remove IOL[13]. Peritomy width and hemorrhage seem to be an important problem in this technique since cauterization to stop hemorrhage may cause scleral melting[14]. Also, the traumatization of the conjunctiva to such a degree may cause problems for the patient if other interventions are required in the future.
Uveitis-Glaucoma-Hyphema Syndrome: Clinical Features and Differential Diagnosis
Published in Ocular Immunology and Inflammation, 2022
Massimo Accorinti, Maria Carmela Saturno, Maria Pia Paroli, Daniele De Geronimo, Marta Gilardi
This might lead to a wide spectrum of clinical pictures ranging from simple iris transillumination defects, to pigmentary dispersion, uveitis, microhyphema or hyphema, vitreous hemorrhages and cystoid macular edema.1,2,4–9 Intraocular pressure (IOP) might rise after the onset of the disease or after some recurrences. Repeated elevated IOP attacks can result in glaucomatous optic nerve damage. The mechanism of glaucoma includes blockage of outflow by inflammatory cells and fibrin, peripheral anterior synechiae formation, and ghost cell glaucoma from vitreous hemorrhage.5,10
Advances in the tools and techniques of vitreoretinal surgery
Published in Expert Review of Ophthalmology, 2020
Ashish Markan, Aman Kumar, Jayesh Vira, Vishali Gupta, Aniruddha Agarwal
In general, several indications of vitreoretinal surgery make it a semi-emergency or an emergency procedure. Conditions such as endophthalmitis, complicated cataract surgery with nucleus dislocation in vitreous cavity, and ghost cell glaucoma, among others, require urgent intervention. In the current era, research is focused on improving the outcomes in these patients with the aid of superior technology, machinery and surgical instrumentation [2].