A capsulorhexis may be difficult to perform in the absence of a red fundus reflex. Using 0.1 mL of trypan blue 0.1% to stain the anterior capsule in 30 patients with a mature cataract enabled us to visualize the capsulorhexis during phacoemulsification. No adverse reactions were observed up to 12 months after surgery. Trypan blue staining of the anterior capsule appears to be a safe technique to facilitate the performance of a capsulorhexis in the absence of a red fundus reflex.
The direct compensation method allows for an accurate (standard deviation below 0.05 log unit) determination of intraocular light scattering between 3.5 and 25 deg of scattering angle and is suitable for untrained subjects. The method was used to study population behaviour and individual variation in 129 volunteers between 20 and 82 yr of age, visual acuity equal to or better than one and no apparent eye pathology. The results indicate straylight to increase with the 4th power of age, doubling at 70. In addition to the age dependence, there was great variation between individuals. Part of this is due to negative correlation with pigmentation.
Aim: To evaluate the Baerveldt glaucoma implant (BGI) in paediatric glaucoma treatment. Methods: In a retrospective non-comparative case series 55 eyes of 40 consecutive paediatric patients ((16 years) with primary or secondary glaucoma underwent Baerveldt (350 mm 2 ) implantation. Surgical outcome was evaluated by Kaplan-Meier table analysis. Results: The overall success rate was 80% at last follow up, with a mean follow up of 32 (range 2-78) months. Cumulative success was 94% at 12 months and 24 months, 85% at 36 months, 78% at 48 months, and 44% at 60 months. 11 eyes (20%) failed postoperatively because of an IOP .21 mm Hg (eight eyes), persistent hypotony (two eyes), and choroidal haemorrhage following cataract surgery (one eye). The most frequent complication needing surgery was tube related (20%). A new observation was mild to moderate dyscoria in 22% of the eyes, all buphthalmic, caused by entrapment of a tuft of peripheral iris in the tube track. Conclusions: The BGI is effective and safe in the management of primary and secondary glaucoma. When angle surgery has proved to be unsuccessful or inappropriate in paediatric patients, a BGI is a good treatment option. One must be prepared to deal with the tube related problems.
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