By measuring intraocular pressure in different body positions from 60 degrees semiupright to 30 degrees head down, a nonlinear relationship between IOP increase and body position was confirmed. IOP postural response in individual subjects was roughly correlated to ophthalmic arterial pressure and to the episcleral venous pressure postural response. In one series of subjects, the episcleral venous pressure increments due to posture wa; parallel to the applanation-indentation disparity in the same individual eyes. Differential tonometry with applanation or indentation procedures under blind conditions gave significantly low indentation readings. It is concluded that IOP postural response depends on arterial and venous vascular changes when subjects move from an erect to a horizontal body position. Blood expulsion from the choroid by indentation tonometry might be the reason that this tonometric procedure does not measure IOP changes based on vascular changes.
For evaluation of hand-applanation tonometry comparative measurements of intraocular pressure have been carried out using the Goldmann applanation tonometer, the Draeger and Perkins hand-applanation tonometers and the Schiötz indentation tonometer. A series of 52 eyes has been tested. The statistical analysis was based on the Goldmann tonometry as a reference system. The hand-applanation tonometers were found to be in satisfactory agreement with the Goldmann tonometer, whereas the Schiötz tonometer gave significantly low values in the pressure range considered.
This report describes the case of a mucinous cystadenocarcinoma of probable urachal origin that presented with mass effect, precipitating deep venous thrombosis and pulmonary embolism. The patient presented with acute symptoms of leg swelling, pain and dyspnoea, and a vague awareness of lower abdominal distension. Computer tomography showed a cystic mass closely related to the anterior abdominal wall and the superior aspect of the bladder. A 1500 cm3cyst adherent to the dome of the urinary bladder was resected on laparotomy. Partial cystectomy was not carried out in the belief that the cyst represented a benign lesion. Subsequent imaging has shown cystic changes in the anterior bladder wall, and the patient has been referred for partial cystectomy.
Both minimally invasive, stroma-sparing methods were effective for the treatment of trauma-associated recurrent erosion. The ablation of Bowman's lamella or anterior stroma does not seem to be necessary. However, for basal membrane dystrophy, we recommend PTK after epithelial debridement for the partial ablation of Bowman's lamella.
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