[Show abstract][Hide abstract] ABSTRACT: First lesions to occur in the course of systemic sclerosis (SSc) involve microcirculation.
The study involved assessment of the suitability of laser Doppler flowmetry (LDF) in examination of the performance of skin microcirculation in the distal portion of the upper extremity in SSc patients.
Overall the study involved 27 patients with systemic sclerosis. The control group comprised age - and gender-matched 27 healthy individuals. All the study subjects underwent microcirculation perfusion measurement at rest (rest flow - RF) as well as microcirculatory flow challenge tests - reactive hyperaemia test (RHT) and thermal stimulation test (TST).
The study did not show any differences in the skin microcirculation perfusion at rest between the test group and the control, while reactive hyperaemia test results revealed significantly lower skin microcirculation perfusion values during the cuff inflation in SSc patients, as compared to the controls. In the test group, a lower perfusion value was observed during secondary hyperaemia following cuff release. Comparative analysis of skin microcirculation perfusion changes during the thermal stimulation test revealed a significantly lower change of the perfusion value and longer time of return to the baseline in the test group as compared to the control group.
The study performed has shown the suitability of LDF in the assessment of the microangiopathy degree in systemic sclerosis patients. The skin perfusion value in SSc patients should be assessed on the basis of parameters obtained in microcirculation challenge tests.
Postepy Dermatologii I Alergologii 02/2014; 31(1):6-11. · 0.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Systemic sclerosis (scleroderma, SSc) is a severe chronic connective tissue disease caused by immune system disorders and changes in the structure and functions of blood vessels, which consequently leads to enhanced tissue fibrosis. The aim of the study was to evaluate changes in the organ of vision in systemic sclerosis patients.
Overall the study involved 27 patients with systemic sclerosis. The control group comprised 27 age- and gender-matched healthy individuals. All the study subjects underwent complete ophthalmological examination that in systemic sclerosis patients additionally involved fluorescein angiography.
OPHTHALMOLOGICAL EXAMINATION REVEALED HIGHER INCIDENCE OF THE FOLLOWING ABNORMALITIES IN THE STUDY GROUP, COMPARED TO THE CONTROL: symptoms of dry eye syndrome (19 eyes, p < 0.02), astigmatism(in 30 eyes, p < 0.01), posterior subcapsular cataract (10 eyes, p < 0.05), increased intraocular pressure (> 21 mm Hg were observed in 11 eyes, p < 0.002) and vascular abnormalities within fundus in fluorescein angiography (20 eyes).
In patients with systemic sclerosis numerous abnormalities within the vision of organ may be found. Regular ophthalmological examinations are essential among the mentioned group. The examination should be particularly focused on the presence of retinal vascular abnormalities.
Archives of Medical Science 12/2013; 9(6):1107-1113. · 1.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to compare the efficacy of verteporfin photodynamic therapy (PDT), intravitreal injections of bevacizumab (IVB) and transpupillary thermotherapy (TTT) in patients with neovascular age-related macular degeneration (AMD).
The study design was a prospective, interventional, comparative case series. Between December 2006 and March 2009, 426 eyes of 426 consecutive patients presenting with neovascular AMD were included into the study. Patients presented with subfoveal CNV predominantly classic, minimally classic, and occult with no classic component; lesion size less than 5000 µm in the greatest linear dimension, and the area of hemorrhages ≤1/3 were randomized to receive either PDT (group I) or IVB (group II) in a 1:1 ratio. Other patients with CNV were included into the group III and received TTT.
One hundred eyes were treated with PDT. Mean baseline logMAR BCVA was 0.62 and final visual acuity decreased to 0.74 (p<0.05, Wilcoxon test); 104 eyes were treated with IVB. Mean baseline BCVA was 0.82 and final visual acuity increased to 0.79 (p>0.05, Wilcoxon test); 222 patients were treated with TTT. Mean baseline BCVA was 1.10 and final visual acuity decreased to 1.15 (p>0.05, Wilcoxon test). Among all eyes the average number of treatment sessions was 2.34 (SD 1.17).
Our study shows that IVB injections had the best efficacy in the improvement of final BCVA. However, both IVB and TTT demonstrated good stabilization of vision. Although after PDT final BCVA was significantly worse from baseline, it may also be beneficial for some patients with neovascular age-related macular degeneration.
Medical science monitor: international medical journal of experimental and clinical research 06/2012; 18(6):CR374-80. · 1.22 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objective was to investigate whether microvascular disturbances in patients with type 2 diabetes (DM) as defined by retinal examination predict the existence of macrovascular disturbances found on radioisotopic perfusion examinations of the heart muscle.
A total of 100 patients with type 2 DM and an additional cardiovascular risk factor were enrolled in the study. All patients underwent comprehensive ophthalmologic examination, including fundus color photography and fluorescein angiography, and were divided into three groups: group 1 (NoDR): met the inclusion criteria but had no diabetic retinopathy; group 2 (NPDR): had signs of nonproliferative diabetic retinopathy; group 3 (PDR): had signs of preproliferative or proliferative diabetic retinopathy. After collecting general medical history and clinical data, patients underwent heart muscle perfusion studies. All patients followed a 48-h protocol heart muscle perfusion examination in the rest state as well as after the standardized exercise test. Single photon emission computed tomography examination was performed.
In the PDR group, the impairment of the heart muscle perfusion at stress and rest was more frequent than in the NPDR and NoDR groups. Analysis of the heart muscle perfusion results for the three groups showed a significant relationship with the severity of microvascular complications observed in eye fundus examinations.
Comprehensive ophthalmologic assessment of the progression of diabetic retinopathy in patients with type 2 DM may be an indicator of heart muscle perfusion disturbance.
Journal of diabetes and its complications 03/2011; 25(4):253-7. · 2.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to investigate the relationship between microvascular and macrovascular disturbances in patients with type 2 diabetes, as shown by results of ophthalmological examination and by vascular and perfusion examinations of the lower limbs.
A total of 85 patients with type 2 diabetes and an additional cardiovascular risk factor were enrolled in the study. All patients underwent complex ophthalmological examination, including fundus colour photography and fluorescein angiography, and were divided into two groups: group I with signs of diabetic non-proliferative retinopathy (NPDR), and group II with signs of diabetic proliferative retinopathy (P/PDR). After collection of the general medical history and analysis of medical data, patients underwent vascular and muscle perfusion examination of the lower limbs.
In the P/PDR group, disturbances of lower-limb perfusion were more frequent than in the NPDR group. Analysis of the blood flow and results of lower-limb muscle perfusion for the two groups showed a significant relationship with the severity of microvascular complications observed in examination of the fundus.
Ophthalmological assessment of the progression of diabetic retinopathy in patients with type 2 diabetes is a reliable indicator of the changes in peripheral vessel systems and perfusion defects in the lower limbs.
Archives of medical science : AMS. 12/2010; 6(6):904-11.
[Show abstract][Hide abstract] ABSTRACT: We aimed to investigate activities of metalloproteinases 2 (MMP-2) and MMP-9 in aqueous humour of patients with diabetes mellitus with various stages of diabetic retinopathy.
We included 36 samples of aqueous humour of patients suffering from diabetes mellitus, undergoing routine cataract surgery. Seven of them suffered from proliferative diabetic retinopathy (PDR), 3 had diabetic maculopathy and the remaining 26 had background or minimal background retinopathy only. Metalloproteinases 2 and MMP-9 activities in aqueous humour were measured by gelatin zymography combined with the densitometric imaging system. Total protein content in aqueous humour samples was also assessed.
Metalloproteinases 2 activities were present in almost all samples of aqueous humour (32 of 36) and were 2.6-fold higher in patients who suffered from diabetic ocular complications (p < 0.0001). Activities of MMP-2 correlated well with the duration of the disease (correlation = 0.37, p = 0.03) and tended to correlate with total protein levels in aqueous humour (correlation = 0.43, p = 0.06). Metalloproteinases 9 activities were observed only in 2 of 7 patients with proliferative diabetic disease and the enzyme was absent from aqueous humour samples of patients without proliferative retinopathy.
Increased activities of MMP-2 in aqueous humour of patients with PDR may be related to the disease process and support the hypothesis that MMP-2 may be of particular importance in diabetic retinal neovascularization. MMP-9 may be activated at a certain disease stage only.
Archives of medical science : AMS. 06/2010; 6(3):375-81.
[Show abstract][Hide abstract] ABSTRACT: To determine the prevalence of ocular diseases among candidates and members of Military Service.
A retrospective review of medical examinations for entry to the military service from The Area of Military Medical Ophthalmic Commission in Lodz. We used statistic analysis to review the results.
Statistic analysis revealed that the commonest ocular diseases are in order: refractive errors, color vision disturbances and strabismus.
1. The prevalence of ocular diseases among candidates and members of Polish Military Service is the same as discovered in other ophthalmologic researches. 2. Commonest ocular diseases were refractive errors (21.63% in total).
[Show abstract][Hide abstract] ABSTRACT: To assess ocular causes for rejection from the military service.
A retrospective review of medical examinations for entry to the military service from The Area Military Medical Commission in Lodz. Ophthalmic examinations were performed according to meet eligibility criteria. We used statistic analysis to review the results.
Statistic analysis revealed that during period 1993-2004 ocular diseases were causes of 4.68% rejections from the army. The major ocular causes were high refractive errors.
1. Ocular diseases are important causes for rejection from the army (4.68% in total). 2. Major ocular causes for rejection are: high refractive errors, glaucoma and chronic diseases of the choroid, retina and optic nerve.
[Show abstract][Hide abstract] ABSTRACT: To determine the prevalence of refractive errors in population.
A retrospective review of medical examinations for entry to the military service from The Area Military Medical Commission in Lodz. Ophthalmic examinations were performed. We used statistic analysis to review the results.
Statistic analysis revealed that refractive errors occurred in 21.68% of the population. The most commen refractive error was myopia.
1) The most commen ocular diseases are refractive errors, especially myopia (21.68% in total). 2) Refractive surgery and contact lenses should be allowed as the possible correction of refractive errors for military service.
[Show abstract][Hide abstract] ABSTRACT: TNFalpha (tumor necrosis factor alpha) plays a central role in the development of thyroid associated ophthalmopathy (TAO). We describe and document by ophthalmic (CAS and NO SPECS scales) and radiological (MRI) evaluation a positive effect of anti-TNFalpha antibody (infliximab) administration on active TAO in a 58 years old woman with Graves' disease. The single dose of infliximab administration resulted in a dramatic reduction of inflammation studies and improvement of visual function as measured by MRI and CAS and NO SPECS scales, without noticeable short-term side effects. A randomized prospective study is needed to determine whether infliximab proves to be sufficiently effective in reducing the inflammatory symptoms of TAO, and whether it can be administered safely for a prolonged period without side effects.
[Show abstract][Hide abstract] ABSTRACT: To present some relevant stages of phacosclerothalamotomy procedure.
Surgery comprised: superior clear corneal phacoemulsification with in the bag IOL implantation combined with 4 ab interno sclerostomy with high frequency diathermic probe. The position of the probe was checked under gonioscopic view and microscopic or endoillumination light. Six patients (6 eyes) were enrolled. In 5 patients there was POAG and POCG in 1.
Phacoemulsification were performed uneventfully. During sclerothalamotomy bleeding within trabecular meshwork and shallowing of anterior chamber were observed. The value of IOP was lower in each case postoperatively. Antiglaucoma medications ratio was decreased.
Phacosclerothalamotomy links up some advantages of small incision cataract surgery with surgical bypass between anterior chamber and Schlemm's canal as well as deep sclerostomy (thalamotomy) performed ab interno with diathermic probe. This technique allows to avoid some complications of filtration surgery.
[Show abstract][Hide abstract] ABSTRACT: To evaluate bacterial flora of conjunctival sac, the skin of the eyelids and inflammatory lesions in patients with acne vulgaris, rosacea and of healthy people. Bacterial colonization of conjunctival sac, the skin of the eyelids and skin lesions is more frequent in patients with acne vulgaris and rosacea. Because antibiotic resistant strains of bacteria are quite often met, it seems important to determine antibiotic-sensitivity of isolated bacteria.
178 people underwent bacteriological examination of conjunctival sac, skin of the eyelids and skin lesions: 64 patients with acne vulgaris, 59 patients with rosacea and 55 healthy persons. Microorganisms were identified with laboratory techniques with the use of bio-Merieux kits and determination of drug-sensitivity was performed with recognized laboratory techniques.
Positive cultures and general frequencies of the isolations were found to be higher in both groups in comparison with the reference group (the group of clinically healthy people). In healthy persons practically the only saprophytic bacteria--the most often S. epidermidis and S. viridans--were isolated. Whereas in patients suffering from acne vulgaris and rosacea the pathogenic bacteria--S. aureus, P. fluorescens, P. acnes, P. aeruginosa--were additionally isolated. Different spectrum of sensitivity to antibiotics of bacteria isolated from conjunctival sac, the skin of the eyelids and skin lesions in the cases of acne vulgaris and rosacea was proved.
1. In the cases of acne vulgaris the majority of isolated bacteria from conjunctival sac included Streptococcus spp., Staphylococcus spp. and Enterobacteriaceae. 2. In the severe cases of rosacea the main bacteria found in conjunctival sac were S. aureus, S.pyogenes, P.aeruginosa, E. faecalis, A. baumanii, P. fluorescens. 3. Because of changeable drug-sensitivity of bacterial strains, it seems to be necessary to perform individual culture and antibiogram in every patient with inflammatory lesions, in particular in clinically severe and resistant to therapy cases of acne vulgaris and rosacea. 4. The higher frequency of the bacterial colonisations in the conjunctival sac in patients with acne vulgaris and rosacea can be a potential source of ocular infections in the cases of local and systemic disorders of protective mechanisms. 5. Estimation of bacterial flora and antibiotic sensitivity of bacteria isolated from conjunctival sac, the skin of the eyelids and skin lesions should be perform, especially when patients are prepared for eye surgery.
[Show abstract][Hide abstract] ABSTRACT: To measure the temperature parameters on the corneal surface during the delivery of standardized ultrasound energy assisted with ophthalmic viscosurgical devices (OVDs) or different temperatures of irrigating solutions in an experimental animal model.
Department of Ophthalmology and Visual Rehabilitation, Medical University of Lodz, and Central Institute for Labor Protection, National Research Institute, Warsaw, Poland.
Thirty rabbits (60 eyes) were randomly divided into 6 groups in which different OVD or balanced salt solutions (BSS) were used: group 1: Viscoat (sodium hyaluronate 3%-chondroitin sulfate); group 2: Provisc (sodium hyaluronate 1%); group 3: soft-shell technique; group 4: Celoftal (hydroxypropyl methylcellulose 2%); group 5: BSS 22 degrees C; and group 6: BSS 4 degrees C. After the nucleus and lens cortex were removed, the anterior chamber was filled with OVD or BSS and a phaco tip was introduced into the pupillary plane and switched on. The same phaco tip parameters were used in all groups. For thermographic measurements (ie, maximal temperature [MT], dynamic rise in temperature [DRT], and time when the maximal level of temperature [TMLT] was achieved), a thermocamera was used.
Mean preoperative temperature on the rabbit corneal surface was 22.76 degrees C +/- 1.48 degrees C (SD). Working with a phaco tip increased the temperature in each group. A significantly higher MT was observed in group 5 (27.85 degrees C +/- 0.52 degrees C), followed by group 2 (27.75 degrees C +/- 0.54 degrees C), group 3 (27.74 degrees C +/- 0.46 degrees C), and group 4 (27.25 degrees C +/- 0.60 degrees C), than in group 6 (26.81 degrees C +/- 0.34 degrees C) and group 1 (26.52 degrees C +/- 0.48 degrees C) (P<.05). Significantly higher values of DRT and shorter TMLT values were observed in group 5 (1.16 degrees C/s +/- 0.42 degrees C/s, 4 seconds) and group 6 (0.91 degrees C/s +/- 0.13 degrees C/s, 5 seconds) than in groups 2, 3, 1, and 4 (0.09 degrees C/s +/- 0.07 degrees C/s, 30 seconds; 0.08 degrees C/s +/- 0.04 degrees C/s, 40 seconds; 0.07 degrees C/s +/- 0.03 degrees C/s, 45 seconds; 0.06 degrees C/s +/- 0.02 degrees C/s, 50 seconds, respectively) (P<.0001).
Currently used OVDs potentially offer different levels of protection against the increase in temperature that occurs during phacoemulsification. Therefore, the surgeon should consider this aspect when choosing an OVD, particularly in difficult cases (ie, hard nucleus, shallow anterior chamber, endothelial abnormalities).
Journal of Cataract and Refractive Surgery 01/2006; 32(1):137-40. · 2.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: retrospective, comparative analysis of the effectiveness of the results among patients who underwent removal of complicated cataract due to uveitis and senile cataract.
Patients with cataract enrolled in this study were divided into two groups. Group 1 comprised 30 eyes with complicated cataract due to uveitis. The main causes of uveitis were: rheumatoid arthritis in 8 eyes, ankylosing spondylitis in 7, Reiter syndrome in 3, psoriatic arthritis in 3, systemic sarcoidosis in 2, post-traumatic uveitis in 1. In 6 patients (6 eyes) the etiology of uveitis was unknown. Group 2 comprised 30 eyes with senile cataract. In 5 patients in each group there were coexisting glaucoma. In both groups phacoemulsification or phacoaspiration and foldable three piece IOL implantation were performed. The follow-up period was 12 months. Best corrected visual acuity and intra and postoperative complications were taken into consideration.
There were no differences in gender and cataract hardness between the two groups. Significantly younger patients were in group 1 p< 0.01. Mean preop./ postop. visual acuity was better in group 2 as compared with group 1: 0.4/ 0.8 and 0.2/ 0.5, respectively, p < 0.01. In both groups however, the preoperative visual acuity was significantly lowest in patients with coexisting glaucoma: group 1, 0.1 p < 0.01 and in group 2: 0.25 p < 0.001. Significantly more frequent intraoperative complications were observed in group 1 as compared with group 2 e.g., corneal burn 10% and 6.6%, local sphincter damage 10% and 0%, zonular rupture 10% and 3.3% respectively. Similarly, in the late postoperative period more frequent complications were observed in group 1 than in group 2 e.g.: secondary cataract 50% and 13.3%, IOL decentration 40% and 6.6%, capsule contraction 80% and 10%, glaucoma 10% and 3.3% respectively. Recurrence of uveitis was observed in 30% of eyes in group 1.
Although the modern microsurgical technology and IOL implantation have led to more effective treatment of senile cataract, the surgery of complicated cataract due to uveitis is still not free from complications. Future surgical strategy of complicated cataract owing to uveitis has to comprise the most adequate qualification criteria e.g. choice of the optimal period for surgery and the most convenient surgical technique as well as the most effective perioperative anti-inflammatory treatment.
[Show abstract][Hide abstract] ABSTRACT: There are currently some techniques of combined cataract and glaucoma treatment. They have been under debate for many years. We present efficacy of different techniques of combined cataract and glaucoma surgery
50 patients (60 eyes, 21 male and 29 female), mean age 64.9+/-5.6 years enrolled in the study were divided into 3 groups in which the combined surgery were performed. Group 1: phacotrabeculectomy (20 patients, 27 eyes) (FT), group 2: phacoemulsification combined with deep nonperforative sclerectomy (20 patients, 23 eyes) (FS) and group 3: phacoemulsification combined with iridocleisis (10 patients, 10 eyes) (FW). Measure outcomes during 6 months of follow up were: value of postoperative intraocular pressure, visual acuity, pre and postoperative antiglaucoma medications ratio, intra and postoperative complications.
There were not differences in preoperative intraocular pressure (IOP) among group 1 and 2 Significantly higher IOP was assessed in group 3. Preoperative antiglaucoma medications ratio was the highest in group 3 (3.5 +/- 1.5) as compared with group 1 and 2, (2.0 +/- 1.5). Postoperatively mean value of IOP was significantly lower as compared with the value in preoperative period in each group. After 3 months of follow up the IOP lower than 20 mmHg was achieved in 81.5% eyes in group 1, 73.9% eyes in group 2 and in 40 % of eyes in group 3. Six months postoperatively the target IOP was decreased to 62.9% in group 1 and 65.2% in group 2 and slightly increased to 50% in group 3. Postoperative antiglaucoma medications ratio was higher in group 3 (2.0 +/- 1.0), as compared with group 1 and 2, (1.5 +/- 1.0). The best visual acuity after 6 month of follow up was achieved in group 2, (0.8 +/- 0.2). More severe intraoperative complications such as: anterior chamber bleeding as well as postoperative complications eg.: hypotension, inflammation were noticed particularly in group 1 and 3 and choroidal effusion only in group 1.
Efficacy in lowering of IOP after FT and FS is the highest within first 3 months postoperatively. In the late postoperative period the efficacy of these methods is significantly decreasing and additional conservative treatment has to be introduced. Interestingly, the efficacy of IOP normalization after FW in the late postoperative period increases. Most of intra and postoperative complications are link up on FT and FW techniques. Our results suggest that further investigations and preparing more adequate indications for surgical strategy among patients with combined cataract and glaucoma are needed.
[Show abstract][Hide abstract] ABSTRACT: The aim of that study was to identify the mutations in rhodopsin and peripherin genes in Polish families with autosomal dominant form of retinitis pigmentosa and determine the population polymorphism in both genes in adRP families.
We performed ERG, visual acuity, Goldman visual fields, intraocular pressure measurements and fundoscopy in all the patients included in the study. On the basis of disease history, the families pedigree was made and the mode of inheritance was analyzed. The molecular analysis of DNA for each family with adRP was conducted. Genomic DNA was obtained from leucocytes by phenol-chloroform procedure according to Maniatis protocol. DNA was amplified by the PCR reaction in a volume of 50 microl containing 100 ng/microl of genomic DNA, water, Cetus buffer pH 8.4 (1 n Tris, 1 n MgCl, 1 n KCl, 2% gelatin), 0.25 microM of each primer, 200 microM of each of dATP, dTTP, dCTP, and dGTP and 2.5 U Taq polymerase (Promega). For amplification of rhodopsin gene 30 cycles of PCR were carried out. Each cycle consisting of denaturation at 95 degrees C for 5 min, annealing: at 58 degrees C (exon 1), 63 degrees C (exon 2 and 3), 68 degrees C (exon 4) and 2 min extension at 72 degrees C min. For amplification of peripherin gene 30 cycles of PCR were carried out with annealing at 60 degrees C. The entire PCR product was in electrophoresis on 8% PAA. The PCR-RFLP PCR-HD PCR-SSCP and analysis of polymorphism (CA)n dinucleotide repetition was performed.
Molecular study demonstrated, that mutations in rhodopsin gene were cause of retinitis pigmentosa in case of two families. In any study families mutations in peripherin gene were not identified. Two kinds of bases polymorphism were identified: restriction fragments length polymorphism (RFLP) in rhodopsin gene in exon 1 and 3 and single strand conformation polymorphism (SSCP) in exon 1 and 3 in rhodopsin gene and in exon 3 in peripherin gene. The confirmed mutations in rhodopsin gene, cosegregation with adRP, whereas two kinds of population polymorphism did not correlate with clinical symptoms. Natural polymorphism appeared to be a frequent feature in rhodopsin gene while a less frequent feature in peripherin gene.
Genetic investigations in patients with adRP allow to confirm the diagnosis and evaluate the prognosis. The mutation in rhodopsin gene should be confirmed in directly sequencing reaction in next study.
[Show abstract][Hide abstract] ABSTRACT: To assess temperature on the eye surface after local anesthesia due to phacoemulsyfication.
15 patients treated with local anesthesia: peribulbar - 5, retrobulbar - 5 and sub Tenon anesthesia. Mean temperature on both eye surface was assessed with termovision camera (Inframetrics 760) before surgery, 20 minutes and 1 hour after anesthesia.
In all examined groups changes in temperature values in anesthetized and contralateral eye were observed. Significant decrease of temperature was observed after sub Tenon anesthesia.
Eye surface temperature and its changes can be considered as indirect indicator of blood supply and blood supply disturbances after local anesthesia.
[Show abstract][Hide abstract] ABSTRACT: The iridocorneal endothelial syndrome (ICE) consists of some disorders, like: progressive essential iris atrophy, Chandler disease and the iris nevus syndrome that are characterized by corneal endothelium proliferation and migration, iris atrophy, corneal oedema and/or pigmentary iris nevi. Secondary, refractory glaucoma affects about 50% of patients with progressive essential iris atrophy. Medication of glaucoma is only initially effective. Some conventional filtering surgeries, to control glaucoma are often unsuccessful. Presented case of our patient with primary essential iris atrophy, with secondary glaucoma shows surgical problems. Multiple filtration surgery with or without antiproliferative agents turn out not to be sufficient. In conclusion, intraocular pressure was effectively lowered with iridocleisis technique.