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Eduardo Pimentel, Jimena Schmidt
INTRODUCTION: Trabeculectomy is considered the standard for glaucoma surgery. Postoperative scarring is one the factors associated with surgery failure. Different antimetabolites have been used in order to reduce this risk, particularly 5-fluorouracil and mitomycin C. Although both are considered effective, it is not clear if they are different in terms of success of trabeculectomy and adverse effects. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others...
January 18, 2018: Medwave
Pierre G Mardelli, Marc E Mardelli
INTRODUCTION: We present a case of persistent aqueous misdirection post Ahmed glaucoma valve despite undergoing an anterior vitrectomy with hyaloido-zonulectomy, and iridectomy. CASE REPORT: A 73 year old female 4 months post phaco-trabeculectomy was referred with persistent high IOP. Post-operatively, she developed aqueous misdirection with a flat anterior chamber (AC) but with an IOP of 15▒mm Hg. On presentation her AC was shallow with peripheral iris-cornea touch and IOP was 39▒mm Hg...
January 11, 2018: Journal of Glaucoma
Shunsuke Nakakura, Asuka Noguchi, Santaro Noguchi, Yuka Hirose, Koji Niimi, Hitoshi Tabuchi, Yoshiaki Kiuchi
We report a case of glaucoma implant tube lumen obstruction visualized with anterior segment optical coherence tomography (ASOCT) and present its surgical management. The patient was a 66-year-old man with refractory glaucoma associated with traumatic aphakia in the right eye after trabeculectomy, several bleb needling procedures, and scleral fixation of the intraocular lens with pars plana vitrectomy. Finally, we performed Baerveldt implantation at the pars plana of the temporal inferior quadrant with a several Sherwood slit...
January 11, 2018: Journal of Glaucoma
Wesley Green, John T Lind, Arsham Sheybani
PURPOSE OF REVIEW: Two new translimbal glaucoma devices (Xen Gel Stent and InnFocus MicroShunt) have been developed with the goal of optimizing the predictability and safety for subconjunctival glaucoma surgery. RECENT FINDINGS: The new subconjunctival glaucoma implants are manufactured from nonsilicone, biocompatible materials, which may reduce the postoperative inflammatory and fibrotic reactions that can lead to failure. Early data suggests a favorable safety profile with significant reductions in intraocular pressure (IOP)...
January 9, 2018: Current Opinion in Ophthalmology
Che-Yuan Kuo, Yu-Fan Chang, Yu-Bai Chou, Chih-Chien Hsu, Pei-Yu Lin, Catherine Jui-Ling Liu
INTRODUCTION: Corticosteroid treatment for uveitis can lead to delayed-onset pressure-induced interlamellar stromal keratitis (PISK), even years after laser in situ keratomileusis (LASIK).A 35-year-old man presented to our clinic after experiencing blurred vision in his left eye for 1 month. For the past month, he had been prescribed topical steroid and anti-glaucomatous medication. He had undergone LASIK for both eyes 5 years earlier, and had suffered uveitis attacks in his left eye over the last 2 years...
December 2017: Medicine (Baltimore)
Karine D Bojikian, Philip P Chen
BACKGROUND/AIMS: To evaluate intraocular pressure (IOP) after phacoemulsification in open angle glaucoma (OAG) patients with uncontrolled or marginally controlled glaucoma and/or severe visual field (VF) loss. METHODS: Retrospective case series of OAG patients without prior glaucoma surgery undergoing phacoemulsification. Uncontrolled or marginally controlled glaucoma was defined as IOP>21▒mm Hg despite maximally tolerated medications or requiring more than 3 topical drugs for IOP control...
January 4, 2018: Journal of Glaucoma
Edward Stephen Yung, Marlene R Moster, Carina Sanvicente, John Pluta, Kamran Rahmatnejad, Arjun S Patel, Alice Williams, Ben Abramowitz, L Jay Katz, Michael Pro
PURPOSE: Phacoemulsification has been cited as a possible cause of bleb failure in eyes with prior trabeculectomy. No method has been developed to directly evaluate the risk of bleb failure after phacoemulsification. We investigate the use of trypan blue during cataract surgery in the setting of a pre-existing trabeculectomy to evaluate the functional status of the bleb and predict post-operative bleb function. PATIENTS AND METHODS: 14 patients contributing one eye each with a history of prior trabeculectomy with mitomycin C undergoing phacoemulsification with intraocular lens implantation were enrolled in this prospective, nonrandomized clinical trial...
January 4, 2018: Journal of Glaucoma
Simrenjeet Sandhu, Michael W Dorey
This case study reports the successful implantation of the Xen ab interno gel stent in a 44-year-old male with refractory chronic open angle glaucoma. The patient had multiple unsuccessful filtration surgeries including a trabeculectomy and two Ahmed glaucoma valves placed superotemporally and inferonasally OD. The patients intraocular pressure was reduced from 29▒mm Hg preoperatively to 17▒mm Hg 1 year after surgery, without any ocular complications. The Xen gel stent may be considered as a possible intervention to lower IOP in patients with refractory glaucoma, despite previous filtration surgeries if the superonasal conjunctiva is spared and healthy...
January 4, 2018: Journal of Glaucoma
Naoki Okumura, Daiki Matsumoto, Yugo Okazaki, Noriko Koizumi, Chie Sotozono, Shigeru Kinoshita, Kazuhiko Mori
PURPOSE: This study investigates the possible role of the filtration bleb in the continuous decrease in corneal endothelial cell (CEC) density observed following trabeculectomy. METHODS: This study involved 51 eyes of 37 glaucoma patients who underwent trabeculectomy. The CEC density was determined by contact specular microscopy in three areas: (1) the cornea center, (2) near the trabeculectomy filtration bleb, and (3) the opposite side of the bleb. The eyes were grouped according to post-surgical follow-up years: 0-1 (Group 1), 1-2 (Group 2), 2-3 (Group 3), 3-4, (Group 4), and 4+ years (Group 5)...
January 4, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Milena Pahlitzsch, Anja M Davids, Malte Zorn, Necip Torun, Sibylle Winterhalter, Anna-Karina B Maier, Matthias K Klamann, Eckart Bertelmann
PURPOSE: To assess the long-term outcome of Trabectome surgery in the treatment of primary open angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEX): 3-year results. METHODS: Trabectome surgery (NeoMedix, Tustin, CA, USA) was performed in 268 POAG patients (women 57.46%, men 42.54%, age 72.35 ± 9.63 years) and 98 PEX glaucoma patients (women 58.16%, men 41.84%, age 73.42 ± 8.54 years), and uncontrolled intraocular pressure (IOP). Parameters were examined preoperatively, 1 day, 6 weeks, 3, 6, 12, 24 and 36 months post surgery...
December 30, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
Hiroko Inuzuka, Akira Sawada, Tetsuya Yamamoto
PURPOSE: To compare changes in the macular ganglion cell layer and inner plexiform layer (mGCIPL) thickness over 5 years between surgically treated eyes (STE) and medically treated eyes (MTE) with advanced glaucoma. DESIGN: Retrospective, comparative case series. METHODS: Eighty-six patients comprising 43 with open angle glaucoma (OAG) with trabeculectomy and 43 with medically treated OAG. The mGCIPL thickness was measured more than 5 times during follow-up by optical coherence tomography...
December 26, 2017: American Journal of Ophthalmology
Vanita Pathak-Ray, Nikhil Choudhari
PURPOSE: The aim of this study is to investigate the efficacy and safety of needling-revision augmented with a high dose of mitomycin C (MMC) in failing or failed blebs after trabeculectomy in Indian eyes. METHODS: Prospective, noncomparative, interventional study. All patients (>18 years) who had raised intraocular pressure (IOP) following trabeculectomy (>6 weeks and <2 years), who had a flat bleb, bleb encapsulation, and/or required antiglaucoma medication (AGM) for IOP control were eligible for inclusion...
January 2018: Indian Journal of Ophthalmology
Winston J Garris, Crystal Le, David Zurakowski, Ramesh S Ayyala
PURPOSE: To compare operative outcomes of patients after canaloplasty and trabeculectomy with mitomycin C (MMC) through 2-year follow-up. METHODS: We included 31 eyes of 31 patients with primary open-angle glaucoma (POAG) who underwent canaloplasty and 37 eyes of 37 patients with POAG who underwent trabeculectomy with MMC with 24 months of postoperative follow-up. All surgeries were performed by a single surgeon between January 2005 and May 2011. Failure was defined as intraocular pressure (IOP> 18 or <4 mmHg at 2 years), second operative procedure, or loss of light perception...
January 2018: Indian Journal of Ophthalmology
Takanori Matsuoka, Kazunobu Asao, Noriyasu Hashida, Kohji Nishida
Background: Chronic retinal necrosis (CRN) is a rare chronic granular necrotizing retinitis that was first described in 2013. CRN is characterized by intraocular inflammation accompanied by occlusive vasculitis, granular retinitis, and slowly progressing necrosis around the retina in a host with partial immune dysfunction. Cytomegalovirus (CMV) is reported to be a causative agent. There are several ocular complications such as retinal detachment and neovascular glaucoma; however, there has been no description of a clinical manifestation of neovascular glaucoma in CRN...
September 2017: Case Reports in Ophthalmology
Harinder Singh Sethi, Mayuresh P Naik, Komal Saluja
PURPOSE: To elucidate the role of trabeculectomy in advanced glaucoma. MATERIALS AND METHODS: Only patients with primary open-angle glaucoma were selected. All patients who had cup-disc ratio of 0.9 or a near-total cupping were given a trial of aggressive maximum medical therapy for IOP control for at least 4 weeks. Target IOP was defined as ≤ 12 mm Hg. Patients who showed progression were included in the study. A total of 10 patients were selected. Trabeculectomy was performed using limbal-based conjunctival flap...
December 26, 2017: International Ophthalmology
Yoichiro Shinohara, Hideo Akiyama, Mikiya Magori, Shoji Kishi
Background: The purpose of this study was to investigate postoperative clinical outcomes in patients with neovascular glaucoma (NVG) who underwent trabeculectomy or EX-PRESS implantation and to identify predictors of successful EX-PRESS implantation. Methods: The study designed as a retrospective observational analysis and was set in a single tertiary center. Eighty-nine patients (89 eyes) with NVG, were treated using trabeculectomy alone (Trab group; n=39) or EX-PRESS implantation (EX group; n=50)...
2017: Clinical Ophthalmology
Fereshteh Abolbashari, Asieh Ehsaei, Ramin Daneshvar, Nasrin Moghaddas Sharif, Ahmad Gholami, Naeemeh Monfared, Seyed Mahdi Ahmadi Hosseini
PURPOSE: To investigate the effect of trabeculectomy on corneal topography, corneal sensitivity and aberrations. METHODS: Twenty-four eyes of 24 subjects with open-angle glaucoma who required glaucoma filtration surgery were assessed. The evaluation of corneal topography, corneal sensitivity and aberrations were done before the trabeculectomy procedure, 1 week and 1 month after the trabeculectomy. RESULTS: There were significant differences in cylindrical power (P = 0...
December 22, 2017: International Ophthalmology
Seong Ho Jo, Je Hyun Seo
PURPOSE: To investigate the changes in ocular higher-order aberrations (HOA) after trabeculectomy using mitomycin-C (MMC). METHODS: We retrospectively reviewed data for 63 eyes from 63 glaucoma patients who had undergone MMC augmented trabeculectomy. We measured intraocular pressure (IOP), refractive errors, anterior chamber depth (ACD), and HOA before surgery and 1, 2, and 4 weeks postoperatively. The patients were divided into two groups on the basis of preoperative lens status: phakic and pseudophakic group...
December 22, 2017: International Ophthalmology
Mehmet Baykara, Basak Can Ermerak, Huri Sabur, Selim Genc
AIM: To present a novel scleral flap suturing technique for filtering glaucoma surgery in order to control high postoperative intraocular pressure (IOP). METHODS: Description of 'the accordion suture' technique for mitomycin C augmented trabeculectomy. In cases of postoperative high IOP, pulling the loop of the suture helps to lift up the scleral flap by an even pressure on both edges. By means of this technique, the scleral flap opens up in an "accordion" manner, thus preventing flap obstruction and providing adequate aqueous flow...
2017: International Journal of Ophthalmology
Bonnie Nga Kwan Choy
Our study retrospectively reviewed the surgical outcomes up to 3mo of 38 consecutive Chinese glaucoma patients who underwent trabeculectomy (n=18) or phacotrabeculectomy (n=20). Baseline age, visual acuity, and intraocular pressure were comparable. Intraocular pressure from post-operative 1d to 3mo were similar between 2 groups. Complete success was achieved in 65% of phacotrabeculectomy, and 66.7% of trabeculectomy cases; while failure occurred in 16.7% of phacotrabeculectomy, and 10% of trabeculectomy cases at 3mo...
2017: International Journal of Ophthalmology
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