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1.
Matthias K. J. Klamann Johannes Gonnermann Anna-Karina B. Maier Eckart Bertelmann Antonia M. Joussen Necip Torun 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(4):627-631
Background
In this retrospective comparative cohort outcome study, the influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and ab interno trabeculectomy (Trabectome) outcomes in Primary Open Angle Glaucoma (POAG), Pseudoexfoliation Glaucoma (PEX), and Pigmentary Glaucoma (PG) was examined.Methods
Combined clear cornea phacoemulsification and Trabectome were performed in 27 consecutive patients with POAG, in 27 patients with PEX, and in 20 patients with PG. Each group was divided into two subgroups including patients without SLT treatment prior to surgery and patients who had insufficient response to 360° SLT treatment three months prior to surgery.Results
In the SLT group, mean IOP at six months measured 13.33?±?2.08 mmHg with an average decrease of 30 % from preoperative IOP in the POAG group, 12.10?±?1.40 mmHg with an average decrease of 46 % in the PEX group, and 11.83?±?2.21 mmHg with an average decrease of 38 % in the PG group. In eyes without previous SLT, mean IOP sixt 6 months measured 11.00?±?1.73 mmHg with an average decrease of 38 % from preoperative IOP in the POAG group, 15.50?±?1.41 mmHg with an average decrease of 35 % in the PEX group, and 15.67?±?2.91 mmHg with an average decrease of 36 % in the PG group, respectively.Conclusions
Prior SLT treatment seems not to negatively influence combined clear cornea phacoemulsification and Trabectome outcomes in glaucoma patients. However, SLT treatment may even have an additive effect on following combined Trabectome outcomes in patients with PEX and PG. 相似文献2.
Fritz H. Hengerer Gerd U. Auffarth Timur M. Yildirim Ina Conrad-Hengerer 《BMC ophthalmology》2018,18(1):339
Purpose
To compare efficacy and safety results of an ab interno gel implant in patients with pseudoexfoliation glaucoma (PXG) and primary open angle glaucoma (POAG).Methods
Retrospective analysis of the medical records of 110 consecutive eyes with open angle glaucoma who had received a XEN45 gel implant between March 2014 and June 2015. Intraocular pressure course, number of glaucoma medications, the need for additional intervention (including needling) and complications were evaluated until 12?months postoperatively.Results
Data of 67 eyes with POAG and 43 eyes with PXG were analyzed. At 12?months postoperatively, the mean IOP had significantly decreased by 54.0% from preoperatively 31.85?±?8.5?mmHg to 13.99?±?2.6?mmHg in the POAG group, (p?=?0.000; Wilcoxon test), and by 55.2% from 31.63?±?9.0?mmHg to 13.28?±?3.1?mmHg in the PXG group (p?=?0.000; Wilcoxon test). The mean number of anti-glaucoma medications had significantly decreased from 3.25?±?0.8 at baseline to 0.3?±?0.7 medications at 12?months postoperatively in POAG eyes (p?=?0.000; Wilcoxon test), and from 3.05?±?1.0 to 0.3?±?0.6 medications in PXG eyes (p?=?0.000; Wilcoxon test). Hypotony (IOP?≤?6?mmHg) was observed in 2 POAG eyes (3.0%) and in 5 PXG eyes (11.7%) at 1?month but normalized in all eyes at 12?months postoperatively. Severe complications were not observed. No statistically significant differences were found between PXG eyes and POAG eyes.Conclusion
Our data indicate that the XEN45 gel implant provides significant and comparable reduction in IOP and anti-glaucoma medication during the one-year follow-up period in POAG as well as PXG eyes. This suggests that it may be a noteworthy alternative to traditional filtering procedures in patients with POAG and PXG respectively.3.
Jens F. Jordan Thomas S. Dietlein Sven Dinslage Christoph Lüke Walter Konen Günter K. Krieglstein 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2007,245(8):1071-1076
Purpose In glaucoma filtration surgery, the problem of subconjunctival scarring has still not been satisfactorily solved. Suprachoroidal
drainage of aqueous humour offers a promising, alternative option for intractable glaucoma. We here present a clinical study
on the surgical approach of gonioscopic cyclodialysis ab interno.
Patients and methods Twenty-eight eyes of 20 patients with intractable glaucoma were included in this prospective, consecutive, case-control study.
The eyes had had a mean of 4.4 ± 2.4 previous antiglaucomatous interventions. Baseline intraocular pressure (IOP) was 34.3 ± 10.5 mmHg
despite maximum therapy. Under gonioscopic control, cyclodialysis ab interno was performed over two clock times to gain access
to the suprachoroidal space. No additional trabecular meshwork surgery was performed. Success was defined as a lowering of
IOP to below 21 mmHg without the need for further medication or intervention.
Results Mean postoperative IOP was 14.6 ± 12.4 mmHg. Mean follow-up (FU) for all eyes was 121.8 days. After a mean of 60 days, 21
eyes (75%) needed further surgical intervention. Qualified success was seen in four eyes (14.3%), with a mean FU of 383.6 days.
Three eyes (10.7%) showed absolute success after a mean FU period of 202.7 days. In our series, we obtained the best results
for phakic eyes, followed by pseudophakic and aphakic eyes.
Conclusion The results of this study do not provide convincing evidence of the functional efficacy of cyclodialysis ab interno. Nevertheless,
the technique is easy to perform and offers safe and atraumatic access to the resorptive capability of the choroid. Conjunctival
manipulation is avoided. Contrary to reports in the current literature, in our series, the best results were obtained for
phakic eyes, though the small number of eyes included does not allow reliable statistics. Further studies will need to focus
on the use of different space-retaining substances or a widening of the cyclodialysis cleft to improve surgical outcome. 相似文献
4.
G. Michelson Marcus J. Langhans Joanna Harazny Albert Dichtl 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》1998,236(2):80-85
• Background: At this time little information is available about the relationship between glaucomatous visual field defects
and impaired blood flow in the optic nerve head. The purpose of this study was to examine blood flow of the juxtapapillary
retina and the rim area of the optic nerve head in primary open-angle glaucoma with a borderline visual defect. • Methods:
Juxtapapillary retinal and neuroretinal rim area blood flow was measured by scanning laser Doppler flowmetry (SLDF). The visual
field was evaluated by static perimetry (Octopus-G1). The optic nerve head was assessed on 15° color stereo photographs. We
examined 116 eyes of 91 patients with POAG with controlled IOP and 66 eyes of 44 healthy individuals. The POAG group was divided
into eyes with a mean defect lower than 2 dB (POAG group I) and in eyes with a mean defect equal to or greater than 2 dB (POAG
group II). The mean age of POAG group I and POAG group II was 55±11 years and 57±10 years, respectively. The mean age of the
control group was 45±15 years. The eyes of POAG group I had an average C/D ratio of 0.71±0.18 with an average mean defect
of the visual field of 0.97±0.68 dB; the eyes of POAG group II had an average C/D ratio of 0.80±0.17 with an average mean
defect of the visual field of 8.2±6.0 dB. The intraocular pressure on the day of measurement in POAG group I was 18.2±3.7 mmHg,
in POAG group II 17.6±4.0 mmHg, and in the control group 15.1±2.5 mmHg. For statistical analysis, age-matched groups of 32
normal eyes of 32 subjects (mean age 52±10 years) were compared to 18 glaucomatous eyes of 18 patients (POAG group I, mean
age 55±11 years) and 59 glaucomatous eyes of 59 patients (POAG group II, mean age 55±10 years). • Results: In the eyes of
POAG group I and POAG group II, both juxtapapillary retinal blood flow and neuroretinal rim area blood flow were significantly
decreased compared to an age-matched control group: neuroretinal rim area “flow” POAG group I −65%, POAG group II −66%; juxtapapillary
retina “flow” POAG group I −52%, POAG group II −44%. All eyes of the POAG group I (MD<2 dB) and 56 of 61 eyes of the POAG
group II (MD>=2 dB) showed a retinal perfusion lower than the 90% percentile of normal blood flow. We found no correlation
between reduction of juxtapapillary or papillary blood flow and mean defect in POAG eyes. • Conclusion: Glaucomatous eyes
with no defects or borderline visual field defects as well as glaucomatous eyes in an advanced disease stage show significantly
decreased optic nerve head and juxtapapillary retinal capillary blood flow.
Received: 2 December 1996 Revised version received: 7 February 1997 Accepted: 27 March 1997 相似文献
5.
Minna L. Ollikainen Tuomo J. Puustjärvi Petri K. Rekonen Hannu M. Uusitalo Markku E. Teräsvirta 《Acta ophthalmologica. Supplement》2011,89(6):548-555
Purpose: To investigate the efficacy and safety of mitomycin C (MMC)‐augmented deep sclerectomy with implant (DSCI) in primary open‐angle glaucoma (POAG) and exfoliation glaucoma (ExG) patients. Methods: A total of 68 eyes of 68 patients with POAG and ExG were enrolled consecutively to undergo DSCI with MMC (0.4 mg/ml for 2 min). The intraocular pressure (IOP), number of antiglaucoma medications, neodymium:yttrium‐aluminum‐garnet (Nd:YAG) laser goniopuncture treatments and complications were compared postoperatively after 36‐ month follow‐up. Surgery was considered as a complete success when IOP was <18 mmHg without antiglaucoma medication. Results: Preoperatively the mean IOPs were 23 ± 6 mmHg and 25 ± 8 mmHg, and 13 ± 4 mmHg and 11 ± 4 mmHg in the POAG and ExG groups, respectively, at 36 months. At 36 months, 74% and 73% of surgeries were a complete success in the POAG and ExG group, respectively [not significant (NS)]. Two patients (8%) of the POAG group and one of the ExG group (3%) were receiving antiglaucoma medication at 36 months (NS). Nd:YAG laser goniopuncture was performed more often in the ExG group (87%) than in the POAG group (61%, p = 0.024). Postoperatively choroidal detachment occurred in 16% of eyes in the POAG group and in 11% of eyes in the ExG group (NS). Conclusions: DSCI with MMC augmentation appears to be as effective in patients with ExG and POAG in lowering IOP to target levels at medium term with few immediate postoperative complications. 相似文献
6.
Purpose
To evaluate the safety and efficacy of primary single-plate Molteno tube implantation in the management of childhood glaucoma
associated with Sturge-Weber syndrome.
Patients and methods
Nine eyes of seven patients were included in this prospective case series. Success was defined as intraocular pressure (IOP) ≤22 mmHg
with (relative success) or without (absolute success) glaucoma medications. Intra- and postoperative complications were also
evaluated.
Results
Mean age at the time of the surgery was 9.6 ± 3.7 years (range: 5–17 years) and mean follow-up duration was 32 ± 4.7 months
(range: 20–36 months). Mean IOP was reduced from 34.2 ± 8.3 mmHg preoperatively to 21.2 ± 7.3 mmHg at the final follow-up
(P = 0.012). The number of anti-glaucoma medications was reduced from 3.4 ± 0.5 preoperatively to 2.2 ± 1.3 at the final follow-up
(P = 0.058). The cumulative probability of relative success was 97.2% [95% confidence interval (CI): 91.85–100%] at 12 months,
78.02% (95% CI: 60.36–95.67%) at 24 months and 43.34% (95% CI: 16.18–70.5%) at the final follow-up. During the first 6 months
after surgery, two patients had controlled IOP without the use of medications (absolute success); however, 6 months and later
no eye had achieved absolute success. There were no intraoperative complications. Postoperative complications included choroidal
effusion necessitating drainage in three eyes (33.3%), cataract formation in one eye (11%) and retinal detachment in one eye
(11%). At the final follow-up, visual acuity was unchanged from preoperative values in five eyes (55.5%); no eye demonstrated
visual improvement.
Conclusion
Outcomes of this small case study reveal that primary single-plate Molteno tube implantation appears to be associated with
a limited success rate and a relatively high complication rate in eyes of children with glaucoma resulting from Sturge-Weber
syndrome. 相似文献
7.
PURPOSE: To present some relevant stages of phacosclerothalamotomy procedure. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. 相似文献
8.
目的 评估微导管辅助小梁切开术治疗青少年性开角型青光眼(JOAG)和原发性开角型青光眼(POAG)的临床效果和安全性。设计 回顾性病例系列。研究对象2017年11月至2018年12月北京同仁医院接受微导管辅助的小梁切开术治疗的JOAG患者22例(26眼),平均年龄(25.2±4.5)岁;POAG患者11例(14眼),平均年龄(46.3±5.1)岁。方法 回顾患者的病历资料,记录眼压、抗青光眼药物使用数量、术中及术后并发症等。术后1、3、6、12个月随访。术后不使用降眼压药物眼压≤21 mmHg且眼压下降幅度≥20%为成功。主要指标 眼压、抗青光眼药物使用数量、术中及术后并发症。结果 所有患者均完成了12个月的随访。JOAG组术前平均眼压(30.6±7.5) mmHg,平均应用(3.5±1.0)种药物;术后12个月平均眼压(15.8±3.3 ) mmHg,平均应用(0.5±1.0)种药物,眼压降幅为44.9%±18.0%。POAG组术前平均眼压(25.4±6.2) mmHg,平均应用(3.4±0.9)种药物;术后12个月平均眼压(15.9±3.2) mmHg,平均应用(0.3±0.6)种药物,眼压降幅为35.8%±15.6%。JOAG组、POAG手术成功率分别为76.0%、78.6%。两组降眼压幅度和成功率均无显著性统计学差异(P=0.122、0.855)。均无严重手术并发症发生。结论 微导管辅助小梁切开术治疗JOAG和POAG均具有较好的短期降眼压效果及安全性。(眼科,2021, 30: 20-24) 相似文献
9.
M. G. Uva A. Longo M. Reibaldi 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2009,247(8):1103-1109
Purpose To evaluate the efficacy and safety of pneumatic trabeculoplasty (PNT) compared with latanoprost 0.005%, in primary open-angle
glaucoma (POAG) and ocular hypertension (OH) not controlled by timolol 0.5%.
Procedures In a randomized clinical study, 18 patients affected with primary open-angle glaucoma (POAG) or ocular hypertension (OH) with
intraocular pressure (IOP) >20 mmHg after timolol 0.5% in one eye were treated with PNT; 18 control eyes received adjunctive
therapy with latanoprost 0.005%. Visual acuity, IOP, visual field, biomicroscopy findings and fundus appearance were evaluated
at each month. Patients with IOP >20 mmHg were excluded from the study. The study was continued until in one group no patients
were left.
Results At 1 month, IOP had decreased significantly in both groups. In PNT-treated eyes the mean IOP decrease was 4.5 ± 1.8 mmHg (19.1 ± 7.8%)
and in latanoprost-treated eyes was 6.6 ± 1.3 mmHg (28.2 ± 5.7%) (between two groups, P < 0.001). Eleven PNT-treated eyes (61%) and 17 latanoprost-treated eyes (94%) had an IOP reduction of more than 20% of baseline
value (P = 0.049); two PNT-treated patients received additional therapy. At the following months, in the latanoprost group, IOP was
stable: an IOP reduction of 20% or more was seen in 89% of the eyes. In some PNT-treated eyes IOP increased: at 2 months,
an IOP reduction≥20% was seen in 50%, at 3 months in 33%, and at 4 months in 17% of the eyes. (between the two groups, respectively,
P = 0.03, P = 0.002, P < 0.001). The number of eyes that required therapy increased progressively in the PNT group, and at 8 months all eyes had
required therapy, whereas one latanoprost-treated eye had had additional therapy. After PNT, no patients had visual acuity
reduction or intraocular inflammation; three eyes had subconjunctival hemorrhage and five eyes a hyperemia that regressed
within 1 week. No posterior segment changes or visual field progression were detected in either groups.
Conclusions In eyes with glaucomatous damage that is not advanced, PNT can reduce the IOP in 60% of the eyes at 1 month, and in 33% of
the eyes at 3 months, without significant side-effects. The indications, efficacy and safety of PNT retreatments remain to
be investigated. IOP reduction is less and of shorter duration than that obtained by latanoprost adjunctive therapy.
No financial relationship 相似文献
10.
Minna Ollikainen Tuomo Puustjärvi Petri Rekonen Hannu Uusitalo Markku Teräsvirta 《Acta ophthalmologica. Supplement》2010,88(1):20-26
Purpose: To investigate the efficacy and safety of mitomycin C (MMC)‐augmented deep sclerectomy with implant (DSCI) in patients with primary open‐angle glaucoma (POAG) and exfoliation glaucoma (ExG). Methods: A total of 68 eyes of 68 patients with POAG and ExG were enrolled consecutively to undergo DSCI with MMC (0.4 mg/ml for 2 min). The intraocular pressure (IOP), number of antiglaucoma medications, neodymium:yttrium‐aluminum‐garnet (Nd:YAG) laser goniopunctures and complications were compared postoperatively. Surgery was considered as a complete success when IOP was < 18 mmHg without antiglaucoma medication. Results: Preoperatively, the mean IOPs were 23.1 ± 5.8 and 25.4 ± 8.3 mmHg, and 13.8 ± 6.1 and 11.2 ± 5.6 mmHg in the POAG and ExG groups, respectively, at 12 months. 77.4% and 75.7% of surgeries were a complete success in the POAG and ExG groups, respectively [not significant (NS)]. Five patients (16.1%) in the POAG group but none in the ExG group (0%) were receiving antiglaucoma medication at 12 months (NS). Nd:YAG laser goniopuncture was performed in 29.0% of eyes in the POAG group and in 55.6% of eyes in the ExG group (p = 0.047). Postoperatively, choroidal detachment occurred in 16.1% of eyes in the POAG group and in 10.8% of eyes in the ExG group (NS). We encountered no serious complications related to MMC use. Conclusion: DS with MMC augmentation appears to be equally effective in ExG and POAG patients in lowering IOP to target levels, at least in the short term, with few immediate postoperative complications. 相似文献
11.
Christoph Hirneiß Aljoscha S. Neubauer Alice Yu Anselm Kampik Marcus Kernt 《Acta ophthalmologica. Supplement》2011,89(2):e189-e192
Purpose: To evaluate the relationship between biomechanical properties of the cornea and intraocular pressure (IOP) and the role of biomechanical properties in eyes of patients with unilateral primary open‐angle glaucoma (POAG). Methods: The biomechanical properties of corneal hysteresis (CH) and the corneal resistance factor (CRF) were measured with the ocular response analyser (ORA). In an experimental setting, three human donor eyes with Schiotz‐tonometry‐controlled IOP were investigated. In addition, a series of patients with unilateral POAG were evaluated. Main outcome measures were CH, CRF, corneal‐compensated IOP (IOPcc), standard automated perimetry parameters mean defect (MD) and pattern standard deviation, central corneal thickness, Goldmann applanation tonometry (GAT), and cup‐to‐disc ratio. Results: A highly significant linear correlation between CH and the corneal‐compensated IOP (IOPcc, r = ?0.926; p < 0.001) was found. The correlation between IOPCC and CRF was not significant (r = 0.335; p = 0.08). In total, 36 eyes of 18 patients with unilateral POAG were examined. Regarding uncorrected CH (mean 7.73 ± 1.46 mmHg glaucomatous eye and 9.28 ± 1.42 mmHg fellow eye), there was a highly significant difference between both eyes. This difference disappears, when CH was corrected for IOP (9.44 ± 3.78 mmHg and 9.97 ± 3.22 mmHg, respectively). Conclusions: Corneal hysteresis but not corneal resistance factor is dependent on IOP. In patients with unilateral POAG, IOP is higher in the affected eye. When CH is corrected for IOP, corneal biomechanical properties do not differ in both eyes of patients with unilateral POAG. 相似文献
12.
Ali Alsheikheh Janine Klink Thomas Klink Heimo Steffen Franz Grehn 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2007,245(2):195-203
Purpose The aim of this study is to assess the functional results and morphological parameters in children surgically treated for
glaucoma.
Methods Data from 43 patients and 68 eyes who were operated in our department between 1990 and 2002 were collected. This retrospective
trial included primary congenital glaucoma (n=36), and secondary glaucoma (n=7) in Rieger-Axenfeld syndrome and Sturge Weber syndrome. Intraocular pressure (IOP), axial length of the eyeball, visual
acuity, refractive errors and orthoptic status were analysed.
Results The age of patients at the first surgery was 6.0±5.3 months (range 0.7 to 28.0 months). The mean period of follow-up was 57.3±36.8
months (6.0–161.0).The mean number of surgical procedures performed on one eye was 2.5±2.4 procedures (1–11). The mean IOP
before the first surgery was 31.0±7.9 mmHg (17.5–52.0), and was 15.0±3.9 mmHg (7.0–28.0) at the last visit. 49 eyes (72.1%)
did not need any further medical treatment after the last surgical procedure. The IOP was 18 mmHg or lower without medication
in 29 eyes (42.6%) after just one surgical procedure (21 trabeculotomy, 8 combined trabeculotomy/trabeculectomy with or without
mitomycin-C). At the first examination, the mean axial length of the eyeball was 22.6±1.8 mm (the mean normal value at this
age is 20.3±0.7 mm), and was 24.4±2.0 mm at the last visit (the mean normal value at this age is 22.2±0.6 mm). The best corrected
visual acuity at the last visit was 0.25±4.6 lines; the normal range of visual acuity at this age is from 0.4±4.0 lines to
0.8±3.0 lines. Visual acuity was 0.32 or more in 53.0% of the eyes. Visual acuity was lower than 0.1 in only 15.2% of the
eyes. Myopia was present in 57.4% of the eyes with a mean spherical equivalent of −6.1±3.9 dioptres. 15 patients (34.9%) developed
strabismus. 22 patients (51.2%) were treated with part-time occlusion. Binocular function as assessed with the Lang-1 test
was positive in 17 of 30 patients (56.7%).
Conclusions Although a good long-term IOP-control can often be achieved in childhood glaucoma, the visual acuity remains below the normal
range in most cases despite close orthoptic follow-up.
Excerpts presented at the meeting of the German Society of Ophthalmology (DOG), Berlin, 2004. 相似文献
13.
Purpose: The aim of this study is to compare the hysteresis and corneal resistance factor (CRF) in normal tension glaucoma (NTG), primary open angle glaucoma (POAG) and ocular hypertension (OHT) eyes measured by the ocular response analyser (ORA). Methods: This is a prospective, cross‐sectional and comparative clinical trial. The setting was a teaching hospital in Birmingham, England. Patients: 216 eyes with POAG, 68 eyes with NTG and 199 eyes with OHT. Observational procedures: Goldmann applanation tonometry and intraocular pressure (IOP), hysteresis and CRF measured by ORA and central corneal thickness (CCT) by ultrasonic pachymetery. The main outcome measures were IOP, CCT, hysteresis and CRF. Results: The hysteresis in NTG, POAG and OHT eyes was 9.0 ± 1.9, 9.9 ± 2.1 and 10.2 ± 2.0 mmHg; CRF was 9.1 ± 2.2, 10.6 ± 2.0 and 12.0 ± 2.0 mmHg; IOP by Goldmann applanation tonometry and ORA was 14.7 ± 2.8 and 15.3 ± 4.2 mmHg, 16.7 ± 4.0 and 16.9 ± 4.6 mmHg and 20.5 ± 4.1 and 20.0 ± 4.5 mmHg; CCT was 526.5 ± 42.2, 537.0 ± 36.0 and 563.4 ± 35.9 µm, respectively. The difference for CRF, IOP and CCT for NTG, POAG and OHT eyes was statistically significant. Conclusion: Hysteresis and CRF were highest in OHT eyes. These factors may prove to be useful measurements of ocular rigidity and may help to understand role of the corneal rigidity in monitoring the progress of conditions such as NTG, POAG and OHT. 相似文献
14.
Michael Diestelhorst 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2000,238(5):433-439
Purpose: To compare the additional intraocular pressure-lowering effect of latanoprost 0.005% administered once daily with that of
pilocarpine 2% administered three times daily in patients with primary open-angle glaucoma or ocular hypertension currently
on monotherapy with timolol 0.5% twice daily. Methods: In a 6-month, multicenter, randomized, open-label study 242 patients with POAG or OH whose IOP was not controlled with timolol
0.5% b.i.d. were enrolled. Eyes had not been treated with pilocarpine and latanoprost for at least 2 years. An analysis of
covariance with diurnal IOP change from baseline to month 6 for study eyes was performed. Results: Four patients on latanoprost 0.005% and 35 on pilocarpine 2% did not complete the study (P<0.001). Two hundred and forty patients were included in the intent-to-treat analysis. For both treatments the diurnal IOP
reduction after 6 months was statistically significant (P<0.001). IOP (mean±SD) was reduced from 23.3±2.8 to 17.8±2.8 (–5.6) mmHg in the latanoprost 0.005% group and from 23.0±3.2
to 18.5±2.4 (–4.8) mmHg in pilocarpine 2% t.i.d.-treated eyes. The mean difference of –0.8 mmHg (per protocol, PP) and –1.6
mmHg (intend-to-treat, ITT) was statistically significant (P<0.04, PP; P<0.001, ITT) in favor of latanoprost 0.005%. Two eyes treated with latanoprost showed an iris color change. Thirty-six patients
in the latanoprost group and 106 in the pilocarpine 2% group reported ocular adverse events (P<0.001). Conclusion: From the data we conclude that the additivity of latanoprost 0.005% is at least as effective as pilocarpine 2% t.i.d. in reducing
IOP when added to eyes currently on monotherapy with timolol 0.5% b.i.d. Latanoprost was better tolerated than pilocarpine
2% eye drops in this study. The increase in iris pigmentation requires further investigation.
Received: 8 November 1999 Revised: 25 November 1999 Accepted: 25 November 1999 相似文献
15.
Trabeculotomy in congenital glaucoma 总被引:1,自引:0,他引:1
Gesine Meyer Oliver Schwenn Norbert Pfeiffer Franz Grehn 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2000,238(3):207-213
Background: Congenital glaucoma is a potentially blinding disease that requires surgical therapy. This paper describes the outcome of
trabeculotomy in primary congenital glaucoma.
Methods: Thirty-nine eyes of 22 children with congenital glaucoma who underwent trabeculotomy with or without a simultaneous trabeculectomy
between 1992 and 1997 were retrospectively analyzed.
Results: Mean follow-up was 24.7±17.9 months. A mean of 1.3 operations per eye were performed. The mean IOP at the end of follow-up
(n=39) was 17.7±6.0 mmHg; in 8 eyes (20.5%) the IOP was >21 mmHg, in 31 eyes (79.5%) it was ≤21 mmHg. The mean difference between
pretreatment IOP and IOP at the end of follow-up (n=39) was –10.5±9.4 mmHg (–37.2%). Success rates were calculated: IOP was ≤21 mmHg in 36/39 eyes (92.3%) after 1/2 year of
follow-up, in 25/27 eyes (92.6%) after 1 year, in 15/18 eyes (83.3%) after 2 years, in 8/12 (66.7%) eyes after 3 years, in
4/8 eyes (50%) after 4 years and in 4/4 (100%) eyes after 5 years of follow-up. Complications included hypotony (three eyes),
subchoroidal bleeding (one eye ), detachment of Descemet’s membrane (one eye) and macular pucker (one eye in which later mitomycin
C was used). Visual acuity (VA) was tested with various methods in 35 eyes. VA was within the normal nomogram range in 12
eyes and below the normal range in 23 eyes at the end of follow-up. Axial length measurements showed normalization according
to the age nomogram in 22 of 35 eyes.
Conclusion: This study shows that trabeculotomy is an effective surgical procedure in congenital glaucoma with satisfactory success rates
up to 5 years of follow-up.
Received: 17 November 1998 Revised version received: 8 July 1999 Accepted: 8 July 1999 相似文献
16.
Sourabh Arora Masahiro Maeda Brian Francis Mariko Maeda Arthur J. Sit Sameh Mosaed Samir Nazarali Karim F. Damji 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):482-486
Objective
To determine the efficacy and safety of ab interno trabeculectomy with Trabectome in juvenile open-angle glaucoma (JOAG) patients.Design
Prospective cohort study.Methods
Evaluation of the 12-month results of 2 patient groups receiving ab interno trabeculectomy: group 1, eyes with no prior incisional surgery; group 2, eyes that had prior incisional cataract or glaucoma surgery.Results
Group 1, 40 eyes (average age 31 ± 7 years), had a significant reduction in intraocular pressure (IOP) of 10.6 mm Hg at 12 months from a baseline of 27.4 mm Hg (p = 0.01), and the number of glaucoma medications reduced by 0.4 (p = 0.80). Four eyes (10%) within the study period required a secondary glaucoma surgery. Group 2, 20 eyes (average age 27 ± 8 years), had a significant reduction in IOP of 8.8 mm Hg from a baseline of 27.1 mm Hg (p = 0.06), and the number of glaucoma medications reduced by 1.4 (p = 0.36). Five eyes (25%) from this group underwent a secondary glaucoma surgery within 12 months.Conclusion
After 1 year of follow-up, ab interno trabeculectomy appears to be an effective and safe intervention for patients with JOAG; however, a reduction in use of topical medications may not be observed in those receiving ab interno trabeculectomy as a primary procedure. 相似文献17.
Risk factors for the progression of treated primary open-angle glaucoma: a multivariate life-table analysis 总被引:1,自引:0,他引:1
Y. Suzuki Shiroaki Shirato Misato Adachi Chikuma Hamada 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》1999,237(6):463-467
· Background: Several factors have been reported as risk factors for the progression of primary open-angle glaucoma (POAG)
but previous reports were not necessarily in agreement. We applied a multivariate life-table analysis to a large number of
longitudinal data to determine the extent of the influence of various factors simultaneously. · Methods: Two hundred fifteen
eyes of 215 POAG patients were included. The follow-up period ranged from 24 to 134 months (average 82.7 months). The visual
field stage was determined separately in upper and lower hemifields according to the classification of Aulhorn (modified by
Greve). The progression was defined as an irreversible increase of the stage in at least one hemifield. The follow-up data
were analyzed with the Cox proportional hazard model. · Results: Mean intraocular pressure (IOP) in the follow-up period and
the initial visual field stage significantly affected POAG progression (P<0.05). The risk of POAG progression was calculated to double as the mean IOP increased by 4 mmHg. Eyes with the initial visual
field of stage 0–1 and moderately advanced stages had a greater risk of progression than other stages. · Conclusion: To prevent
the progression of POAG, the IOP should be kept as low as possible, particularly at the early and moderately advanced stages.
Received: 5 February 1998 Revised version received: 4 August 1998 Accepted: 1 October 1998 相似文献
18.
选择性激光小梁成形术治疗青光眼的临床观察 总被引:3,自引:0,他引:3
目的评价选择性激光小梁成形术(SLT)治疗原发性开角型青光眼(POAG)、正常眼压性青光眼(NTG)的疗效和安全性。方法选择局部用药眼压不能控制的原发性开角型青光眼20例(37眼),正常眼压性青光眼6例(10眼)。观察应用选择性激光小梁成形术后6个月眼压的变化。结果术后眼压平均降低幅度为4.86±2.14mmHg(24.04±10.21%),两组患眼的眼压在激光治疗后均有显著下降:开角型青光眼组术后6个月的眼压较术前平均下降5.44±2.32mmHg(24.90±11.09%);正常眼压性青光眼组平均下降2.71±1.12mmHg(19.06±7.19%)。术后暂时的眼压升高、前房炎症反应为常见的并发症。结论选择性激光小梁成形术具有降眼压效果明显、安全、实用、损伤小、可重复等特点,是治疗青光眼的一种较安全有效的方法。 相似文献
19.
Judith Eha Esther M. Hoffmann Jochen Wahl Norbert Pfeiffer 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2008,246(6):869-874
Background A serious complication following trabeculectomy with mitomycin C (MMC) is intraocular hypotony with hypotony maculopathy,
papilledema, flattening of the anterior chamber, corneal decompensation and a decrease in visual acuity. We describe a new
simple surgical technique for the treatment of hypotony maculopathy following trabeculectomy with MMC.
Methods In a prospective consecutive case study, 16 patients with hypotony maculopathy following trabeculectomy with MMC were included.
Through the intact conjunctiva, additional 10.0 nylon sutures were placed through the scleral flaps into the adjacent sclera.
Assessment of visual acuity, intraocular pressure (IOP) measurement and fundoscopy were performed on the 1st and 7th day postoperatively
and 1, 3 and 6 months postoperatively. Photography of the bleb and the posterior pole and optical coherence tomography imaging
of the posterior pole were performed.
Results Before surgery (flap suture), the mean IOP was 2.8 mmHg (±1.1; range from 1 to 4 mmHg). It was 24.9 ± 11.7 mmHg (range; 9–48 mmHg)
on the 1st postoperative day, 15.7 ±8.1 mmHg (range; 5–35 mmHg) on day 7, 11.1 ±4.1 mmHg (range; 5–20 mmHg) 1 month after
surgery, 9.3 ±3.9 mmHg (range; 2–20 mmHg) after 3 months, and 9.6 ±4.2 mmHg (range; 2–20 mmHg) after 6 months. The best corrected
mean visual acuity was 20/50 before trabeculectomy and 20/160 before flap suture. It improved to 20/63 at 6 months postoperatively.
Clinical signs of hypotony maculopathy disappeared in all patients. No bleb leakage was observed in any patient during follow-up.
Conclusion Resuturing the scleral flap through the intact conjunctiva is an effective and minimally invasive method to treat hypotony
maculopathy following trabeculectomy with MMC. Thus, opening the conjunctiva can be avoided.
The authors have no financial interest in the subject of this paper. 相似文献
20.
Yildiray Yildirim Taner Kar Eyup Duzgun Sercan Koray Sagdic Ali Ayata Melih Hamdi Unal 《International ophthalmology》2016,36(5):719-726
The aim of this study was to investigate the safety and efficacy of ab interno trabeculectomy which is a minimally invasive glaucoma surgery, in the late period, performed via trabectome instrument. A total of 70 eyes followed up with a diagnosis of open-angle glaucoma (OAG) and undertaken trabectome surgery were included in the study. Preoperative and postoperative intraocular pressures (IOPs), number of the drugs used, and complications were retrospectively investigated and the data were evaluated. The criteria of success were accepted as an IOP value ≤21 mmHg or ≥30 % reduction in IOP and no need for a second operation. Mean IOP was decreased by 38 % from a preoperative value of 28.77 ± 5.34 to 17.62 ± 2.81 mmHg at the end of 18 months. Likewise, mean drug usage was decreased by 48 % from a preoperative value of 3.3 ± 1.01 to 1.7 ± 1.16 at the end of 18 months. Both decreases were statistically significant (p < 0.05). Postoperative success rates were 82.8 % in the 6th month, 81.4 % in the 9th month, 77.1 % in the 12th month, and 70 % in the 18th month. Most common complication observed was intraoperative reflux hemorrhage and no serious complication was observed. Trabectome surgery is an effective and safe method in early-stage open-angle glaucoma types that cannot be controlled despite maximal medical therapy. This procedure is a proper surgical option in patients targeted for moderate IOP without the need for a topical medication or with less drug usage. 相似文献