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Oded Ohana Igor Kaiserman Yuval Domniz Eyal Cohen Oz Franco Tzahi Sela Gur Munzer David Varssano 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):523-528
Objective
To report the outcomes and complications of combined photorefractive keratectomy (PRK) and collagen crosslinking (CXL).Design
A retrospective cohort study of consecutive patients undergoing combined PRK-CXL between 2011 and 2013 at Care Laser, Inc, Tel Aviv, Israel.Participants
Ninety-eight eyes of 56 patients were included. Only patients without keratoconus were included.Methods
Data were collected from the patients’ files and imaging devices. Main outcome measures were corrected and uncorrected distance visual acuity (CDVA/UDVA); spherical equivalent (SE); refractive, keratometric, and pachymetric stability; and the occurrence of postoperative complications.Results
Mean age was 27.69 ± 6.6 years. UDVA improved from 1.38 ± 0.60 to 0.15 ± 0.24 logMAR (p < 0.001). SE improved from ?4.45 ± 2.87 diopter (D) to +0.20 ± 0.90 D (p < 0.001), and 69% of the patients were within ±0.50 D from emmetropia. Four eyes had significant corneal haze; of them 3 eyes lost more than 2 Snellen lines. No cases of corneal ectasia were recorded.Conclusions
In our cohort PRK-CXL achieved significantly improved UDVA and SE compared to baseline. Corneal haze was a significant complication. Refractive results were less accurate than published for patients undergoing PRK procedures. Although no cases of corneal ectasia were seen, given the rarity of such complication, the added benefit of CXL remains to be proven. 相似文献3.
David S. Sands Stephanie C.Y. Chan Chloe C. Gottlieb 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(4):349-353
Objective
To assess corticosteroid-sparing and inflammation control in patients with noninfectious scleritis treated with methotrexate.Design
Retrospective review.Participants
Patients who received methotrexate treatment for noninfectious scleritis and who had 12 months of follow-up after treatment initiation were included in this review.Methods
The clinical records of noninfectious scleritis patients presenting at the University of Ottawa Eye Institute between September 1, 2010 and December 31, 2014 treated with methotrexate were retrospectively reviewed. Seventeen patients (21 eyes) were included in the study. Main outcome included inflammation control and corticosteroid-sparing success. Secondary outcomes were reduction of immunosuppression load and best-corrected visual acuity.Results
The proportion of eyes with corticosteroid-sparing success was 69.2% at 3 months and 92.3% at 12 months. The proportion of eyes that achieved inflammation control was 61.9% at 3 months and 90.5% at 12 months. The corticosteroid immunosuppression load at treatment start was 1.9 ± 2.07 and at 12 months was 0.48 ± 1.03 (p < 0.01). There was no statistically significant difference in best-corrected visual acuity.Conclusions
The treatment of noninfectious scleritis with methotrexate appears to be effective at both achieving steroid-sparing success and controlling inflammation during 12 months of therapy. Immunosuppression load decreased significantly over 12 months of therapy while best corrected visual acuity was stable. 相似文献4.
Kelsey A. Roelofs Chris J. Rudnisky 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):533-537
Objective
To evaluate the refractive outcomes after anterior capsular tear (ACT).Design
Retrospective case–control study.Participants
After ethics approval, the surgical operative records of 4301 consecutive patients undergoing cataract surgery by a single surgeon were reviewed for cases of ACT.Methods
All ACTs were managed using a balancing incision of the capsulorrhexis margin 180 degrees away from the tear. If the patient’s other eye had undergone cataract surgery by the same surgeon, it was included as a control.Results
Fifty-one eyes of 51 patients were complicated by ACT (incidence = 1.2%). The mean age of patients in the study was 64.2 ± 12.1 years. Of the 51 patients with ACT, 34 underwent contralateral surgery. These eyes were used as the control group. There was no significant difference in preoperative visual acuity (p = 0.683) or proportion of eyes that received in-the-bag intraocular lens placement (p = 0.347) between groups (ACT = 92.2%; control = 97.1%). In 3 ACT eyes, the tear extended into the posterior capsule (5.9%), and although this did not occur in control eyes, this difference was not statistically significant (p = 0.150). There was no difference in best-corrected final logMAR visual acuity between groups (p = 0.424) or postoperative spherical equivalent between ACT (?0.23 ± 1.2D) and control (?0.15 ± 0.62D) eyes (p = 0.985).Conclusions
Cataract extraction complicated by ACT can result in equivalent visual and refractive outcomes as in uncomplicated surgery. The technique used in this study prevented extension of ACT to the posterior capsule in 94.1% of cases. 相似文献5.
Zofia Michalewska Michael W. Stewart Maurice B. Landers Maciej Bednarski Ron A. Adelman Jerzy Nawrocki 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(4):402-407
Objective
To determine the efficacy of vitrectomy in eyes with treatment-naïve diabetic macular edema (DME).Methods
Consecutive patients with treatment-naïve DME who underwent pars plana vitrectomy with internal limiting membrane peeling at a single institution were identified from the electronic medical records. Morphologic and visual acuity changes from baseline were analyzed at both the primary temporal endpoint (6 months) and the final examination with the investigators. The primary outcome measures included changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT).Results
Forty-four eyes of 44 patients were included in this retrospective study. The mean BCVA improved significantly from baseline until the 6-month primary endpoint (1.35 logMAR vs 0.83 logMAR, p < 0.001) and stabilized through the final examination (0.77 logMAR). The BCVA improved by at least 0.1, 0.3, and 0.6 logMAR in 26 (60%), 24 (55%), and 14 (32%) of eyes, respectively, whereas it worsened by 0.3 logMAR in only 1 (2%) eye. Final BCVA correlated inversely with duration of diabetes (p = 0.01), presence of an epiretinal membrane (p = 0.02), and initial visual acuity (p = 0.03). Mean CRT decreased significantly from baseline through 6 months (595 µm vs 266 µm; p < 0.001), and edema recurred in only 3 eyes (6%), one of which was subsequently treated with intravitreal bevacizumab.Conclusions
Pars plana vitrectomy significantly improves macular edema and visual acuity in eyes with treatment-naïve DME. Prospective randomized trials are needed to better determine the efficacy of early vitrectomy. 相似文献6.
Erika Massicotte Salima Hassanaly Marie-Lyne Bélair Karin Oliver Eric Fortin 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):435-440
Objective
Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome is a rare entity with a potentially poor visual prognosis. Our objective is to review the clinical presentation and long-term outcomes of patients with IRVAN syndrome.Design
This is a retrospective case series.Methods
We reviewed the charts of all the patients diagnosed with IRVAN syndrome at our tertiary care centre from 2002 to 2015.Results
We included the long-term clinical outcomes of 7 eyes (5 patients) diagnosed with IRVAN syndrome. After a mean follow-up of 84.9 months, best-corrected visual acuity was 20/40 or better in the majority of eyes (70%). Four (57.1%) patients had systemic conditions, namely, multiple sclerosis, ischemic stroke, and positive antiphospholipid titres. All eyes were treated with laser photocoagulation. Four (40%) eyes received adjunctive intravitreal bevacizumab injections.Conclusion
IRVAN is an important diagnosis for clinicians to recognize. When treated in a timely manner, long-term visual outcomes can be favourable. 相似文献7.
Michelle M. Porter Andrew W. Cull 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):538-541
Objective
Cataract surgery can have many benefits for older adults, including enabling continued ability to drive. However, it is not known how objectively measured driving patterns change after cataract surgery. The purpose of this study was to examine how participants drove before and after cataract surgery.Design
Longitudinal study.Participants
Individuals from the Winnipeg site of Candrive (a longitudinal study of older drivers in Canada).Methods
An in-vehicle device monitored all trips taken in 1-second intervals, allowing for the analysis of distances driven, number of trips, time of trips, speeding, excessive braking/accelerating, and types of roadways.Results
Over the 4 years of data collection, there were 16 cases of participants having cataract surgery, whereby there was also suitable driving data for analyses. Participants drove 28% further after surgery (p = 0.022). They also drove further from home and more on primary roads (p < 0.05) and had fewer episodes of hard braking per distance travelled (p < 0.001). No other variables significantly changed.Conclusions
This study suggests that older drivers changed some of their driving patterns after cataract surgery. Future studies could explore the effects of increased driving exposure, in conjunction with potentially safer driving behaviors, on overall driving safety after cataract surgery. 相似文献8.
Howard V. Gimbel Bronson M. LeClair Brice Jabo Hala Marzouk 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):518-522
Objective
Although the literature on the implantable Collamer lens (ICL) suggests an increasing rate of anterior subcapsular cataract (ASC) development with increasing age and decreasing anterior chamber depth (ACD), the exact correlation is not known. We performed a retrospective observation study of 1653 eyes and calculated the incidence of ICL removal with cataract extraction and intraocular lens placement (CE-IOL) as a result of ASC, in correlation to patient’s age and ACD.Design
Retrospective observation study.Setting
The Gimbel Eye Centre, Calgary, Alberta, Canada.Methods
We analyzed ICL V4 model (Visian ICL; STAAR Surgical, Monrovia, CA) implanted in 1653 eyes with myopia from 2000 to 2012 at the Gimbel Eye Centre, Calgary. Myopic patients aged 19 years and older with no history of cataracts were included. The rate of ICL removal with cataract extraction was calculated. Parameters such as age, sex, refractive sphere, refractive cylinder, length of follow-up, and ACD were collected. Cataract-free survival with comparison of FDA and non-FDA cohorts was conducted using Kaplan–Meier survival curves with the log-rank test. In addition, covariates adjusted hazards ratios and 95% confidence intervals were calculated using Cox regression.Results
Of the 1653 eyes included in this study, a total of 46 eyes underwent ICL removal with CE-IOL. The length of follow-up varied between 2 and 14 years.Conclusions
This retrospective study demonstrated that the rate of developing ASCs positively correlated with age and negatively correlated with ACD. 相似文献9.
Tomoaki Murakami Kiyoshi Suzuma Akihito Uji Shin Yoshitake Yoko Dodo Masahiro Fujimoto Tatsuya Yoshitake Yuko Miwa Nagahisa Yoshimura 《Japanese journal of ophthalmology》2018,62(3):292-301
Purpose
To investigate the association between the characteristics of foveal cystoid spaces and short-term responsiveness to ranibizumab treatment for diabetic macular edema (DME) at 3 months from the initial injection.Methods
We retrospectively reviewed 66 eyes of 61 patients with center-involved DME who received three consecutive ranibizumab injections and following as-needed administrations. We evaluated the relationship between visual improvement at 3 months and the preoperative optical coherence tomography (OCT) parameters including hyperreflective foci, heterogeneous OCT reflectivity, mean levels of OCT reflectivity and height of foveal cystoid spaces.Results
Twenty-three eyes without preoperative hyperreflective foci in the foveal cystoid spaces had significantly greater improvement in the logarithm of the minimum angle of resolution visual acuity (logMAR VA) at 3 months than 43 eyes with foci (P = 0.006). That was similar to the greater reduction in CSF thickness in eyes without lesions after treatment at the same time point (P < 0.001). VA improvement at 3 months was not associated with the height (R = 0.215, P = 0.083) or the reflectivity levels (R = -0.079, P = 0.538) of foveal cystoid spaces. There were no differences in VA changes between eyes with and without heterogeneous reflectivity in foveal cystoid spaces (P = 0.297). Multivariate analyses showed that logMAR VA and the absence of hyperreflective foci in foveal cystoid spaces were associated with VA improvement at 3 months.Conclusion
Hyperreflective foci in foveal cystoid spaces at baseline predict poorer short-term responsiveness to ranibizumab injections for DME.10.
Verena R. Juncal David R. Chow Natàlia Vilà Michael A. Kapusta R. Geoff Williams Amin Kherani Alan R. Berger 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):441-446
Objective
To compare the anatomical and visual outcomes of patients with bilateral macular holes (MH) who have been treated with pars plana vitrectomy in one eye and intravitreal ocriplasmin in the fellow eye.Design
Multicentre, retrospective case series.Participants
Twenty-two eyes of 11 patients with bilateral MH treated with vitrectomy in one eye and ocriplasmin in the other were included. Patients were followed-up by 5 vitreoretinal surgeons from 3 retinal practices in Canada.Methods
All charts were reviewed for data collection, and optical coherence tomography (OCT) scans pre- and posttreatment were evaluated.Results
MH closed primarily in 36.4% (n = 4) of the ocriplasmin-treated eyes and in 90.9% (n = 10) of the vitrectomy-treated eyes (p = 0.031). The 4 successfully treated ocriplasmin MH were preceded by a vitreomacular traction (VMT) release. Three additional ocriplasmin-treated eyes achieved a VMT release without MH closure. All persistent MH (100%) closed with subsequent vitrectomy, with no significant difference in final best-corrected visual acuity (BCVA) between those who achieved MH closure with primary or secondary interventions (p = 0.073). Final BCVA improved from logMAR 0.85 ± 0.34 to 0.37 ± 0.22 (p = 0.005) in the vitrectomy eyes and from 0.56 ± 0.28 to 0.28 ± 0.16 (p = 0.009) in the ocriplasmin eyes, with no significant difference in final BCVA between treatments (p = 0.306). Postoperative ellipsoid zone disruption persisted more frequently in vitrectomy-treated eyes.Conclusion
Both procedures were associated with improved visual outcomes, but eyes initially treated with vitrectomy had a higher primary MH closure rate. On OCT, patients had more outer structural changes in vitrectomy eyes than in ocriplasmin eyes. 相似文献11.
Youssef Rayess Nicolas Arej Youssef Abdel Massih Joelle Antoun Naji Waked 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(2):135-138
Objective
Corneal warpage represents a reversible distortion of the corneal surface induced by soft contact lens (SCL) wear. The aim of the study is to assess the influence of SCL materials, age, wearing duration, cylindrical refraction, and spherical equivalence on the prevalence and time to resolution of corneal warpage.Methods
This is an interventional prospective study in which SCL wearers volunteered to remove their SCLs and underwent, on each visit, a corrected distance visual acuity and anterior and posterior segment evaluation, along with keratometry measurement and corneal topography. Visits were scheduled 30 minutes after SCL removal, on day 4, day 7, and then weekly after SCL removal until warpage resolution.Results
A total of 17 volunteers (34 eyes) were included, with 9 (18 eyes) in the hydrogel SCL group and 8 (16 eyes) in the silicone hydrogel SCL group. The difference in warpage prevalence between the hydrogel group (28%, 5 eyes) and silicone hydrogel group (31%, 5 eyes) was not statistically significant (p > 0.90). Duration necessary for warpage resolution ranged from 7 to 21 days with no statistically significant difference between the 2 groups (p = 0.12).Conclusions
Both types of SCL had similar corneal warpage prevalence and time to resolution, with slightly longer mean time to resolution with silicone hydrogel. All eyes had resolution of warpage by 3 weeks. It seems more cautious to wait longer than the usual 1-week interval before performing refractive surgery, especially in patients wearing SCL for long periods and regardless of the type of material. 相似文献12.
Edsel Ing Christian Pagnoux Felix Tyndel Arun Sundaram Seymour Hershenfeld Paul Ranalli Shirley Chow Tran Le Carla Lutchman Susan Rutherford Kay Lam Harleen Bedi Nurhan Torun 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(3):215-221
Objectives
To determine the role of the ocular pulse amplitude (OPA) from Pascal dynamic contour tonometry in predicting the temporal artery biopsy (TABx) result in patients with suspected giant cell arteritis (GCA).Design
Prospective validation study.Participants
Adults aged 50 years or older who underwent TABx from March 2015 to April 2017.Methods
Subjects on high-dose glucocorticoids more than 14 days or without serology before glucocorticoid initiation were excluded. The OPA from both eyes was obtained and averaged just before TABx of the predominantly symptomatic side. The variables chosen for the a priori prediction model were age, average OPA, and C-reactive protein (CRP). Erythrocyte sedimentation rate (ESR), platelets, jaw claudication, and eye findings were also recorded. In this study, subjects with a negative biopsy were considered not to have GCA, and contralateral biopsy was performed if the clinical suspicion for GCA remained high. An external validation set (XVAL) was obtained.Results
Of 109 TABx, 19 were positive and 90 were negative. On univariate logistic regression, the average OPA had 0.60 odds for positive TABx (p = 0.03), with no statistically significant difference in age, sex, CRP, ESR, or jaw claudication. In suspected GCA, an OPA of 1 mm Hg had positive likelihood ratio 4.74 and negative likelihood ratio 0.87 for positive TABx. Multivariate regression of the prediction model using optimal mathematical transforms (inverse OPA, log CRP, age >65 years) had area under the receiver operating characteristic curve (AUROC) = 0.85 and AUROCXVAL = 0.81.Conclusions
OPA is lower in subjects with biopsy-proven GCA and is a statistically significant predictor of GCA. 相似文献13.
M. Ashraf A.A. Souka M. Daich Varela H. el Kayal P.G. Schlottmann 《Archivos de la Sociedad Espa?ola de Oftalmología》2018,93(11):523-529
Aim
To determine the efficacy of switching to ranibizumab in patients with diabetic macular oedema refractory to treatment with bevacizumab, and to evaluate the outcomes when switching back to bevacizumab.Methods
A prospective study was conducted that included 43 eyes of 31 patients refractory to previous bevacizumab treatment. The patients were switched to ranibizumab, and optical coherence tomography was performed one month post-injection. Patients showing improvement (>10% reduction in central sub-field thickness) were switched back to bevacizumab, and optical coherence tomography was performed one month post-switch back.Results
The 34 eyes switched to ranibizumab showed a statistically significant improvement in mean best corrected visual acuity from 0.67±0.39 logMAR to a mean of 0.55±0.36 logMAR (P<.05). In addition, there was a statistically significant decrease in central subfield thickness (CST) from a mean of 475.3±122.8 to a mean of 417.3±109.1 (P<.05). In the 21 eyes that were switched back to bevacizumab, there was no significant difference either in the change in CST or in the change in best corrected visual acuity post-switch back.Conclusion
Switching to ranibizumab in patients improves both the best corrected visual acuity and CST in diabetic patients refractory to previous bevacizumab treatment. This effect is pronounced in patients with increased CST prior to the switch. Switching back to bevacizumab adds no further improvement. 相似文献14.
Jay C. Wang Christopher J. Rudnisky Michael W. Belin Joseph B. Ciolino 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(3):284-290
Objective
To investigate the visual and anatomical outcomes of Boston keratoprosthesis (Kpro) type 1 reimplantation.Design
Subgroup analysis of multicentre prospective cohort study.Participants
Of 303 eyes that underwent Kpro implantation between January 2003 and July 2008 by 1 of 19 surgeons at 18 medical centres, 13 eyes of 13 patients who underwent reimplantation of Boston Kpro type 1 were compared with 13 eyes of 13 diagnosis-matched patients who underwent initial implantation.Methods
Forms reporting preoperative, intraoperative, and postoperative parameters were prospectively collected and analyzed. Main outcome measures were Kpro retention and logMAR visual acuity.Results
After a mean follow-up time of 17.1 ± 17.6 months, the retention of both initial and repeat Kpro implantation was 92.3% (12/13 in both groups), and 62% of initial implantation and 58% of repeat implantation eyes achieved visual acuity better than 20/200. Vision worse than 20/200 was often due to glaucoma or posterior segment pathology. Best-recorded logMAR visual acuity was significantly improved postoperatively in both groups (p < 0.001), and there was no statistically significant difference in final logMAR visual acuity between the 2 groups (p = 0.89). Sterile keratolysis (n = 4) and fungal infection (n = 5) were the most common causes of initial Kpro failure in the repeat Kpro group. The single failure in the repeat Kpro implantation group was due to fungal keratitis, and in the control group it was related to Kpro extrusion.Conclusions
Repeat Kpro implantation is a viable option after failed initial Kpro, with visual and anatomical outcomes comparable to those of initial procedures. 相似文献15.
Nilufer Yesilirmak Vasilios F. Diakonis Juan F. Batlle Ibrahim O. Sayed-Ahmed Zachary Davis Daniel P. Waren Sonia H. Yoo Terrence P. O’Brien Kendall E. Donaldson 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):542-547
Objective
To compare the nucleus removal time (NRT) and cumulative dissipated energy (CDE) outcomes of traditional phacoemulsification and femtosecond laser-assisted cataract surgery (FLACS) performed by cornea attendings and fellows.Design
Prospective nonrandomized comparative study.Participants
A total of 410 eyes of 410 patients.Methods
Nucleus removal time and CDE were recorded from patients who underwent cataract surgery using either FLACS (Catalys, LenSx, or Victus) or traditional phacoemulsification technique performed by 3 cornea attendings and 4 cornea fellows. One-way analysis of variance with Bonferroni post hoc tests and unpaired t tests were used to determine the differences between groups.Results
There was no statistically significant difference in cataract grade between groups. NRT was significantly lower only when using the Catalys system compared with the LenSx and Victus platforms and the traditional surgery, in both the attending group (p = 0.006, p = 0.002, p < 0.000, respectively) and the fellow group (p = 0.049, p = 0.038, p = 0.011, respectively). With respect to CDE, there was no significant difference when using the laser systems compared with the traditional surgery in both attending and fellow groups (p > 0.05). NRT and CDE were significantly higher in the fellow group (NRT = 269.10 ± 117.67, CDE = 7.30 ± 4.83) compared with the attending group (NRT = 218.87 ± 109.67, CDE = 5.76 ± 3.66) in traditional cases; however, in FLACS cases, there was no significant difference in NRT and CDE between the fellow group and the attending group.Conclusions
Inexperienced surgeons seem to require more time and use more ultrasound energy during traditional phacoemulsification when compared with experienced surgeons. The use of FLACS seems to significantly improve the NRT of experienced and inexperienced surgeons. 相似文献16.
Rida Shahzad M.A. Rehman Siddiqui Sidra Zafar Farzana Kausar Masroor H. Shahzad 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(1):60-64
Objective
The aim of this study was to assess changes in subfoveal choroidal thickness (SFCT), measured using swept-source optical coherence tomography (SS-OCT), after routine phacoemulsification cataract surgery.Design
This is a prospective, interventional, controlled study that took place at Shahzad Eye Hospital, Karachi, Pakistan, between February 2015 and January 2016.Participants
One hundred and one patients who were undergoing routine cataract surgery were recruited. One eye per patient was included. The unoperated fellow eyes acted as controls.Methods
Swept-source optical coherence tomography scans were performed preoperatively, 1 week postoperatively, and 1 month postoperatively. Two independent graders evaluated the scans to measure the SFCT. The SFCT was measured and recorded for OCT scans from each visit. The general linear model repeated analysis technique was used to assess data from the 3 different time intervals, and paired t tests were used to assess a statistically significant difference between mean preoperative and postoperative SFCT. Probability values of less than 0.05 were considered to be statistically significant.Results
The mean preoperative SFCT in the study eye was 272.9 ± 96.2; SFCT was 278.9 ± 101.4 (p = 0.051) and 281.5 ± 105.2 (p = 0.01) at week 1 and month 1, respectively. In the control eyes, the mean measurement of preoperative SFCT was 274.2 ± 98.5; measurements were 273.8 ± 100.7 (p = 0.875) and 277.9 ± 103.1 (p = 0.063) at week 1 and month 1, respectively.Conclusions
There was a gradual increase in SFCT at 1 month after cataract removal in the study eyes. The effect was more pronounced in younger individuals and nondiabetic individuals. 相似文献17.
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18.
Mahmood Showail Murad Al Obthani Nir Sorkin Adi Einan-Lifshitz Tanguy Boutin Armand Borovik Clara C. Chan David S. Rootman 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):510-517
Objective
To report and analyze the clinical outcomes of the first 250 cases of Descemet membrane endothelial keratoplasty (DMEK).Methods
A retrospective case series was conducted on the first 250 DMEK cases. The cohort included eyes with previous trabeculectomy, pre-existing glaucoma drainage device, and previous vitrectomy. Outcomes measures were best spectacle-corrected visual acuity (BSCVA), endothelial cell loss (ECL), episodes of rejection, detachment, rebubbling rate, and the need for repeat transplantation. Subgroup analysis was performed between eyes with different etiologies and between different DMEK injectors.Results
The median BSCVA increased from 0.6 [0.4, 1.3] logMAR (Snellen equivalent, 20/80) before surgery to 0.3 [0.2, 0.5] logMAR (Snellen equivalent, 20/40) 6 months after DMEK (p < 0.001). The median ECL at 6 months after surgery was 26.1%. Thirty-nine eyes (15.6%) had graft detachment involving more than one third of the graft and required rebubbling. Two eyes (0.8%) had a graft rejection episode. Fifteen eyes (6%) had graft failure for which 13 eyes (5.2%) had repeat DMEK, 1 eye (0.4%) had repeat Descemet stripping automated endothelial keratoplasty (DSAEK), and 1 eye (0.4%) had repeat penetrating keratoplasty (PKP). Fuchs’ patients and failed PKP patients gained more vision at 6 months post-DMEK compared with other etiologies (pseudophakic bullous keratopathy and failed DSAEK) (p < 0.001).Conclusions
Our data suggest that DMEK is a safe and effective procedure with excellent visual outcomes. DMEK can be done in association with other co-morbidities such as post-trabeculectomy, glaucoma drainage device, previous vitrectomy, and failed corneal grafts with a good prognosis. 相似文献19.
20.
Gordon Ngo Graham Trope Yvonne Buys Ya-Ping Jin 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(3):260-265