The Results of Trabeculectomy with Antimetabolites in Elderly Patients: A Retrospective Study

Objective: To examine the effectiveness and results of primary trabeculectomy with 5-fluorouracil (group 1) or mitomycin-C (group 2) in elderly patients. Materials and Methods: This was a retrospective study including 67 eyes with primary open-angle glaucoma that underwent primary trabeculectomy with group 1 or group 2. Patients who were followed up for less than 1 year or were under 55 years of age were excluded from the study. Surgical success was evaluated according to a decrease in cup/disk ratio and reduction of intraocular pressure without any topical medication. Results: The mean ages of participants were 65.7 years (range 59–88) and 65.9 years (range 59–74) in groups 1 and 2, respectively. The mean preoperative and postoperative intraocular pressure values were 31.3 ± 5.7 mmHg (range 17–46) and 14.8 ± 0.4 mmHg (range 10–21) in group 1 (p < 0.001) and 31.5 ± 7.4 mmHg (range 18–52) and 14.8 ± 2.9 mmHg (range 10–21) in group 2 (p < 0.001). Conclusion: The use of 5-fluorouracil or mitomycin-C during primary trabeculectomy is associated with high postoperative success rates. There were no significant differences between 5-fluorouracil and mitomycin-C in terms of intraocular pressure reduction.

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Ab Interno vs. Ab Externo Microcatheter-Assisted Circumferential Trabeculotomy in Treating Patients With Primary Open-Angle Glaucoma

Frontiers in Medicine ◽

10.3389/fmed.2021.795172 ◽

2021 ◽

Vol 8 ◽

Author(s):

Weijia Zhang ◽

Yiwei Wang ◽

Chen Xin ◽

Yang Sun ◽

Kai Cao ◽

...

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Case Series ◽

Open Angle ◽

Success Rates ◽

Criterion A ◽

The Mean ◽

Group 2 ◽

Ab Interno ◽

Group 1

Background: Circumferential trabeculotomy have evolved from ab externo to ab interno approach. Both procedures may lower IOP, but it is unclear which maybe a superior approach.Purpose: To compare the outcomes of ab interno and ab externo circumferential trabeculotomy in patients with primary open-angle glaucoma.Design: Retrospective, comparative case series.Participants: Primary open angle glaucoma patients undergoing ab interno (40 patients in Group 1) or ab externo (54 patients in Group 2) circumferential trabeculotomy, with about one half of them having prior incisional glaucoma surgery.Methods: Outcomes including intraocular pressure (IOP), glaucoma medications and surgical complications were analyzed.Main Outcome Measures: IOP, medications and surgical success defined as an IOP of ≤ 21 mmHg and a reduction of IOP ≥20% from baseline (criterion A) or IOP ≤ 18 mmHg and a reduction of IOP 20% from baseline (criterion B) with (qualified success) or without (complete success) medications.Results: At 1 year, IOP decreased by 37.1% (26.0–14.8 mmHg) in Group 1 and 39.5% (28.5–15.1 mmHg) in Group 2. Medications decreased from 3.5 in Group 1 and 3.6 in Group 2 pre-operatively to 0.6 ± 1.0 and 0.3 ± 0.6 post-operatively, respectively. Success rates did not differ significantly between groups based on criterion A (complete and qualified success: 68.7 and 81.9% in Group 1, and 75.3 and 90.4% in Group 2, respectively) or criterion B (complete and qualified success: 58.2 and 79.3%in Group 1, and 69.5 and 88.4% in Group 2, respectively). For eyes with prior filtration surgeries, the mean percent reduction of IOP (41.7 ± 32.7% in Group 1, 39.7 ± 27.8% in Group 2, P = 0.724) and the mean medication reduction (2.9 ± 1.6 in Group 1, 3.4 ± 1.0 in Group 2, P = 0.454) were not significantly different.Conclusions: Ab interno circumferential trabeculotomy achieved comparable outcomes to ab externo trabeculotomy and may be an effective surgical option for patients with primary open-angle glaucoma.

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The effectiveness of descemethogoniopuncture depending on the timing of its implementation after microinvasive non-penetrating deep sclerectomy in patients with glaucoma

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-1-79-82 ◽

2021 ◽

pp. 79-82

Author(s):

E.L. Sorokin ◽

◽

N.V. Postupaeva ◽

◽

Keyword(s):

Intraocular Pressure ◽

Antihypertensive Effect ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Hypotensive Effect ◽

Ultrasound Biomicroscopy ◽

Deep Sclerectomy ◽

Group 2 ◽

Group 1

Purpose. Evaluation of the efficacy of descemethogoniopuncture (DGP) at various times after microinvasive non-penetrating deep sclerectomy (MNPDS) in patients with glaucoma. Material and methods. The analysis of the results of DGP in 64 eyes of patients with primary open-angle glaucoma after previously performed MNPDS. According to the timing of DGP after MNPDS, the patients were divided into 3 groups. In the 1st group BPH was performed after 1–2 months (22 eyes), the 2nd group – after 3–4 months (21 eyes), the 3rd group after 5–6 months (21 eyes). The follow-up period was 1 year. Results. The level of intraocular pressure before DGP averaged 15.1±0.6 mm Hg in group 1, 17.5±0.9 mm Hg in group 2, and group – 18.6±0.7 mm Hg. After DGP, 13.1±0.4 mm Hg, 14.6±0.7 mm Hg, 16.1±0.5 mm Hg respectively. According to ultrasound biomicroscopy, the highest and extended intrascleral cavities and tunnels, as well as a thin loose trabeculodescemet membrane (TDM), were observed in the eyes of the 1st group. With an increase in the time after MNPDS, there was a compaction of TDM, a decrease in the height and length of the intrascleral cavity and tunnels. 12 months after DGP, the most pronounced antihypertensive effect without antihypertensive therapy occurred in group 1 – 55% of cases compared with groups 2 and 3 (33% and 14% respectively). Conclusion. The greatest efficiency was shown by performing DGP within 1–2 months after MNPDS, which is associated with the minimum development of proliferative processes in the intrascleral outflow tract in the early stages after this operation. Key words: descemethogoniopuncture, microinvasive non-penetrating deep sclerectomy, intraocular pressure, hypotensive effect, glaucoma.

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The role of mitomycin C and porcine extracellular matrix in phacotrabeculectomy

European Journal of Ophthalmology ◽

10.1177/1120672120944339 ◽

2020 ◽

pp. 112067212094433 ◽

Cited By ~ 1

Author(s):

Momen Mahmoud Hamdi ◽

Islam Mahmoud Hamdi

Keyword(s):

Extracellular Matrix ◽

Intraocular Pressure ◽

Mitomycin C ◽

Low Dose ◽

Open Angle Glaucoma ◽

Group Iii ◽

Group I ◽

Pressure Lowering ◽

The Mean

Purpose: To compare between mitomycin C alone, porcine extracellular matrix alone, and combined low dose mitomycin C with porcine extracellular matrix in term of efficacy and safety in phaco-trabeculectomy surgery. Study design: Prospective comparative. Methods: Sixty eyes of 60 patients complaining of primary open angle glaucoma and cataract, undergoing phaco-trabeculectomy, were distributed into three groups: group I: surgery was augmented with mitomycin C, group II with porcine extracellular matrix, and group III with porcine extracellular matrix combined with low dose mitomycin C. Intraocular pressure was evaluated, postoperatively, at day 1, week 1, and 1, 3, 6, 9, and 12 months. Bleb vascularity, pre- and post-operative intraocular pressure lowering medications, success of IOP control and complications were also evaluated. Results: After 12 months, the mean preoperative intraocular pressure (mm Hg) improved from 30.85 ± 4.7, 33.8 ± 4.2, and 31.05 ± 5.4 mm Hg, in groups I, II, and III respectively, to 13.8 ± 4.7 (55.2%), 15.2 ± 4.8 (55%), and 13 ± 4.9 (58.1%) ( p > 0.05). Success of IOP control, postoperative IOP lowering medications and complications were comparable ( p > 0.05). Bleb vascularity was significantly different ( p < 0.05). Conclusion: Mitomycin C, porcine extracellular matrix and their combination are equally effective in phacotrabeculectomy.

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Efficacy of Selective Laser Trabeculoplasty in Medically Uncontrolled Glaucoma

ISRN Ophthalmology ◽

10.1155/2013/975281 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Nihat Sayin ◽

Zeynep Alkin ◽

Abdullah Ozkaya ◽

Abdulvahit Demir ◽

Ahmet Taylan Yazici ◽

...

Keyword(s):

Intraocular Pressure ◽

Success Rate ◽

Medical Records ◽

Open Angle Glaucoma ◽

Open Angle ◽

Efficacy And Safety ◽

Success Rates ◽

Selective Laser Trabeculoplasty ◽

Laser Trabeculoplasty ◽

The Mean

Purpose. To investigate the efficacy and safety of 360° selective laser trabeculoplasty (SLT) on medically uncontrolled open-angle glaucoma (OAG) and to evaluate the effects of antiglaucomatous medications on the results of therapy. Materials and Methods. The medical records of 62 eyes of 51 patients with OAG, which did not reach the targeted intraocular pressure (IOP) with maximum antiglaucomatous medical therapy, were retrospectively reviewed. Results. A statistically significant decrease was observed in the mean baseline IOP at 1, 3, 6, and 12 months of followup (P<0.01). The success rate was 64.5% in all of the patients. The success rates did not vary significantly by taking 1, 2, 3, or 4 medications with the rates of 63.6%, 71.4%, 64.2%, and 58.3% (P=0.06). The success rate of eyes on medication more or less than 6 months was 62.5% or 66.7%, respectively (P=0.3). There was a positive correlation between mean baseline IOP and mean reduction in IOP from baseline (P<0.001, r=0.8). Conclusion. Application of 360° of SLT provided an effective and safe IOP reduction in medically uncontrolled OAG. Baseline IOP was found to be the most important factor in the efficacy of therapy.

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Viscocanalostomy with Mitomycin-C: A Preliminary Study

European Journal of Ophthalmology ◽

10.1177/112067210501500204 ◽

2005 ◽

Vol 15 (2) ◽

pp. 202-208 ◽

Cited By ~ 15

Author(s):

A. Yarangümeli ◽

ö. Gürbüz Köz ◽

M.N. Alp ◽

A.H. Elhan ◽

G. Kural

Keyword(s):

Mitomycin C ◽

Long Term Results ◽

Success Rates ◽

Surgical Success ◽

Significant Difference ◽

The Difference ◽

Group 2 ◽

Conjunctival Bleb ◽

Group 1

Purpose To compare the results of viscocanalostomy with and without mitomycin-C (MMC). Methods Retrospective results of 15 standard viscocanalostomy (VCO) operations (Group 1) were compared with the prospective results of 15 VCO operations performed with intraoperative adjunctive MMC (Group 2). MMC (0.2 mg/mL) was applied over and under the superficial scleral flap for 3 minutes in Group 2 before the deep flap was prepared. Each patient was followed up for at least 1 year, and results of examinations in the first 12 months were used in the statistical comparison of the two groups. Surgical success was defined as intraocular pressure (IOP) ≤ 18 mmHg. Results Pr eoperative mean intraocular pressures (IOP) in Group 1 and Group 2 wer e 35.3±11.0 and 39.1±8.9, respectively. Mean IOP levels at the 12th month were 14.4±2.6 and 11.9±4.0, respectively, showing a significant decrease in both groups (p<0.001). Postoperative IOP course appeared to be lower in the MMC group, however, the difference was not statistically significant (p=0.554). Complete success rates without medications were 40% in Group 1 and 67% in Group 2. No significant difference was found between the two groups in terms of early and late postoperative complications, pre- and postoperative number of antiglaucoma medications, and surgical success rates at the end of the study period (p>0.05 for all). A significant difference was verified between the two groups of eyes considering the conjunctival bleb types, as low-lying, localized blebs were the most frequent type in Group 1 and thin-walled, avascular blebs were more predominant in the MMC group (p=0.004). Conclusions Intraoperative adjunctive MMC use might improve the long-term results of viscocanalostomy by facilitating subconjunctival filtration and might widen the indication range of the technique.

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Intraocular Pressure Changes during Femtosecond Laser-Assisted Cataract Surgery: A Comparison between Two Different Patient Interfaces

Journal of Ophthalmology ◽

10.1155/2019/5986895 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Chiara De Giacinto ◽

Rossella D’Aloisio ◽

Alessandro Bova ◽

Tommaso Candian ◽

Alberto Armando Perrotta ◽

...

Keyword(s):

Intraocular Pressure ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Soft Contact ◽

Soft Contact Lens ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Pressure Changes ◽

Group 1

Purpose. The aim of this retrospective cohort study was to evaluate intraocular pressure (IOP) changes during femtosecond laser-assisted cataract surgery (FLACS) using two different patient interface systems. Methods. 116 eyes of 116 patients scheduled for cataract surgery were divided into 2 groups: group 1 (61 eyes) and group 2 (55 eyes) underwent FLACS using Catalys Laser with fluid interface (liquid optics interface, LOI) and LenSx Laser with curved interface and soft contact lens (SoftFit), respectively. IOP was assessed using a portable rebound tonometer (Icare®) preoperatively, after docking, immediately after surgery, at one and seven days postoperatively. Results. In group 1, the mean IOP (±SD) was 14.1 ± 0.4 mmHg before surgery, 33.2 ± 1.1 mmHg after docking, and 21.4 ± 0.9 mmHg immediately after surgery. In group 2, the mean IOP was 13.8 ± 0.4 mmHg before surgery, 24.2 ± 1.4 mmHg after docking, and 20.2 ± 1.2 mmHg immediately after surgery. After the docking procedure, a statistically significant increase in IOP from the baseline was found in both groups (p<0.001). Moreover, no statistically significant difference in IOP measured at 1 and 7 days postoperatively was observed compared with the preoperative values (p>0.05) using both laser platforms. No intraoperative and postoperative complications were observed. Conclusions. FLACS suction phase resulted in a transient increase of IOP in both groups, especially with the LOI system, and it is probably related to the greater pressure of a suction ring and suction generated through the vacuum, independently from the effect of femtosecond laser itself.

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Simultaneous Bilateral Same-Day Endoscopic Myringoplasty Using Tragal Cartilage From One Ear

Ear Nose & Throat Journal ◽

10.1177/0145561319854065 ◽

2019 ◽

Vol 99 (8) ◽

pp. 522-527 ◽

Cited By ~ 1

Author(s):

Baklaci Deniz ◽

Kuzucu Ihsan ◽

Guler Ismail ◽

Kum Rauf Oguzhan ◽

Ozcan Muge

Keyword(s):

Chronic Otitis Media ◽

Operation Time ◽

Entire Group ◽

Success Rates ◽

Endoscopic Myringoplasty ◽

The Mean ◽

The Difference ◽

Group 2 ◽

Graft Success ◽

Group 1

The aim of this study is to investigate the outcomes of bilateral same-day endoscopic myringoplasty using tragal cartilage from one ear in patients with bilateral chronic otitis media. In this retrospective study, medical records of 62 (84 ears) patients aged between 18 and 65 years who underwent endoscopic myringoplasty at our center between January 2015 and December 2017 were evaluated. Patients were classified into 2 groups according to surgical procedure they received: unilateral myringoplasty (group 1) and bilateral same-day myringoplasty (group 2). The comparisons were made between groups in terms of anatomical graft success and functional outcomes. There were 40 patients in the unilateral group (group 1) and 22 patients in the bilateral same-day group (group 2). The graft success rates were 92.5% and 93.2% for groups 1 and 2, respectively ( P = .904). The mean preoperative air–bone gaps (ABGs) were 21.1 ± 7.1 and 20.5 ± 6.7 dB, respectively, whereas the mean postoperative ABGs were 8.1 ± 2.7 dB and 7.9 ± 3.0 dB, respectively. The difference between pre- and postoperative ABGs for the entire group was statistically significant ( P < .001). Mean hearing gain was 12.5 ± 11.0 dB and 15.6 ± 10.1 dB in groups 1 and 2, respectively, ( P = .183). Postoperative ABG was ≤10 dB in 33 (82.5%) and 36 (81.8%) ears in groups 1 and 2, respectively. The functional success rates were similar in both groups ( P = .582). The average lengths of operation time were 61.6 ± 12.5 minutes and 110.1 ± 25.2 minutes for groups 1 and 2, respectively. Bilateral same-day endoscopic myringoplasty using tragal cartilage from one ear seems to be a safe and satisfactory procedure with a good satisfactory success rate.

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One-shot dilation versus metallic dilation technique for access in percutaneous nephrolithotomy: comparison of efficacy, access time and fluoroscopic time

Insight Urology ◽

10.52786/isu.a.38 ◽

2021 ◽

Vol 42 (2) ◽

pp. 154-159

Author(s):

Somboon Phaijitwichian ◽

Keyword(s):

Percutaneous Nephrolithotomy ◽

Access Time ◽

Success Rates ◽

Fluoroscopic Time ◽

Tract Dilation ◽

The Mean ◽

Group 2 ◽

The One ◽

Dilatation Group ◽

Group 1

Objective: The aim of this study was to compare the efficacy, access tract dilation time and fluoroscopic time between the one-shot dilation technique and telescopic metal dilatation technique in patients undergoing percutaneous nephrolithotomy in Nakornping Hospital. Materials and Methods: Sixty-six patients who underwent percutaneous nephrolithotomy from January 2020 to July 2021 were included in the study and they were randomly divided into two groups. In group 1 (32 patients), telescopic metal dilation was used, in group 2 (33 patients), the one-shot technique was used. Success rates of dilation, access tract dilation time and fluoroscopic time were evaluated. Results: The success rate of dilation was 100% in both groups. The access tract dilation time was 835.63 ± 309.68 seconds in group 1 and 569.42 ± 314.75 seconds in group 2 (p = 0.001). The fluoroscopic time was 48.16 ± 22.16 seconds in group 1 and 41.97 ± 23.99 seconds in group 2 (p = 0.29). The access tract dilation time of the one-shot dilation technique was statistically significantly shorter than that in the telescopic metal dilatation group. The mean fluoroscopic time of the one- shot dilation technique was shorter than in telescopic metal dilatation but was not statistically significant. Conclusion: One-shot dilation technique is as effective as telescopic metal dilatation, with a significant reduction in access tract dilation time.

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Predictors for the Healing of Transmetatarsal Amputations: Retrospective Study of 91 Amputations

Vascular ◽

10.2310/6670.2007.00035 ◽

2007 ◽

Vol 15 (3) ◽

pp. 126-133 ◽

Cited By ~ 21

Author(s):

Peter Blume ◽

Christine Salonga ◽

Juan Garbalosa ◽

Daphne Pierre-Paul ◽

Jonathon Key ◽

...

Keyword(s):

Retrospective Study ◽

Renal Disease ◽

End Stage Renal Disease ◽

Final Examination ◽

The Mean ◽

Group 2 ◽

Stage Renal Disease ◽

End Stage ◽

Group 1

This retrospective study reviewed 80 consecutive patients (mean age 62 years; range 21–91 years) who underwent 91 transmetatarsal amputations (TMAs) between 1995 and 2003. The mean follow-up was 12 ± 1.36 months. Sixty-two TMAs healed initially (group 1), whereas 29 TMAs did not heal by 3 months (group 2). At the final examination, in groups 1 and 2, 63 of 91 (69%) limbs were healed. Of the 28 limbs that did not heal, 25 of 28 (89%) required further proximal amputation. Initial healing correlated significantly with the ability to ambulate ( p < .0001) and overall limb salvage ( p < .0001). In group 1, 20 of 27 (74%) limbs that were revascularized healed ( p = .0336). Nonhealing amputations were associated with end-stage renal disease (13 of 19; 68%) ( p = .0209) and leukocytosis (13 of 19; 68%) ( p = .0052).

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Effect of Varying Duration of Ocular Compression on Raised Intraocular Pressure following Fractionated Peribulbar Anaesthesia for Cataract Surgery

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v12i4.317 ◽

1970 ◽

Vol 12 (4) ◽

pp. 197-200

Author(s):

Jaichandran Venkatakrishnan ◽

Lingam Vijaya ◽

Ronnie J. George ◽

Thennarasu Maruthamuthu

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Local Anaesthetic ◽

Ocular Surgery ◽

Peribulbar Anaesthesia ◽

Peribulbar Block ◽

Digital Compression ◽

The Mean ◽

Group 2 ◽

Group 1

Aim: To evaluate the effect of fractionated peribulbar anaesthesia and varying digital ocular compression time on intraocular pressure.Methods: Forty non-glaucomatous patients aged 40 years and older planned for cataract surgery were randomly divided into 2 groups based on the duration for which the globe was compressed digitally following each injection. Patients with a history of glaucoma or those who had had previous ocular surgery were excluded. Group 1 underwent 1 minute of compression and group 2 underwent 2 minutes of compression. Local anaesthetic (2% lidocaine 5 mL, 0.5% bupivacaine 5 mL, and hyaluronidase 25 IU/mL) was injected into the inferotemporal and superomedial quadrants. Intraocular pressure was measured (3 readings with <5% SD) before peribulbar block, after inferotemporal injection, following digital compression, after superomedial injection, following digital compression again, and at 1-minute intervals without compression until the globe attained normotension.Results: The mean (SD) intraocular pressure in group 1 was significantly elevated compared with the baseline mean intraocular pressure of 19.21 mm Hg (SD, 2.82 mm Hg) throughout the procedure (p < 0.0001). In group 2, the mean intraocular pressure was not significantly elevated from the baseline mean intraocular pressure of 19.13 mm Hg (SD, 3.27 mm Hg) following compression after each injection.Conclusions: Intraocular pressure rises significantly following each 5 mL of local anaesthetic injected into the peribulbar space at both the inferotemporal and superomedial sites. Digital ocular compression given for 2 minutes after each injection makes the globe normotensive.

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