No Abstract Available.
Filtering Surgery* ; Genistein* ; Glaucoma*

Among the complication of filtering surgery for glaucoma, late bacterial endophthalmitis is relatively uncommon, but very disatrous and so requires a prompt and vigorous treatment. Recently, authors experienced 2 cases of late onset endophthalmitis, each developed 13 years and 15 years after filtering surgery. And we performed pars plana vitrectomy as well as medical treatment. These cases had a good response to our medical and surgical treatment with no loss of vision.
Endophthalmitis* ; Filtering Surgery* ; Glaucoma ; Vitrectomy

PURPOSE: To evaluate the histopathologic changes after insertion of polymer made of poly- glycolic acid(PGA) and poly(lactic acid-co-glycolic acid)(PLGA)/5-FU following filtering surgery in the rabbit. METHOD: A polymer with 0.3 mm thickness made of PGA and PLGA/5-Fluorouracil(5-FU, 10% by weight) composite were made in a size of 3 x 7 mm. After full-thickness filtration surgery performed, PGA was inserted under the conjunctiva in group I, PLGA/5-FU was inserted in group II and none in control group. Twelve rabbit eyes were enrolled in each group. RESULT: Postoperatively, no serious complication was found in anterior segment. In the control eyes inflammatory cell reaction was minimal at 2 weeks after surgery and decreased thereafter. While severe fibrovascular tissue reaction with loss of conjunctival filtration space was noted at 2 and 4 weeks after surgery in group I, the filtration space was well maintained without fibrovascular tissue reaction until 4 weeks after surgery in group II. At 8 weeks after surgery, fibrous tissue reaction was observed in group I, but not in group II and contol. The polymer was not found and the filtration space was obliterated at 8 weeks after surgery in group I and II. CONCLUSION: PLGA/5-FU may be used as an effective adjunct to improve the success rate of the filtration surgery, without inducing serious fibrous tissue reaction. PGA was not suitable.
Conjunctiva ; Filtering Surgery* ; Filtration ; Polymers*

Objective: To assess the safety and incidence of subconjunctival fibrosis in rabbits eyes with and without intraoperative application of Seprafilm Bioresorbable Membrane (Genzyme Corp., Cambridge, MA) Methodology: A fornix based conjunctival peritomy was made on 20 eyes of10 rabbits. Ten eyes were randomly assigned to receive Seprafilm on the subconjunctival area while the opposite eye had no intraoperative application of the membrane. Two orbits (one rabbit) were exenterated each week for ten weeks and gross and histologic evaluation for signs of morbidity and scarring were performed Results: Seprafilm did not show any adverse effect on the rabbits eyes. All eyes with Seprafilm (100 percent) were a vascular while 5 eyes (50 percent) without Seprafilm showed the presence of conjunctival vascularity. Conjunctival mobility was normal in eyes with Seprafilm (100 percent) while the conjunctiva was immobile in 6 eyes (60 percent) without Seprafilm. Histologic sections on eyes without Seprafilm showed presence of fibrosis and inflammatory infiltrates in 7 eyes (70 percent) while only 2 (20 percent) and 3 eyes (30 percent) with Seprafilm showed the presence of fibrosis and inflammatory infiltrates, respectively. Failed "blebs" were evident in 6 eyes (60 percent) while only 4 eyes (40 percent) without Seprafilm were considered as functioning "blebs". All eyes with Seprafilm (100 percent) were considered as functioning "blebs" (p.005) and is statistically significant Conclusion: Pre-clinical evaluation has shown that Seprafilm is safe and effective in preventing postoperative subconjunctival fibrosis.
Animal ; FILTERING SURGERY ; MOLTENO IMPLANTS ; GLAUCOMA SURGERY ; SURGERY, FILTRATION ; SURGERY, FILTERING

The purpose of this study was to determine whether preoperative topical antiglaucomatous therapy influences the outcome of subsequent trabeculectomy. We investigated 50 eyes of 36 patients with primary open anlge glaucoma(POAG)and 86 eyes of 77 patients with primary angle closure glaucoma (PACG), who had undergone trabeculectomy. All the patients had received topical antiglaucomatous therapy preoperatively and had been followed up for at least 6 months postoperatively. Both groups, POAG and PACG were divided into two subgroups according to the duration of preoperative antiglaucomatous therapy: (a)for less than 1 month and (b)for more than 6 months. The criterion for success was maintenance of postoperative intraocular pressure(IOP)below 21 mmHg without medication. The rates of success were compared at 1 week, 1 month, 3 months, and 6 months postoperatively. In POAG patients, the overall success rate was clinically significantly higher in subgroup (a)than in subgroup (b)(P<0.05). The success rate in subgroup (a)of POAG patients remained higher irrespective of class of antiglaucomatous medications(P<0.05). In PACG patients, the success rate was also higher in subgroup A, but it failed to reach clinical significance. Postoperative mean IOP was slightly lower in subgroup (a)of all the participants, but it was not clinically significant. Our study suggests that long-term use topical antiglaucoma medications can affect adversely the result of filtering surgery in POAG.
Filtering Surgery ; Glaucoma, Angle-Closure ; Humans ; Trabeculectomy*

Intraoperative mitomycin c has been popularized for use as an adjuvant to increase the success rate of trabeculectomy because of its antifibroblastic effects. Basically it has a potent antifibroblastic effect and its use presents many potential problems and side effects. As a result, many surgeons concentrate on method to gain the optimal surgical results with the minimal complications with MMC. But the long-term effects of MMC have not been determined because of its short history of clinical applications. So, we evaluated the surgical results and complications of MMC in a long-term follow-up study (more than 30 months) , which was divided into 4 groups by the use of MMC and the high-risk characteristics. A total of 135 eyes were studied. Each group included: A, 40 eyes; B, 17 eyes; C, 52 eyes; D, 26 eyes. Failed filtering surgery and young age were major factors in high-risk groups. In high-risk groups (A, B), the difference in success rates was statistically significant A(M+), 88.5%; B(M-), 52.9% (p=0.010), but in non-high risk groups (C, D), it was not: C(M+), 75%; D(M-), 76.9% (p=0.852). The difference in isual acuity (more than 3 lines in a snellen chart) between each groups was not shown. And in non-high risk groups (C, D), the difference in the hypotony rate was statistically significant C(M+), 21%; D(M-), 49% (p=0.046), but in high-risk groups, it was not: A(M+), 15%; B(M-), 11% (p=0.748). Regardless of the preoperative IOP level, postoperative IOP was less in cases where MMC was used than in cases where MMC was not used. In conclusion, MMC increased the success rate in high-risk groups but it aggravated complications, especially in non-high risk groups. To get optimal results with minimal complications, discreet use of MMC in selected cases is highly recorninended.
Filtering Surgery ; Follow-Up Studies* ; Mitomycin* ; Trabeculectomy*

Endophthalmitis following the filtering surgery is rare and the visual prognosis is reported to be very poor. In many cases the infection starts in the bleb. Methods of treatment should be chosen according to the type and stage of infection, but the prompt use of appropriate antibiotic and corticosteroid is important. This report presents a case of endophthalmitis following trabeculectomy in a 61-year old female patient, which was successfully treated.
Blister ; Endophthalmitis* ; Female ; Filtering Surgery ; Humans ; Middle Aged ; Prognosis ; Trabeculectomy*

As fibroblasts proliferation at the sclerectomy wound is known to be vigorous after the fifth or sixth postoperative day, this study was performed to know if a delay in the administration of 5-fluorouracil until this time can still interfere with fibroblasts proliferation. The delayed onset of administration was seem to be efficacious. If this is more confirmed at further study, a decreased dose of postoperative 5-fluorouracil may interfere less with corneal wound healing.
Fibroblasts ; Filtering Surgery* ; Fluorouracil* ; Glaucoma* ; Wound Healing ; Wounds and Injuries

PURPOSE: To evaluate the outcome of Ahmed valve implantation as a primary or secondary glaucoma surgery to treat refractory glaucoma patients. METHODS: A total of 101 eyes of 101 patients with refractory glaucoma, who received Ahmed valve implantation between March 1995 to September 2004 were included. We divided cases into primary surgery group, who had no trabeculectomy, and secondary surgery group, who had trabeculectomy before Ahmed valve implantation. Successful operation was defined as having the following outcomes: (1) postoperative intraocular pressure (IOP) sustained between 5 and 21mmHg and reduced 30% from the baseline IOP with or without medication, (2) no visual decline due to IOP or complications, and (3) no additional filtering surgery. Clinical records were reviewed, and IOP, antiglaucoma medications, and complications were recorded. Kaplan-Meier survival analysis was used to calculate the overall probability of success. RESULTS: In primary surgery group, overall success rate was 57.6%, 46.7%, 39.7%, and 39.7% at 1, 3, 5, and 7 years, respectively. In secondary surgery group, overall success rate was 67.8%, 58.1%, 52.4%, and 43.5% at the same time points. There was, however, no statistical difference in success rates between two groups. The incidence of complications were as follows: 4.2% of endophthalmitis, 4.2% of valve exposure, 4.2% of hypotony was found in the primary surgery, and 3.8% of endophthalmitis, 1.9% of valve exposure, 9.4% of hypotony were found in the secondary surgery. There were no statistical differences in the incidences of complications between the two groups. CONCLUSIONS: Ahmed valve implantation was effective for IOP control in refractory glaucoma patients. Success rate did not show significant difference between primary and secondary Ahmed valve implantation group.
Endophthalmitis ; Filtering Surgery ; Glaucoma* ; Humans ; Incidence ; Intraocular Pressure ; Trabeculectomy

We compared the effect of topical minoxidil after filtering surgery with that of mitomycin C (MMC) application in rabbits. Fourty-nine eyes were divided into the minoxidil-treated eyes, MMC_treated eyes and control eyes. Intraocular pressure (IOP) in minoxidil-treated eyes and MMC-soaked eyes were significantly lower than that of the control eyes at postoperative 1 and 3 days. MMC-soaked eyes had lower IOPs than the minoxidil-treated and control eyes, but IOPs in the minoxidil- and control eyes were similar at days 5 to 21. IOP survival in the MMC-treated eyes was significantly longer than in both the minoxidil-treated and control eyes. These results suggest that topical minoxidil can cause reduction of IOP at the early postoperative period. Howver, the IOP lowering effect of Minoxidil did not last as long as that of MMC soaking. Further study is necessary to enhance the efect of topical minoxidil including its method of application and optimal concentration.
Filtering Surgery ; Glaucoma* ; Intraocular Pressure ; Minoxidil* ; Mitomycin* ; Postoperative Period ; Rabbits*