We performed the prospective study on the clinical result of sutureless phacotrabeculectomy using 3.0mm ~ 6.5mm self-sealing scleral tunnel incision. This study included 9 eyes of 8 patients who have been suffering from chronic angle-closure glaucoma or chronic open-angle glaucoma with coexisting cataract. The mean preoperative intraocular pressure(IOP) was 28.55mmHg and mean postoperative IOP was 15.55mmHg. The IOP maintained below 19mmHg in all cases after 6 months. The number of medications decreased from 1.77 preoperatively to 0.33 postoperatively. No medication needed in 7 eyes postoperatively. The mean preoperative cup-disc ratio was 0.64. Visual acuity improved in 8 eyes and 5 eyes recovered to 20/40 or better. The blebs were visible in 8 cases which shows low diffuse in character in most cases. Postoperative complications were hypotony in 5 cases, hyphema in 1 case, partial posterior capsular rupture in 1 case and posterior capsular opacification in 1 case respectively. This result suggests that sutureless phacotrabeculectomy may be performed as safe and effective combined procedure in the management of coexisting cataract and glaucoma.
Blister ; Cataract ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Hyphema ; Postoperative Complications ; Prospective Studies ; Rupture ; Visual Acuity

PURPOSE: To evaluate the outcomes of trabeculectomy performed on eyes with medically uncontrolled acute angle closure glaucoma (AACG). METHODS: The authors reviewed 31 eyes of 30 acute primary angle-closure glaucoma patients who had undergone trabeculectomy. The eyes were divided into two groups: eyes which did not respond to medical and/or laser treatment (Group A, 16 eyes) and those which initially responded to medical and/or laser treatment and later had an intraocular pressure (IOP) increase (Group B, 15 eyes). Complete success was defined as a final IOP below 21 mmHg without medication, and qualified success was defined as a final IOP below 21 mmHg with medication. Patients whose postoperative IOP was 22 mmHg or greater on at least two serial measurements or who required additional glaucoma surgery were classified as failures. RESULTS: The mean follow-up was 43.1+/-32.3 months. The five-year qualified success rate was 56.3% in Group A and 100% in Group B (log-rank test, p=0.02). The preoperative IOP was significantly higher in Group A (38.0+/-11.5 mmHg) than in Group B (21.8+/-12.2 mmHg) (p<0.01). Factors found not to be significant included age, gender, peripheral anterior synechiae, a glaucomatous optic disc, and visual field damage. The postoperative complications were similar between the two groups (p>0.05). CONCLUSIONS: The medically uncontrolled AACG appears to have an adverse effect on the outcome of trabeculectomy. Success of trabeculectomy in AACG seems to be inversely related with elevated preoperative intraocular pressure.
Eye ; Follow-Up Studies ; Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Intraocular Pressure ; Postoperative Complications ; Trabeculectomy ; Visual Fields

PURPOSE: To evaluate the outcomes of trabeculectomy performed on eyes with medically uncontrolled acute angle closure glaucoma (AACG). METHODS: The authors reviewed 31 eyes of 30 acute primary angle-closure glaucoma patients who had undergone trabeculectomy. The eyes were divided into two groups: eyes which did not respond to medical and/or laser treatment (Group A, 16 eyes) and those which initially responded to medical and/or laser treatment and later had an intraocular pressure (IOP) increase (Group B, 15 eyes). Complete success was defined as a final IOP below 21 mmHg without medication, and qualified success was defined as a final IOP below 21 mmHg with medication. Patients whose postoperative IOP was 22 mmHg or greater on at least two serial measurements or who required additional glaucoma surgery were classified as failures. RESULTS: The mean follow-up was 43.1+/-32.3 months. The five-year qualified success rate was 56.3% in Group A and 100% in Group B (log-rank test, p=0.02). The preoperative IOP was significantly higher in Group A (38.0+/-11.5 mmHg) than in Group B (21.8+/-12.2 mmHg) (p<0.01). Factors found not to be significant included age, gender, peripheral anterior synechiae, a glaucomatous optic disc, and visual field damage. The postoperative complications were similar between the two groups (p>0.05). CONCLUSIONS: The medically uncontrolled AACG appears to have an adverse effect on the outcome of trabeculectomy. Success of trabeculectomy in AACG seems to be inversely related with elevated preoperative intraocular pressure.
Eye ; Follow-Up Studies ; Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Intraocular Pressure ; Postoperative Complications ; Trabeculectomy ; Visual Fields

No abstract available.
Female ; Glaucoma, Angle-Closure/complications/surgery ; Humans ; Middle Aged ; Optic Neuropathy, Ischemic/complications/*diagnosis

No abstract available.
Female ; Glaucoma, Angle-Closure/complications/surgery ; Humans ; Middle Aged ; Optic Neuropathy, Ischemic/complications/*diagnosis

A retrospective clinical study to evaluate the use of the argon and Nd: YAG laser in sequential combination for iridotomy was carried out on 29 eyes of 19 patients with angle closure glaucoma. The argon laser settings were standardized at 0.01-0.02 second duration and 50 micrometerspot size. The total mean energies for the argon and Nd: YAG stages were 2.7 +/-1.49J and 9.0 +/-5.83 mJ respectively. Mean postoperative decrease of intraocular pressure(IOP)was 26.4 +/-20.14 mmHg. Postoperative complications were bleeding at iridotomy site (3 eyes),transient increse in IOP (2 eyes),and posterior synechia (1 eye),but there was no lenticularopacity,and no closure of the iridotomy site. The laser iridotomy using sequential argon and Nd: YAG laser is an effective method in dark irides, lowering the mean total energy delivered per eye by the argon and YAG laser repectively, combining the advantages of both laser procedures while avoiding most of the disadvantages. We think that it is the more safe and effective method with the decreased mean total energy of argon laser at 0.01-0.02 second duration, 50 micrometerspot size followed by YAG laser.
Argon* ; Glaucoma, Angle-Closure* ; Hemorrhage ; Humans ; Lasers, Solid-State* ; Postoperative Complications ; Retrospective Studies

The purpose of this study is to evaluate the clinical factors in eye with continued appositional angle closure in the presence of a patent iridectomy and the clinical avaiability of argon laser peripheral iridoplasty(ALPI). In this study we retrospectively reviewed the outcome in 59 eyes of 32 patients who underwent iridectomy. After Dark Room Prone-position Test(DRPT), 15 eyes among 59 eyes(25.4%) showed DRPT positive and ALPI was successfully performed in 13 eyes among these 15 eyes(86.7%). Patients with DRPT positive were younger than those with DRPT negative. One eye had postoperative complication; iritis more than 1 week. In this study it was found that Argon lader peripheral iridoplasty is a Safe and an effective means of opening an appositionally closed angle in situations in which laser ridotomy does not physically eliminate appositional angle closure.
Argon* ; Glaucoma, Angle-Closure* ; Humans ; Iridectomy ; Iritis ; Postoperative Complications ; Retrospective Studies

PURPOSE: To report the results of primary trabeculectomy with mitomycinmitomycin C (MMC) for medically uncontrolled, primary angle-closure glaucoma. METHODS: A retrospective study of 20 eyes from 18 consecutive patients with medically uncontrolled primary angle-closure glaucoma who underwent trabeculectomy with MMC, from 1997 to 2000. RESULTS: The mean follow up was 33.9 +/- 12.9 months (range 24~60). After trabeculectomy with MMC, IOP remained below 22 mmHg in 17 eyes (85%) with or without medication. Postoperative complications occurred in 5 eyes (25%). CONCLUSIONS: Trabeculectomy with MMC resulted in favorable long-term IOP control and relatively low complications in medically unresponsive acute angle-closure glaucoma.
Follow-Up Studies ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Mitomycin* ; Postoperative Complications ; Retrospective Studies ; Trabeculectomy*

In order to evaluate the effect of Q-switched YAG laser iridotomy to the intraocular pressure, we performed the Q-switched Nd-YAG laser iridotomy in 39 eyes of 28 patients with angle closure glaucoma. Postoperative difference of the intraocular pressure was 27.5 +/- 27.0mmHg and the intraocular pressure was reduced. After 2 months, 12 eyes had needed one kind of anti-glaucomatous medication, 7 eyes had needed no medication, 6 eyes had needed two medications and 1 eye had needed three medications. Postoperative complications were iris bleeding(10 eyes), transient pressure rising(9 eyes), focal corneal opacities(2 eyes) and closure of iridotomy(2 eyes). These result shows that laser iridotomy should be considered in the management of angle closure glaucoma.
Glaucoma, Angle-Closure ; Humans ; Intraocular Pressure ; Iris ; Lasers, Solid-State* ; Postoperative Complications

PURPOSE: In this study we evaluated the safety and efficacy of combined phacoemulsification and synechiolysis without aid of gonioprism lens and intraoperative intracameral tissue plasminogen activator (tPA) injection for angle-closure glaucoma. METHODS: The method used in this study was synechiolysis with Kuglen hook without aid of gonioprism lens and intraoperative intracameral tPA injection following cataract surgery. RESULTS: A total of 20 patients with a mean age of 71.4 +/- 5.4 years were treated. Mean follow-up time was 31.3 +/- 24.3 months. Mean preoperative and last visit intraocular pressures (IOPs) were 21.70 +/- 9.50 mm Hg and 12.40 +/- 2.30 mm Hg, respectively (p < 0.0001). The mean number of glaucoma medications decreased from 2.40 to 0.30 (p < 0.0001). IOP was maintained below 16 mm Hg in all cases. No significant intraoperative and postoperative complications, hyphema, or fibrin reaction occurred. CONCLUSIONS: Combined phacoemulsification and peripheral anterior synechiolysis with Kuglen hook without aid of gonioprism lens and intraoperative intracameral tPA injection is an effective and safe surgical procedure.
Cataract ; Fibrin ; Follow-Up Studies ; Glaucoma ; Glaucoma, Angle-Closure* ; Humans ; Hyphema ; Intraocular Pressure ; Phacoemulsification* ; Postoperative Complications ; Tissue Plasminogen Activator*