A potent antiproliferative agent, Mitomcin-C, has been known to improve the surgical outcom of glaucomatous eyes with poor prognosis after filtering surgery. Twenty one eyes of 21 patients underwent trabeculectomy with Mitomyc-C. Overall success rate is 81%: 2 of 3 eyes with glaucoma after unsuccessful filtering surgery, 3 of 4 eyes with neovascular glaucoma, 2 of 3 eyes with secondary glaucoma, 1 of 2 eyes with aphakic glaucoma and all of 9 eyes with advanced glaucoma. Postoperative complications were prolonged conjuntival wound leakage in two eyes, conjuntibval wound leakage and corneo-lenticular touch in one eye, choroidal detachment in one eye, progression of cataract in one eye, hyphema in 3 eyes.
Cataract ; Choroid ; Filtering Surgery* ; Glaucoma* ; Glaucoma, Neovascular ; Humans ; Hyphema ; Mitomycin* ; Postoperative Complications ; Prognosis ; Trabeculectomy ; Wounds and Injuries

A potent antiproliferative agent, Mitomcin-C, has been known to improve the surgical outcom of glaucomatous eyes with poor prognosis after filtering surgery. Twenty one eyes of 21 patients underwent trabeculectomy with Mitomyc-C. Overall success rate is 81%: 2 of 3 eyes with glaucoma after unsuccessful filtering surgery, 3 of 4 eyes with neovascular glaucoma, 2 of 3 eyes with secondary glaucoma, 1 of 2 eyes with aphakic glaucoma and all of 9 eyes with advanced glaucoma. Postoperative complications were prolonged conjuntival wound leakage in two eyes, conjuntibval wound leakage and corneo-lenticular touch in one eye, choroidal detachment in one eye, progression of cataract in one eye, hyphema in 3 eyes.
Cataract ; Choroid ; Filtering Surgery* ; Glaucoma* ; Glaucoma, Neovascular ; Humans ; Hyphema ; Mitomycin* ; Postoperative Complications ; Prognosis ; Trabeculectomy ; Wounds and Injuries

PURPOSE: We carried out to determine the effectiveness of trabeculectomy and neodymium:YAG (Nd: YAG) cyclophotocoagulation in eyes with neovascular glaucoma from diabetic retinopathy. METHODS: We retrospectively reviewed medical records of patients who had undergone trabeculectomy or Nd:YAG cyclophotocoagulation from May 1992 to August 1997. RESULTS: The average drop in IOP was 24.6 mmHg in the trabeculectomy group and 17.3 mmHg in the transscleral cyclophotocoagulation group. Success rate was 69.2% in the trabeculectomy group and 21.4% in the transscleral cyclophotocoagulation group. Most common postoperative complication was hyphema (38.4%) in the trabeculectomy group and phthisis bulbi (21.4%) in the transscleral cyclophotocoagulation group. CONCLUSIONS: Trabeculectomy had higher success rate and less serious complications than transscleral cyclophotocoagulation. Transcleral cyclophotocoagulation may be considered as a treatment of neovascular glaucoma in the patients who have severe pain or poor general condition.
Diabetic Retinopathy* ; Glaucoma, Neovascular* ; Humans ; Hyphema ; Medical Records ; Postoperative Complications ; Retrospective Studies ; Trabeculectomy*

From January to September 1995, eleven eyes of eleven patients with medically uncontrollable glaucoma or previously failed filtering cases underwent installation of Baerveldt implant. Seven men and four women were enrolled into this study,, and meand age of the patients was 41.7+/-22.9 years (range, 2-65years). Nine eyes had neovascular glaucoma (diabetic retinopathy) in six eyes, Coats` disease in one, central tetinal vein occlusion in one, other in one of nine eyes), two eyes had secondary glaucoma after penetrating keratoplasty. The mean follow-up period was 10.6+/-8.4 months (range, 2-22 months), and preoperative intraocular pressure(IOP)s averaged 54.8+/-16.0mmHg range, 26-76mmHg) were lowered to a mean of 14.7+/-3.1mmHg (range, 12-40mmHg) postoperatively. Ten eyes achieved final IOPs between 6 and 14mmHg without medication, and one eye was eviscerated. Postoperative complications included hyphema in five eyes (45.5%), flat anterior chamber in two eyes(18.1%), obstruction of the tube in two eyes(18.1%), and cataract progression in two eyes(18.1%) of the eleven eyes. We installed Baerveldt implant in eleven recalcitrant glaucomas, and obtained successful result of 90.0% without serious complication. In conclusion, although Baerveldt implant is large, it is easier to implant an requires less extensive conjunctival incision than other large implants, and it afforded a good IOP control.
Anterior Chamber ; Cataract ; Female ; Follow-Up Studies ; Glaucoma* ; Glaucoma, Neovascular ; Humans ; Hyphema ; Keratoplasty, Penetrating ; Male ; Postoperative Complications ; Veins

The objective of this research is to examine the visual outcome of diabetic vitrectomy depending on each indication, to examine the factors influential to last visual acuity, to identify the causes for low vision and to learn the frequency of postoperative complications. Risk factors for the development of neovascular glaucoma either preoperative or intraoperative were carefully evaluated. Postoperative visual improvement was achieved in 67 eyes[53.6%]of 97 patients[125 eyes]who had undergone surgery due to diabetic retinopathy. Anatomical success was achieved in 111 eyes[88.8%]and vision better than 5/200 in 54 eyes [43.2%]. Statistically significant improvement of vision was obtained among the patients who had been controlling their blood sugar level successfully. Postoperative complications such as rubeosis iridis or neo-vascular glaucoma proved to be detrimental to visual outcome. Neovascular glaucoma occured in 20 eyes among the total 125 eyes[16%]and more frequently associated in eyes with postoperative retinal detachment[37.5%]than in eyes without retinal detachment[12.8%]. The difference was significant statistically. To summarize :first, thorough control of blood sugar level is indispensible in order to reduce postoperative visual loss and obtain the maximum effect of diabetic vitrectomy, second, postoperative occurrence of retinal detachment is at high risk for developing neovascular glaucoma.
Blood Glucose ; Diabetic Retinopathy* ; Glaucoma ; Glaucoma, Neovascular ; Humans ; Postoperative Complications ; Retinal Detachment ; Retinaldehyde ; Risk Factors ; Vision, Low ; Visual Acuity ; Vitrectomy*

We analyzed the clinical result of trabeculectomy with amniotic membrane transplantation which has antifibrotic and antiinflammatory action in risky glaucoma patients. Subjects were included four eyes of four patients with neovascular glaucoma, one eye of one patient with primary open angle glaucoma and four eyes of three patients with congenital glaucoma. After limbal based scleral flap was made in triangular shape with 5x4 mm sized, amniotic membrane, sized by 6x6 mm with epithelial side up, was placed on the scleral flap and then sutured to medial and lateral portion at 3 mm superior to base of scleral flap base with 10-0 nylon(2 points). The state of bleb, intraocular pressure and complications were observed at postoperative 1st, 3rd, 6th and 9th week. The IOP was reduced from 33.6+/-11.1 mmHg, to 15.5+/-6.5 mmHg at postoperative one week, 17.0+/-8.3 mmHg at three weeks, 16.9+/-8.1 mmHg at six weeks, 17.1+/-6.4 mmHg at nine weeks. 6 eyes(77.7%)had controlled IOP under 21 mmHg without antiglaucomatous agents at last follow up. Avascular blebs were observed throughout postoperative period in all subjects. Postoperative complications were shallow anterior chamber in one eye at 1st week and low intraocular pressue in one eye at 1st, 3rd week, that resolved at six weeks. Trabeculectomy with amniotic membrane transplantation on the scleral flap appeared to be effective as an augment therapy for filtering surgery in risky glaucoma.
Amnion ; Anterior Chamber ; Blister ; Filtering Surgery ; Follow-Up Studies ; Glaucoma ; Glaucoma, Neovascular ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Membranes* ; Postoperative Complications ; Postoperative Period ; Trabeculectomy

More intraoperative and postoperative complications of diabetic vitrectomy may result in poor visual prognosis. Sixty eye (49 patients) underwent vitrectomy for complications of proliferative diabetic retinopathy. Iatrogenic retinal breaks occurred in 6 (10%) of 60 eyes. Postoperative vitreous emorrhage was complicated in 13 (21%) of 60 eyes. Postoperative vitreous hemorrhage cleared spontaneously in one eye. Fluid-air exchange alone was successful in clearing the vitreous cavity in 4 eyes. Two eyes in which clearing does not occur in the postexchange period underwent repeated vitrectomy. Remaining 6 eyes required repeated vitrectomy. Choroidal effusion occurred in 4 eyes (7%) and resolved spontaneously within one week. Neovascular glaucoma occurred in 4 eyes (7%) and was treated with glaucoma implant surgery in 2 eyes, trabeculectomy with Mitomycin C in 1 ye, and cyclophotocoagulation in 1 eye. Retinal detachment developed postoperatively in 3 eyes (5%) and was treated successfully. Corneal epithelial defect persisting more than one week was present in 2 eyes (3%). Accidental mechanical lens damage occurred in one eye. The anatomical success rate was 98% (59 eyes). Visual acuity of 0.025 or better was obtained in 49 eyes (82%). Minimizing intraoperative complications as well as properly managing postoperative complications produced better surgical results.
Choroid ; Diabetic Retinopathy* ; Glaucoma ; Glaucoma, Neovascular ; Incidence* ; Intraoperative Complications ; Mitomycin ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Trabeculectomy ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

PURPOSE: To evaluate the efficacy of preoperative intravitreal bevacizumab injection (IVBI) and prognostic factors of surgical success in neovascular glaucoma patients, who underwent trabeculectomy. METHODS: A total of 58 patients (58 eyes) diagnosed with neovascular glaucoma who underwent trabeculectomy between 2003 and 2013 were enrolled in this retrospective study. Trabeculectomy with mitomycin C was performed between 2003 and 2006 and additional preoperative IVBI with the above mentioned technique was performed between 2007 and 2013. To evaluate the efficacy of preoperative IVBI, the patients were divided into the preoperative IVBI group and control group. Best corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured from preoperative to postoperative 12 months. To evaluate the prognostic factors related to surgical success, the following was investigated: age, lens status, preoperative IVBI, time interval between preoperative IVBI and trabeculectomy, previous vitrectomy and, postoperative complications. RESULTS: Trabeculectomy with mitomycin C only was performed in 26 eyes and additional preoperative IVBI was performed in 32 eyes. Surgical success was 81.3% in the IVBI group and 57.7% in the control group at postoperative 6 months (p = 0.012), and 78.1% in the IVBI group and 50.0% in the control group at postoperative 12 months (p = 0.021). Statistically significant IOP reduction effect was observed in the IVBI group (p = 0.048), and reduced anti-glaucoma eye drop usage was observed in the IVBI group (0.4) compared with 0.8 in the control group (p = 0.040). Postoperative hyphema (hazard ratio [HR] = 2.872, p = 0.044) and preoperative IVBI (HR = 0.280, p = 0.030) were considered risk factors for surgical failure in univariate analysis, however, only preoperative IVBI was statistically significant in multivariate analysis (p = 0.046). CONCLUSIONS: In neovascular glaucoma patients, preoperative IVBI before trabeculectomy is a good prognostic factor of surgical success and shows benefit in lowering the IOP and reducing anti-glaucoma eye drop usage at postoperative 1 year.
Glaucoma, Neovascular* ; Humans ; Hyphema ; Intraocular Pressure ; Mitomycin ; Multivariate Analysis ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Trabeculectomy* ; Visual Acuity ; Vitrectomy ; Bevacizumab

PURPOSE: To determine the clinical effect of radial optic neurotomy (RON) in central retinal vein occlusion (CRVO). METHODS: The retinal findings, visual acuity and complications were analyzed in patients who had undergone RON for the treatment of CRVO and were followed up 10 months or more after surgery. RESULTS: Of all 16 patients (16 eyes), the mean age was 55 years and the follow-up period was 14 months. Preoperative anterior segment and retinal neovascularization was observed in each three eyes. All eyes showed improvement in the retinal findings within two weeks after RON. The postoperative complications included vitreous hemorrhage in 1 eye, chorioretinal collateral circulation in 1 eye, neovascular glaucoma in 1 eye, vitreous hemorrhage and neovascular glaucoma in 1 eye. The visual acuity was counting fingers or less in 8 eyes preoperatively and in 2 eyes finally, and was less than 0.1 in 13 eyes preoperatively and in 10 eyes finally. The mean visual improvement in the 3.8 lines was in 11 eyes and a loss of 2.5 lines in 2 eyes. The maximum velocity of the blood flow of CRV improved with 1.95 +/- 0.93 cm/sec on the average in the 7 eyes examined by color doppler. CONCLUSIONS: RON appears to be safe and effective for improving the retinal findings, visual acuity and blood flow of CRV in CRVO. However, the visual recovery is limited.
Collateral Circulation ; Fingers ; Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Postoperative Complications ; Retinal Neovascularization ; Retinal Vein* ; Retinaldehyde ; Visual Acuity ; Vitreous Hemorrhage

As combined procedure with pars plana vitrectomy, pars plana lensectomy lowers the incidences of corneal edema and constriction of pupil, and elimi-nates the risk of corneal incision leakage.When intraocular lens is inserted, conventional procedure requires large anterior capsulectomy to prevent after-cataract.To maintain barrier between anterior and posterior seg-ments, anterior capsule was preserved and lens epithelial and cortical cells were polished off thoroughly with enhancement of visualization by intraocu-lar illuminator.Intraocular lenses were inserted into ciliary sulcus after vitrectomy.After a minimum of 1 year, postoperative vision was better in 17 of the 24 eyes (71%).the same in six eyes (25%)and worse in one eye (4%). Postoperative complications included after-cataract in 4 eyes (17%), decen-tration of intraocular lens in 2 eyes (8%), retinal detachment in 1 eye (4%) and neovascular glaucoma in 1 eye.Only two eyes required Nd:YAG laser capsulotomies. If intraocular illumination is utilized properly, lens epithelial and cortical cells can be removed thoroughly after pars plana lensectomy combined with vitrectomy and anterior capsule can be maintained without significant increase of after-cataract.
Constriction ; Corneal Edema ; Glaucoma, Neovascular ; Incidence ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Lighting ; Postoperative Complications ; Pupil ; Retinal Detachment ; Vitrectomy