The authors analysed 30 eyes that "Trabeculectomy ab externo" was performed in S.N.U.H. Trabeculectomy was preferable operation in simple glaucoma and even in chronic closed angle glaucoma, but in congenital glaucoma, goniotomy was more preferable than trabeculectomy. In its mode of action, trabeculectomy was regarded as a sort of filtering precedure.
Glaucoma ; Glaucoma, Open-Angle ; Trabeculectomy*

Thirty-three trabeculectomies were performed in various types of glaucoma during the periolf of May 1976 to May 1977. Mishima's modified method was applied as a surgical technique following the possible medical treatment controlling the normal I.O.P. before operations: the operations were performed without surgical microscoping in the most cases. Success was achieved in 26 (78.8%) of the 33 cases. Trabeculectomy was very effective in all pur cases of 5 chronic simple glaucoma and 3 chronic narrow angle glaucoma. However, in acute narrow angle glaucoma, we gained the good results in normotensive cases following medical treatment before operation, the results were not good in the cases that I.O.P. was not controlled despite of the vigrous medical treatment. It seemed that trabeculectomy was more advisable operation than goniotomy in long standing congenital glaucoma and in previously failed case with goniotomy. Success was achieved in 5 of 6 congenital glaucoma(4 previously failed with goniotomy and 1 with very severe buphthalmos). It seemed that, in the previously operated eye(e.g. in failed case with other glaucoma surgery or in aphakic glaucoma) the sound lower half was rather preferable to the upper half for operating site.
Glaucoma* ; Glaucoma, Open-Angle ; Trabeculectomy*

To evaluate clinical availability of the Dark Room Prone-position Test (DRPT), which is one of the provocative tests of angle-closure glaucoma, this study was carried out. Twenty nine patients (43 eyes) with primary angle-closure glaucoma (PACG) were enrolled, and seventeen primary open angle glaucoma (POAG) patients (34 eyes) arld fourty one normal persons (82 eyes) were used as control group. After DRPT, P ACG showed statistically significant intraocu lar pressure (IOP) rise of 6.3 +/- 6.82mmHg as compared with group of POAG or normal 2.0 +/- 2.04mmHg and 1.4 +/- 1.47mmHg, respectively (p<0.05). Fifteen eyes among 43eyes (34.9%) of PACG showed DRPT positive defined as over 7mmHg rise after DRPT, and the final IOP of DRPT over 21mmHg showed significant DRPT positive (43.5%) than that of under 20mmHg (0.00%) (p<0.05). Glaucomatous attack was more occurred 1.9 times in DRPT postive group than in DRPT negative one.
Glaucoma, Angle-Closure* ; Glaucoma, Open-Angle ; Humans

Several kinds of non-contact tonometers have been used since the first non-contact tonometer was introduced in the 1970's in order to measure intraocular pressure with easiness and accuracy. However several problems were still remained because of:he inaccuracy of the non-contact tonometer in high and low range of intraocular pressure. A new non-contact tonometer (Model CT-20, Japan) was recently introduced by Topcon Company to evaluate the clinical efficacy of the non-ccntact tonometers. The authors measured the intraocular pressure with Topcon tonometer, AO tonometer and Pulsair non-contat tonometer and compared the results with those measured with Goldmann tonometer. The results were as follows: 1) The correlation coefficient between Goldmann and Topcon tonometer was 0.8452 (p=0.001), Goldmann and Pulsair tonometer was 0.7084 (p=O.OOl) and Goldmann and AO tonometer was 0.6048 (p=O.OOl) in the normal eyes. 2) The correlation coefficient between Goldmann and Topcon tonometer was 0.8651 (p=0.0001) in the ocular hypertensive or open angle glaucoma eyes. 3) The correlation coefficient between Goldmann and Topcon tonometer was 0.6987 (p=0.000l) in the low lOP eyes. 4) The correlation coefficient between Goldmann and Topcon tonometer was 0.6829 (p=0.0001) in the high myopic eyes. As above, a new-contact tonometer (Model CT-20, Japan) made by Topcon Company was relatively accurate in measuring not only the intraocular pressure of normal eyes but that of ocular hypertensive, low IOP and high myopic eyes.
Glaucoma, Open-Angle ; Intraocular Pressure

The options for surgical control of intraocular pressure (IOP) in open-angle glaucoma (OAG) patients are expanding. In the last few years, traditional glaucoma filtration surgery is being challenged with the introduction of new surgical approaches and implants that offer innovative solutions to safely lower IOP in OAG eyes. These new procedures and devises are collectively termed as Minimally Invasive Glaucoma Surgery or MIGS. They involve an ab interno approach and are oftentimes done in conjunction with cataract surgery. The following techniques and devices fall under the category of MIGS1 :
Glaucoma, Open-Angle ; Intraocular Pressure

To find the factors that affect on the success rate of the trabeculectomy, we investigated 208 eyes of 158 patients with various types of glaucoma which had undergone trabeculectomy. The patients were followed up at least 3 month postoperatively. The criteria of success was maintenance of postoperative IOP below 21 mmHg. The total success rate was 89.4%. In young patients, the success rate was lower than that of older ones. The success rate of open angle glaucoma, acute angle closure glaucoma and chronic angle closure glaucoma were higher than that of congenital glaucoma and secondary glaucoma. Recently performed operation demonstrated higher success rate. The type of conjunctival flap, scleral flap and use of 5-fluorouracil were independent factors that affect on the success rate.
Fluorouracil ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Trabeculectomy*

PURPOSE: To compare the characteristics of visual field defect in primary open-angle glaucoma (HTG), normal-tension glaucoma (NTG) and primary angle-closure glaucoma (ACG). METHODS: We investigated the visual field defect of HTG (n=75), NTG (n=58), ACG (n=150) patients from March 2000 to November 2002. We compared the severity and asymmetry of the visual field defect in both eyes, the asymmetry of a more severely affected hemifield between both eyes, and the frequency of an early visual field defect with equivalently affected superior and inferior hemifield. RESULTS: The visual field defect was the severest in HTG, and the mildest in ACG. Asymmetry in severity of visual field defect between both eyes was the severest in HTG, and the mildest in NTG. The asymmetry of the affected hemifield between both eyes in terms of superior and inferior hemifields was most frequent in NTG. The frequency of the early visual field defect with equivalently affected superior and inferior hemifields occured mostly in NTG. ACG without an attack history had a more severe visual field defect than that with an attack history. CONCLUSIONS: The topographical pattern of the visual field defect was different in HTG, NTG, and ACG. There may be different pathophysiological mechanisms in the three types of primary glaucoma.
Glaucoma* ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Visual Fields*

PURPOSE: To investigate the measurement repeatability of peripapillary atrophy (PPA) parameters obtained by optic disc stereophotography (ODP) and evaluate the usefulness of PPA parameters to differentiate open-angle glaucoma (OAG) from normal eyes in patients with PPA. METHODS: Sixty-five eyes of 65 patients with PPA were examined. Disc area, cup area, rim area, vertical cup to disc (CD) ratio, CD area ratio, PPA area, zone beta (beta) area and zone alpha (alpha) area were obtained by ODP using intrinsic algorithms. The area under the receivers operating characteristic (AUROC) curves was used to compare the PPA parameters with that of the disc parameters to differentiate OAG from normal eyes. Two examiners analyzed PPA parameters to confirm reproducibility and repeatability of ODP. RESULTS: Vertical CD ratio (VCD), area CD ratio, zone beta area, zone beta area per PPA area, zone beta area per disc area and axial length were significantly larger in OAG patients (p < 0.05). Among PPA parameters, zone beta area per PPA area was strongly correlated with MD (r =-0.431) and PSD (r = 0.411). In addition, PPA (area) to disc area ratio showed the best diagnostic ability (AUROC curve value of 0.786) when comparing the OAG group to the normal group. PPA area and zone beta area obtained by ODP showed good reproducibility and repeatability (ICC > 0.997). CONCLUSIONS: The PPA measurement obtained by ODP has good reproducibility and consistency and can be a useful tool in monitoring PPA changes in glaucoma patients.
Atrophy* ; Glaucoma ; Glaucoma, Open-Angle ; Humans

PURPOSE: To compare dorzolamide-timolol fixed combination (DTFC) and latanoprost with regard to their effects on intraocular pressure (IOP) and ocular pulse amplitude (OPA). METHODS: Sixty eyes of 60 patients with open angle glaucoma or glaucoma suspect were included in the present study. Patients were divided into 2 groups, DTFC-treated (n = 30) and latanoprost-treated (n = 30). IOP and OPA were measured with dynamic contour tonometer (DCT) and Goldmann applanation tonometer (GAT), before and at least 1 month after treatment. RESULTS: GAT IOP, DCT IOP and OPA decreased by 2.25 +/- 2.23 mm Hg, 1.97 +/- 2.06 mm Hg, and 0.14 +/- 0.88 mm Hg, respectively in the DTFC-treated group. In the latanoprost-treated group, GAT IOP, DCT IOP and OPA was reduced by 2.74 +/- 2.96 mm Hg, 2.06 +/- 3.50 mm Hg, and 0.69 +/- 1.07 mm Hg, respectively. There was no significant difference (p = 0.311) in the decline of IOP between the 2 groups, but OPA of the DTFC-treated group decreased less than the latanoprost-treated group (p = 0.032). CONCLUSIONS: No significant differences were observed in the short-term decline of IOP between the 2 medications. However, the influence of DTFC on OPA appeared negligible in the latanoprost-treated group.
Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure*

To identify the pattern of glaucomatous changes of the optic disc, the rim area to disc area ratio (RA/DA ratio) of 149 eyes (149 cases) with primary open-angle glaucoma (POAG) were measured and compared with that of 88 eyes (88 cases) of normal individuals. At all stages of the disease, glaucomatous rim loss was present in all sectors of the optic disc. The location of the most pronounced rim loss changed depending on the severity of the disease. In the early (RA/DA ratio > 61%; mean deviation(MD): -6.43+/-3.32dB) and medium (RA/DA ratio=41~60%; MD: -7.54+/-5.65dB) glaucoma subgroups, rim loss was found predominantly at the inferior temporal and superior temporal disc region. In the advanced glaucoma subgroup (RA/DA ratio=40~21%; MD: -18.27+/-8.40dB), the temporal horizontal disc region showed relatively marked rim loss. In the far advanced glaucoma subgroup (RA/DA ratio=20~0%; MD: -25.91+/-5.40dB), the rim remnants were located mainly in the nasal disc sector, with a larger rim portion in the upper nasal region than in the lower nasal region. These results indicate that generally in POAG, the loss of neuroretinal rim was found to start predominantly in the inferior temporal and superior temporal disc region, and then the temporal horizontal, the inferior nasal, and the superior nasal disc sectors followed.
Glaucoma ; Glaucoma, Open-Angle* ; Optic Disk