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

No abstract available.
Aged ; Amnion/*transplantation ; Conjunctiva/*surgery ; Female ; Glaucoma/surgery ; Humans ; Intraoperative Complications/*surgery ; Trabeculectomy/*adverse effects

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

To report acute onset lens particle glaucoma associated with a spontaneous anterior capsular dehiscence. A 66-year-old man presented with spontaneous anterior lens capsule dehiscence with an acute onset of right eye pain that was associated with white particles in the anterior chamber angle and intraocular pressure (IOP) of 55 mmHg. No trauma or other inflammatory antecedents were reported. A hypermature cataract was observed at slit lamp exam. After medical treatment without IOP control, we performed extracapsular cataract extraction and anterior vitrectomy. Anterior chamber aspirate confirmed the presence of macrophages. The postoperative IOP at one month was 16 mmHg OD without medication. Spontaneous dehiscence of the anterior lens capsule in a patient with a hypermature cataract may release lens cortical material, resulting in lens particle glaucoma. Prompt surgical removal of the lens material usually controls the high IOP, and the need for additional glaucoma surgery is not common.
Aged ; Cataract ; Cataract Extraction ; Eye Injuries/*complications/surgery ; Glaucoma, Open-Angle/*diagnosis/*etiology/surgery ; Humans ; Male

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

To evaluate the efficacy of amniotic membrane in the management of painful bullous keratopathy secondary to the intractable glaucoma and in preventing exposure of drainage devices, we inserted Ahmed valve with amniotic membrane patch graft over the implant itself, and debrided corneal epithelium with amniotic membrane graft over the exposed stroma as a single operation. During the follow-up periods, we monitored vision, intraocular pressure (IOP), presence of ocular pain, and postoperative complications associated with the implants. The mean follow up period was 8.4+/-3.2 months. IOP was well controlled after the intervention. The preoperative mean IOP was measured as 43.9+/-9.0 mmHg and lowered to 16.1+/-1.8 mmHg at the last visit and no complications associated with the implants were noted. Even though the improvement in vision was not prominent, the ocular surface stabilized rapidly and ocular pain associated with bullous keratopathy disappeared soon after surgery. Conclusively the use of amniotic membrane in conjunction with Ahmed valve implantation is an effective way to relieve ocular pain and lessen the chances of complications associated with the implant in patients with intractable glaucoma and bullous keratopathy.
Retrospective Studies ; Middle Aged ; Male ; Humans ; *Glaucoma Drainage Implants ; Glaucoma/complications/surgery ; Female ; Epithelium, Corneal/pathology/surgery ; Corneal Transplantation/*methods ; Corneal Diseases/etiology/pathology/*surgery ; Amnion/*transplantation ; Aged

To evaluate the additive efficacy of postoperative low dose 5-FU subconjunctival injection, we analyzed 43 patients[43 eyes]who had undergone trabeculectomy or triple surgery with intraoperative MMC for 2.5~3min.18eyes[case group =MMC 5-FU group]of 43 eyes had postoperative low dose 5-FU injection additionally and 25 eyes[control group =MMC group]of which had only undergone intraoperative MMC. The mean[+/-SD]follow-up periods were 13.6 +/-5.3 months in MMC 5-FU group and 12.1 +/-3.6 months in MMC group.There was no statistically significant difference in preoperative IOP between the two groups[p>0.05].Mean postoperative intraocular pressures were 12.9 +/-4.2 mms of mercury in MMC 5-FU group and 13.3 +/-4.4 mms of mercury in MMC group at 12 months postoperatively[p>0.05]. Kaplan-Meier survival analysis showed that the cumulative success rates at 1.5 year were 82.6%and 87.2%in the case and control groups, respectively[p>0.05].Of the postoperative complications, corneal epithelial defect was more frequent in MMC 5-FU group[p<0.05]. In conclusion, postoperative injection of low dose 5-FU additionally did not have an additive effect on the IOP control in patients undergone MMC applied filtering surgery. We may need additional postoperative injection of higher dose of 5-FU.Or, we may need to individualize the duration of application or the concentration of intraoperative MMC to begin with.
Filtering Surgery* ; Fluorouracil ; Glaucoma* ; Humans ; Intraocular Pressure ; Mitomycin* ; Postoperative Complications ; Trabeculectomy

We conducted a retrospective study to compare surgical outcome and postoperative complications based on the time of subconjunctival injection of mitomycin C (MMC)in glaucoma filtering surgery. 10 eyes of 10 patients with glaucoma was injected subconjunctivally with 0.1 ml of 0.02 mg/ml MMC 12 hours before surgery (preoperative group).13 eyes of 12 patients was injected subconjunctivally with 0.1 ml of 0.02 mg/ml MMC just before making the conjunctival incision and waited 2 minutes before performing trabeculectomy (intraoperative group). Postoperative mean follow-up period were 15.3 months in preoperative group, and 14.2 months in intraoperative group. Preoperative mean IOPs were 25.9 +/-10.9 mmHg in preoperative group, and 37.5 +/-13.1 mmHg in intraoperative group.Postoperative mean IOP in 1, 3, 6, 12 months were 8.4 +/-6.8, 10.1 +/-5.1, 10.4 +/-4.9, 11 +/-3.7 mmHg in preoperative group, and 11.4 +/-7.8, 12.1 +/-8.2, 15.5 +/-5.2, 12.1 +/-7.0 mmHg in intraoperative group.There were statistically significant decreases of IOPs in both groups during follow-up period. We defined surgical success as following :1)IOP below 21 mmHg without any antiglaucomatous therapies ;2)postoperative intraocular pressure reduction exceeding 30%of preoperative intraocular pressure. The success rate by Kaplan-Meier method showed no statistical significance between two groups in each definition (p>0.05, log rank test). In conclusion, there was no difference in success rate between two groups. This result suggests that the antiproliferative effect of MMC persists at least 12 hours after subconjunctival injection and the preoperative subconjuctival injection can be more quantitative application method.Futher studies should be done to reduce avascular filtering bleb related complications.
Blister ; Filtering Surgery* ; Follow-Up Studies ; Glaucoma* ; Humans ; Intraocular Pressure ; Mitomycin* ; Postoperative Complications ; Retrospective Studies ; Trabeculectomy