1.Clinical Results of Sutureless Phacotrabeculectomy.
Jae Woo KIM ; Chul Ho PARK ; Chang Wook HAN
Journal of the Korean Ophthalmological Society 1996;37(5):739-745
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
2.Trabeculectomy with Mitomycin C(MMC).
Yong Su CHO ; Young Joo CHOE ; Young Jae HONG
Journal of the Korean Ophthalmological Society 1995;36(6):915-923
Mitomycin C has an inhibitory effect on the proliferation of fibroblasts and it is used as an adjunct to trabeculectomy. To clarify the effects of mitomycin C on trabeculectomy, we ana lysed 95 eyes that received trabeculectomy with mitomycin C and 90 eyes that received trabeculectomy without mitomycin C. There were no significant differences in sex, age, type of glaucoma and preoperative intraocular pressure (IOP) between two groups (p>0.05 respectively). The mean rops at 6 months after surgery and the success rate were not significantly different between two groups (p>0.05). But considering the mean IOP of successful cases, the mitomycin C used group showed the lower postoperative IOP(p<0.05). The rate of complete seccess which had no antiglaucoma medications and 5-fluorouracil administration during the postoperative period was higher in the mitomycin C used group (p<0.05). Postoperative complications, espicially hypotony, were more common in the mitomycin C used patients. Hypotony was more frequent in the patients who received brief exposure of mitomycin C. Most of the hypotony patients had primary open angle glaucoma and lower preoperative IOP. According to the results of our study, mitomycin C should be used in the high risk group patients who are young and have secondary glaucoma or history of failure of filtering procedures, and also in the patients with difficulty of postoperative medical treatment and requiring lower IOP.
Fibroblasts
;
Fluorouracil
;
Glaucoma
;
Glaucoma, Open-Angle
;
Humans
;
Intraocular Pressure
;
Mitomycin*
;
Postoperative Complications
;
Postoperative Period
;
Trabeculectomy*
3.Ab Interno Trabeculotomy with Trabectome(R) for Refractory Primary Open-Angle Glaucoma: A Case Report.
Heeyoung CHUNG ; Jaewan CHOI ; Jin Young CHOI ; Yeon Deok KIM
Journal of the Korean Ophthalmological Society 2011;52(4):502-506
PURPOSE: To report a case of ab interno trabeculotomy with Trabectome(R) (NeoMedix Corp., CA, USA) conducted on a refractory primary open angle glaucoma (POAG) patient. CASE SUMMARY: Trabectome(R) has microelectrocautery with simultaneous infusion and aspiration of debris and ablates a segment of trabecular meshwork and the inner wall of Schlemm's canal. The patient, a 54-year-old man had uncontrolled intraocular pressure (IOP) with topical anti-glaucoma medications after trabeculectomy and Ahmed valve implantation for POAG. For the patient, ab interno trabeculotomy with Trabectome(R) was performed. There were no other postoperative complications except for microhyphema immediately after surgery. The IOP was controlled between 14 to 24 mm Hg up to 3 months postoperatively with topical anti-glaucoma medications (Cosopt(R), Alphagan-P(R), Lumigan(R)). CONCLUSIONS: Ab interno trabeculotomy with Trabectome(R) appears to offer a newer method of lowering IOP in POAG than conventional trabeculectomy and glaucoma drainage device surgery.
Drainage
;
Glaucoma
;
Glaucoma, Open-Angle
;
Humans
;
Intraocular Pressure
;
Middle Aged
;
Postoperative Complications
;
Trabecular Meshwork
;
Trabeculectomy
4.Trabeculectomy for Medically Uncontrolled Acute Primary Angle-Closure Glaucoma.
Mun Hee CHANG ; Chung Kwon YOO ; Yong Yeon KIM
Journal of the Korean Ophthalmological Society 2009;50(8):1242-1246
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
5.Trabeculectomy for Medically Uncontrolled Acute Primary Angle-Closure Glaucoma.
Mun Hee CHANG ; Chung Kwon YOO ; Yong Yeon KIM
Journal of the Korean Ophthalmological Society 2009;50(8):1242-1246
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
6.Effect of Intraoperative Mitomycin C in High-risk Glaucoma Filtering Surgery.
Seong Wook SEO ; Ji Hong BAE ; Joon Kyeong SONG
Journal of the Korean Ophthalmological Society 1993;34(5):432-435
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
7.Effect of Intraoperative Mitomycin C in High-risk Glaucoma Filtering Surgery.
Seong Wook SEO ; Ji Hong BAE ; Joon Kyeong SONG
Journal of the Korean Ophthalmological Society 1993;34(5):432-435
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
8.Surgical Results of Repeated Trabeculectomy in Congenital Glaucoma.
Kyung Hyup MIN ; Jung Chul SHIN ; Chan Yun KIM ; Gong Jae SUNG ; Young Jae HONG
Journal of the Korean Ophthalmological Society 2005;46(12):2016-2020
PURPOSE: To investigate the surgical results of repeated trabeculectomy in primary congenital glaucoma. METHODS: The authors retrospectively reviewed the data of 16 patients (23 eyes) who underwent two or more trabeculectomies with or without mitomycin C for primary congenital glaucoma between 1990 and 2004. Surgical success rate and postoperative complications were assessed. The relationship between the use of mitomycin C and the surgical outcomes was also studied. RESULTS: Among the 23 eyes, 10 had a history of previously failed goniotomy or trabeculotomy and 6 eyes had undergone trabeculectomy more than 3 times. The overall success rate of repeated trabeculectomy was 63.9% and the success rate of the 14 eyes operated on with mitomycin C was not higher than that of the 9 eyes that did not receive mitomycin C (p=0.166). Two eyes were reported to have postoperative hypotony and there was one case of endophthalmitis after trabeculectomy; however, the use of mitomycin C did not increase the overall rate of surgical complication (p=1.00). CONCLUSIONS: Repeated trabeculectomy can be considered as a procedure to treat primary congenital glaucoma, particularly in severe cases of congenital glaucoma.
Endophthalmitis
;
Glaucoma*
;
Humans
;
Mitomycin
;
Postoperative Complications
;
Retrospective Studies
;
Trabeculectomy*
9.The Effect of Transscleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma.
Journal of the Korean Ophthalmological Society 1999;40(8):2252-2258
The purpose of this study was to validate the efficacy of transscleral diode laser cyclophotocoagulation (CPC)procedure in refractory glaucoma cases for which conventional medical or surgical filtering procedures had failed or were thought to have a poor likelihood of success. Thirty-eight eyes of 38 consecutive patients with refractory glaucoma received transscleral diode CPC. Patients were followed for a mean of 5.5 months. We reviewed available data at preoperative state and at 1 day, 1week, 1 month, 2 months and 4 months postoperatively. Data analyzed were visual acuity, intraocular pressure(IOP)and postoperative complications. There was a statistically significant decrease in IOP at postoperative 1day, 1 week, 1 month, 2 months and 4 months compared with preoperative IOP. Postoperative complications were hyphema in 4 eyes and fibrinousuveitis in 1 eye but all of these complications were controlled with medical treatment. We concluded that transscleral diode CPC could be a good treatment proce-dure for the IOP control in refractory glaucoma cases.
Glaucoma*
;
Humans
;
Hyphema
;
Lasers, Semiconductor*
;
Postoperative Complications
;
Visual Acuity
10.Factors Associated with Outcomes of Combined Phacoemulsification and Ahmed Glaucoma Valve Implantation.
Korean Journal of Ophthalmology 2018;32(3):211-220
PURPOSE: To evaluate outcomes and factors associated with surgical failure in patients who underwent combined phacoemulsification and Ahmed glaucoma valve (AGV) implantation. METHODS: This retrospective and longitudinal study enrolled 40 eyes (38 patients) that underwent combined phacoemulsification and AGV implantation. Visual acuity, intraocular pressure (IOP), and number of antiglaucoma medications were evaluated preoperatively and postoperatively. Complete success was defined as a last follow-up IOP of 6 to 21 mmHg without medication, qualified success as an IOP of 6 to 21 mmHg with medication, and failure as an IOP of >21 or <6 mmHg. RESULTS: The mean follow-up period was 18 ± 10 months. Preoperative diagnoses were chronic angle closure glaucoma (35.0%), neovascular glaucoma (22.5%), uveitic glaucoma (17.5%), primary open-angle glaucoma (15.0%), and other (10.0%). IOP decreased from a mean of 30.5 ± 8.7 to 14.5 ± 3.7 mmHg at the last follow-up visit (p < 0.001). Treatment was classified as qualified success in 18 eyes (45%), complete success in 15 (37.5%), and failure in seven (17.5%). Twenty-two eyes (55%) showed improvement in visual acuity. The most common postoperative complication was a transient hypertensive phase (five eyes, 12.5%). Tube-iris touch was associated with surgical failure (hazard ratio, 8.615; p = 0.008). CONCLUSIONS: Combined phacoemulsification and AGV implantation is an effective and safe surgical option for patients with refractory glaucoma and cataract. Postoperative tube-iris touch is an indicator of poor prognosis.
Cataract
;
Diagnosis
;
Follow-Up Studies
;
Glaucoma Drainage Implants
;
Glaucoma*
;
Glaucoma, Angle-Closure
;
Glaucoma, Neovascular
;
Glaucoma, Open-Angle
;
Humans
;
Intraocular Pressure
;
Longitudinal Studies
;
Phacoemulsification*
;
Postoperative Complications
;
Prognosis
;
Retrospective Studies
;
Visual Acuity