- MeSH
- bolest očí * chirurgie etiologie radioterapie terapie MeSH
- ganglia parasympatická chirurgie diagnostické zobrazování MeSH
- glaukom chirurgie komplikace MeSH
- lidé MeSH
- oftalmologické chirurgické výkony * MeSH
- poranění oka chirurgie komplikace MeSH
- radiochirurgie metody MeSH
- senioři MeSH
- slepota etiologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- kazuistiky MeSH
Aims: To compare the changes of central corneal thickness (CCT) and intraocular pressure (IOP) post-phacoemulsification between cataract patients with and without pre-existing glaucoma. Materials and methods: A prospective cohort study of 86 patients with visually significant cataract: 43 with pre-existing glaucoma (GC group) and 43 without pre-existing glaucoma (CO group). CCT and IOP were evaluated at baseline (pre-phacoemulsification), as well as at 2 hours, 1 day, 1 week and 6 weeks post-phacoemulsification. Results: The GC group have significantly thinner CCT pre-operatively (p = 0.003). There was a steady increase of CCT with the highest peak at 1 day post-phacoemulsification, followed by a steady decline of CCT and back to baseline at 6 weeks post-phacoemulsification in both groups. The GC group demonstrated a significant difference in CCT at 2 hours (mean difference 60.2 μm, p = 0.003) and 1 day (mean difference 70.6 μm, p = 0.002) post-phacoemulsification, compared to the CO group. There was a sudden increase in IOP at 2 hours post-phacoemulsification measured by GAT and DCT in both groups. This was followed by a gradual reduction of IOP, with significant reduction at 6 weeks post-phacoemulsification in both groups. However, there was no significant difference in IOP between the two groups. IOP measured by GAT and DCT showed strong correlation (r > 0.75, p < 0.001) in both groups. There was no significant correlation between GAT-IOP and CCT changes; nor between DCT-IOP and CCT changes in both groups. Conclusions: CCT changes post-phacoemulsification in patients with pre-existing glaucoma were similar, in spite of having thinner CCT pre-operatively. IOP measurement was not affected by CCT changes in glaucoma patients post-phacoemulsification. IOP measurement using GAT is comparable with DCT post-phacoemulsification.
- MeSH
- amblyopie etiologie MeSH
- anizometropie etiologie MeSH
- glaukom * chirurgie diagnostické zobrazování diagnóza vrozené MeSH
- kojenec MeSH
- lidé MeSH
- nemoci rohovky diagnóza klasifikace patologie MeSH
- oči patologie MeSH
- trabekulektomie metody MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Aim of the study: To compare the intraocular pressure (IOP) lowering effect and postoperative complications between primary augmented trabeculectomy and glaucoma drainage device (GDD) implantation as primary surgical intervention in patients with juvenile-onset open angle glaucoma (JOAG). Patients and Methods: A retrospective review study involving 20 eyes that underwent primary augmented trabeculectomy with mitomycin (MMC) and 10 eyes GDD implantation in 3 tertiary centres in Malaysia between 1 January 2013 and 31 December 2019. They were followed up for at least 12 months postsurgical intervention. Intraocular pressure (IOP), number of topical IOP lowering medication and complications were evaluated at 1, 3, 6 and 12 months post-intervention. Based on the IOP, the success was divided into complete and partial success, and failure. IOP and postsurgical complications were compared using the Repetitive Measure Analysis of Variance (RM ANOVA) and the Pearson chi-square test. Results: Both methods were effective in lowering the IOP. Eyes with primary augmented trabeculectomy have significant lower IOP compared to GDD implantation (p = 0.037). There was a higher incidence of postoperative hypotony (30%) in the trabeculectomy group. There was also a significant reduction of mean number of topical pressure-lowering drugs required postoperatively (p = 0.015). Complete success was achieved in 100% of eyes with trabeculectomy and 67% in GDD implantation (p = 0.047). Conclusions: Primary augmented trabeculectomy and GDD implantation are good surgical options for the treatment of JOAG. Both methods provide IOP lowering at 1 year. However, trabeculectomy provides better pressure lowering, compared to GDD implantation in patients with JOAG.
PURPOSE: To present a case series of a modified three-quarter Descemet's membrane endothelial keratoplasty (3/4-DMEK) technique to treat pseudophakic bullous keratopathy in the presence of a glaucoma drainage device (GDD) tube in the anterior chamber by reducing the risk of donor endothelial damage due to absence of donor endothelial cells overlying the GGD tube area. METHODS: In this prospective case series, four eyes of three patients with stable glaucoma underwent 3/4-DMEK surgery for pseudophakic bullous keratopathy after GDD insertion. The patients were followed up to 24 ± 2.5 months postoperatively. RESULTS: No intraoperative or postoperative complications were noted. The average central endothelial cell density (ECD) was 1093 ± 74 cells/mm2 at 12 months postoperatively, corresponding to an ECD decrease of 58 (±6)% as compared to preoperative values. Average best-corrected visual acuity increased from finger counting before surgery to 20/60 (logMar 0.5) at 12 months after 3/4-DMEK and remained stable up to 24 months postoperatively. All corneas remained clear at the last available follow-up. CONCLUSION: This case series demonstrates the technical feasibility of 3/4-DMEK in eyes with pseudophakic bullous keratopathy in the presence of a GDD tube. The absence of a donor DM and donor cells above the silicone tube excludes direct tube contact with the graft. Longer term studies are needed to show the effect of this modified graft pattern and dimensions on transplant survival.
- MeSH
- časové faktory MeSH
- drenážní implantáty glaukomové * MeSH
- glaukom etiologie patofyziologie chirurgie MeSH
- lidé MeSH
- následné studie MeSH
- přežívání štěpu MeSH
- prospektivní studie MeSH
- protézy - design MeSH
- pseudofakie komplikace MeSH
- refrakce oka MeSH
- rejekce štěpu prevence a kontrola MeSH
- rohovkový endotel transplantace MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zadní lamelární keratoplastika metody MeSH
- zraková ostrost * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Excimer laser refractive surgery is a procedure performed worldwide to solve refractive errors and reduce dependence on glasses or contact lenses. There has been an increase in the number of procedures performed around the world. Myopia is the most common indication for corneal photorefractive surgery. Myopic patients have a higher risk of developing some type of glaucoma in their lifetime, such as primary open-angle glaucoma and others. Refractive surgery ablates central corneal stromal tissue, altering its thickness and biomechanics, which in turn makes it difficult to accurately measure intraocular pressure (IOP), since it underestimates it. This underestimation of IOP may delay the diagnosis of de novo glaucoma in patients with a history of refractive surgery. Each patient who wishes to undergo corneal refractive surgery should undergo a thorough glaucoma examination in order to monitor and detect the possible development and / or progression of glaucoma. A very useful practical approach is to perform a series of IOP measurements before and after surgery, when the eye is already stable, and the difference between the averages of the two sets of readings can then be used as a personalised correction factor for postoperative IOP monitoring in that eye. Also, if there is any suspicion of a possible glaucoma, paraclinical tests, such as coherent optical tomography of the retinal nerve fibre layer (RNFL), visual fields and photos of the optic nerve should be requested. All this data prior to refractive surgery should be provided to these patients, so that they can save it and give it to their treating ophthalmologists in the future.
- MeSH
- glaukom s otevřeným úhlem * chirurgie MeSH
- glaukom * chirurgie MeSH
- laserová modelace rohovky pod rohovkovou lamelou * MeSH
- lasery excimerové terapeutické užití MeSH
- lidé MeSH
- následné studie MeSH
- nitrooční tlak MeSH
- refrakční chirurgické výkony * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Cíl: Zjistit účinek intrakamerální aplikace triamcinolon acetonidu (TA) na chirurgický úspěch v případech 5-fluorouracilem (5-FU) podporovaných primárních fakotrabekulektomií (PT). Metody: Tato retrospektivní studie zahrnovala 23 očí (studijní skupina) 23 pacientů, kteří podstoupili intrakamerální aplikaci TA během PT a 26 očí (kontrolní skupina) 26 pacientů bez aplikace TA. Pacienti s PT ve studované skupině dostávali intraoperačně 1 mg TA na konci operace. Byla porovnána pre- a pooperační zraková ostrost, nitrooční tlak (IOP) a počet použitých antiglaukomatik. U obou skupin byly hodnoceny pooperační komplikace a potřeba aplikace injekce 5-FU. Výsledky: Průměrný věk byl v kontrolní skupině 64,12 ± 1,91 (48–86) let a ve studijní skupině 66,52 ± 2,02 (52–86) let (p = 0,824). Porovnání hodnot IOP před a po operaci ukázalo významné snížení pooperačního IOP ve všech časových bodech v kontrolní i studijní skupině (p < 0,001). Jediný významný rozdíl mezi skupinami byl v pooperační den 1 (studijní skupina: 9,22 ± 1,41 mmHg; kontrolní skupina: 6,35 ± 2,17 mmHg, p < 0,001). Potřeba pooperační injekce 5-FU byla signifikantně častější v kontrolní skupině (p = 0,023). Závěr: Intrakamerální injekce 1 mg TA na konci operace PT nepřinesla lepší výsledky v pooperačním IOP ve srovnání s PT samotnou a obě skupiny vykazovaly podobné snížení IOP. Když je 1 mg TA podáván jako doplněk k PT, potlačuje zánět předního segmentu a snižuje potřebu injekce 5-FU.
Aims: To investigate the effect of intracameral triamcinolone acetonide (TA) on surgical success in 5-fluorouracil (5-FU) supported primary phacotrabeculectomy (PT) cases. Material and Methods: This retrospective study included 23 eyes (study group) of 23 patients who underwent TA during PT and 26 eyes (control group) of 26 patients without TA. PT patients in the study group received 1 mg TA intraoperatively at the end of surgery. Pre- and postoperative visual acuity, intraocular pressure (IOP), and number of antiglaucoma drugs used were compared. Postoperative complications and need for 5-FU injection were evaluated for both groups. Results: Mean age was 64.1 2 ± 1.91 (48–86) years in the control group and 66.52 ± 2.02 (52–86) years in the study group (p = 0.824). Comparison of pre- and postoperative IOP values showed significant decreases in postoperative IOP levels at all-time points in both the control and study groups (p < 0.001). The only significant difference between groups was on postoperative first day (study group: 9.22 ± 1.41 mmHg; control group: 6.35 ± 2.17 mmHg, p < 0.001). Need for postoperative 5-FU injection was significantly more common in the control group (p = 0.023). Conclusion: Intracameral injection of 1 mg TA at the end of PT surgery did not yield superior results in postoperative IOP compared to PT alone, and the two groups showed similar IOP reduction. When given as an adjunct to PT, 1 mg TA suppresses anterior segment inflammation and reduces the need for 5-FU injection.
- MeSH
- fluoruracil terapeutické užití MeSH
- glaukom * chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- trabekulektomie metody MeSH
- triamcinolonacetonid * terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
