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[PMID]:29310612
[Au] Autor:Song YJ; Kim S; Yoon GJ
[Ad] Endereço:Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea.
[Ti] Título:Impending extrusion of Ex-PRESS shunt treated by shunt-position adjustment: a case report.
[So] Source:BMC Ophthalmol;18(1):4, 2018 Jan 08.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To report a case of impending extrusion of Ex-PRESS shunt treated by shunt-position adjustment. CASE PRESENTATION: A 56-year-old Asian woman presented with impending extrusion and malposition of Ex-PRESS shunt in her left eye. The bleb of the left eye was shallow and diffuse. In the past, the patient was treated by Ex-PRESS shunt implantation under the scleral flap in both eyes. There had been no Ex-PRESS shunt-related complication in her right eye, and she reported no history of left-eye trauma. Based on these findings, we hypothesized that the source of the left-eye problem was a loosely fixed Ex-PRESS shunt spur. It was thought, furthermore, that this inadequate scleral resistance during the Ex-PRESS shunt implantation was due to the low scleral rigidity resulting from high myopia and insufficient maintenance of the anterior chamber. We proceeded to make an incision in the area adjacent to the Ex-PRESS shunt using a super sharp blade. The shunt was then pushed into the anterior chamber with forceps, and the spur was fixed firmly. Pushing the shunt to the anterior chamber was found to have been sufficient to fix it firmly. In fact, when the sclera was palpated with a sponge, aqueous outflow was observed with no shunt displacement. Postoperative intraocular pressure (IOP) was managed well, and the bleb had formed with diffuse, prominent shapes. The Ex-PRESS shunt was well sustained with good positioning. CONCLUSIONS: When an Ex-PRESS shunt operation is performed on a patient who shows a tendency for low scleral rigidity, shunt implantation should be accomplished carefully and with force adequate for firm spur fixation.
[Mh] Termos MeSH primário: Implantes para Drenagem de Glaucoma/efeitos adversos
Glaucoma/cirurgia
Pressão Intraocular/fisiologia
Esclera/cirurgia
Retalhos Cirúrgicos
Trabeculectomia/métodos
[Mh] Termos MeSH secundário: Câmara Anterior
Feminino
Glaucoma/fisiopatologia
Seres Humanos
Meia-Idade
Período Pós-Operatório
Falha de Prótese
Reoperação
Tonometria Ocular
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-017-0665-2


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[PMID]:29422751
[Au] Autor:Marco S; Damji KF; Nazarali S; Rudnisky CJ
[Ad] Endereço:Department of Ophthalmology, University of Nairobi, Nairobi, Kenya.
[Ti] Título:Cataract and Glaucoma Surgery: Endoscopic Cyclophotocoagulation versus Trabeculectomy.
[So] Source:Middle East Afr J Ophthalmol;24(4):177-182, 2017 Oct-Dec.
[Is] ISSN:0975-1599
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To compare the efficacy and safety of endoscopic cyclophotocoagulation (ECP) versus trabeculectomy with mitomycin C (trab) in combination with cataract surgery. MATERIALS AND METHODS: We evaluated the 6-month results of patients undergoing phacoemulsification (phaco) with either ECP or trab. The primary outcome was mean intraocular pressure (IOP) at 6 months; secondary outcomes were change in glaucoma medications, visual acuity, intraocular inflammation, and postoperative complications. Complete success was a target IOP of <21 mmHg and >6 mmHg without glaucoma medications. Qualified success was target IOP achieved through glaucoma medications. RESULTS: We evaluated 53 eyes of 53 patients; 24 (45.3%) eyes were treated with ECP-phaco and 29 (54.7%) with trab-phaco. At 6 months, there was no significant difference in mean IOP of the two groups (ECP-phaco 14.2 ± 3.6 mmHg; trab-phaco 13.0 ± 2.5 mmHg; = 0.240). Six (25.0%) ECP-phaco eyes and 20 (69.0%) trab-phaco eyes achieved complete success ( = 0.002). Qualified success was achieved in 18 (75.0%) ECP-phaco eyes and 9 (31.0%) trab-phaco eyes ( = 0.002). The mean reduction of medication from baseline was significant (ECP-phaco 1.2 ± 1.1; trab-phaco 2.1 ± 1.5; = 0.020). ECP-phaco resulted in more IOP spikes on the 1 postoperative day ( = 0.040) and more anterior cellular reaction at 1 week and 1 month compared to trab-phaco ( < 0.05). The rate of postoperative complications was not significantly different between groups. CONCLUSION: At 6 months, ECP-phaco demonstrated similar improvements in IOP and visual acuity compared to trab-phaco. However, ECP-phaco patients had higher incidences of immediate postoperative IOP spikes and anterior chamber inflammation as well as requiring additional medications postoperatively.
[Mh] Termos MeSH primário: Corpo Ciliar/cirurgia
Glaucoma/cirurgia
Fotocoagulação a Laser/métodos
Facoemulsificação
Trabeculectomia/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Alquilantes/administração & dosagem
Endoscopia
Feminino
Glaucoma/fisiopatologia
Seres Humanos
Pressão Intraocular/fisiologia
Masculino
Meia-Idade
Mitomicina/administração & dosagem
Tonometria Ocular
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Alkylating Agents); 50SG953SK6 (Mitomycin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE
[do] DOI:10.4103/meajo.MEAJO_232_16


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[PMID]:28450776
[Au] Autor:Tolesa K; Gebreal GW
[Ad] Endereço:Department of Ophthalmology, Jimma University, Ethiopia.
[Ti] Título:Brainstem Anesthesia after Retrobulbar Block: A Case Report and Review of Literature.
[So] Source:Ethiop J Health Sci;26(6):589-594, 2016 Nov.
[Is] ISSN:2413-7170
[Cp] País de publicação:Ethiopia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Retro-bulbar anesthesia is one of the most common regional blocks used for intraocular surgeries. Complications associated with regional blocks may be limited to the eye or may be systemic. CASE REPORT: After a retro-bulbar block for glaucoma surgery, a 60-year-old man developed loss of consciousness, apnea with hypotension and bradycardia-features of brainstem anesthesia. We present the clinical features, treatment and comments on how to prevent the problem as well as a review of the literature on reported cases. CONCLUSION: Although it is rare, treating physicians should be aware of the potentially lethal consequences of retro-bulbar block, understand measures to reduce the risks and early recognition and treatment. Facilities where ophthalmic surgeries are performed under local anesthesia should be properly equipped and staffed for advanced resuscitation.
[Mh] Termos MeSH primário: Anestésicos Locais/efeitos adversos
Tronco Encefálico/efeitos dos fármacos
Bupivacaína/efeitos adversos
Trabeculectomia/efeitos adversos
[Mh] Termos MeSH secundário: Anestésicos Locais/administração & dosagem
Apneia/induzido quimicamente
Bupivacaína/administração & dosagem
Glaucoma/cirurgia
Seres Humanos
Hipotensão/induzido quimicamente
Masculino
Meia-Idade
Trabeculectomia/métodos
Inconsciência/induzido quimicamente
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Local); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29183045
[Au] Autor:Shin JW; Sung KR; Uhm KB; Jo J; Moon Y; Song MK; Song JY
[Ad] Endereço:Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
[Ti] Título:Peripapillary Microvascular Improvement and Lamina Cribrosa Depth Reduction After Trabeculectomy in Primary Open-Angle Glaucoma.
[So] Source:Invest Ophthalmol Vis Sci;58(13):5993-5999, 2017 Nov 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To evaluate peripapillary microvascular changes in patients with primary open-angle glaucoma (POAG) after trabeculectomy using optical coherence tomography (OCT) angiography, and to determine the influence of lamina cribrosa (LC) displacement on changes in peripapillary microvasculature. Methods: The peripapillary retinal microvasculature and LC were imaged using OCT angiography and OCT-enhanced depth imaging, respectively. The microvasculature and LC depth (LCD) were measured before, and 1 week, 1 month, and 3 months after trabeculectomy. The microvascular improvement was arbitrarily defined as a reduction >30% of the area of vascular dropout (blue/black areas with <20% vessel density on the color-coded vessel density map). LCD was determined as the mean of vertical distance between the anterior LC surface and a reference plane of Bruch's membrane. Results: Thirty-one eyes of 31 POAG patients were included. At 3 months postoperatively, intraocular pressure (IOP) and LCD were significantly decreased from 26.3 ± 11.8 mm Hg to 12.5 ± 3.6 mm Hg, and 501.1 ± 130.2 µm to 455.8 ± 112.7 µm, respectively (all P < 0.001), compared with baseline. The microvascular improvement was observed in 19 eyes (61.3%) at 3 months after trabeculectomy. The maximal reductions in IOP and LCD were significantly greater in eyes with improved microvasculature compared to eyes without improvement (P = 0.020 and P = 0.005). The microvascular improvement was significantly associated with maximal reduction in LCD (odds ratio, 1.062; P = 0.026). Conclusions: Trabeculectomy can improve peripapillary retinal microcirculation in patients with POAG. This finding suggests that the reduction of LCD induced by lowering IOP may affect peripapillary microvascular improvement in eyes with POAG.
[Mh] Termos MeSH primário: Glaucoma de Ângulo Aberto/cirurgia
Microvasos/patologia
Nervo Óptico/patologia
Vasos Retinianos/patologia
Trabeculectomia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Angiofluoresceinografia
Glaucoma de Ângulo Aberto/patologia
Seres Humanos
Pressão Intraocular/fisiologia
Masculino
Meia-Idade
Estudos Prospectivos
Tomografia de Coerência Óptica
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171201
[Lr] Data última revisão:
171201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-22787


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[PMID]:29068979
[Au] Autor:Den Beste KA; Okeke C
[Ad] Endereço:aDepartment of Ophthalmology, Eastern Virginia Medical School bVirginia Eye Consultants, Norfolk, VA.
[Ti] Título:Trabeculotomy ab interno with Trabectome as surgical management for systemic fluoroquinolone-induced pigmentary glaucoma: A case report.
[So] Source:Medicine (Baltimore);96(43):e7936, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Bilateral acute iris transillumination (BAIT) is a poorly-understood ocular syndrome in which patients present with acute iridocyclitis and pigmentary dispersion with or without ocular hypertension. The etiology of the disease remains unknown, though recent reports suggest an antecedent upper respiratory tract infection or systemic antibiotic administration may trigger the clinical syndrome. PATIENT CONCERNS: A 55-year-old female was referred for a second opinion regarding her bilateral ocular pain, photophobia, and ocular hypertension. Her medical history was notable for a diagnosis of pneumonia managed with oral moxifloxacin several weeks prior to her initial presentation. DIAGNOSES: Visual acuity was 20/40 with an intraocular pressure (IOP) of 30 mmHg in the affected eye despite maximal tolerated medical therapy. The patient had severe bilateral iris transillumination defects with posterior synechiae formation and 3+ pigment with rare cell in the anterior chamber. This constellation of findings was consistent with a diagnosis of BAIT. INTERVENTIONS: A peripheral iridotomy was placed, which mildly relieved the iris bowing, but did not affect the IOP or inflammatory reaction. The patient then underwent cataract extraction with posterior synechiolysis and ab interno trabeculotomy of the left eye with the Trabectome. OUTCOMES: The patient's IOP on the first post-operative day was 13 mmHg, and anterior chamber inflammation was noted to be significantly reduced at post-operative week 2. The patient was recently seen at a 1-year post-operative visit and her IOP remains in the low teens on a low-dose combination topical agent. LESSONS: Ophthalmologists should remain aware of the association between systemic fluoroquinolones and acute pigmentary dispersion that can progress to glaucoma. The Trabectome remains a viable option for management of pigmentary and uveitic glaucoma resistant to medical treatment.
[Mh] Termos MeSH primário: Antibacterianos/efeitos adversos
Fluoroquinolonas/efeitos adversos
Glaucoma de Ângulo Aberto/induzido quimicamente
Glaucoma de Ângulo Aberto/cirurgia
Trabeculectomia/métodos
[Mh] Termos MeSH secundário: Extração de Catarata
Dor Ocular/induzido quimicamente
Feminino
Seres Humanos
Meia-Idade
Hipertensão Ocular/induzido quimicamente
Fotofobia/induzido quimicamente
Pneumonia Bacteriana/tratamento farmacológico
Trabeculectomia/instrumentação
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Fluoroquinolones); U188XYD42P (moxifloxacin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007936


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[PMID]:28977004
[Au] Autor:Wasielica-Poslednik J; Schmeisser J; Hoffmann EM; Weyer-Elberich V; Bell K; Lorenz K; Pfeiffer N
[Ad] Endereço:Department of Ophthalmology, University Medical Center, Johannes Gutenberg- University, Mainz, Germany.
[Ti] Título:Fluctuation of intraocular pressure in glaucoma patients before and after trabeculectomy with mitomycin C.
[So] Source:PLoS One;12(10):e0185246, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Intraocular pressure (IOP) fluctuation is considered as a risk factor for glaucoma progression. We investigated IOP values and IOP fluctuation before and after trabeculectomy (TE) with mitomycin C (MMC) measured by 48-hour diurnal-nocturnal-IOP-profiles (DNP). METHODS: Pre- and postoperative DNPs of 92 eyes undergoing primary TE with MMC were analysed. Each 48-hour IOP-profile involved 10 IOP measurements (8:00 a.m., 2:00 p.m., 6:00 p.m., and 9:00 p.m. in sitting and at 00:00 in supine position). The "preoperative DNP" was performed a few weeks before TE. The "postoperative DNP" was performed at least six months (range: 6 months-2 years) after TE. Mean IOP values and IOP fluctuations were calculated. RESULTS: After TE with MMC mean IOP was reduced from 16.94±3.83 to 11.26±3.77 mmHg at daytime and from 18.17±4.26 to 11.76±3.90 mmHg at night. At daytime mean IOP-fluctuation decreased from 8.61±4.19 to 4.92±2.52 mmHg, at night from 3.15±2.95 to 1.99±1.82 mmHg. Mean IOP was lower on the second day of the preoperative DNP. This effect was not present in the postoperative DNP. Preoperatively, IOP was controlled in all eyes with a mean of 3.22±0.94 antiglaucomatous agents. Postoperatively, IOP≤15 mmHg was achieved in 71.7%, IOP≤18 mmHg in 77.1% and a decrease in IOP of >30% in 47.8% without antiglaucomatous therapy. Postoperatively, pseudophakia was associated by a higher mean IOP-fluctuation compared to the phakic eyes. CONCLUSIONS: TE with MMC significantly reduces both mean IOP-values and IOP- fluctuations at day and night at least 6 months postoperatively. The effect of TE on the IOP fluctuation was less pronounced in pseudophakic eyes.
[Mh] Termos MeSH primário: Glaucoma/fisiopatologia
Pressão Intraocular
Mitomicina/administração & dosagem
Trabeculectomia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Glaucoma/cirurgia
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
50SG953SK6 (Mitomycin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185246


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[PMID]:28929279
[Au] Autor:Tanito M; Ikeda Y; Fujihara E
[Ad] Endereço:Division of Ophthalmology, Matsue Red Cross Hospital, 200 Horo-machi, Matsue, Shimane, 690-8506, Japan. tanito-oph@umin.ac.jp.
[Ti] Título:Effectiveness and safety of combined cataract surgery and microhook ab interno trabeculotomy in Japanese eyes with glaucoma: report of an initial case series.
[So] Source:Jpn J Ophthalmol;61(6):457-464, 2017 Nov.
[Is] ISSN:1613-2246
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To report the early postoperative results and safety profile of ab interno microhook trabeculotomy (µLOT) combined with cataract surgery. PATIENTS AND METHODS: This retrospective observational case series included 68 consecutive glaucomatous eyes of 23 Japanese men and 25 Japanese women [mean (SD) age, 76.0 ± 8.5 years] who underwent µLOT for intraocular pressure (IOP) and visually relevant cataracts. The LOT site/extent, perioperative complications, and complication treatments were collected from the medical and surgical records. The preoperative and postoperative IOP, numbers of antiglaucoma medications, logarithm of the minimum angle of resolution visual acuity (VA), anterior chamber (AC) flare, and corneal endothelial cell density (CECD) were compared. RESULTS: After small incisional cataract surgery, the trabecular meshwork was incised in the nasal (6 eyes, 3.6 ± 0.5 clock hours), temporal (6 eyes, 3.8 ± 0.8 clock hours), or both nasal and temporal (56 eyes, 6.5 ± 0.6 clock hours) angles. The mean preoperative IOP (16.4 ± 2.9 mmHg) and number of antiglaucoma medications (2.4 ± 1.2) decreased significantly (P < 0.0001 and P = 0.0039, respectively) to 11.8 ± 4.5 and 2.1 ± 1.0 mmHg at 9.5 months postoperatively. Compared with the preoperative conditions, the final VA improved (P = 0.0002), the AC flare increased by 6.3 pc/ms (P = 0.0157), and the CECD decreased by 6% (P = 0.0005). Hyphema with niveau formation (28 eyes, 41%) and hyphema washout (6 eyes, 9%) were the most common postoperative complication and intervention, respectively. At the final visit, 54 eyes (79%) had achieved successful IOP control of 15 mmHg or less and IOP reduction of 15% or greater. CONCLUSION: Combined µLOT and cataract surgery improves IOP and VA during the early postoperative period in patients with glaucoma and cataract.
[Mh] Termos MeSH primário: Extração de Catarata/métodos
Catarata/complicações
Glaucoma/cirurgia
Pressão Intraocular
Complicações Pós-Operatórias/epidemiologia
Trabeculectomia/instrumentação
Acuidade Visual
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Desenho de Equipamento
Feminino
Glaucoma/complicações
Glaucoma/fisiopatologia
Seres Humanos
Incidência
Japão/epidemiologia
Masculino
Meia-Idade
Miniaturização
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170921
[St] Status:MEDLINE
[do] DOI:10.1007/s10384-017-0531-z


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[PMID]:28860043
[Au] Autor:Neustein RF; Beck AD
[Ad] Endereço:Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
[Ti] Título:Circumferential Trabeculotomy Versus Conventional Angle Surgery: Comparing Long-term Surgical Success and Clinical Outcomes in Children With Primary Congenital Glaucoma.
[So] Source:Am J Ophthalmol;183:17-24, 2017 Nov.
[Is] ISSN:1879-1891
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: This study compares the long-term efficacy of circumferential trabeculotomy to that of conventional angle surgeries in primary congenital glaucoma (PCG), as judged by glaucoma and visual outcomes. DESIGN: Retrospective observational case series. METHODS: Setting: Emory Eye Center, Atlanta, Georgia. STUDY POPULATION: This was a single-institution retrospective study involving children with PCG who underwent circumferential trabeculotomy, standard trabeculotomy, or goniotomy with ≥2-year follow-up. MAIN OUTCOME MEASURES: Postoperative success (intraocular pressure [IOP] < 22 mm Hg ± glaucoma medications, without glaucoma progression/additional IOP-lowering surgery), Snellen-equivalent visual acuity (VA), and IOP at last follow-up. Kaplan-Meier method estimated the probability of glaucoma control vs time postoperatively, and values were compared between angle surgery cohorts using Wilcoxon signed rank tests, Mann-Whitney U tests, and Fisher exact tests. RESULTS: Included were 58 eyes (33 children) after circumferential trabeculotomy and 42 eyes (27 children) after standard trabeculotomy/goniotomy, with mean follow-up of 7.2 ± 4.0 and 8.2 ± 4.5 years, respectively. Postoperative success at last follow-up in the circumferential vs conventional cohorts was 81% (47 of 58 eyes) vs 31% (13 of 42 eyes) (P < .0001). At last follow-up, the circumferential cohort had better median VA than the conventional cohort (20/30 (interquartile range [IQR] 20/25 to 20/70) vs 20/70 (IQR 20/40 to 20/200), P = .009), required fewer glaucoma medications (0.55 ± 1.2 vs 1.61 ± 1.51, P < .0001), had lower IOP in first operated eye (15.2 ± 3.6 vs 18.2 ± 7.0, P = .048), and had comparable incidence of devastating complications (P = .065). CONCLUSIONS: In this retrospective study, circumferential trabeculotomy afforded better long-term success and visual outcomes than conventional angle surgery for children with PCG.
[Mh] Termos MeSH primário: Glaucoma/cirurgia
Pressão Intraocular
Trabeculectomia/métodos
Acuidade Visual
[Mh] Termos MeSH secundário: Feminino
Cirurgia Filtrante/métodos
Seguimentos
Glaucoma/congênito
Glaucoma/fisiopatologia
Gonioscopia
Seres Humanos
Lactente
Masculino
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE


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[PMID]:28850613
[Au] Autor:Naito T; Fujiwara M; Miki T; Araki R; Fujiwara A; Shiode Y; Morizane Y; Nagayama M; Shiraga F
[Ad] Endereço:Department of Ophthalmology, Okayama University Medical School Hospital, Okayama, Japan.
[Ti] Título:Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg.
[So] Source:PLoS One;12(8):e0184096, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We examined the effectiveness of trabeculectomy in decreasing the slope of mean deviation (MD) in Japanese patients with progressive normal-tension glaucoma (NTG) at low intraocular pressure (IOP) levels. The charts of patients who had undergone initial trabeculectomy with adjunctive mitomycin C for progressive NTG with medically controlled IOP < 15 mmHg in 2010-2013 were retrospectively reviewed. Seventeen eyes of 13 NTG patients who had undergone at least 5 times of visual field (VF) examinations in both of preoperatively and postoperatively with postoperative follow-up of ≥ 2 years were enrolled. Preoperative and postoperative MD slopes were compared to evaluate the effectiveness of trabeculectomy in slowing progression of VF. Mean IOP (8.1 ± 2.9 mmHg) and number of IOP-lowering medications (0.8 ± 1.5) were significantly lower postoperatively than preoperatively (13.9 ± 0.9 mmHg; P < 0.001 and 3.0± 0.4; P < 0.0001). In total, 91.7% of eyes with single-digit IOP postoperatively showed improvement in MD slope, whereas only 20.0% of eyes with IOP ≥ 10 mmHg postoperatively showed the improvement. Three eyes (17.6%) showed a decrease in visual acuity (VA) of ≥ 0.1 unit; this group had a lower mean postoperative IOP (6.0 ± 1.0 vs. 8.6 ± 3.0 mmHg; P = 0.1717) and a higher mean IOP reduction rate (56.2 vs. 38.5%; P = 0.8296) than eyes with a VA decrease of < 0.1 unit or no change. Thus, in this analysis of Japanese NTG patients with medically controlled IOP < 15 mmHg, achieving an IOP < 10 mmHg with trabeculectomy was beneficial for reducing the VF progression rate in progressive NTG at low IOP levels. However, an IOP < 7 mmHg by surgery would be required careful attention to VA decline.
[Mh] Termos MeSH primário: Pressão Intraocular/fisiologia
Glaucoma de Baixa Tensão/cirurgia
Trabeculectomia
Campos Visuais/fisiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Progressão da Doença
Feminino
Seres Humanos
Japão
Glaucoma de Baixa Tensão/fisiopatologia
Masculino
Meia-Idade
Mitomicina/uso terapêutico
Estudos Retrospectivos
Tonometria Ocular
Resultado do Tratamento
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
50SG953SK6 (Mitomycin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170830
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184096


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[PMID]:28834827
[Au] Autor:Aptel F; Bron AM; Lachkar Y; Schweitzer C
[Ad] Endereço:*Department of Ophthalmology, University Hospital of Grenoble, Grenoble †Department of Ophthalmology, University Hospital of Dijon, Dijon ‡Institut du Glaucome, Fondation Hôpital Saint-Joseph, Paris §Department of Ophthalmology, CHU Bordeaux ∥Bordeaux Population Health Research Center, Team LEHA, University Bordeaux, Inserm, Bordeaux, France.
[Ti] Título:Change in Visual Field Progression Following Treatment Escalation in Primary Open-angle Glaucoma.
[So] Source:J Glaucoma;26(10):875-880, 2017 Oct.
[Is] ISSN:1536-481X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the effect of treatment escalation on the rate of visual field progression in patients with primary open-angle glaucoma (POAG). PATIENTS AND METHODS: Multicenter database study. We reviewed the electronic records of 171 patients with POAG under medical hypotensive treatment who underwent 5 consecutive visits 6 months apart before and after medical treatment escalation or additive laser trabeculoplasty. We calculated the rate of visual field progression (mean deviation change per year) before and after treatment escalation. RESULTS: The mean duration of follow-up was 5.1±0.5 years and the mean number of visual field examinations was 10.2±0.2. In 139 eyes with medical treatment escalation, the rate of progression was significantly reduced [from -0.57 to -0.29 dB/y; P=0.022; intraocular pressure (IOP) reduction 11.1%]. In detail, the rate of progression was significantly reduced after escalation from mono to dual therapy, dual to triple therapy, and from mono to triple therapy (-0.35 to -0.24 dB/y, P=0.018; -1.01 to -0.48 dB/y, P=0.038; -1.04 to -0.35 dB/y, P=0.020, respectively). In 32 eyes with additive laser trabeculoplasty, the rate of progression was significantly reduced (-0.60 to -0.24 dB/y; P=0.014; IOP reduction 9.4%). CONCLUSIONS: Medical treatment escalation or additive laser trabeculoplasty significantly reduced the rate of visual field progression in POAG. Larger IOP reduction has a greater probability of reducing glaucoma progression.
[Mh] Termos MeSH primário: Anti-Hipertensivos/uso terapêutico
Glaucoma de Ângulo Aberto/fisiopatologia
Pressão Intraocular/fisiologia
Terapia a Laser/métodos
Trabeculectomia/métodos
Campos Visuais/fisiologia
[Mh] Termos MeSH secundário: Idoso
Progressão da Doença
Feminino
Seguimentos
Glaucoma de Ângulo Aberto/terapia
Seres Humanos
Masculino
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Antihypertensive Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/IJG.0000000000000748



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