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Lin HS, Xu XP, Zheng XL, Wang JB, Fan SJ, Wu ZH, Cheng SM, Zhao LJ, Cai QH, Zhang SD, Liu SS, Lyu AG, Zhang Y, Chen H, Jiang DN, Li WL, Congdon N, Tham CC, He MG, Liang YB. Malignant glaucoma treated by low-dose laser cycloplasty: a 1-year multicenter prospective non-comparative study. Int J Ophthalmol 2024; 17:1248-1254. [PMID: 39026914 PMCID: PMC11246926 DOI: 10.18240/ijo.2024.07.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/09/2024] [Indexed: 07/20/2024] Open
Abstract
AIM To report a one-year clinical outcomes of low-dose laser cycloplasty (LCP) among malignant glaucoma patients. METHODS In this prospective, multicenter, non-comparative clinical study, participants with malignant glaucoma were recruited and underwent LCP at eight ophthalmic centers in China. Patients were followed up at 1wk, 1, 3, 6, and 12mo. Intraocular pressure (IOP), number of glaucoma medications, anterior chamber depth (ACD), and complications were recorded. Anatomical success was defined as the reformation of the anterior chamber based on slit-lamp biomicroscopy. Recurrence was defined by the presence of a shallow or flat anterior chamber after initial recovery from treatment. RESULTS A total of 34 eyes received LCP. Mean IOP and medications decreased from 36.1±11.5 mm Hg with 3.3±1.5 glaucoma medications pre-treatment to 20.9±9.8 mm Hg (P<0.001) with 2.9±1.6 medications (P=0.046) at 1d, and 17.4±6.7 mm Hg (P<0.001) with 1.3±1.7 medications (P<0.001) at 12mo. The ACD increased from 1.1±0.8 mm at baseline to 1.7±1.0 mm and to 2.0±0.5 mm at 1d and 12mo, respectively. A total of 32 (94.1%) eyes achieved initial anatomical success. During follow-up, 2 (5.9%) eyes failed and 8 (23.5%) eyes relapsed, yielding a 12-month anatomical success rate of 64.3%. Complications including anterior synechia (8.82%), choroidal/ciliary detachment (5.88%) and hypopyon (2.94%) were observed within 1wk. CONCLUSION LCP is simple, safe, and effective in reforming the anterior chamber in malignant glaucoma.
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Affiliation(s)
- Hai-Shuang Lin
- Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xiao-Ping Xu
- Ningbo Eye Hospital, Ningbo 315100, Zhejiang Province, China
| | - Xuan-Li Zheng
- Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Ji-Bing Wang
- Weifang Eye Hospital, Weifang 261000, Shandong Province, China
| | - Su-Jie Fan
- Handan Eye Hospital, Handan 056000, Hebei Province, China
| | - Zuo-Hong Wu
- Aier Eye Hospital (Wuhan), Wuhan 430061, Hubei Province, China
| | - Su-Mian Cheng
- Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Li-Jun Zhao
- The Third People's Hospital of Dalian, Dalian 116033, Liaoning Province, China
| | - Qin-Hua Cai
- First Affiliated Hospital of Suzhou University, Suzhou 215031, Jiangsu Province, China
| | - Shao-Dan Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
- Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Shan-Shan Liu
- Weifang Eye Hospital, Weifang 261000, Shandong Province, China
| | - Ai-Guo Lyu
- Handan Eye Hospital, Handan 056000, Hebei Province, China
| | - Ying Zhang
- Aier Eye Hospital (Wuhan), Wuhan 430061, Hubei Province, China
| | - Hong Chen
- Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Dan-Ni Jiang
- The Third People's Hospital of Dalian, Dalian 116033, Liaoning Province, China
| | - Wu-Liang Li
- Ningbo Eye Hospital, Ningbo 315100, Zhejiang Province, China
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast BT7 1NN, UK
- Orbis International, New York, USA
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong SAR 999077, China
| | - Ming-Guang He
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne 3000, VIC, Australia
| | - Yuan-Bo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
- Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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Cao Y, Lin HS, Mao HY, Zhao Y, Xie YQ, Zhang SD, Zhang Q, Wang PJ, Li GX, Fang AW, Liang YB. Trend of glaucoma internal filtration surgeries in a tertiary hospital in China. Int J Ophthalmol 2023; 16:251-259. [PMID: 36816210 PMCID: PMC9922641 DOI: 10.18240/ijo.2023.02.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/07/2022] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the trend of glaucoma internal filtration surgeries for inpatients between 2015 and 2021 at the Eye Hospital of Wenzhou Medical University. METHODS A review of the medical records of inpatients who had been diagnosed with glaucoma and received anti-glaucoma surgery between January 1, 2015 and December 31, 2021 was conducted. The glaucoma diagnosis in this study included primary open angle glaucoma, primary angle-closure glaucoma, secondary glaucoma, and paediatric glaucoma. The types of surgeries were categorised as internal filtration, external filtration, and cyclodestruction surgery based on the pathway of aqueous humor outflow. The trend of these glaucoma surgeries in the sample of patients with different types of glaucoma was then analysed. RESULTS The number of patients hospitalised for glaucoma surgery increased yearly, from 752 in 2015 to 1373 in 2021, at the Eye Hospital of Wenzhou Medical University. Regarding the patients diagnosed with primary open angle glaucoma, internal filtration surgery increased from 27.40% of the sample to 54.40% of the sample, while external filtration surgery decreased from 71.50% to 44.20% between 2015 and 2021. For paediatric glaucoma, internal filtration surgery increased from 37.50% in 2015 to 88.20% in 2021. Whilst different types of surgeries were performed on the sample of patients with secondary glaucoma, the proportion of internal filtration surgery also showed an increase from 18.20% in 2015 to 40.90% in 2021. Meanwhile, internal filtration surgery in the patient sample with primary angle-closure glaucoma already accounted for over 70.00% in 2015, and showed a small increase by 2021. CONCLUSION As surgical technology and surgical experience continue to elevate and improve, the range of glaucoma surgeries are correspondingly evolving. This study find that internal filtration surgeries accounted for an increasing proportion of treatments in the surgical management of glaucoma between 2015 and 2021.
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Affiliation(s)
- Yang Cao
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Hai-Shuang Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Hui-Yan Mao
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Yin Zhao
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Yan-Qian Xie
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Shao-Dan Zhang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Qi Zhang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Pei-Juan Wang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Guo-Xing Li
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Ai-Wu Fang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Yuan-Bo Liang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Glaucoma Research Institute, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
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Tanito M, Matsuoka Y. Proportion of Glaucoma Types and Surgeries Among Young, Pre-Old, Old, and Oldest-Old Age Groups or Different Sex Groups. Clin Ophthalmol 2022; 16:1815-1819. [PMID: 35698600 PMCID: PMC9188399 DOI: 10.2147/opth.s370082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background We report the real-world distribution of glaucoma types and glaucoma surgeries in each age or sex group in our department. Methods The department database of Matsue Red Cross Hospital, a tertiary care hospital, for eyes surgically treated to manage glaucoma between April 2014 and March 2018 was searched. Patient age, sex, disease type, and surgical procedure were collected from the database. The age was stratified by ≤64 years (young), 65–74 years (pre-old), 75–89 years (old), and ≥90 years (oldest-old or super-old). Results In the database, 2036 consecutive surgeries (70.3 ± 14.4 years; 1015 males) were identified. Among all subjects, primary open-angle glaucoma (POAG) (42.7%) was the most frequent identifiable glaucoma type followed by primary angle-closure disease (PACD) (18.8%) and exfoliation glaucoma (17.9%). The glaucoma types differed significantly among the age groups (P < 0.0001); POAG was the most frequent type of glaucoma in young and pre-old groups, while PACD and exfoliation glaucoma were the most frequent glaucoma types in the oldest-old group. Among all subjects, trabeculotomy or other goniotomy/gonio-bypass surgery (41.7%) was the most frequent glaucoma surgery followed by long-tube shunt (22.1%) and trabeculectomy (16.2%). The glaucoma surgeries performed differed significantly among the age groups (P < 0.0001). The frequency of trabeculectomy was the highest in the young group (27.8%), trabeculotomy was the highest in the pre-old (42.6%) and old (46.6%) groups, and long tube shunt (41.3%) and cataract extraction + goniosynechialysis (32.6%) were the highest in the oldest-old group. The glaucoma type (P < 0.0001) and surgeries performed (P < 0.0001) differed significantly between sex groups; the rates of PACD and cataract extraction + goniosynechialysis were remarkably higher in female than male group. Conclusion The types of glaucoma and required glaucoma surgeries differ among the different age groups and sexes. Primary angle-closure disease and exfoliation glaucoma are the major glaucoma types in the old and oldest-old age groups.
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Affiliation(s)
- Masaki Tanito
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
- Correspondence: Masaki Tanito, Department of Ophthalmology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan, Tel +81-853-20-2284, Fax +81-853-20-2278, Email
| | - Yotaro Matsuoka
- Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Shimane, Japan
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