1
|
Wang Y, Pu S, Li G. Combined phacoemulsification and viscogoniosynechialysis in treating patients with angle-closure glaucoma and coexisting cataract. Asian J Surg 2024; 47:2333-2334. [PMID: 38331616 DOI: 10.1016/j.asjsur.2024.01.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024] Open
Affiliation(s)
- Yun Wang
- Department of Ophthalmology, Qijiang District People's Hospital, Chongqing, 401420, China
| | - Shanshan Pu
- Department of Otolaryngology, Qijiang District People's Hospital, Chongqing, 401420, China
| | - Gongju Li
- Department of Ophthalmology, Qijiang District People's Hospital, Chongqing, 401420, China.
| |
Collapse
|
2
|
Costa VP, Leung CK, Kook MS, Lin SC, Al-Aswad LA, Araie M, Baudouin C, Coupal DJ, Fechtner R, Tee Khaw P, Khaderi KR, Khawaja A, Mattox C, Miller-Ellis E, Nagori S, Olivier M, Pfeiffer N, Serle J, Stalmans I, Varma DK. Clear lens extraction in eyes with primary angle closure and primary angle-closure glaucoma. Surv Ophthalmol 2020; 65:662-674. [DOI: 10.1016/j.survophthal.2020.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 10/24/2022]
|
3
|
An update on therapeutic modalities for the prevention of angle closure glaucoma. Curr Opin Ophthalmol 2017; 28:175-180. [DOI: 10.1097/icu.0000000000000350] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
4
|
Pahlitzsch M, Gonnermann J, Maier AKB, Bertelmann E, Klamann MKJ, Erb C. Modified goniotomy as an alternative to trabectome in primary open angle glaucoma and pseudoexfoliation glaucoma: 1 year results. Can J Ophthalmol 2016; 52:92-98. [PMID: 28237157 DOI: 10.1016/j.jcjo.2016.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/07/2016] [Accepted: 07/25/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess the outcome of modified goniotomy and trabeculotomy ab interno (Trabectome) surgery in adult primary open-angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma. DESIGN Retrospective cohort outcome study. PARTICIPANTS Two hundred and thirty-six eyes of 236 patients. METHODS This cohort outcome study included 68 POAG (mean age: 65.7 ± 16.0 years) and 22 PEX glaucoma patients (mean age: 78.3 ± 7.9 years) in the modified goniotomy cohort and 119 POAG (mean age: 73.9 ± 9.6 years) and 27 PEX glaucoma patients (mean age: 75.2 ± 8.0 years) in the Trabectome cohort. Modified goniotomy is defined as combined ab interno cyclodialysis and goniotomy. The patients were followed up for 12 months, and we analysed the data using SPSS v19.0. RESULTS In POAG, the intraocular pressure (IOP) was significantly reduced by 4.6 mm Hg in the Trabectome cohort (p < 0.001) and by 5.8 mm Hg (p < 0.001) in the goniotomy group at 1-year follow-up. In PEX glaucoma, the mean IOP was reduced by 9.7 mm Hg (p = 0.002) in the Trabectome surgery and by 6.7 mm Hg (p = 0.004) in the goniotomy cohort 1 year later. Comparing both surgery techniques in POAG, no significant correlation was found in terms of IOP at any of the follow-up visits (IOP at 1 year, p = 0.553). In PEX glaucoma, the IOP, visual acuity, and number of glaucoma medications did not differ significantly between the 2 surgery techniques 1 year later (IOP: p = 0.300; VA: p = 0.391; therapy: p = 0.908). CONCLUSION Modified goniotomy and Trabectome surgery are reliable and effective tools for the management of moderate POAG and PEX glaucoma. There was no significant difference in IOP between the 2 procedures over a follow-up period of 1 year.
Collapse
Affiliation(s)
- Milena Pahlitzsch
- University College London Institute of Ophthalmology, London, United Kingdom.
| | - Johannes Gonnermann
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Anna-Karina B Maier
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Eckart Bertelmann
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Matthias K J Klamann
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Carl Erb
- Eye Clinic Wittenbergplatz, Berlin, Germany
| |
Collapse
|
5
|
Wang Y, Sheng Y, Wang M, Tao J. Management of Different Subtypes of Primary Angle Closure with Phacoemulsification and Viscogoniosynechialysis. Semin Ophthalmol 2016; 32:496-500. [PMID: 27192389 DOI: 10.3109/08820538.2015.1123730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To retrospectively assess the effectiveness of combined phacoemulsification with viscogoniosynechialysis for patients with different subtypes of primary angle closure (PAC). METHODS Forty-three eyes of 37 patients diagnosed with PAC (12 eyes), PAC with glaucoma (PACG, 20 eyes), and acute PAC (11 eyes) were treated with phacoemulsification and viscogoniosynechialysis between November 2010 and October 2012. Main outcome measures were anterior chamber depth (ACD), intraocular pressure (IOP), the number of IOP-lowering medication, extent of peripheral anterior synechia (PAS), and visual acuity preoperatively and one month postoperatively. RESULTS All operations were successfully accomplished and no intra-operative complications were observed. The ACD, IOP, PAS, and visual acuity were all significantly improved postoperatively, especially in the acute PAC group, which resulted in few glaucoma drugs being needed. The IOP was decreased into equal or less than 21 mmHg in most patients postoperatively, except four patients had IOP slightly higher than 21 mmHg. However, they were restored to normal spontaneously or by medication at last follow-up. The extent of PAS was all reduced to less than 90 or 180°, with the visual acuity restored to more than 0.1. CONCLUSIONS Combined phacoemulsification with viscogoniosynechialysis seems to be an effective surgical procedure in the treatment of various subtypes of PAC.
Collapse
Affiliation(s)
- Yulan Wang
- a Department of Ophthalmology , Shanghai Aier Eye Hospital , Shanghai , China
| | - Yaohua Sheng
- a Department of Ophthalmology , Shanghai Aier Eye Hospital , Shanghai , China
| | - Min Wang
- a Department of Ophthalmology , Shanghai Aier Eye Hospital , Shanghai , China
| | - Jinhua Tao
- a Department of Ophthalmology , Shanghai Aier Eye Hospital , Shanghai , China
| |
Collapse
|
6
|
Baig N, Kam KW, Tham CCY. Managing Primary Angle Closure Glaucoma - The Role of Lens Extraction in this Era. Open Ophthalmol J 2016; 10:86-93. [PMID: 27014390 PMCID: PMC4780513 DOI: 10.2174/1874364101610010086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 11/24/2022] Open
Abstract
Trabeculectomy has been the gold standard in reducing intraocular pressure (IOP) in glaucoma patients, no matter it is angle closure or open angle glaucoma. However in primary angle closure glaucoma, no matter the lens is cataractous or not, it is likely to be pathological, this thicker than usual lens, with or without a more anterior position, is often regarded as a strong contributing factor to angle closure. Lens extraction, no matter it is cataractous or clear, can theoretically eliminate this anatomical predisposing factor of angle closure, and thus IOP can be reduced. Based on recent results of a number of clinical trials, lens extraction alone or in combination with other IOP-lowering surgeries, may therefore play a more important role in the treating primary angle closure glaucoma. In cases when greater IOP-lowering effect is needed or if drug dependency has to be minimized, combined procedures, such as phacotrabeculectomy, can be considered, but the surgical risk can be higher than lens extraction alone.
Collapse
Affiliation(s)
- Nafees Baig
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China; Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, People's Republic of China
| | - Ka-Wai Kam
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China; Prince of Wales Hospital, Shatin, N.T., Hong Kong SAR, People's Republic of China
| | - Clement C Y Tham
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China; Prince of Wales Hospital, Shatin, N.T., Hong Kong SAR, People's Republic of China
| |
Collapse
|
7
|
Hong J, Yang Y, Wei A, Deng SX, Kong X, Chen J, Girard MJA, Mari JM, Xu J, Sun X. Schlemm's canal expands after trabeculectomy in patients with primary angle-closure glaucoma. Invest Ophthalmol Vis Sci 2014; 55:5637-42. [PMID: 25118266 DOI: 10.1167/iovs.14-14712] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the in vivo changes in the Schlemm's canal (SC) in patients with primary angle-closure glaucoma (PACG) after trabeculectomy using spectral-domain optical coherence tomography (SD-OCT). METHODS Forty eyes of 40 patients with PACG who underwent trabeculectomy were included. All participants underwent SD-OCT. The diameter and area of SC were examined and measured before and within 1 month after trabeculectomy. All SD-OCT images were processed using adaptive compensation algorithm to improve contrast and image quality. Multivariate linear regression analysis was performed for predictors of percentage change in the mean SC diameter and area. RESULTS The mean age of participants was 60.5 ± 14.6 years. Adaptive compensation significantly increased the percentage of sections in which SC was observable in the subjects studied from 52.5% (21/40) to 75.0% (30/40), which has acceptable intraobserver and interobserver repeatability. There was a significant increase in the SC diameter and area at the follow-up examination compared with the baseline value (SC diameter: 34.2 ± 6.2 μm vs. 28.4 ± 6.1 μm; SC area: 8117 ± 1942 μm(2) vs. 5200 ± 996 μm(2); all P < 0.001). After multivariate analysis, the only variable related to changes in SC was percentage change in IOP (SC diameter, P = 0.002; SC area, P < 0.001). In addition, the magnitude of the change in the SC area also correlated with angle opening distance at 750 μm from the scleral spur at baseline. CONCLUSIONS Expansion of SC was observed after trabeculectomy in PACG patients. The degree of SC expansion was related to the extent of the IOP decrease.
Collapse
Affiliation(s)
- Jiaxu Hong
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yujing Yang
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Anji Wei
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Sophie X Deng
- Cornea Division, Jules Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Xiangmei Kong
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Junyi Chen
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Michaël J A Girard
- In Vivo Biomechanics Laboratory, Department of Biomedical Engineering, National University of Singapore, Singapore Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | | | - Jianjiang Xu
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Shanghai, China
| |
Collapse
|