Incidence Of Shallow Anterior Chamber Research Articles

Efficacy of anti-vascular endothelial growth factor and mitomycin C on wound healing after trabeculectomy in glaucoma patients: A meta-analysis.

Trabeculectomy is the main surgical treatment for glaucoma, but scar formation during wound healing may lead to surgical failure. In this study, we evaluated the efficacy of anti-vascular endothelial growth factor (anti-VEGF) and mitomycin C (MMC) on wound healing after glaucoma surgery. We have been looking for Pubmed, Embase and other databases. The last time we looked at an electronic database was August 2023. A case control study was conducted to compare the use of anti-VEGF and mitomycin C for the treatment of glaucoma. We used the Cochrane standard methodology for collecting and analysing the data. Based on the criteria of inclusion, we have determined 369 related papers and selected seven eligible trials for data analysis. Three hundred and twenty-six cases were treated with trabeculectomy, of which 166 were injected with anti-VEGF and 160 were given MMC for trabeculectomy. In six trials, anti-VEGF and MMC were not found to have any statistical significance on postoperative wound leakage after surgery (OR, 1.55; 95% CI, 0.71, 3.35 p = 0.27). The three trials showed that anti-VEGF and MMC did not differ in terms of reducing postoperative wound hypotony after surgery (OR, 0.78; 95% CI, 0.20, 3.11 p = 0.73). Five trials demonstrated that anti-VEGF and MMC were not associated with a lower incidence of shallow anterior chamber (OR, 1.17; 95% CI, 0.5, 2.76 p = 0.71). There is no significant difference in the effect of anti-VEGF and MMC on wound healing after glaucoma surgery. A multicentre randomized controlled trial with a larger sample size is needed to confirm this study.

Effect of immediate shallow anterior chamber after Ahmed glaucoma valve implantation on intermediate-term intraocular pressure control.

To evaluate the incidence of shallow anterior chamber in the early postoperative period following Ahmed glaucoma valve (AGV) implantation and its effect on the hypertensive phase (HP), intermediate-term intraocular pressure (IOP) control, and success rate. A retrospective analysis of 369 eyes of 360 patients who underwent AGV implantation between January 2005 and January 2020 with a minimum follow-up of 2 months was performed. Twenty-six patients developed shallow anterior chamber (AC) within 8 weeks following surgery (cases). They were compared with 39 randomly selected controls (no shallow AC post AGV). HP (IOP spike >21 mmHg), use of ocular hypotensive medications, and other associations were compared. Incidence of shallow AC post AGV was 7% (95% confidence interval [CI] 4, 9). The onset of shallow AC was 3 ± 2.1 days and resolved within 6 ± 4.7 days. Hypotony (12 [47%] vs. 1 [2.5%], P 0.0001) and choroidal detachment (CD; 7 [27%] vs. 3 [8%], P 0.03) were more common in cases compared to controls. The HP occurred in 11 (43%) cases versus 13 (34%) controls (P 0.4). Cases required more ocular hypotensive medications than controls at the end of 8 weeks (1.1 ± 1 vs. 0.5 ± 0.5, P 0.01). There was no significant difference in the qualified success between the groups at 1 year. The development of postoperative shallow AC post AGV implantation was not detrimental to IOP control at 1 year. However, there is a need to monitor the occurrence of HP in these eyes.

小梁切除术中巩膜瓣不同缝合法联合丝裂霉素C的临床观察

目的：探讨小梁切除术中巩膜瓣不同缝合法联合丝裂霉素C的临床应用及术后疗效观察。方法：回顾性分析我院2015年11月~2016年11月收诊的46例(46眼)，随机将其分为传统的小梁切除术联合丝裂霉素C (对照组)和巩膜瓣可调节缝线的小梁切除术联合丝裂霉素C (观察组)，各23例，对其术后效果进行比较分析。结果：术后浅前房的发生观察组明显低于对照组，术后眼压和术后滤过泡的形态，观察组和对照组没有差异。结论：可调节缝线小梁切除术联合丝裂霉素C只可以减少术后早期浅前房的发生，传统的小梁切除术中只要使用丝裂霉素C就可以取得很好的远期临床疗效，取得很高的远期手术成功率，所以完全没有必要在术中用可调节缝线缝合巩膜瓣。 Objective: To observe the clinical application and curative effect of trabeculectomy with different suture methods for scleral flap combined with mitomycin C. Methods: We analyze 46 cases (46 eyes) received by our hospital from November 2015 to November 2016 retrospectively. These cases were randomly divided into two groups: traditional trabecular resection combined with mitomycin C (control group) and trabeculectomy with adjustable sutures for scleral flap combined with mitomycin C (observation group), 23 cases each. The postoperative effect of the two groups was compared and analyzed. Results: The incidence of shallow anterior chamber after operation was significantly lower than that in control group; for intraocular pressure and the shape of filtering bleb after operation, there was no difference between the two groups. Conclusion: Trabeculectomy with adjustable sutures combined with mitomycin C can only reduce the incidence of early postoperative shallow anterior chamber, while traditional trabeculectomy can obtain a good clinical effect and a high success rate for a long term as long as the use of mitomycin C, so there is no need to use adjustable suture to suture scleral flap in the operation.

Clinical results of preventing postoperative shallow anterior chamber at early stage by implanting Ahmed glaucoma valve with adjustable suture

Objective To evaluate the effect of preventing the postoperative shallow anterior chamber at early stage by implanting Ahmed glaucoma valve with adjustable suture. Methods Thirty neovascular glaucoma cases (31 eyes) , who received the implantation of Ahmed glaucoma valve with adjustable suture (removable suture + ligating drainage tube with absorbable 6-0 Vcry1 suture) were retrospectively reviewed in the study. The postoperative early shallow anterior chamber, IOP and success rate of surgery was discussed. Results The incidence of postoperative early shallow anterior chamber was 6. 45% , postoperative early high IOP was 12.90% , the mean IOP in the last follow -up visit was (23.5 ±4.0)mmHg , The complete success rate was 54.84% , the relative success rate was 19.35% , the average success rate was 74.19%. Conclusion Applying the adjustable suture in the implantation of Ahmed glaucoma valve for neovascular glaucoma patients , which is a simple techinique, can effectively decreases the incidence of shallow anterior chamber postoperative. Key words: adjustable suture; glaucoma, neovascular; Ahmed glaucoma valve; anterior chamber, shallow

A Comparison of the Intraocular Pressure Lowering Effect of Adjustable Suture Versus Laser Suture Lysis for Trabeculectomy

To compare the intraocular pressure lowering effect of adjustable sutures and laser suture lysis for trabeculectomy in eyes with primary open angle glaucoma. Fifty patients with primary open angle glaucoma were studied. Eyes were assigned randomly to either trabeculectomy augmented with mitomycin C with adjustable sutures or with laser suture lysis. Patients were followed up for 12 months and success rate based on intraocular pressure was compared. Adjustable sutures were carried out as reported by Wells et al. Mean baseline intraocular pressure was 27.8±2.8 mm Hg in the adjustable suture group and 27.3±2.9 mm Hg in the laser suture lysis group (P=0.7). Mean postoperative intraocular pressure was 12.1±2.0 mm Hg at 3 months, 12.7±3.2 mm Hg at 6 months, and 12.9±3.4 mm Hg at 12 months in the adjustable suture group and 12.1±2.6 mm Hg at 3 months, 13.1±4.7 mm Hg at 6 months, and 13.4±3.5 mm Hg at 12 months in the laser suture lysis group. There was no significant difference in the mean intraocular pressure between the groups at any time point. At 12 months, 24 patients (96%) in the adjustable suture group and 23 patients (92%) in the laser suture lysis group achieved an intraocular pressure of ≥20 mm Hg without medication and a minimum of 30 percent reduction (P=0.7). Significant anterior chamber reduction was found in no patient (0%) in the adjustable suture group and 6 patients (24%) in the laser suture lysis group after loosening of the adjustable sutures or laser suture lysis. There was no significant difference in hypotensive efficacy between adjustable suture group and laser suture lysis group. The use of adjustable sutures may reduce the incidence of shallow anterior chamber and hypotony after postoperative intraocular pressure lowering procedures.

The application of releasable suture technique in trabeculectomy for primary angle-closure glaucoma

Objective To observe the releasable suture technique in trabeculectomy for primary angle-closure glaucoma to prevent early complications and improve long-term lowered intraocular pressure.Methods 60 eyes of 60 chronic angle-closure glaucoma patients were randomly divided into test group and control group.32 eyes in test group underwent trabeculectomy with releasable suture and MMC,28 eyes in control agroup underwent trabeculectomy and MMC.All of them were fellowed up for 6 months.Results There were no significant statistical differences between tow groups with shallow anterior chamber.Postoperative IOP between the two groups was no significant difference except for that 1 day after operation.Conclusions Releasable suture techniques has not significantly reduce early postoperative trabeculectomy incidence of shallow anterior chamber,or long-term intraocular pressure control. Key words: glaucoma; trabeculecomy; releasable suture

Different scleral sutures in primary angle-closure glaucoma

目的 探讨可拆除缝线小梁切除术联合丝裂霉素C在闭角型青光眼小梁切除术中的临床疗效和并发症.方法 采用随机对照临床研究方法,将原发性闭角型青光眼55例随机分为2组.A组:小梁切除术+丝裂霉素C(MMC),29例(29眼);B组:可拆除缝线小梁切除术+MMC,26例(29眼).观察并比较两组术后前房、眼压、早期并发症及滤过泡情况.结果 术后3月、6月、1年2组间眼压差异及手术成功率差异均无统计学意义.术后浅前房的发生率两组间差异有统计学意义.B组浅前房发生率低于A组.结论 小梁切除术+MMC与可拆除缝线小梁切除术+MMC两种术式相比疗效相当.可拆除缝线技术的应用有利于减少术后早期并发症。

Efficacy and Complications of Releasable Suture Trabeculectomy and Standard Trabeculectomy

To compare the efficacy and complications of releasable suture trabeculectomy and standard trabeculectomy. Sixty-four patients with uncontrolled glaucoma despite maximally tolerated medical therapy were included in a prospective, comparative, randomized clinical study. Standard trabeculectomy was performed on the 32 patients (Group 1) by one ophthalmologist and releasable suture trabeculectomy was also performed on the 32 patients (Group 2) by another ophthalmologist. Intraocular pressure, hypotony, shallow anterior chamber, iridocorneal touch and other complications were evaluated postoperatively. Examinations were performed daily for 1 week, for the 1st month and thereafter for every 3 months. The mean follow-up period was 11.0 +/- 2.4 months in Group 1 and 11.5 +/- 3.8 months in Group 2. On the first postoperative day mean intraocular pressure was determined 9 +/- 2.7 mmHg in Group 1, and 21.6 +/- 1.1 mmHg in Group 2 (p = 0.007). The mean intraocular pressure was 10.1 +/- 1.4 mmHg in Group 2 after suture removal. Shallow anterior chamber was observed in 11 (34.3%) patients of Group 1 and 2 (6.2%) patients of the Group 2 in the early postoperative period (p = 0.005). Iridocorneal touch was observed in 5 (15.6%) patients of Group 1 and 1 (3.1%) patient of Group 2 (p = 0.196). There was no statistically significant difference in the mean intraocular pressure between the two groups at 3, 6 and 12 months (p = 0.663, p = 0.362, p = 0.182, respectively). Releasable scleral flap sutures reduce the incidence of shallow anterior chamber and iridocorneal touch after trabeculectomy. Releasable scleral flap suture technique and standard trabeculectomy are similar in terms of lowering intraocular pressure at 1-year-follow up.

The application of filtration test throughout trabeculectomy

目的 观察在巩膜瓣可拆缝线小梁切除术全过程滤过试验的应用及效果.方法在64例(78眼)巩膜瓣可拆缝线小梁切除术全过程中应用滤过试验.即小梁切除、巩膜瓣缝合、结膜缝合后,经前房穿刺口各进行1次前房注水.通过全过程滤过试验来检验滤过情况并加以调整.观察术后前房深度,眼压,滤过泡.结果术后无发生持续性浅前房者.术后第7天眼压在11.7～18.0 mmHg之间.术后7～14天,全部病例拆除可拆缝线,眼压在9.8～14.8 mmHg之间.追踪观察6月,形成功能性滤过泡66眼(84.62%).结论在巩膜瓣可拆缝线小梁切除术全过程应用滤过试验,可以有效预防术后浅前房的发生,充分发挥可拆缝线的作用,提高手术的质量和安全性。

The application of filtration test throughout the trabeculectomy

目的:探讨全过程滤过试验在小梁切除术中的应用及效果.方法: 即在小梁切除、巩膜瓣缝合、结膜瓣缝合后经前房穿刺口各进行一次前房注水,检验小梁切除的内口、巩膜隧道及外口的滤过情况,并予以调整.将施行该试验的159眼确定为Ⅰ组,未行试验的107眼定为Ⅱ组.比较两组术后眼压、前房、视力的变化情况.结果: Ⅰ、Ⅱ组术后高眼压发生率分别为3.14%、8.41%,浅前房发生率分别为4.4%、20.56%.Ⅰ组视力均保持术前水平,提高者55.35%,Ⅱ组视力下降者占8.41%,提高者占36.45%.结论: 全过程滤过试验的应用可明显提高小梁切除术的质量.

Excimer Laser Filtration Surgery

In order to remove precisely scleral tissue overlying Schlemm's canal with minimal trauma as an outpatient procedure under local anesthetic, we used a VisX Twenty/Twenty excimer laser. We performed excimer laser filtration in three enucleated pig eyes, seven enucleated human eyes, and seven eyes of seven patients with severe glaucoma. Precise ablation to Schlemm's canal was confirmed by scanning electron microscopy in the enucleated eyes. For the patients, a local anesthetic was used, and a custom-made holder was used to mobilize the conjunctiva and fix the eye. A functional sclerostomy was obtained with 1,780 to 5,965 pulses, using a 2 x 1-mm slit. In our mean follow-up of nine months (range, six to 12 months) the excimer laser filtration technique achieved controlled filtration in five of seven patients and minimized conjunctival trauma. One patient subsequently underwent cataract extraction. This study indicates that excimer laser filtration is an effective technique for achieving filtration in glaucoma. It may reduce the complications of glaucoma filtration surgery, particularly the incidence of shallow anterior chamber postoperatively, as it leaves the trabecular meshwork intact.

Surgical treatment of open-angle glaucoma.

The influence of intraocular pressure (IOP) on the visual field of glaucoma patients is discussed; the criterion level for postoperative IOP control was set at 20 mmHg. When the IOP exceeded this level for two consecutive months, the IOP control was judged to be a failure, and the surgical results were analysed by a life-table method. Argon laser trabeculoplasty (ALT) with 50 shots over 180 degrees of the angle was used routinely, because of fewer complications than with 360 degrees ALT. A second session sometimes improved the final success rate, which was about 57% in primary open-angle glaucoma and 94% in capsular glaucoma after a follow-up period of two years and two months. All patients (120 eyes) required drugs, but their use could be reduced in about 35%. The IOP distribution in successful cases showed a peak at 16 to 17 mmHg, and the IOP was 15 mmHg or less in 21%. In trabeculectomy, pretreatment with topical indomethacin and steroid drip infusion was advocated, and concentrated sodium hyaluronate was used during surgery. These procedures reduced the incidence of shallow anterior chamber and associated choroidal detachment. The final success rate was about 60% after five years of follow-up. The IOP distribution after more than two years peaked at 13 to 15 mmHg, and the IOP was 15 mmHg or less in 53%.