Trabeculectomy For Open-angle Glaucoma Research Articles

A systematic review comparing Mytomicyn-C subtenon injection to sponge during trabeculectomy in open angle glaucoma

Introduction & ObjectivesMitomycin-C (MMC) is an effective agent to prevent scarring during the healing process followingtrabeculectomy procedure by inhibiting the multiplication of cells producing scar tissue. The aim ofthis study is to compare the efficacy of Mitomycin-C (MMC) delivered by either subtenon injection orsponge application during trabeculectomy surgery in open angle glaucoma patients.
 MethodsA systematic search was done using several databases including Pubmed, Medline, Embase, Scopus,and Jstor. Inclusion criteria were open angle glaucoma patients underwent trabeculectomy surgery,given either MMC via subtenon or sponge application, article in English, Randomized ControlledTrial (RCT) studies which published in the last 10 years. Intra-Ocular Pressure (IOP), EndothelialCell Counts (ECC) and Bleb Morphologic features with at least 1 month follow-up were evaluated.
 ResultsTwo RCT studies were included in this study. Both studies demonstrated that sub-tenon injectionand sponge application has no significant difference regarding IOP reduction from the baseline.Regarding morphologic features, both studies favor subtenon to conventional sponge application.Lastly, ECC in both studies conclude that there was no marked differences.
 ConclusionThe outcome of administration of MMC through subtenon injection and sponge application werecomparable to one another. However, less vascularization are shown in subtenon injection group.

A Comparison of the Effectiveness Between Trabeculectomy and Minimally Invasive Glaucoma Surgeries

Background and Hypothesis: Glaucoma affects 3 million Americans and is the second most common cause of blindness globally, after cataracts. It involves the degeneration of the optic nerve, often associated with increased eye pressure, leading to vision loss. Trabeculectomy was traditionally the standard surgical approach for managing glaucoma progression once medication and laser had failed. Recently, minimally invasive glaucoma surgeries (MIGS) have gained FDA approval for mild and moderate cases and are being implemented in practice. We hypothesize that MIGS procedures are just as effective as trabeculectomy in mild, moderate, and severe cases of glaucoma.
 Experimental Design or Project Methods: Using data from IU Health, patients that underwent either a MIGS procedure or a trabeculectomy for open-angle glaucoma at least a year ago were identified. Visual field data was used to stage their glaucoma. Any future glaucoma surgery was noted. Using this information, three separate Kaplan-Meier curves at 95% confidence intervals were created corresponding to each stage of glaucoma with a second surgery defined as a failure and a survival analysis was done to visualize the difference between these surgical approaches.
 Results: The sample included 119 patients and 179 eyes with a mean age of 80 and 57% females. The study had 80% power at a two-sided 5% significance level. Based on the survival analysis, there were no significant differences between trabeculectomy and MIGS in mild and moderate glaucoma (p=0.69 and 0.97 respectively). In severe glaucoma, MIGS had a lower failure rate compared to trabeculectomy (p=0.026).
 Conclusion and Potential Impact: The research comparing trabeculectomy to MIGS is still relatively new and this study shows the safety and efficacy of MIGS procedures. If confirmed, this study could potentially change the standard of care to MIGS for all stages of open-angle glaucoma.

Clinically Observable Ocular Manifestations of Axonal Transport

This report illustrates and provides a novel explanation for post-trabeculectomy improvements in the visual field, cup disc contours, and apparent deepening of an arcuate nerve fiber layer (NFL) defect after trabeculectomy for open-angle glaucoma. These changes are all plausible manifestations of recovered axonal transport and thickening retina, previously thinned by elevated intraocular pressure (IOP). Serial pre-and post-operative clinical fundus photos in case 1(A,B) demonstrate increased prominence of an inferior temporal arcuate nerve fiber layer defect, improved cup disc ratio, and visual field following eye pressure lowering by + 50% after trabeculectomy. Case 2 (C,D) also demonstrates obvious cup disc improvement in post-operative photos with associated improvement in visual field after trabeculectomy and lowering IOP by + 30%. We suggest that elevated IOP suppresses primarily orthograde axonal transport resulting in nerve fiber layer (NFL) thinning that can recover back to normal thickness when IOP is surgically lowered by the magnitude achieved in these two examples.

Gel Stent Versus Trabeculectomy: The Randomized, Multicenter, Gold-Standard Pathway Study (GPS) of Effectiveness and Safety at 12 Months

To compare effectiveness and safety of the gel stent to trabeculectomy in open-angle glaucoma (OAG). Prospective, randomized, multicenter, noninferiority study. Patients with OAG and intraocular pressure (IOP) 15 to 44 mm Hg on topical IOP-lowering medication were randomized 2:1 to gel stent implantation or trabeculectomy. Primary end point (surgical success): percentage of patients at month 12 achieving ≥20% IOP reduction from baseline without medication increase, clinical hypotony, vision loss to counting fingers, or secondary surgical intervention (SSI) in a noninferiority test with 24% margins. Secondary end points (month 12) included mean IOP and medication count, postoperative intervention rate, visual recovery, and patient-reported outcomes (PROs). Safety end points included adverse events (AEs). At month 12, the gel stent was statistically noninferior to trabeculectomy (between-treatment difference [Δ], -6.1%; 95% CI, -22.9%, 10.8%); 62.1% and 68.2% achieved the primary end point, respectively (P=.487); mean IOP and medication count reductions from baseline were significant (P<.001); and the IOP change-related Δ (2.8 mm Hg) favored trabeculectomy (P=.024). The gel stent resulted in fewer eyes requiring in-office postoperative interventions (P=.024 after excluding laser suture lysis), faster visual recovery (P≤.048), and greater 6-month improvements in visual function problems (ie, PROs; P≤.022). The most common AEs were reduced visual acuity at any time (gel stent, 38.9%; trabeculectomy, 54.5%) and hypotony (IOP <6 mm Hg at any time) (gel stent, 23.2%; trabeculectomy, 50.0%). At month 12, the gel stent was statistically noninferior to trabeculectomy, per the percentage of patients achieving ≥20% IOP reduction from baseline without medication increase, clinical hypotony, vision loss to counting fingers, or SSI. Trabeculectomy achieved a statistically lower mean IOP, numerically lower failure rate, and numerically lower need for supplemental medications. The gel stent resulted in fewer postoperative interventions, better visual recovery, and fewer AEs.

Long-Term Efficacy and Safety of Modified Canaloplasty Versus Trabeculectomy in Open-Angle Glaucoma.

To evaluate the long-term efficacy and safety of modified canaloplasty versus trabeculectomy in open-angle glaucoma. In total, 210 subjects with open-angle glaucoma were included. 70 were treated with Mitomycin C-augmented modified canaloplasty with enhanced subconjunctival filtration and 140 with Mitomycin C-augmented trabeculectomy. Cases were matched 1:2 by sex and age. In canaloplasty and trabeculectomy groups, 61.4% and 57.9% of participants were female. Mean age was 60.0 ± 13.9 and 63.0 ± 12.2 years, median follow-up time was 4.6 [IQR 4.3, 5.05] years and 5.8 [IQR 5.4, 6.3]. Strict success was achieved in 20.0% and 56.4%, complete success in 24.3% and 66.4%, and qualified success in 34.3% and 73.6% (each p < 0.001). Kaplan-Meier survival analysis showed a better survival probability for trabeculectomy than for canaloplasty (p < 0.001) and Cox regression analysis revealed an HR of 6.03 (95%-CI 3.66, 9.93, p < 0.001) after canaloplasty. Trabeculectomy showed superiority in terms of IOP decrease (9.2 ± 7.9 mmHg vs. 13.7 ± 10.4 mmHg, p = 0.002), use of AGM (50.0% vs. 10.7%, p < 0.001), and the number of revision surgeries (41.4% vs. 21.4%, p = 0.004). Occurrence of complications was similar in both groups (14.5% vs. 7.5%, p = 0.19). Trabeculectomy showed superiority in efficacy and equality in safety compared to modified canaloplasty.

Subconjunctival Bevacizumab Versus Mitomycin-C as an adjunctive therapy to Trabeculectomy in Open Angle Glaucoma

Subconjunctival Bevacizumab Versus Mitomycin-C as an adjunctive therapy to Trabeculectomy in Open Angle Glaucoma

Long-term success after trabeculectomy in open-angle glaucoma: results of a retrospective cohort study

ObjectiveTo evaluate the long-term outcomes of trabeculectomy (TE) surgery in a large cohort with a minimum follow-up of 3 years.DesignRetrospective cohort study.SettingUniversity Eye Hospital, Germany.ParticipantsThree hundred and seventy-nine patients with...

Waveform changes of laser speckle flowgraphy in the temporal optic nerve head and peripapillary atrophy after trabeculectomy in open-angle glaucoma

A prospective study was conducted on 33 eyes of 33 patients with open-angle glaucoma who underwent trabeculectomy to investigate hemodynamic changes in the temporal optic nerve head (ONH) and peripapillary atrophy (PPA) after trabeculectomy. Laser speckle flowgraphy of ONH and PPA was performed at baseline and at 1, 3, and 6 months postoperatively. The waveforms of the mean blur rate in the tissue area (MT) in the temporal ONH, βPPA (with Bruch’s membrane), and γPPA (without Bruch’s membrane) were evaluated. Mean intra-ocular pressure (IOP) decreased from 19.1 ± 0.8 to 8.5–9.6 ± 0.7 mmHg at postoperative visits. The average MT in the βPPA region increased significantly at all postoperative time points, whereas those in the ONH and γPPA regions remained unchanged. The blowout score (BOS) increased significantly, and the resistivity index decreased significantly at all time points in all regions, which was associated with decreased IOP. The current study showed two novel findings: MT increased after trabeculectomy only in βPPA, where the choroid was present. IOP decrease-associated BOS increase occurred postoperatively in all regions, which indicates that IOP reduction may decrease vascular transmural pressure and contribute to stable blood flow uniformly, despite structural differences between the regions.

Effect of Prior Phacoemulsification Surgery in Trabeculectomy Surgery Outcomes.

PurposeTo evaluate whether previous clear-cornea phacoemulsification surgery affects the surgical outcomes of trabeculectomy in open-angle glaucoma (OAG).MethodsWe performed a retrospective cohort study, which included 82 patients with OAG that underwent trabeculectomy between January 1, 2010, and December 31, 2017. The primary outcome was the probability of surgical failure. Failure was defined as IOP >21 mmHg or reduced <20% from baseline, IOP ≤5 mmHg in three consecutive visits, need for further glaucoma surgery, phthisis or loss of light perception vision due to glaucoma.ResultsEighty-two eyes (58 phakic and 24 pseudophakic) were included. Phakic group patients were younger than those in the pseudophakic group, 65.8 ± 11.7 vs 76.2 ± 7.9 years (p < 0.001). The most common type of glaucoma was primary OAG [59% (n = 34) phakic vs 63% (n = 15) pseudophakic], followed by exfoliative and pigmentary glaucomas. The mean preoperative IOP was not significantly different between groups nor was the number of preoperative hypotensive medications. The rate of surgical failure was not significantly different between groups at year 1 [17% (n = 10) phakic vs 29% (n = 7) pseudophakic; p = 0.361] nor at year 2 [28% (n = 16) phakic vs 46% (n = 11) pseudophakic; p = 0.110]. No significant differences were observed regarding the postoperative IOP or any secondary outcome measures at year 1 or 2.ConclusionPrevious clear-cornea phacoemulsification surgery does not lead to statistically significant differences in the rate of trabeculectomy failure. Despite not being significant, clinically relevant differences were observed between groups. Future studies with a larger sample and/or randomized are needed to clarify this association.

Outcomes of Trabeculectomy at a Newly Established Glaucoma Clinic in Khyber Pakhtunkhwa

Purpose: To determine the outcomes of trabeculectomy in patients with open angle glaucoma at a newly established glaucoma clinic in a tertiary care hospital of Khyber Pakhtunkhwa. Study Design: Retrospective chart review. Place and Duration of Study: Glaucoma Clinic, Hayatabad Medical Complex, Peshawar from May 2018 to December 2019. Methods: A retrospective chart review of patients of 18 years age or above and who underwent trabeculectomy for open angle glaucoma, with at least one follow-up visit were included. Data was collected for age, gender, type of glaucoma, preoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of pre-operative/post-operative topical anti-glaucoma medications, indication for trabeculectomy, preoperative comorbidities and postoperative complications. Data were analyzed using SPSS version 23. The student’s paired t-test was used for comparative analysis of the same group. A p-value of &lt; 0.05 was considered significant. Results: A total of 20 eyes of 20 patients were included in this study, 13 (65%) patients were males, and the mean age was 54.60 ± 18.22 years. There was a statistically significant change in mean IOP postoperatively (35.60 ± 13.28 versus 11.2 ± 6.1, P &lt; 0.001) and number of antiglaucoma medication (2.95 ± 1.19 versus 0.4 ± 0.99, P &lt; 0.001). While there was no significant change in best-corrected visual acuity (1.35 ± 0.88 versus 1.06 ± 0.72, p = 0.36). Conclusion: Trabeculectomy performed at the newly established glaucoma clinic showed a significant reduction in Intraocular pressure without compromising the visual acuity of the study participants. Key Words: Trabeculectomy; Open Angle Glaucoma; Intraocular pressure.

Intraocular Pressure, Axial Length, and Refractive Changes after Phacoemulsification and Trabeculectomy for Open-Angle Glaucoma.

Purpose To compare changes in intraocular pressure (IOP), axial eye length (AEL), and refractive outcome in primary open-angle glaucoma patients undergoing cataract surgery and trabeculectomy in dependence of the sequence of surgeries. Materials and Methods We retrospectively analysed 48 eyes. The changes in refraction, intraocular pressure, and axial eye length were analysed after surgery. In group A (21 subjects), phacoemulsification was performed before trabeculectomy, and in group B (27 subjects), trabeculectomy was performed before phacoemulsification with a minimum time span between interventions of 6 months. Results The reduction in IOP and the decrease in AEL after trabeculectomy were significant after 6 and 12 months postsurgery (p < 0.001 each). The decrease in AEL was 0.42 ± 0.11% at 6 months after surgery and 0.40 ± 0.13% after 12 months from surgery; this decrease in AEL was comparable between the groups. The refractive outcome was significantly different between the groups (group A: 0.35 ± 0.75 dpt, group B: −0.05 ± 0.36 dpt, p = 0.018); in group A, trabeculectomy caused a hyperopic shift of 0.34 ± 0.44 dpt (p = 0.002) at 12 months postsurgery. Conclusion IOP reduction after trabeculectomy causes AEL shortening. The effect on refractive outcome depends on the sequence of surgeries. Better refractive outcome is achieved if phacoemulsification is performed after trabeculectomy.

Trabeculectomy: long term visual field stability

PurposeEvaluation of 10 year visual field (VF) stability following trabeculectomy for open angle glaucoma (OAG).MethodsConsecutive visual fields (VFs) of patients who had undergone primary trabeculectomy for OAG were reviewed for evidence of glaucomatous progression. Progression rate was determined by the difference between the better of the last two Mean Deviations (MDs) and the better of the first two MDs (or first and last MD if &lt;4 VFs were available), divided by time. &lt;0.3 dB/year was classified as stable, ≥0.3 dB/year as borderline progression and ≥0.5 dB/year as definite progression. Eyes with &lt;3 reliable VFs over &lt;2 years were excluded.Results143 eyes (120 patients) underwent trabeculectomy; 84 (66 patients) met the inclusion criteria. Mean follow‐up was 11.2 ± 1.71 years; IOP (mean ± SD) at final review was 11.5 ± 4.2 mmHg. Mean progression rate was 0.14 dB/year; 66.7% (56/84) eyes were stable, 15.5% (13/84) showed evidence of borderline progression and 19% (16/84) definite progression.Of those with definite progression, 62.5% (10/16) failed to achieve good IOP control post‐operatively (final IOP was &gt;13 mmHg) or had VF loss attributable to causes other than glaucoma. Only 6 (7.1%) eyes progressed despite good IOP control.ConclusionsIn the majority of cases, current trabeculectomy surgery can achieve VF stability or markedly curtailed progression for at least 10 years.

Meta-analysis of randomized controlled trials comparing EX-PRESS implantation with trabeculectomy for open-angle glaucoma.

PurposeTo evaluate the efficacy and safety of EX-PRESS implantation compared with trabeculectomy for uncontrolled open-angle glaucoma.MethodsPertinent randomized controlled trials were identified through systematic searches of the PubMed, EMBASE, and Cochrane Library. The efficacy measures utilized were the weighted mean differences (WMDs) for the intraocular pressure reduction (IOPR), the reduction in glaucoma medications, the change of visual acuity, and the relative risks (RRs) for operative success rates. The safety measures utilized were RRs for postoperative complications. The pooled effects were calculated using the random-effects model.ResultsFour randomized controlled trials of 292 eyes were included in this meta-analysis. The WMDs of the IOPR comparing the EX-PRESS with trabeculectomy were −0.25 (95% Cl: −3.61 to 3.11) at 6 month, 0.053 (−4.31 to 4.42) at 12 months, 0.81 (−4.06 to 5.67) at 24 months, and 0.20 (−2.11 to 2.51) at final follow-up. There was no statistically significance for IOPR at any point after surgery. There were also no significant differences in the reduction in glaucoma medications or visual acuity between the groups. The pooled relative risks comparing EX-PRESS with Trabeculectomy were 1.36 (1.11 to 1.66) for the complete operative success rate and 1.05 (0.94 to 1.17) for the qualified operative success rate. EX-PRESS and Trabeculectomy were associated with similar incidences in most complications with the exception of hyphema, with pooled RR being 0.18 (0.046 to 0.66).ConclusionsEX-PRESS implantation and trabeculectomy have similar efficacy in IOP-lowering, medication reduction, vision recovery, and qualified operative success rates. EX-PRESS associated with higher rates of complete operative success and fewer hyphema than with Trabeculectomy. However, these should be interpreted with caution because of the inherent limitations of the included studies.

Trabeculectomy for Open-angle Glaucoma in Phakic Eyes vs in Pseudophakic Eyes After Phacoemulsification

Whether pseudophakic eyes are resistant to trabeculectomy remains unknown. To determine the effect of previous phacoemulsification on surgical success of trabeculectomy with mitomycin C for open-angle glaucoma. Prospective clinical cohort study at Kumamoto University Hospital, Kumamoto, Japan, among patients 55 years or older having open-angle glaucoma with intraocular pressure (IOP) of 22 mm Hg or higher, including 39 phakic eyes (phakic group) and 25 pseudophakic eyes after phacoemulsification (pseudophakic group). Trabeculectomy with mitomycin C was performed. The primary outcome measure was the probability of success at 1 year after trabeculectomy. Surgical failure was defined as the following 3 IOP levels: 21 mm Hg or higher (criterion A), 18 mm Hg or higher (criterion B), and 15 mm Hg or higher (criterion C). Secondary outcome measures included IOP, the number of postoperative antiglaucoma medications, and the number of laser suture lysis procedures, as well as postoperative complications. The probabilities of success at 1 year in the phakic vs pseudophakic groups were 95% vs 74% for criterion A (P = .02), 84% vs 62% for criterion B (P = .04), and 67% vs 53% for criterion C (P = .10). Only pseudophakia was significantly associated with outcome in the multivariable analysis for criterion A (relative risk, 9.37) and for criterion B (relative risk, 5.52) (P = .01 for both). Postoperative IOP in the pseudophakic group was significantly higher than that in the phakic group at 6 months (P = .03) and 9 months (P = .047) after trabeculectomy. No significant difference between groups was noted in postoperative complications or in the number of postoperative antiglaucoma medications or the number of laser suture lysis procedures. Among patients with open-angle glaucoma, trabeculectomy with mitomycin C in pseudophakic eyes after phacoemulsification for target IOP of less than 21 mm Hg or less than 18 mm Hg is less successful compared with that in phakic eyes. No significant difference between phakic and pseudophakic eyes was observed for secondary outcome measures other than IOP. clinicaltrials.gov Identifier: University Hospital Medical Information Network Clinical Trials Registry of Japan UMIN000001196.

Selective Laser Trabeculoplasty after Failed Trabeculectomy in Open Angle Glaucoma

Objective: To determine the efficacy of selective laser trabeculoplasty (SLT) for uncontrolled open angle glaucoma (OAG) on maximal tolerated medical therapy and with a history of previously failed trabeculectomy. Methods: This was a prospective, non-randomized, interventional case series. Participants included 22 eyes of 20 consecutive glaucoma patients with a previously failed trabeculectomy and medically uncontrolled intraocular pressure, unable or unwilling to undergo further incisional surgery. A single SLT treatment was performed over 270° to 360°, and participants were followed for a minimum of 12 months. Success was defined in two separate analyses as 1) absolute IOP reduction ≥ 3 mm Hg and 2) percentage IOP reduction of 20% or 15% without additional laser or surgical intervention. Results: The mean IOP dropped from 20.8 mm Hg to 16.3 mm Hg 12 months after SLT. The mean reduction in IOP was 19.5% or 4.5 mm Hg (95% confidence interval, 1.06-7.92, p<0.001). The cumulative success rate at 12 months (3 mmHg IOP reduction) was 16%. There was no statistically significant change in the number of medications (2.2 ± 0.8 to 2.0 ± 1.1). Conclusions: In the short- and intermediate-term, SLT had mild to moderate success in achieving lower IOP in individuals with medically uncontrolled OAG with previously failed trabeculectomy.

Low-dose subconjunctival bevacizumab to augment trabeculectomy for glaucoma

Background:The purpose of this study was to assess the effect of bevacizumab in maintaining intraocular pressure lowered by trabeculectomy in refractory open-angle glaucoma.Methods:Thirty-seven eyes from 37 patients referring to Nikoukari Ophthalmology University Hospital in Tabriz were enrolled in this randomized clinical trial. Seventeen patients were randomly assigned to receive bevacizumab augmentation after trabeculectomy, and 20 patients were assigned to a control group receiving a placebo injection of normal saline. Bevacizumab was injected subconjunctivally at a dose of 0.2 mg. Intraocular pressure was measured on eight occasions, ie, at baseline, 24 hours, 3 days, 7 days, 2 weeks, 1 month, 2 months, and 3 months after treatment.Results:Men constituted 81% of the participants, who were of mean age 67.5 years. Twenty-nine patients had secondary open-angle glaucoma, while eight patients had primary open-angle glaucoma. Intraocular pressure decreased from a mean of 28.4 mmHg at baseline to a mean of 12.1 mmHg during the first day and to 15.1 mmHg after 3 months. Adding bevacizumab to trabeculectomy was not found to affect intraocular pressure differently to placebo. Neither the results of repeated measurements analysis nor single comparison statistical tests were significant for a difference in efficacy of bevacizumab versus placebo.Conclusion:Subconjunctival bevacizumab 0.2 mg was not found to affect the trend in intraocular pressure more than placebo after trabeculectomy for open-angle glaucoma.

Comparison of long-term surgical success of Ahmed Valve implant versus trabeculectomy in open-angle glaucoma

Comparison of long-term surgical success of Ahmed Valve implant versus trabeculectomy in open-angle glaucoma

Long-term Outcomes of Repeat vs Initial Trabeculectomy in Open-Angle Glaucoma

To evaluate the long-term intraocular pressure (IOP) control and to identify risk factors for failure of repeat trabeculectomy with mitomycin C (MMC) in patients with open-angle glaucoma. Retrospective case-control study. Seventy-five eyes (67 patients) that had undergone repeat trabeculectomy with MMC were matched to 75 eyes (64 patients) that had undergone initial trabeculectomy with MMC according to age, gender, race, diagnosis, preoperative IOP, number of glaucoma medications, and lens status in an institutional setting. Surgical successes were defined as: 1) IOP < or =18 mm Hg and > or = 20% reduction in IOP, 2) < or = 15 mm Hg IOP and > or = 25% reduction in IOP, and 3) < or = 12 mm Hg IOP and > or = 30% reduction in IOP from baseline, with or without glaucoma medications, and were assessed by Kaplan-Meier survival analyses. Risk factors for failure in the repeat trabeculectomy group were analyzed by the Cox proportional hazard regression model. The main outcome measures were success rate, number of medications, and visual acuity. Eyes that underwent initial trabeculectomy with MMC had a statistically significantly higher cumulative surgical success rate than those that underwent repeat trabeculectomy with MMC at 3 years according to criteria B (61.3% vs 41.3%; P = .022) and C (52.0% vs 32.0%; P = .021). In eyes that underwent repeat trabeculectomy, younger age and requirement of laser suture lysis were significant risk factors for surgical failure. Eyes that underwent initial trabeculectomy required a statistically fewer number of medications than eyes that underwent repeat trabeculectomy (0.6 vs 1.2; P = .013). Repeat trabeculectomy with MMC is less successful at achieving IOP reduction in open-angle glaucoma than is initial trabeculectomy with MMC at 3 years or more.

Comparison of long-term surgical success of Ahmed Valve implant versus trabeculectomy in open-angle glaucoma

Aim:To compare the long-term intraocular pressure (IOP) outcomes of Ahmed Glaucoma Valve (AGV) implantation to trabeculectomy with mitomycin C (MMC) in open-angle glaucoma (OAG).Methods:78 OAG patients who underwent AGV implantation...

The clinical effect of no penetrating trabeculectomy in open angle glaucoma

目的 探讨非穿透小梁切除术术中联合丝裂霉素C应用及透明质酸钠凝胶植入术治疗开角型青光眼的疗效.方法 对17例(20眼)开角型青光眼施行非穿透小梁切除术术中联合丝裂霉素C应用及透明质酸钠凝胶植入术.术中患者年龄不同,放置丝裂霉素C的时间亦不同.术后观察眼压、视功能、滤过泡及眼内反应等,随访8～36月.结果 术中1例(1眼)因穿透前房改行复合式小梁切除术外,其余16例(19眼)术后眼压9～17 mmHg,视力同术前.所有患者未见严重并发症发生.结论 非穿透小梁切除术术中联合丝裂霉素C应用及透明质酸钠凝胶植入术是治疗开角型青光眼较好的一种手术方法。