Intermediate-term outcomes of Aurolab aqueous drainage implant in refractory paediatric glaucoma

AimTo report the intermediate-term outcomes of Aurolab aqueous drainage implant (AADI) surgery in paediatric eyes with refractory glaucoma.MethodsCase records of patients below 18 years, who underwent AADI surgery between 2012 and 2015 with >2 years follow-up, were analysed. The intraocular pressure (IOP), visual acuity, number of antiglaucoma medications, complications and resurgery if any were recorded at baseline, day 1and then at months 1, 3, 6, 9, 12, 18, 24 and at the last visit. Failure was defined as IOP >18 mm Hg or not reduced by at least 30% below baseline, IOP ≤5 mm Hg on two consecutive follow-up visits after 3 months, reoperation for a complication or loss of light perception vision.Results101 eyes of 101 patients were included with a mean age of 10.4±4.7 years at the time of surgery and a mean follow-up of 40.9±15.1 months. Glaucoma following cataract surgery was the most common type of glaucoma (n=31, 30%), followed by primary congenital glaucoma (n=29, 29%). The cumulative probability of failure was 15.8% (95% CI 10.1% to 24.5%) at 1 year, 22.7% (95% CI 15.7% to 32.2%) at 2 years, 42.5% (95% CI 32.6% to 53.9%) at 3 years and 62.1% (95% CI 49.5% to 74.8%) at the 4 years time point.ConclusionThe AADI showed excellent success until 2 years after surgery in paediatric eyes after which failure rates increased. Further prospective studies with longer follow-up are required to evaluate the long-term success of the AADI for paediatric glaucomas.

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Long-term functional outcomes of different subtypes of primary congenital glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315131 ◽

2019 ◽

pp. bjophthalmol-2019-315131 ◽

Cited By ~ 2

Author(s):

Richard Sher Chaudhary ◽

Amisha Gupta ◽

Ajay Sharma ◽

Shikha Gupta ◽

Rayees Ahmad Sofi ◽

...

Keyword(s):

Visual Acuity ◽

Congenital Glaucoma ◽

Cumulative Probability ◽

Primary Congenital Glaucoma ◽

Visual Outcomes ◽

Post Surgery ◽

Kaplan Meier ◽

Significant Difference

AimTo analyse long-term visual outcomes across different subtypes of primary congenital glaucoma (PCG).MethodsPatients with PCG with a minimum of 5-year follow-up post surgery were included in the study. Snellen visual acuity recordings taken at their last follow-up were analysed. We evaluated the results using Kaplan-Meier curves to predict the probability of maintaining good vision (as defined by a visual acuity of 6/18 or better) in our patients after 30-year follow-up. The results were also analysed to determine whether there were any differences in the long-term visual acuities with time between the neonatal and infantile PCG. We also analysed the reasons for poor visual outcomes.ResultsWe assessed a cohort of 140 patients with PCG (235 eyes) with an average follow-up of 127±62.8 months (range 60–400 months). Overall, the proportion of eyes with good visual acuity was 89 (37.9%), those with fair visual acuity between 6/60 and 6/18 was 41 (17.4%), and those with poor visual acuity (≤6/60) was 105 (44.7%). We found a significant difference (p=0.047) between neonatal and infantile patients with PCG whereby the neonatal cohort fared worse off in terms of visual morbidity. On Kaplan-Meier analysis, the cumulative probability of survival of a visual acuity of 6/18 or better was more among the infantile PCG in comparison to the neonatal PCG (p=0.039) eyes, and more among the bilateral than the unilateral affected eyes (p=0.029). Amblyopia was the most important cause for poor visual acuity as shown on a Cox proportional-hazards regression model .ConclusionsLong-term visual outcomes of infantile are better than neonatal PCG. Eyes with unilateral have worse visual outcomes compared with those with bilateral PCG because of the development of dense amblyopia.

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On the problem of the classification of congenital glaucoma

Russian Pediatric Ophthalmology ◽

10.18821/1993-1859-2016-11-4-179-183 ◽

2016 ◽

Vol 11 (4) ◽

pp. 179-183 ◽

Cited By ~ 1

Author(s):

L. A Katargina ◽

Andrei Olegovich Tarasenkov ◽

E. V Mazanova

Keyword(s):

Visual Acuity ◽

Age And Growth ◽

Congenital Glaucoma ◽

Initial Examination ◽

Anatomical Changes ◽

Long Term Follow Up ◽

Objective State

Objective. To monitor congenital glaucoma and to determine the proportion of the exposed stage of the disease revealed during the initial examination and the long-term follow up. Materials and methods. The present study included 27 children (47 eyes) at the age ranging from 8 to 17 years presenting with various forms of compensated congenital glaucoma at the initial, advanced, and terminal stages of the disease. Results. The clinical and functional characteristics of the eyes at each stage of congenital glaucoma were analyzed during the initial examination and the long-term follow-up period. It was found that the currently universally accepted classification of congenital glaucoma that subdivides the disease into stages based on the structural anatomical changes in the eyes ceases to adequately reflect the objective state of the visual system as the child grows. Conclusion. The study has demonstrated that the stage of congenital glaucoma needs to be corrected in accordance with the age and growth of the child and the possibility of its examination with the use of the psychophysical methods and the evaluation of visual acuity.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v3 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

Abstract Background To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in a Chinese population. Methods We retrospective compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in these two groups underwent a corresponding procedure from June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, the number of anti-glaucoma agents used and complications were reviewed and compared between groups. Proper statistical methods were selected according to comparison models under IBM SPSS 25 software. Results After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents used in the two groups were both reduced than the baseline level, and the differences were statistically significant (P<0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P＞0.05). In terms of complications, the pain at 1 day after surgery in the UCP group was significantly milder than that in the TSCP group (P<0.05). And there were no significant differences in other complications between the two groups (P>0.05). Conclusions Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.

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Comparison of outcomes between Aurolab aqueous drainage implant placed in the superotemporal versus inferonasal quadrant

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315558 ◽

2020 ◽

pp. bjophthalmol-2019-315558

Author(s):

George Varghese Puthuran ◽

Paul Frederic Palmberg ◽

Hiruni Kaushalya Wijesinghe ◽

Thandra Sai Shreya ◽

S R Krishnadas ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Light Perception ◽

Refractory Glaucoma ◽

Significant Drop ◽

Time Points ◽

Corrected Visual Acuity ◽

Surgical Option ◽

Best Corrected Visual Acuity

AimTo determine the outcomes of Aurolab aqueous drainage implant (AADI) placed in the superotemporal versus the inferonasal quadrant in adult eyes with refractory glaucoma.MethodsThis was a retrospective study of eyes that had AADI placement and completed a minimum of 2-year follow-up. The choice of the quadrant was at the surgeon’s discretion and mainly depended on the amount of scarring and conjunctival mobility. The cumulative failure rate of the AADI was defined as intraocular pressure (IOP) >21 mm Hg or not reduced by 20% below baseline on two consecutive follow-up visits after 3 months, IOP ≤5 mm Hg on two consecutive follow-up visits after 3 months, reoperation for glaucoma or a complication, or loss of light perception vision.ResultsWe included 84 eyes with AADI in the inferonasal quadrant versus 69 eyes in the superotemporal quadrant. A significant drop in IOP was seen in both groups (18.4±10.4 mm Hg in the inferonasal group vs 17.7±11.1 mm Hg in the superotemporal group; p=0.63) at 3-month follow-up and this was maintained until last follow-up. Best-corrected visual acuity, IOP, number of IOP-lowering medications and complications were similar between the two groups at all time points. The cumulative success rate at 2-year follow-up without IOP-lowering medications was 57.1% (47.1%–68.1%) in the inferonasal group and 50.7% (39.8%–63.1%) in the superotemporal group (p=0.47).ConclusionsInferonasal AADI placement appears to be an equally safe and effective surgical option compared with superotemporal AADI placement and may be helpful in certain clinical situations.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v1 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

Abstract Background: To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in Chinese population. Methods: We retrospective compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in this two groups underwent a corresponding procedure during June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, use of anti-glaucoma agents and complications were reviewed and compared between the two groups. Results: After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents, which were used postoperatively in the two groups were both lower than the baseline level, and the differences were statistically significant (P<0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P＞0.05). In terms of complications, the pain at 1d after surgery in the UCP group was significantly milder than that in the TSCP group (P<0.05), while there were no significant differences in other complications between the two groups (P>0.05).Conclusions: Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.

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Comparison of ultrasound cycloplasty and transscleral cyclophotocoagulation for refractory glaucoma in Chinese population

BMC Ophthalmology ◽

10.1186/s12886-020-01655-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

Abstract Background To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in a Chinese population. Methods We retrospectively compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in these two groups underwent a corresponding procedure from June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, the number of anti-glaucoma agents used and complications were reviewed and compared between groups. Proper statistical methods were selected according to comparison models under IBM SPSS 25 software. Results After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents used in the two groups were both reduced than the baseline level, and the differences were statistically significant (P < 0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P>0.05). In terms of complications, the pain at 1 day after surgery in the UCP group was significantly milder than that in the TSCP group (P < 0.05). And there were no significant differences in other complications between the two groups (P > 0.05). Conclusions Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v4 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

Abstract Background: To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in a Chinese population. Methods: We retrospective compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in these two groups underwent a corresponding procedure from June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, the number of anti-glaucoma agents used and complications were reviewed and compared between groups. Proper statistical methods were selected according to comparison models under IBM SPSS 25 software.Results: After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents used in the two groups were both reduced than the baseline level, and the differences were statistically significant (P<0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P＞0.05). In terms of complications, the pain at 1 day after surgery in the UCP group was significantly milder than that in the TSCP group (P<0.05). And there were no significant differences in other complications between the two groups (P>0.05).Conclusions: Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.

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The Long-term Visual Outcomes of Primary Congenital Glaucoma

Journal of Ophthalmic and Vision Research ◽

10.18502/jovr.v15i3.7451 ◽

2020 ◽

Author(s):

Hamed Esfandiari ◽

Alisa Prager ◽

Kiana Hassanpour ◽

Sudhi P. Kurup ◽

Rebecca Mets-Halgrimson ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Congenital Glaucoma ◽

Series Data ◽

Final Visit ◽

Primary Congenital Glaucoma ◽

Surgical Success ◽

Visual Outcomes

Purpose: To evaluate the long-term visual outcomes of ab externo trabeculotomy for primary congenital glaucoma (PCG) at a single pediatric ophthalmology center. Methods: In this retrospective single-center case series, data from 63 eyes of 40 patients who underwent ab externo trabeculotomy between September 2006 and June 2018 were included. The data were analyzed for best corrected visual acuity (BCVA), stereopsis, and surgical success. Kaplan–Meier analysis was performed using the surgical success criteria defined as intraocular pressure (IOP) ≤ 21 mmHg and ≥ 20% below baseline without the need for additional glaucoma surgery. Results: BCVA at the time of diagnosis was 0.37 ± 0.48 logMAR, which changed to 0.51 ± 0.56 logMAR at the final follow-up (P = 0.08). Twenty-five percent of patients had BCVA equal to or better than 20/40 at the final visit. The mean refraction at baseline was –4.78 ± 5.87 diopters, which changed to less myopic refraction of –2.90 ± 3.83 diopters at the final visit. Optical correction was prescribed in 66% of eyes at the final visit. The average final stereopsis was 395.33 sec of arc. The linear regression model showed a significant association between the surgery success rate and final BCVA as well as stereoacuity (Pvalues: 0.04 and 0.03, respectively). Intraocular pressure (IOP) decreased significantly from 29.79 ± 7.67 mmHg at baseline to 16.13 ± 3.41 mmHg at the final follow-up (P = 0.001). Conclusion: Patients with PCG can achieve an acceptable visual acuity and stereoacuity, particularly in cases of timely intervention and close follow-up.

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Evaluation of the long-term effect of foldable capsular vitreous bodies in severe ocular rupture

International Journal of Ophthalmology ◽

10.18240/ijo.2021.12.19 ◽

2021 ◽

Vol 14 (12) ◽

pp. 1935-1940

Author(s):

Jin Deng ◽

◽

Rong-Le Zhou ◽

Tao Chen ◽

Jian-Zhou Wang ◽

...

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Vitreous Body ◽

Term Effect ◽

Subjective Feeling ◽

Light Perception ◽

Long Term Effect ◽

Before And After

AIM: To evaluate the long-term effect of foldable capsular vitreous body (FCVB) in the treatment of severe ocular rupture to provide a practical basis for clinical selection. METHODS: A total of 26 patients (26 eyes), 23 men and 3 women, with severe ocular rupture who underwent FCVB implantation between March 2018 and September 2018 were retrospectively analysed. All open ocular wounds located in zone III, with preoperative visual acuity grade IV and above (Snellen less than 4/200). The best corrected visual acuity (BCVA), intraocular pressure (IOP), cornea, anterior chamber, iris, lens, choroid, and retina were evaluated before and after the surgery. The subjective feeling and the location of FCVB were also assessed. RESULTS: The average age of the 26 patients was 36y (20-60y). Postoperative follow-up was from 10 to 14mo. At the end of follow up, BCVA was light perception (LP) in 10 cases, no light perception (NLP) in 13 cases, hand motions (HM) in 3 cases. IOP was 11±5 mm Hg. Corneal degeneration was in 3 cases and corneal endothelial dystrophy was in 7 cases. Shallow anterior chamber was in 8 cases and hyphema was in 8 cases. Organized membrane in the pupil was in 14 cases. Epiphora occurred in 3 cases. FCVB drainage tube exposed in 3 cases. All FCVBs were in their normal location and no rejection occurred. CONCLUSION: FCVB implantation is a long-term effective treatment and may provide a practical selection for severe ocular rupture.

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