Surgical Outcomes of Trabeculectomy in Uveitic Glaucoma: A Long-Term, Single-Center, Retrospective Case-Control Study

Purpose. To evaluate the long-term outcomes of trabeculectomy with mitomycin C (MMC-TLE) in patients with uveitic glaucoma (UG). Patients and Methods. This was a retrospective, nonrandomized case series study. MMC-TLE was performed on 50 eyes with UG between February 2001 and January 2015 at Hokkaido University Hospital. Age- and sex-matched patients with primary open angle glaucoma (POAG) who underwent MMC-TLE were matched by age and sex and enrolled as controls. Surgical success was defined as an intraocular pressure (IOP) less than 18 or 15 mmHg. The Kaplan–Meier survival curves for surgical failure were analyzed. Results. The mean preoperative IOP in UG and POAG was 27.6 ± 10.6 and 18.0 ± 4.5 mmHg, respectively. After the surgery, the mean IOP in UG and POAG was reduced to 11.7 ± 4.2 and 12.2 ± 3.8 mmHg at 12 months, 11.9 ± 7.0 and 12.1 ± 3.1 mmHg at 36 months, and 13.0 ± 5.2 and 10.6 ± 1.2 mmHg at 120 months, respectively. The success rates (IOP <18 mmHg, IOP reduction >20%) in UG and POAG were 91.7% and 88.0% at 12 months, 82.2% and 75.6% at 36 months, and 66.5% and 61.8% at 120 months, respectively. The success rates (IOP <15 mmHg) in UG and POAG were 64.0% and 58.0% at 12 months, 55.1% and 45.5% at 36 months, and 47.9% and 37.8% at 120 months, respectively. There was no significant difference in the success rate between UG and POAG at 120 months after surgery by either definition of surgical success. Conclusions. MMC-TLE effectively reduced IOP in both UG and POAG. There was no significant difference in the success rate between UG and POAG. Following sufficient inflammation suppression, surgical outcomes of UG may be comparable with those of POAG.

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The Effects of Trabeculectomy on Pseudoexfoliation Glaucoma and Primary Open-Angle Glaucoma

Journal of Ophthalmology ◽

10.1155/2020/1723691 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Fan Li ◽

Guangxian Tang ◽

Hengli Zhang ◽

Xiaowei Yan ◽

Lihua Ma ◽

...

Keyword(s):

Medical Treatment ◽

Success Rate ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Open Angle ◽

Success Rates ◽

Pseudoexfoliation Glaucoma ◽

Long Term Effects ◽

Surgical Success

Purpose. To compare long-term effects of trabeculectomy on pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG). Methods. This retrospective case-control study included 53 eyes of PXG and 76 eyes of POAG. Intraocular pressure (IOP), number of antiglaucoma medications used, surgical success rate, and occurrence of complications were observed and statistically analyzed in both groups at 3 and 6 months and at 1, 3, and 5 years after trabeculectomy. Surgical success was defined according to the following 3 criteria: (1) IOP ≤ 21 mmHg; (2) IOP ≤ 18 mmHg; (3) IOP ≤ 15 mmHg. Complete success is defined as patients met these criteria without medical treatment, and qualified success is defined as patients met these criteria with medical treatment (≤3 medications). Cumulative probabilities of success were compared using the Kaplan–Meier survival analysis. Results. For the 3 criteria, there were no statistically significant differences in complete and qualified success rates between the two groups at 3 and 6 months after trabeculectomy (P>0.05). For criterion A, complete success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion B, complete and qualified success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion C, complete and qualified success rates in PXG at 1, 3, and 5 years after surgery were lower than those in POAG, the differences were statistically significant (P<0.05). Conclusions. The short-term success rates of both types of glaucoma were similar; however, the long-term success rate of PXG was significantly lower, and it was difficult to achieve long-term control of IOP at a low target level.

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Comparing Upper Airway Stimulation to Expansion Sphincter Pharyngoplasty: A Single University Experience

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418771395 ◽

2018 ◽

Vol 127 (6) ◽

pp. 379-383 ◽

Cited By ~ 8

Author(s):

Colin Huntley ◽

David W. Chou ◽

Karl Doghramji ◽

Maurits Boon

Keyword(s):

Success Rate ◽

Upper Airway ◽

Upper Airway Stimulation ◽

Surgical Success ◽

Obstructive Sleep ◽

Significant Difference ◽

Expansion Sphincter Pharyngoplasty ◽

The Mean ◽

Sphincter Pharyngoplasty ◽

Surgical Option

Introduction: Expansion sphincter pharyngoplasty (ESP) is a surgical option for patients with obstructive sleep apnea (OSA). Upper airway stimulation (UAS) is an alternative that has shown success in initial outcomes studies. We compare outcomes of a cohort of patients undergoing UAS to ESP. Methods: We compared demographic and polysomnographic data of the UAS to ESP cohorts. We also calculated the proportion of patients achieving surgical success. Results: The ESP cohort consisted of 33 patients. The mean preoperative Apnea-Hypopnea Index (AHI), O2 nadir, Epworth Sleepiness Scale (ESS), and BMI were 36.47 ± 20.01, 82.63 ± 5.37, 10.69 ± 4.42, and 29.6 ± 4.49, which improved to 13.47 ± 18.74, 84.84 ± 5.48, 7.00 ± 5.81, and 29.92 ± 4.59 postoperatively. There was a 63.64% success rate. The UAS cohort consisted of 75 patients. The mean preoperative AHI, O2 nadir, ESS, and BMI were 36.76 ± 20.72, 80.24 ± 8.43, 11.18 ± 4.16, and 29.50 ± 3.96, which improved to 7.25 ± 11.19, 88.71 ± 3.25, 5.36 ± 3.35, and 29.36 ± 3.68 postoperatively. The success rate was 86.67%. We found a significant difference in gender, age, preoperative AHI, postoperative AHI, postoperative O2 nadir, surgical success, and patients reaching an AHI less than 10 and 5. Conclusion: Upper airway stimulation is a new surgical option for select patients with OSA showing comparable or improved outcomes to a cohort of patients undergoing ESP.

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Hepaticojejunostomy for Benign Disease: Long-Term Stricture Rate and Management

The American Surgeon ◽

10.1177/000313481908501228 ◽

2019 ◽

Vol 85 (12) ◽

pp. 1350-1353 ◽

Cited By ~ 1

Author(s):

Shannon M. Zielsdorf ◽

John J. Klein ◽

Vidya A. Fleetwood ◽

Martin Hertl ◽

Edie Y. Chan

Keyword(s):

Success Rate ◽

Benign Disease ◽

Success Rates ◽

Transplant Patients ◽

Stricture Rate ◽

Anastomotic Strictures ◽

The Mean ◽

Radiological Intervention

The objective of the study was to determine the long-term stricture rate of hepaticojejunostiomy (HJ) performed for benign disease, to compare stricture rates for transplant patients and non-transplant patients, and to compare the success rates of procedural and surgical treatment options. Hospital charts of 135 consecutive patients undergoing HJ between 1998 and 2016 were analyzed retrospectively. The primary outcome was stricture formation. Secondary outcomes were time to stricture diagnosis and success rates of various interventions. The anastomotic stricture rate was 13.3 per cent (18). The mean follow-up period was 4.3 years. The mean time to stricture diagnosis was 2.3 years. Stricture rates were similar between the transplant (19.2%) and nontransplant, non-Whipple group (13%). Strictures were treated with radiological intervention with a 44.4 per cent success rate; each required multiple interventions. Mortality from liver disease after failure of nonoperative management of HJ strictures reached 30 per cent (3). Five of ten patients who failed radiological intervention underwent HJ revision; the success rate was 80 per cent. Anastomotic strictures of HJ performed for benign disease occur in 13 per cent of patients and typically develop within 2.5 years postoperatively. Yet, given the dangerous sequelae of chronic biliary obstruction and potential delay in presentation, a follow-up is recommended for up to 10 years. When strictures occur, HJ revision should be considered early, after two failed radiological interventions.

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Surgical outcomes according to distance between preplaced suture and muscle insertion in lateral rectus recession

European Journal of Ophthalmology ◽

10.5301/ejo.5001045 ◽

2017 ◽

Vol 28 (3) ◽

pp. 253-258

Author(s):

Ki W. Jin ◽

Yoon P. Lee ◽

Dong G. Choi

Keyword(s):

Success Rate ◽

Surgical Outcomes ◽

Lateral Rectus ◽

Secondary Outcome ◽

Dose Ratio ◽

Surgical Success ◽

Muscle Insertion ◽

Angle Of Deviation ◽

The Mean

Purpose: To compare surgical outcomes according to the distance between the preplaced suture and the muscle insertion in lateral rectus (LR) recession for exotropia. Methods: We retrospectively reviewed 64 patients who had undergone unilateral LR recession by one right-handed surgeon and divided the patients into 2 groups: right LR recession (R group, 26 patients) and left LR recession (L group, 38 patients). In the R group, the preplaced suture was behind the hook, far from the insertion; in the L group, the suture was in front of the hook, near the insertion. The main outcome measures were postoperative alignment and surgical success rate and the secondary outcome measure was effect/dose ratio. Surgical success was defined as an alignment between 10 prism diopters (PD) of exodeviation and 5 PD of esodeviation both at distance and at near. The effect/dose ratio was defined as the corrected angle of deviation at postoperative 6 months divided by the amount of LR recession. Results: The mean angle of deviation at distance showed a significant difference between the groups at postoperative 3 months (p = 0.022), but not at final follow-up (p = 0.163). There was no difference between the groups in the mean angle of deviation at near postoperatively. Surgical success was achieved in 73.1% of the R group and 71.1% of the L group at final follow-up, which was not significant (p = 0.860). Conclusions: The distance between the preplaced suture and the muscle insertion in LR recession did not affect the surgical success rate or the postoperative alignment at final follow-up.

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Comparison between Ultrasound-guided TIVAD via the right innominate vein and the right internal jugular vein approach

10.21203/rs.2.12173/v2 ◽

2019 ◽

Author(s):

Xingwei Sun ◽

Xuming Bai ◽

Jiaofeng Shen ◽

Ziyang Yu ◽

Zhixiang Zhuang ◽

...

Keyword(s):

Success Rate ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Perioperative Complications ◽

Innominate Vein ◽

Success Rates ◽

Advantages And Disadvantages ◽

Significant Difference ◽

The Right

Abstract Purpose: To compare the efficacy and safety of right internal jugular vein (IJV) approach and right innominate vein (INV) approach for US-guided totally implantable venous access devices (TIVADs), and to explore the advantages and disadvantages of the two approaches. Methods: Six hundred and nineteen adult patients had long-term infusion and chemotherapy needs and inconvenience of peripheral venous infusion. Right INV approach was used to implant 339 cases of TIVADs, and right IJV approach was used to implant 280 cases of TIVADs. The success rate of one-time catheterization and the incidence of complications in the two groups were retrospectively analyzed. Results: All patients were successfully implanted in TIVAD. The success rates of one-time puncture in INV group and IJV approach group were 98.53% (334/339) and 95.36% (267/280), respectively. There was significant difference between the two groups (P=0.020). The incidence of perioperative complications was 1.18% (4/339) and the long-term complications was 3.54% (12/339) in the right INV group. The incidence of perioperative complications was 1.43% (4/280) and the long-term complications was 3.93% (11/280) in the right INV group. There was no significant difference in the incidence of complications between the two groups (P=0.785，P=0.799, respectively). Conclusions: US-guided TIVADs via the right INV approach and the right IJV approach are both safe and reliable. The right INV approach improves the one-time puncture success rate, as long as the technique is properly operated, serious complications rarely occur.

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Surgical Success Evaluation in Limbal Stem Cell Deficiency Due to Chemical Injury – How to Be Accurate?

10.21203/rs.3.rs-517607/v1 ◽

2021 ◽

Author(s):

Ilayda Korkmaz ◽

Melis Palamar ◽

Sait Egrilmez ◽

Mehmet Gurdal ◽

Ayse Yagci ◽

...

Keyword(s):

Stem Cell ◽

Success Rate ◽

Cell Transplantation ◽

Limbal Stem Cell Deficiency ◽

Grading System ◽

Success Rates ◽

Surgical Success ◽

Chemical Injury ◽

The Mean ◽

Limbal Stem Cell

Abstract Purpose: To evaluate limbal stem cell transplantation (LSCT) success in limbal stem cell deficiency (LSCD) due to chemical injury in a tertiary eye care center in Turkey by using ‘Limbal Stem Cell Working Group’ LSCD grading system.Methods: Medical records of 80 eyes of 80 patients who underwent LSCT for LSCD secondary to chemical injury were included. The patients were divided into 3 groups according to performed surgery as limbal autograft, limbal allograft, cultivated limbal epithelial cell transplantation (CLET). Surgical success was defined as improvement in the post-operative 1st year LSCD stage.Results: The mean age of the patients was 37.9±15.7(4-71) with a Male/Female ratio of 2.4. Forty-five(56.3%) patients were injured with alkaline and 16(20%) were injured with acid substance. The mean follow-up time was 60.3±30.6(6-118.6) months. Limbal autograft, allograft and CLET were performed in 58(72.5%), 12(15%) and 10(12.5%) eyes, respectively. The interval between injury and surgery in limbal autograft, limbal allograft and CLET were 43.3±94.1(0.5-592); 14.5±10.6(2.4-32.5) and 122.8±158.9(21.1-504) months, respectively (p=0.02). The overall surgical success rate was 65%. Surgical success rates in each groups were 65.5%, 41.7% and 90%, respectively (p=0.03).Conclusion: It is vital to accurately determine the stage of the LSCD in order to evaluate the surgical success rates. Surgery type and a longer time interval between the chemical injury and surgery seems to be the most important factors associated with a higher surgical success rate. Despite the limited subject number for subgroups, the results were remarkable to emphasize the significance of the novel LSCD grading system.

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Viscocanalostomy with Mitomycin-C: A Preliminary Study

European Journal of Ophthalmology ◽

10.1177/112067210501500204 ◽

2005 ◽

Vol 15 (2) ◽

pp. 202-208 ◽

Cited By ~ 15

Author(s):

A. Yarangümeli ◽

ö. Gürbüz Köz ◽

M.N. Alp ◽

A.H. Elhan ◽

G. Kural

Keyword(s):

Mitomycin C ◽

Long Term Results ◽

Success Rates ◽

Surgical Success ◽

Significant Difference ◽

The Difference ◽

Group 2 ◽

Conjunctival Bleb ◽

Group 1

Purpose To compare the results of viscocanalostomy with and without mitomycin-C (MMC). Methods Retrospective results of 15 standard viscocanalostomy (VCO) operations (Group 1) were compared with the prospective results of 15 VCO operations performed with intraoperative adjunctive MMC (Group 2). MMC (0.2 mg/mL) was applied over and under the superficial scleral flap for 3 minutes in Group 2 before the deep flap was prepared. Each patient was followed up for at least 1 year, and results of examinations in the first 12 months were used in the statistical comparison of the two groups. Surgical success was defined as intraocular pressure (IOP) ≤ 18 mmHg. Results Pr eoperative mean intraocular pressures (IOP) in Group 1 and Group 2 wer e 35.3±11.0 and 39.1±8.9, respectively. Mean IOP levels at the 12th month were 14.4±2.6 and 11.9±4.0, respectively, showing a significant decrease in both groups (p<0.001). Postoperative IOP course appeared to be lower in the MMC group, however, the difference was not statistically significant (p=0.554). Complete success rates without medications were 40% in Group 1 and 67% in Group 2. No significant difference was found between the two groups in terms of early and late postoperative complications, pre- and postoperative number of antiglaucoma medications, and surgical success rates at the end of the study period (p>0.05 for all). A significant difference was verified between the two groups of eyes considering the conjunctival bleb types, as low-lying, localized blebs were the most frequent type in Group 1 and thin-walled, avascular blebs were more predominant in the MMC group (p=0.004). Conclusions Intraoperative adjunctive MMC use might improve the long-term results of viscocanalostomy by facilitating subconjunctival filtration and might widen the indication range of the technique.

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Comparison between ultrasound-guided TIVAD via the right innominate vein and the right internal jugular vein approach

BMC Surgery ◽

10.1186/s12893-019-0651-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Xingwei Sun ◽

Xuming Bai ◽

Jiaofeng Shen ◽

Ziyang Yu ◽

Zhixiang Zhuang ◽

...

Keyword(s):

Success Rate ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Perioperative Complications ◽

Innominate Vein ◽

Success Rates ◽

Advantages And Disadvantages ◽

Significant Difference ◽

The Right

Abstract Background To compare the efficacy and safety of right internal jugular vein (IJV) approach and right innominate vein (INV) approach for US-guided totally implantable venous access devices (TIVADs), and to explore the advantages and disadvantages of the two approaches. Methods Six hundred and nineteen adult patients had long-term infusion and chemotherapy needs and inconvenience of peripheral venous infusion. Right INV approach was used to implant 339 cases of TIVADs, and right IJV approach was used to implant 280 cases of TIVADs. The success rate of one-time catheterization and the incidence of complications in the two groups were retrospectively analyzed. Results All patients were successfully implanted in TIVAD. The success rates of one-time puncture in INV group and IJV approach group were 98.53% (334/339) and 95.36% (267/280), respectively. There was significant difference between the two groups (P = 0.020). The incidence of perioperative complications and long-term complications in the right INV group were 1.18% (4/339) and 3.54% (12/339), respectively, while those in the right IJV group were 1.43% (4280) and 3.93% (11280). There was no significant difference in the incidence of perioperative or long-term complications between the two groups (P = 0.785, P = 0.799, respectively). Conclusions US-guided TIVADs via the right INV approach and the right IJV approach are both safe and reliable. The right INV approach improves the one-time puncture success rate, as long as the technique is properly operated, serious complications rarely occur.

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Clinical Characteristics, Intraoperative Findings, and Surgical Outcomes of Canalicular Laceration Repair with Monocanalicular Stent in Asia

Journal of Ophthalmology ◽

10.1155/2019/5872485 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Chun-Hsien Lin ◽

Chun-Yuan Wang ◽

Ying-Cheng Shen ◽

Li-Chen Wei

Keyword(s):

Success Rate ◽

Clinical Data ◽

Surgical Outcomes ◽

Traffic Accidents ◽

Success Rates ◽

Tertiary Center ◽

Common Etiology ◽

The Mean ◽

Subgroup Classification

Purpose. To report the epidemiological and clinical data as well as surgical outcomes of canalicular lacerations with Mini-Monoka insertion at a tertiary center in Taiwan and to discuss differences in traumatic pattern, pathogenesis, and surgical outcomes between Taiwan and other countries. Methods. From 2009 to 2018, all 48 patients who underwent canalicular laceration repair with Mini-Monoka stent at a tertiary center in Taiwan were retrospectively analyzed. Demographic and clinical data and surgical outcomes were recorded. Results. The mean age of the 48 patients was 38 years. Single lower canaliculus was involved in 37 (77.1%) patients, upper canaliculus in 10 (20.8%) patients, and both in 1 (2.1%) patient. The most common etiology was motorcycle accident (41.7%), and all traffic accident injuries accounted for 68.75% of cases. Subgroup classification revealed 64.6% of patients (n=31) were categorized in the deep laceration group, and lower anatomical and functional outcomes were noted in deep laceration. The mean follow-up time was 14.5 months. Overall, the anatomical success rate was 87.5%, and the functional success rate was 91.7% after stent removal. Conclusion. Canalicular laceration caused by traffic accidents occurred with a relatively high frequency in Taiwan. Affected patients tended to be middle-aged, and deep laceration accounted for 64.6% of patients. These were contributed by the avulsive eyelid injury mechanism caused by traffic accidents. Furthermore, the deeper lacerated site was located, and the lower anatomical and functional success rates were observed. Early repair after trauma with Mini-Monoka stents achieved good eyelid position (100%) as well as good anatomical (87.5%) and functional (91.7%) success without serious complication.

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