scholarly journals Cyclophotocoagulation under Microscopy Combined with Phacoemulsification for Primary Angle-Closure Glaucoma

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xiaoli Xiang ◽  
Haiying Chen ◽  
Jian Li ◽  
Pan Xiao ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Angle Closure Glaucoma ◽  
Direct Vision ◽  
Angle Closure ◽  
Fiber Layer ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Nerve Fiber Layer Thickness ◽  
Postoperative Changes ◽  
Additional Surgery ◽  
The Mean

The purpose of this study was to evaluate the safety and efficacy of cyclophotocoagulation under microscopy combined with phacoemulsification in patients with primary chronic angle-closure glaucoma. We retrospectively reviewed the results of cyclophotocoagulation under microscopic direct vision combined with phacoemulsification in 35 eyes (35 patients) with primary chronic angle-closure glaucoma and coexisting visually significant cataracts, treated between January 2017 and April 2020 at the glaucoma unit of the affiliated Changshu Hospital of Xuzhou Medical University. All patients were followed up for at least 12 months postoperatively. The preoperative to postoperative changes in best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucoma medications, and surgery-associated complications were recorded. The BCVA improved from 1.15 ± 0.91 logMAR preoperatively to 0.86 ± 0.82 logMAR at the final postoperative examination (Z = −3.62, P < 0.0001 ). The mean IOP was 36.63 ± 13.50 mmHg preoperatively and 15.14 ± 3.19 mmHg at the final examination (Z = −5.16, P < 0.0001 ). The number of antiglaucoma drugs was significantly reduced from 2.23 ± 0.55 preoperatively to 0.54 ± 0.86 at the final postoperative examination (Z = −5.26, P < 0.0001 ). The absolute value of the mean defect and retinal nerve fiber layer thickness at the last follow-up postoperatively were significantly reduced compared to preoperative values (Z = −3.35, P = 0.001 ; Z = −4.56, P < 0.001 , respectively). One patient experienced an explosive suprachoroidal hemorrhage during the operation. The sclera was incised at the corresponding site of the intraoperative hemorrhage. The operation was continued once there was no active bleeding, and the outcome was satisfactory. None of the patients required additional surgery to treat complications. Thus, cyclophotocoagulation under microscopic direct vision combined with phacoemulsification can be performed safely for the management of primary angle-closure glaucoma.

scholarly journals Effect of Phacoemulsification on Anterior Chamber Angle in Eyes with Medically Uncontrolled Filtered Primary Angle-Closure Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Chengguo Zuo ◽  
Bing Long ◽  
Xinxing Guo ◽  
Liming Chen ◽  
Xing Liu
Keyword(s):  
Anterior Chamber ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Anterior Chamber Angle ◽  
Iol Implantation ◽  
Anatomical Changes ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
The Mean ◽  
Chamber Angle

Purpose. To evaluate the effect of phacoemulsification and intraocular lens (IOLs) implantation in eyes with medically uncontrolled primary angle-closure glaucoma (PACG) previously treated with trabeculectomy and to quantify the anatomical changes in the anterior chamber angle by ultrasound biomicroscopy (UBM). Methods. Forty-four eyes of 37 consecutive patients with medically uncontrolled PACG coexisting cataracts with a surgical history of trabeculectomy were included in this study. Each patient underwent phacoemulsification and IOL implantation. Indentation gonioscopy and UBM were performed preoperatively and then again 3 months after surgery. The main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucoma medications and anatomical changes in the anterior chamber angle. Results. The mean logarithm of the minimum angle of resolution BCVA significantly improved from 0.52 ± 0.30 preoperatively to 0.26 ± 0.23 postoperatively (p<0.001). The mean IOP significantly decreased from 24.33 ± 9.65 mmHg preoperatively to 18.04 ± 7.86 mmHg postoperatively (p<0.05). 001). The median number of antiglaucoma medications decreased from 2 preoperatively to 1 postoperatively (p<0.001). There was no significant difference in the extent of peripheral anterior synechia after the surgery (p>0.05). Some parameters, including anterior central chamber depth, angle opening distance at 500 μm, trabecular-iris angle, and scleral ciliary process angle, were significantly higher after than before surgery (p<0.001). However, the crystalline lens rise was significantly smaller following the surgery (p<0.001). Conclusions. Phacoemulsification and IOL implantation reduced the IOP and improved vision in eyes with medically uncontrolled filtered PACG. The mechanism underlying the outcomes observed following surgery might be related to the anterior chamber deepening, widened drainage angle, and improved aqueous fluid flow to the trabecular meshwork.

scholarly journals Intraocular asymmetry of visual field defects in primary angle-closure glaucoma, high-tension glaucoma, and normal-tension glaucoma in a Chinese population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junhong Jiang ◽  
Cong Ye ◽  
Cong Zhang ◽  
Wenqing Ye ◽  
Xiaoyan Wang ◽  
...  
Keyword(s):  
Visual Field ◽  
Normal Tension Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
High Tension ◽  
Significant Difference ◽  
The Mean ◽  
Severity Levels

AbstractDirect comparison data on spatial patterns of visual field (VF) defects among primary angle-closure glaucoma (PACG), high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) are not available. We aimed to compare the intraocular asymmetry of VF loss among patients with PACG, NTG and HTG across different severity levels. A total of 162 eyes of 114 patients with PACG, 111 eyes of 74 patients with HTG and 148 eyes of 102 patients with NTG were included. VF defects were categorized into 3 stages (early, moderate, and advanced), and each hemifield was divided into 5 regions according to the Glaucoma hemifield test (GHT). The mean total deviation (TD) of each GHT region was calculated. In the early stage, the paracentral, peripheral arcuate 1 and peripheral arcuate 2 regions in the superior hemifield in the NTG group had significantly worse mean TDs than their corresponding regions in the inferior hemifield. In the advanced stage, the central region in the superior hemifield in the PACG group had a significantly worse mean TD than that in the inferior hemifield. There was no significant difference in the mean TD for any of the five regions between hemifields across all severity levels in the in the HTG group. The superior hemifield was affected more severely than the inferior hemifield in all three subtypes of primary glaucoma. This asymmetric tendency was more pronounced in NTG than in PACG and HTG.

scholarly journals Combined Phacoemulsification and Goniosynechialysis under an Endoscope for Chronic Primary Angle-Closure Glaucoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Li Nie ◽  
Weihua Pan ◽  
Aiwu Fang ◽  
Zhangliang Li ◽  
Zhenbin Qian ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Corrected Visual Acuity ◽  
Corneal Endothelial Cell Density ◽  
The Mean

Purpose. To investigate the clinical efficacy and safety of combined phacoemulsification with goniosynechialysis (GSL) under an ophthalmic endoscope for chronic primary angle-closure glaucoma and coexisting cataract. Methods. This is a retrospective study. The intraocular pressure (IOP), best-corrected visual acuity (BCVA), and number of glaucoma medications at baseline and each postoperative follow-up visit were recorded. Other measurements included supraciliochoroidal fluid measured by anterior segment optical coherence tomography, corneal endothelial cell density (ECD), and peripheral anterior synechia (PAS). All patients were followed for more than a year. Results. Thirty-eight eyes of 31 patients were included. The mean follow-up duration was 16.3 ± 3.9 months. The IOP decreased from 22.2 ± 9.3 mmHg at baseline to 15.4 ± 4.2 mmHg at the last follow-up (P<0.001). The mean number of glaucoma medications (0.1 ± 0.6) at the last follow-up was significantly lower than the preoperative number (2.3 ± 1.1) (P<0.001). All patients achieved improved or stable visual acuity after surgery. All patients achieved a complete opened angle after GSL. The postoperative complications included hyphema (7.9%), exudation (5.3%), transiently elevated IOP (55.3%), and supraciliochoroidal fluid (40%). Conclusions. Combined phacoemulsification and GSL under an endoscope can completely reopen PAS and is an effective and safe method for patients with chronic primary angle-closure glaucoma and coexisting cataract.

scholarly journals Peripapillary Vessel Density Measurement of Quadrant and Clock-Hour Sectors in Primary Angle Closure Glaucoma Using Optical Coherence Tomography Angiography

2021 ◽  
Author(s):  
YongDong Lin ◽  
ShiRong Chen ◽  
MingZhi Zhang
Keyword(s):  
Optical Coherence Tomography ◽  
Nerve Fiber ◽  
Layer Thickness ◽  
Vessel Density ◽  
Angle Closure ◽  
Fiber Layer ◽  
Diagnostic Ability ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Nerve Fiber Layer Thickness

Abstract Background: The purpose of this study was to investigate peripapillary vessel density of primary angle closure glaucoma (PACG) eyes in quadrant and clock-hour sectors, and the diagnostic ability of peripapillary vessel density was also studied.Methods: This was a cross-sectional study on forty-one PACG patients(50 eyes)and twenty-seven healthy subjects(27 eyes). The optic disc was imaged using a 1050-nm-wavelength swept-source optical coherence tomography system (DRI OCT Triton, TOPCON). Peripapillary vessel density was quantified by imageJ software. Characteristics of peripapillary vessel density of quadrant and clock-hour sectors were analyzed, and diagnostic capability was evaluated by areas under the receiver operating characteristics curves (AUCs).Results: Compared to the control group, four quadrants and each clock-hour sectors of peripapillary vessel density of glaucomatous group decreased to different degrees, and vessel density reduced most at 7 o'clock. Except 4 o'clock, there was not any statistical difference between the diagnostic ability of peripapillary vessel density and peripapillary retinal nerve fiber layer thickness. The inferior quadrant peripapillary vessel density had the best diagnostic value (AUCs0.944), followed by 7 o'clock vessel density (AUCs0.937), average vessel density (AUCs0.926) and 7 o'clock RNFL thickness (AUCs0.922).Conclusions: In PACG, the diagnostic ability of peripapillary vessel density is equivalent to peripapillary retinal nerve fiber layer thickness. Understanding spatial characteristics of peripapillary vessel density in PACG may be helpful for clinical diagnosis and treatment.

scholarly journals Optical coherence tomography angiography of the macular retina in primary angle closure glaucoma

2019 ◽  
Author(s):  
Yang Zhang ◽  
Shunhua Zhang ◽  
Chan Wu ◽  
Yao Zhang ◽  
Ailing Bian ◽  
...  
Keyword(s):  
Pearson Correlation ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Control Group ◽  
Mean Deviation ◽  
Case Group ◽  
Ganglion Cell Complex ◽  
Fiber Layer ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma

Abstract Background: To detect the macular vessel density (MVD) changes in primary angle closure glaucoma (PACG) and to investigate the correlation between MVD and other glaucomatous changes. Methods: A case-control study. Eyes of 22 PACG patients with an episode of acute primary angle closure (APAC) in one of the two eyes. Structural OCT scans were used to obtain peripapillary retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC) thickness and C/D area ration. OCT angiography (OCTA) was used to measure MVD. Results: In the control group, the dense macular blood vessels were visible on OCTA， the macular vessels were sparse in the case group, and with an enlarged fovea avascular zone. There was a reduction in MVD in the case group compared with the controls (P<0.01). No correlations between MVD, VF mean deviation (MD), C/D area ratio, GCC thickness or RNFL thickness were found in the control group. In the case group, the Pearson correlation analysis showed that MVD was significantly correlated with BCVA (r=0,65, P=0.001), GCC (r=0.50, P=0.018) and VF MD (r=-0.54, P=0.009). In the case group, the multiple stepwise regression analysis, in which MVD were considered the dependent variables, showed that BCVA and GCC were significant predictors. Conclusions: Macular microvascular network attenuated and MVD reduced significantly caused by APAC. MVD was strongly linked to BCVA and GCC.

Primary angle-closure glaucoma in young people

2016 ◽  
Vol 3 (4) ◽  
pp. 237-247
Author(s):  
Maria Hanna Niżankowska
Keyword(s):  
Young People ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma
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