scholarly journals Risk factors for flat anterior chamber after glaucoma filtration surgery

2018 ◽  
Keyword(s):  
Risk Factors ◽  
Anterior Chamber ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Flat Anterior Chamber

scholarly journals Effect of peripheral iridectomy on VEGF-A and TGF-β levels in rabbit aqueous humour

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Annabel C. Y. Chew ◽  
Li-Fong Seet ◽  
Stephanie W. L. Chu ◽  
Nyein C. Lwin ◽  
Tina T. Wong
Keyword(s):  
Anterior Chamber ◽  
Aqueous Humour ◽  
Glaucoma Surgery ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Peripheral Iridectomy ◽  
New Zealand White Rabbits ◽  
The Right ◽  
Tgf Β1 ◽  
Time Point

Abstract Background Peripheral iridectomy (PI), routinely performed during glaucoma filtration surgery, may contribute to scarring. This study aims to determine whether PI alters the concentrations of VEGF-A and TGF-β isoforms in the rabbit aqueous humour. Methods Anterior chamber paracentesis (ACP) was performed in both eyes of six New Zealand white rabbits, with additional surgical PI performed in the right eyes. Eyes were examined on postoperative days (PODs) 1, 7, 30 and 60 by means of the tonopen, slit-lamp biomicroscopy, and bead-based cytokine assays for TGF-β and VEGF-A concentrations in the aqueous humor. Results ACP caused a significant reduction in intraocular pressure (IOP) from mean preoperative 11.47 ± 1.01 mmHg to 5.67 ± 1.63 mmHg on POD 1 while PI did not cause further IOP reduction. Limbal conjunctival vasculature appeared slightly increased on POD 1 in both ACP and PI eyes with PI also causing mild bleeding from damaged iris vessels. Two PI eyes developed fibrinous anterior chamber reaction and/ or peripheral anterior synechiae. Aqueous VEGF-A levels were not significantly different between eyes treated with ACP and PI. Aqueous TGF-β concentrations distributed in the ratio of 4:800:1 for TGF-β1:TGF-β2:TGF-β3 respectively. While aqueous TGF-β2 was not significantly induced by either procedure at any time point, TGF-β1 and TGF-β3 were significantly induced above baseline levels by PI on POD 1. Conclusion PI increases the risk of inflammation. The combined induction of aqueous TGF-β1 and TGF-β3 by PI in glaucoma surgery may impact surgery success in glaucoma subtypes sensitive to these isoforms.

Postoperative flat anterior chamber: incidence, risk factors, and effect on the long-term success of trabeculectomy

2013 ◽  
Vol 57 (6) ◽  
pp. 520-528 ◽  
Author(s):  
Takeshi Ono ◽  
Kenya Yuki ◽  
Daisuke Shiba ◽  
Takayuki Abe ◽  
Keisuke Kouyama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Chamber ◽  
Incidence Risk ◽  
Flat Anterior Chamber

Effects of Membrane Adhesion Barriers on Wound Healing Reaction after Glaucoma Filtration Surgery: A Comparative Study with Interceed and Seprafilm

2005 ◽  
Vol 15 (5) ◽  
pp. 591-597 ◽  
Author(s):  
N. Akyol ◽  
S. Aydogan ◽  
N. Akpolat
Keyword(s):  
Wound Healing ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Fistula Tract ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Cell Counts ◽  
Significant Difference ◽  
Hematoxylin And Eosin ◽  
Group 1

Purpose To evaluate and compare the effectiveness of two adhesion barriers, Interceed and Seprafilm, on wound healing reaction after glaucoma filtration surgery. Materials and Methods Full-thickness filtration surgery was carried out on three groups, each containing four rabbits. Interceed and Seprafilm prepared in 3×4 mm dimensions was put on and around scleral opening in Groups 1 and 2, respectively. All groups received tobramycin and dexamethasone drops tid for 14 days. Intraocular pressure (IOP), anterior chamber depth, and bleb appearance were checked on the first, third, seventh, and 14th days. The rabbits were killed on the 14th day and the trabeculectomy area with overlying conjunctiva was excised. The samples were fixed with 10% formalin, buried in paraffin, and stained with hematoxylin and eosin. The surgical site and surrounding subconjunctival area were evaluated histopathologically for cell counts (fibroblast, lymphocyte, eosinophil, and macrophage), presence of edema and foreign body reaction, and potency of the fistula tract. Results Mean IOP at the first and third day examinations was significantly different between groups, but there was no statistically significant difference among the groups with respect to IOP, anterior chamber depth, or bleb appearance at the seventh and 14th days. The groups were similar with respect to number of fibroblasts, eosinophils, and neutrophils. Number of macrophages was significantly increased in Groups 1 and 2 and number of vessels was significantly decreased in Group 1. Conclusions Neither of these two adhesion-preventing substances seems to suppress wound healing reaction after glaucoma filtration surgery. However, a diminished wound healing reaction was expected with a decreased number of vessels, such as in Group 1. Increased number of macrophages in both groups may result in a decreased level of some inflammatory mediators.

scholarly journals Ex-PRESS shunt implantation for intractable glaucoma with posterior chamber phakic intraocular lens: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rongrong Hu ◽  
Wei Xu ◽  
Baishuang Huang ◽  
Xiaoyu Wang
Keyword(s):  
Anterior Chamber ◽  
Intraocular Lens ◽  
High Myopia ◽  
Posterior Chamber ◽  
Filtration Surgery ◽  
Phakic Intraocular Lens ◽  
Glaucoma Filtration Surgery ◽  
Shallow Anterior Chamber ◽  
The Right ◽  
Intractable Glaucoma

Abstract Background Implantation of the posterior chamber phakic intraocular lens has been widely performed to correct high and extreme myopia. Chronic intraocular pressure (IOP) elevation may occur in its late postoperative period. For medically uncontrolled cases, surgical treatment is necessary, and benefits should be weighed against risks when determining whether to remove the lens. Case presentation A 32-year-old man with extremely high myopia presented with progressive blurred vision and medically uncontrolled IOP in the right eye. His past ocular history was significant for bilateral implantable collamer lens (ICL) implantation ten years ago. On ophthalmic examination, the ICL was well placed with a vault height of 456 µm in the right eye. The anterior chamber angles were open but narrow, and mild to moderate trabecular pigmentation was noted. Ex-PRESS glaucoma filtration surgery without ICL removal was performed to control IOP. During surgery, an Ex-PRESS P50 shunt was inserted into the anterior chamber via the front edge of the blue-grey transition zone between the sclera and cornea. Transient hypotony and shallow anterior chamber occurred in the first week after surgery, along with an ICL tilt towards the cornea with reduced vault height. No other complications related to either the ICL or the Ex-PRESS shunt were noted. IOP remained stable at 12 ~ 14 mmHg at the first 3-month follow-up. Conclusions Ex-PRESS glaucoma filtration surgery might be a safe and effective alternative treatment for intractable glaucoma with high myopia and ICL implantation. Careful assessment of the ICL position and anterior chamber angle is necessary to plan the appropriate surgical procedure. A postoperative shallow anterior chamber may result in ICL dislocation.

Use of Intraocular Gas in Flat Anterior Chamber After Filtration Surgery

1988 ◽  
Vol 106 (10) ◽  
pp. 1345-1345 ◽  
Author(s):  
M. R. Wilson ◽  
M. O. Yoshizumi ◽  
D. A. Lee ◽  
W. Martin ◽  
E. J. Higginbotham
Keyword(s):  
Anterior Chamber ◽  
Filtration Surgery ◽  
Flat Anterior Chamber ◽  
Intraocular Gas

scholarly journals Bullous choroidal detachment requiring drainage following endoscopic cyclophotocoagulation

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110467
Author(s):  
Adi Mohammed Al Owaifeer ◽  
Abdulrahman AlDarrab ◽  
Ohoud Owaidhah
Keyword(s):  
Risk Factors ◽  
Anterior Chamber ◽  
Complication Rate ◽  
Choroidal Detachment ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Flat Anterior Chamber

Endoscopic cyclophotocoagulation is a relatively safe cyclodestructive procedure with a lower complication rate compared to trans-scleral cyclophotocoagulation. Serous choroidal detachment is a complication that has been reported following endoscopic cyclophotocoagulation; however, it is usually mild and transient. A case of bullous choroidal detachment with a flat anterior chamber requiring drainage after endoscopic cyclophotocoagulation is presented, along with a discussion on the risk factors precipitating such complication.

Intraoperative Hyphema

2013 ◽  
Author(s):  
Edney R. Moura Filho ◽  
Arthur J. Sit
Keyword(s):  
Risk Factors ◽  
Anterior Chamber ◽  
Anticoagulation Therapy ◽  
Glaucoma Surgery ◽  
Systemic Hypertension ◽  
Surgical Trauma ◽  
Common Complication ◽  
Filtration Surgery ◽  
Advanced Glaucoma ◽  
Tube Versus

Hemorrhage is a common complication in trabeculectomy. Hyphema can be a manifestation of an intraoperative hemorrhage and has numerous potential causes. Although generally self-limited, severe complications are possible due to intraoperative hyphemas, and effort should be made to prevent or minimize their occurrence. Large clinical trials suggest that intraoperative hyphema is a common complication of filtration surgery. In the Advanced Glaucoma Intervention Study (AGIS), the investigators found a 13% prevalence of intraoperative anterior chamber bleeding in eyes treated with trabeculectomy (67 of 513 eyes). Similarly, the Collaborative Initial Glaucoma Treatment Study (CIGTS) found a hyphema prevalence of 8% in eyes (37 of 465 eyes) treated surgically. More recently, the Tube Versus Trabeculectomy Study reported an intraoperative hyphema rate of 3% (3 of 105 eyes) in the trabeculectomy arm of the trial. Ocular risk factors for an intraoperative hyphema include elevated intraocular pressure (IOP), a sudden drop in IOP as a result of filtration surgery, and surgical trauma, particularly an iridectomy. Additionally, the fragile rubeotic iris vessels that may be present in neovascular and inflammatory glaucomas may make those eyes especially susceptible to intraoperative (or postoperative) hyphema. Moreover, patients undergoing glaucoma surgery are often older and have multiple risk factors for intraoperative hemorrhage, including systemic hypertension and vasculopathy, as well as chronic oral anticoagulation therapy (ACT) or antiplatelet therapy (APT). Anterior chamber bleeding leading to a hyphema can occur at multiple stages of filtration surgery. Intraoperative bleeding tends to happen most commonly when cutting the iridectomy, due to direct incision of the major arterial circle of the iris or from damage to the adjacent highly vascular ciliary processes. Hemorrhage also may occur while excising the sclerostomy or following the creation of the paracentesis (especially if there is a large drop in IOP with consequent rupture of fragile rubeotic vessels). During dissection of the partial thickness scleral flap, aqueous or episcleral veins may be cut. If hemorrhage from these vessels is not adequately cauterized, blood may eventually flow into the anterior chamber.

Comparison of phaco time parameters in eyes with and without glaucoma filtration surgery due to pseudoexfoliation glaucoma

2021 ◽  
pp. 112067212110177
Author(s):  
Ayse Gul Kocak Altintas ◽  
Cagri Ilhan
Keyword(s):  
Clinical Characteristics ◽  
Pseudoexfoliation Glaucoma ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Mean Values ◽  
Time Parameters ◽  
The Mean ◽  
Group 2 ◽  
Surgical Manipulations ◽  
Phaco Time

Purpose: To compare the phaco time parameters including ultrasound time (UST), effective phaco time (EPT), and average phaco power (APP) in eyes with pseudoexfoliation glaucoma (PEG) and had or had not glaucoma filtration surgery. Methods: In this retrospective comparative study, Group 1 was constructed with 84 PEG patients who had not operated previously, and Group 2 was constructed with 49 PEG patients who had glaucoma filtration surgery. The mean values of UST, EPT, and APP were compared. The preoperative clinical characteristics and surgical manipulations were also compared. Results: The mean ages and male-to-female ratios of the groups were similar ( p > 0.05, for both). There was no difference in the preoperative clinical characteristics, including biometric values between the groups ( p > 0.05, for all). Some surgical manipulations, including pupillary stretching ( p = 0.004), pupillary membrane peeling ( p = 0.021), iris hook using ( p = 0.041), and capsular tension ring implantation ( p = 0.041), were significantly performed more commonly in Group 2. Although the mean UST and EPT values were similar ( p > 0.05, for both), the mean APP value was significantly lower in Group 2 ( p = 0.011). Conclusion: The lower APP parameter was observed in PEG patients having had glaucoma filtration surgery. Needing more surgical manipulation to overcome poor pupillary dilation and weak zonular instability can be a reason for this result.

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