Individualized transscleral cyclophotocoagulation as the initial surgical intervention for medically uncontrolled glaucoma after blunt trauma

Abstract Background: To investigate the safety and feasibility of individualized transscleral cyclophotocoagulation (TSCPC) as the initial non-incisional surgical intervention for medically uncontrolled glaucoma after blunt trauma. Methods: The therapy records were reviewed of medically uncontrolled traumatic glaucoma after blunt trauma treated with TSCPC in a single hospital between January 2014 and December 2018. 31 patients (31 eyes) received individualized TSCPC after ultrasound biomicroscopy and gonioscopy examination to localize and quantify the injured quadrants of the anterior chamber angle. In addition to the number of IOP lowing drugs, visual acuity (VA), IOP, inflammation and hemorrhage in the anterior chamber were analyzed at 1 day, 3 weeks and 3 months after operation, respectively. Success was defined as the IOP was not more than 21 mmHg.Results: Compared with the data of pre-operation, constituent ratio of VA had no significant difference at 3 weeks (c2 = 0.56, P > 0.75). At 3 months the mean IOP was 22.2±5.0 mmHg, which was significantly lower than that of pre-operation (46.6±5.6 mmHg) (t=19.818, P<0.001). No IOP lowing drug was needed in 12 eyes, and more than 3 kinds of drugs were still needed in 5 eyes. The average number of medications decreased significantly (c2=93.496，P＜0.001). The complete success rate was 38.7% and the relative success rate (combined with no more than two kinds of drugs) was 83.9% at 3 months.Conclusions: Individualized TSCPC could be applied as an initial non-incisional surgical intervention to treat traumatic glaucoma refractory to the medicine therapy.

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Individualized transscleral cyclophotocoagulation as the initial surgical intervention for medically uncontrolled glaucoma after blunt trauma

European Journal of Ophthalmology ◽

10.1177/1120672120965512 ◽

2020 ◽

pp. 112067212096551

Author(s):

Xu Hou ◽

Jing Wu ◽

Jian Zhou ◽

Yu-Sheng Wang ◽

Dan Hu

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Success Rate ◽

Blunt Trauma ◽

Surgical Intervention ◽

Ultrasound Biomicroscopy ◽

Anterior Chamber Angle ◽

Significant Difference ◽

Transscleral Cyclophotocoagulation ◽

Chamber Angle

Aim: To investigate the safety and feasibility of individualized transscleral cyclophotocoagulation (TSCPC) as the initial non-incisional surgical intervention for medically uncontrolled glaucoma after blunt trauma. Methods: The therapy records were reviewed of medically uncontrolled traumatic glaucoma after blunt trauma treated with TSCPC in a single hospital between January 2014 and December 2018. Thirty-one patients (31 eyes) received individualized TSCPC after ultrasound biomicroscopy and gonioscopy examination to localize and quantify the injured quadrants of the anterior chamber angle. In addition to the number of IOP lowing drugs, visual acuity (VA), IOP, inflammation and hemorrhage in the anterior chamber were analyzed at 1 day, 3 weeks and 3 months after operation, respectively. Success was defined as the IOP was not more than 21 mmHg. Results: Compared with the data of pre-operation, constituent ratio of VA had no significant difference at 3 weeks (χ2 = 0.56, p > 0.75). At 3 months the average IOP was 22.2 ± 6.8 mmHg, which was significantly lower than that of pre-operation (46.6 ± 5.6 mmHg) ( t = 19.818, p < 0.001). No IOP lowing drug was needed in 12 eyes, and more than three kinds of drugs were still needed in five eyes. The average number of medications decreased to 1.2 ± 1.2 (χ2 = 93.496, p < 0.001). The complete success rate was 38.7% and the relative success rate (combined with no more than two kinds of drugs) was 83.9% at 3 months. Conclusions: Individualized TSCPC could be applied as an initial non-incisional surgical intervention to treat traumatic glaucoma refractory to the medicine therapy.

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Anterior Chamber Angle and Volume Do Not Change after Myopic Laser-Assisted In Situ Keratomileusis in Young Patients

Journal of Ophthalmology ◽

10.1155/2018/8646275 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Ertuğrul Tan Yassa ◽

Cihan Ünlü

Keyword(s):

Anterior Chamber ◽

Anterior Segment ◽

Young Patients ◽

Anterior Chamber Depth ◽

Ablation Depth ◽

Anterior Chamber Angle ◽

Chamber Volume ◽

The Mean ◽

Chamber Angle

Purpose. We aimed to investigate whether anterior chamber angle, depth, and volume change after myopic laser-assisted in situ keratomileusis (LASIK) in young patients. Methods. This retrospective study included 29 eyes of 29 patients (15 females and 14 males) between the ages of 18 and 39 years who underwent LASIK for the treatment of myopia. In addition to complete ophthalmic examination, anterior chamber angle (ACA), central anterior chamber depth (ACD), and anterior chamber volume (ACV) were measured by using a Sirius rotating Scheimpflug camera combined with Placido disc corneal topography (CSO, Florence, Italy). Preoperative and postoperative values were compared using paired t-tests. Linear regression was used to evaluate the relationship between changes in refraction and changes in ACA, ACD, and ACV as well as between attempted maximum ablation depth and changes in ACA, ACD, and ACV. Results. The mean age of the study population was 25.5 ± 6.2 years. The mean preoperative and postoperative spherical equivalent values were −3.30 ± 1.92 D and −0.18 ± 0.29 D, respectively. ACV and ACA were not significantly changed after surgery; however, central ACD was significantly decreased (preoperatively = 3.366 ± 0.316 mm vs postoperatively = 3.3 ± 0.298 mm) with a mean difference of 0.066 ± 1.121 mm. There were no significant relationships between changes in refraction and anterior segment dimensions or between attempted maximum ablation depth and anterior segment dimensions. Conclusion. Measurements with Sirius showed that ACA and ACV did not change; however, central ACD significantly decreased after myopic LASIK in young patients, indicating that the preoperative central ACD value should not be used interchangeably with the postoperative central ACD value.

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

Journal of Ophthalmology ◽

10.1155/2020/8720450 ◽

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.

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Reproducibility of Anterior Chamber Angle Measurement Using the Tongren Ultrasound Biomicroscopy Analysis System

Journal of Glaucoma ◽

10.1097/ijg.0b013e3182698094 ◽

2014 ◽

Vol 23 (2) ◽

pp. 61-68 ◽

Cited By ~ 6

Author(s):

Zhong Lin ◽

Da P. Mou ◽

Yuan B. Liang ◽

Si Z. Li ◽

Rui Zhang ◽

...

Keyword(s):

Anterior Chamber ◽

Ultrasound Biomicroscopy ◽

Angle Measurement ◽

Anterior Chamber Angle ◽

Analysis System ◽

Chamber Angle

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Intraobserver and Interobserver Agreement in Evaluating the Anterior Chamber Angle Configuration by Ultrasound Biomicroscopy

Journal of Glaucoma ◽

10.1097/00061198-199702000-00004 ◽

1997 ◽

Vol 6 (1) ◽

pp. 13???17 ◽

Cited By ~ 22

Author(s):

George L. Spaeth ◽

Augusto Azuara-Blanco ◽

Silvana V. Araujo ◽

James J. Augsburger

Keyword(s):

Anterior Chamber ◽

Interobserver Agreement ◽

Ultrasound Biomicroscopy ◽

Anterior Chamber Angle ◽

Chamber Angle

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Age and Positional Effect on the Anterior Chamber Angle: Assessment by Ultrasound Biomicroscopy

ISRN Ophthalmology ◽

10.1155/2013/706201 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Nicholas P. Bell ◽

Kundandeep S. Nagi ◽

Ricardo J. Cumba ◽

Alice Z. Chuang ◽

David A. Lee ◽

...

Keyword(s):

Statistical Analysis ◽

Anterior Chamber ◽

Ultrasound Biomicroscopy ◽

Anterior Chamber Angle ◽

Age Related ◽

The Subject ◽

Inferior Quadrant ◽

Healthy Eyes ◽

Chamber Angle ◽

Age Related Changes

Purpose. To investigate age- and position-related changes of anterior chamber angle anatomy in normal, healthy eyes. Patients and Methods. Thirty subjects were separated into a younger and older cohort. The superior and inferior anterior chamber angles of the eyes were measured in supine and sitting positions by ultrasound biomicroscopy (UBM) with bag/balloon technology. Statistical analysis was used to evaluate positional and age-related changes in angle morphology. Results. In the younger cohort, no location or positional differences in angle anatomy were observed. In the older cohort, the inferior quadrant was significantly narrower than the superior quadrant (P=0.0186) in the supine position. This cohort also demonstrated an interaction effect between position and location. In the older cohort, the angle was deeper inferiorly while the subject was sitting but was deeper superiorly while the subject was supine. Conclusion. Comparison of positional variations in anterior chamber angle anatomy as measured by UBM has recently become possible. This study found that age-related positional changes in the anterior chamber angle anatomy exist in normal healthy eyes.

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The changes of anatomic and topographic characteristics of eye anterior segment after uncomplicated cataract phacoemulsification

Kazan medical journal ◽

10.17816/kmj1805 ◽

2013 ◽

Vol 94 (6) ◽

pp. 853-858

Author(s):

A A Ryabtseva ◽

M P Yugaj ◽

N S Nikitina

Keyword(s):

Intraocular Pressure ◽

Anterior Chamber ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Ultrasound Biomicroscopy ◽

Anterior Chamber Angle ◽

Ciliary Processes ◽

Lens Implantation ◽

Topographic Characteristics ◽

Chamber Angle

Aim. To study the changes of anatomic and topographic characteristics of the eye anterior segment after uncomplicated cataract phacoemulsification using corneal incision with intraocular soft lens implantation. Methods. The data of ultrasound biomicroscopy and noncontact tonometry of 58 eyes (56 patients, 32 females, 24 males aged 54 to 78 years) before and after cataract phacoemulsification were analyzed. Paitents with survived ocular trauma, refractive keratoplasty, glaucoma, uveitis, and surgical complications (incomplete capsulorrhexis, posterior capsule rupture, ciliary zonule disinsertion, corneal burn). Apart from the common examinations (visual acuity testing, tonometry, tonography, eye A- and B-ultrasonography, biomicroscopy), all patients underwent eye ultrasound biomicroscopy. Results. Anterior chamber depth increased from 2.73±0.10 to 4.17±0.06 mm (p ≤0.001). Trabecula-iris distance measured at 500 μm from the scleral spur, increased from 0.38±0.02 to 0.47±0.02 mm (p ≤0.001). Anterior chamber angle increased from 28.69±1.87 to 42.73±1.56 degrees (p ≤0.001), the angle between the iris and the sclera increased from 32.78±1.39 to 41.36±0.84 degrees (p ≤0.001), the angle between the sclera and ciliary processes increased from 39.48±1.29 to 45.30±1.16 degrees (p ≤0.001). Intraocular pressure according to the non-contact tonometry data decreased from 18.16±1.29 to 13.55±0.95 mm Hg (p ≤0.001). Conclusion. Anterior chamber depth, trabecula-iris distance, anterior chamber angle, the angle between sclera and iris and the angle between sclera and ciliary processes increased significantly after phacoemulsification with intraocular lens implantation. Intraocular pressure decreased significantly according to the non-contact tonometry data.

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