scholarly journals The Progression of Peripheral Anterior Synechia after Combined Phacoemulsification with Goniosynechialysis Under an Ophthalmic Endoscope: A Three-Year Study

2021 ◽  
Author(s):  
Xinyi Liu ◽  
Yau Kei Chan ◽  
Lin Fu ◽  
Yunhe Song ◽  
Junhua Li ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Early Postoperative Period ◽  
Angle Closure ◽  
Success Rates ◽  
Recurrence Rates ◽  
Primary Angle Closure Glaucoma ◽  
Nasal Side ◽  
Temporal Side

Abstract Aim To investigate the long-term changes of peripheral anterior synechia (PAS) after phacoemulsification with goniosynechialysis under an ophthalmic endoscope (Phaco-OE-GSL) in primary angle-closure glaucoma (PACG) assisted with viscoelastics alone or viscoelastics combined with iris repositor (viscoelastics-repositor). Method A retrospective study was conducted. Thirty-nine eyes of 31 PACG patients were included. The follow-up period was 36 months. The main outcomes of the study included the changes of PAS, intraocular pressure (IOP), and the success rate.Results Phaco-OE-GSL was performed assisted with viscoelastics-alone on 20 eyes, and viscoelastics-repositor on 19 eyes. The total recurrence rates of PAS were 62.5% in viscoelastics-alone group and 87.5% in viscoelastics-repositor group. In particular, the recurrence rate of PAS at the same location at which were separated intraoperatively were 37.3% and 75.0% respectively (P=0.033). The recurrence of PAS was observed in 2 eyes in viscoelastics-alone group and 12 eyes in viscoelastics-repositor group within 1-month follow-up (P<0.001). In addition, comparing any two follow-ups 6 months after surgery, there are not significant differences in the extent of re-PAS in total eyes (P>0.05). The extent of postoperative PAS at final follow-up was positively correlated with the range of PAS preoperatively (P=0.036, r=0.356). The complete success rates were 85.0% and 89.5% of viscoelastics-alone group and viscoelastics-repositor group at 36-month follow-up respectively. Both the preoperative and postoperative distribution of PAS are mainly concentrated on the upper (84.6% and 95.8%) and nasal side (74.4% and 62.5%), followed by the inferior side, and the least on the temporal side. Conclusion In summary, although the recurrence rate of PAS was high in early postoperative period, the progression of PAS was rapidly resolved after 6 months postoperatively, and Phaco-OE-GSL is an effective treatment for the long-term control of IOP of PACG patients especially with large range of PAS (> 180°). Both preoperative and postoperative PAS are mainly concentrated on the upper and nasal side. Besides, our results suggested that mechanical separation may be easier to promote the progression of postoperative PAS than viscoelastics-alone separation.

scholarly journals Efficacy and Safety of Combined Phacoemulsification, Intraocular Lens Implantation, Goniosynechialysis, and Trabectome in Patients With Primary Angle-Closure Glaucoma

2021 ◽  
Author(s):  
Yu Wang ◽  
Zhiqiao Liang ◽  
Yu Zhang ◽  
Hennein Lauren ◽  
Ying Han ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Intraocular Lens Implantation ◽  
Efficacy And Safety ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Lens Implantation

Abstract We evaluated the efficacy and safety of combined phacoemulsification, intraocular lens implantation, goniosynechialysis (GSL), and trabectome in patients with primary angle-closure glaucoma (PACG). In this prospective interventional study, twenty patients (22 eyes) of PACG treated with combined phacoemulsification, intraocular lens implantation, GSL, and trabectome between September 2017 to September 2020 were recruited. The intraocular pressure (IOP), the number of glaucoma medications, and best-corrected visual acuity (BCVA) were recorded at baseline, 1, 3, 6, 12, and 24 months after operation. IOP was decreased significantly from 20.69±6.90 mmHg at baseline to 15.83±2.79mmHg at 24 months’ follow-up (P=0.043). The number of glaucoma medications reduced from 2.76±1.14 preoperatively to 0.73±0.77 at 24 months’ follow-up (P=0.026). The qualified success rate was 86.8% at 2 years. The reduction of IOP showed a positive correlation with baseline IOP (p<0.001) and the reduction of the number of glaucoma medications was positively correlated with baseline number of glaucoma medications (p<0.001). There was no vision-threatening complication during and after operation. The combined procedure of phacoemulsification, IOL implantation, GSL, and trabectome was effective and safe for PACG patients. It may provide a new method for PACG patients especially those with long term and extensive goniosynechia.

scholarly journals Long-Term Outcomes of Primary Trabeculectomy in Diabetic Patients without Retinopathy with Primary Angle-Closure Glaucoma

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Jian Liu ◽  
Miaomiao Zhang ◽  
Bin Li ◽  
Jianrong Wang
Keyword(s):  
Case Series ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Control Group ◽  
Diabetic Patients ◽  
Surgical Success ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma

Purpose. To evaluate primary trabeculectomy with adjunctive mitomycin-C (MMC) in diabetic patients without retinopathy with primary angle-closure glaucoma (PACG). Design. This is a retrospective case series comparison. Participants. This retrospective trial compared outcomes of 88 eyes that underwent trabeculectomy in patients with diabetes mellitus (DM) without retinopathy and in 97 patients without DM. Methods. In this study, the intraocular pressure (IOP), visual acuity, visual field, and postoperative complications were compared between the two groups. Qualified surgical success is defined as an IOP between 6 and 18 mmHg with or without topical antiglaucoma medication. Results. After a follow-up of 5 years, the IOP decreased from a mean basal IOP of 27.8±7.3 mmHg to 15.0±5.6 mmHg in the DM group and from 27.3±6.0 mmHg to 12.4±5.3 mmHg in the control group. The mean number of antiglaucoma medications was 3.4±1.3 and 3.3±1.2 preoperatively (P=0.587) whereas it was 1.7±1.5 and 1.1±1.4 at the 5-year follow-up (P=0.049). The 5-year qualified surgical success rates were 42.9% and 65.4% for both groups (P=0.046; log-rank test). Encysted blebs were seen in 21 (23.9%) patients in the DM group and in 12 (12.4%) patients in the control group (P=0.041). Conclusion. PACG patients with DM without retinopathy undergoing primary trabeculectomy with MMC may have a lower long-term surgical survival rate compared with patients without DM.

scholarly journals Combined Phacoemulsification and Ex-PRESS Implant with Everting Suture in Primary Angle-Closure Glaucoma: Survival Analysis and Predictive Factors

2021 ◽  
Vol 10 (4) ◽  
pp. 774
Author(s):  
Giuseppe Covello ◽  
Pasquale Loiudice ◽  
Maria Novella Maglionico ◽  
Marco Nardi ◽  
Michele Figus ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Predictive Factors ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Success Rates ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Cox Proportional Hazard ◽  
Kaplan Meier

The purpose of this study was to evaluate the efficacy and safety of combined phacoemulsification and Ex-PRESS implant with everting suture in primary angle-closure glaucoma (PACG) and to examine predictive factors of failure. Twenty-three eyes of 18 patients were enrolled. Data about time of removal of releasable sutures and traction of the everting suture and about changes in intraocular pressure (IOP) were collected, as well as comprehensive ophthalmic examinations. Success was defined by the following criteria: IOP ≤ 18 mmHg (criterion 1); IOP ≤ 15 mmHg (criterion 2); and IOP ≤ 12 mmHg (criterion 3). Success was categorized as complete or qualified, depending on whether it was reached without or with drugs, respectively. Success rate was assessed with Kaplan–Meier survival analysis with a Cox proportional hazard model to adjust for potential confounders. The lowering of IOP and the reduction of medications were statistically significant at every follow-up visit compared with the baseline (p < 0.05). The complete success rates were 87%, 70%, and 17% accordingly to criterion 1, 2, and 3; the qualified success rates were 93%, 70%, and 20%, respectively. Most of the complications resolved spontaneously and conservatively. In conclusion, combined phacoemulsification and Ex-PRESS Minishunt implant with everting suture is a safe and effective surgery, even in PACG, lowering IOP and number of medications.

Recurrence rates and form of recurrence after endoluminal ablation of the great saphenous vein – A comparison of laser ablation (EVLA) 1470 nm, radio frequency (RFITT and ClosureFast) and superheated steam with an average follow-up time of 3.8 years

Phlebologie ◽  
2020 ◽  
Author(s):  
Lisa Schuler ◽  
I. Weingard ◽  
M. Kiderlen ◽  
A. Theodoridis ◽  
N. Kriechenbauer ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Superheated Steam ◽  
Duplex Ultrasound ◽  
Success Rates ◽  
Recurrence Rates ◽  
Puncture Site ◽  
Thermal Methods ◽  
Lower Closure ◽  
Median Pain

Abstract Objectives In addition to combined crossectomy and stripping or pure sclerotherapy, various endovenous thermal procedures are now available for treatment, which are compared in the present study. Methods Between 2009 and 2013, the GSV was ablated in 297 patients using one of four methods: EVLA 1470 nm, ClosureFast, RFITT or superheated steam. The recurrence rate after treatment was defined as the primary endpoint. Follow-up examinations with duplex ultrasound took place 14 days, 3 months and 1 year post-operatively, and thereafter annually with average follow-up time of 3.8 years and a follow-up rate of 81 %. Results At the time of the last follow-up examination, the following complete closure rates of treated GSV were found: ClosureFast 95 %, EVLA 97 %, RFITT 79 % and superheated steam 71 %. Serious complications occurred only with superheated steam (necrosis at the puncture site). The median pain intensity recorded 14 days post-operatively was 1–3 on a scale of 1–10. Both the CIVIQ score and the VCSS were significantly improved by all endovenous thermal methods. In 5–12 % of cases, reflux was found in the previously non-refluxive AASV. Conclusions EVLA and ClosureFast are indicated for the treatment of GSV incompetence with high success rates, comparable to the results with crossectomy and stripping. The RFITT and superheated steam methods present significantly lower closure rates. Particular attention should be paid to the presence of an initially non-refluxive AASV. Since there was an increased recurrence rate over this vein, it seems reasonable to treat the AASV primarily.

scholarly journals Long-Term Follow-Up of Nonoperatively and Operatively Treated Acute Primary Patellar Dislocation in Skeletally Immature Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Eva Bengtsson Moström ◽  
Christina Mikkelsen ◽  
Lars Weidenhielm ◽  
Per-Mats Janarv
Keyword(s):  
Recurrence Rate ◽  
Patellar Dislocation ◽  
Knee Function ◽  
Muscle Performance ◽  
Thigh Muscle ◽  
Recurrence Rates ◽  
Kujala Score ◽  
Long Term Follow Up

Purpose. The present study reports a long-term follow-up of acute primary patellar dislocation in patients with open physes. The purpose of the study was to evaluate knee function and recurrence rates after surgical and nonsurgical treatment of patellar dislocation.Methods. A total of 51 patients, including 29 girls and 22 boys, who were 9–14 years of age at the time of injury, were retrospectively evaluated. The minimum follow-up time was 5 years. Thigh muscle torque, range of motion, the squat test, the knee injury and osteoarthritis outcome score (KOOS), the Kujala score, and the recurrence rate were registered. Radiological predisposing factors at the time of injury were determined.Results. Quality of life and sports/recreation were the most affected subscales, according to KOOS, and a reduced Kujala score was also observed in all treatment groups. The surgically treated patients had a significantly lower recurrence rate. Those patients also exhibited reduced muscle performance, with a hamstring to quadriceps ratio (H/Q) of 1.03. The recurrence rate was not correlated with knee function.Conclusions. Patellar dislocation in children influences subjective knee function in the long term. Surgery appears to reduce the recurrence rate, but subjective knee function was not restored.

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