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Comparison of phacotrabeculectomy and sequential surgery in the treatment of chronic angle-closure glaucoma coexisted with cataract

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International Journal of Ophthalmology(English edition) 2016年第5期9卷 687-692页

作者： Hai-Jun Li Jie Xuan Xiao-Min Zhu Lin Xie Department of Ophthalmology Daping Hospitalthe Third Mlitary Medical University

AIM： To compare the safety and effectiveness of phacotrabeculectomy versus sequential surgery in chronic angle-closure glaucoma（CACG） with coexisting cataract.·METHODS： One hundred and sixty-two CACG patients（162 eyes） were retrospectively analyzed. Of them, 87patients（87 eyes） in group A had underwent phacotrabeculectomy with intraocular lens（IOL）implantation, and 75 patients（75 eyes） in group B had underwent sequential surgery with IOL implanted. Best-corrected visual acuity（BCVA）, intraocular pressure（IOP）, complications and anterior chamber angle（ACA）were measured.· RESULTS： Demographic characteristics of the two groups were similar. A mean follow-up period was 15±6mo（range 13 to 24mo）, a mean IOP of 12.14 ±5.32 mm Hg in group A and 11.38 ±4.06 mm Hg in group B（P =0.84） at the last follow up. The Kaplan-Meier analysis revealed that the cumulative probability of success in both groups was similar（P =0.61）. Anterior uveitis and hypotony were the most common complications in group A, whereas group B experienced shallow anterior chamber with trabeculectomy. With the exception of anterior uveitis, no complications occurred to 11 trabeculectomized eyes. All postoperative measurements of anterior chamber showed statistically significant differences in each group according to the preoperative data（P〈 0.05）. However,fewer changes occurred in group B than in group A.· CONCLUSION： Phacotrabeculectomy and sequential surgery exhibit similar IOP reduction, visual recovery,and complications when treating CACG patients with cataract. However, for a wider ACA, phacotrabeculectomy has demonstrated higher effectiveness than sequential surgery.

关键词： chronic angle-closure glaucoma phacotrabeculectomy sequential surgery anterior chamber angle

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MITOMYCIN C “STRAIGHT SCLERAL TUNNEL INCISION”-TRABECULECTOMY WITH A RELEASABLE SUTURE

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Chinese Medical Sciences Journal 2006年第3期21卷 157-162页

作者： Lin-nong Wang Fang Fang Yang Zhang Li-xun Chen Tai-hong Zhao Lei Xiao Hong Tang Ophthalmic Center Nanjing First Hospital Nanjing Medical University Nanjing 210006

Objective To evaluate the efficacy of ＂straight scleral tunnel incision＂-trabeculectomy with a releasable suture supplemented with mitomycin C （MMC） on reducing intraocular pressure （ IOP）, complications, and corneal astigmatism in patients with primary angle-closure glaucoma （PACG）. Methods Totally 217 acute or chronic PACG patients with occludable angle above 180℃ and IOP above 21 mm Hg were divided into 3 groups. Patients in group A （98 cases, 128 eyes）, B （71 cases, 95 eyes）, and C （48 cases, 60 eyes） were treated with ＂straight scleral tunnel incision＂-trabeculectomy with a releasable suture supplemented with MMC, releasable suture trabeculectomy with MMC, and trabeculectomy with MMC, respectively. IOP, complications, and sureicallv induced astigmatism （SIA） were evaluated oreooerativelv and up to 12 months oostoperatively. Results IOP of 2 weeks after treatment was significantly lower than preoperative IOP in all the 3 groups （ all P〈0.001）. Success rates （IOP≤20 mmHg） in groupA, B, and C were 87. 91% , 89.23%, and 83.72% respectively at 12 months after treatment （P = 0.256）. The incidence of shallow anterior chamber and hypotony had no significant difference between group A and B, but both of them were lower than that in group C （ P 〈 0.05 ）. There were no significant differences in preoperative corneal astigmatism among the 3 groups. The corneal astigmatism after 2 weeks in group A （1.71 ±1.47D） was higher than that before operation （ 1.28 ± 1.05D, P =0. 126）. With 12 months gone, the astigmatism almost returned to preoperative levels. The corneal astigmatisms after 2 weeks in group B and C （ 1.99 ± 1.20D and 2. 22 ± 1.39D） were significantly higher than those before operation （ 1.20 ± 0. 85D and 1.18 ±0.93D, P =0. 002, P =0. 001 ）, respectively. With 112 months gone, the mean astigmatisms in group B and C （ 1.87 ± 0. 91D and 1.90 ± 1.16D） were still significantly higher than those before operation （P = 0. 001, P = 0. 003 ）. The highest astigmatic polar

关键词： angle-closure glaucoma trabeculectomy incision postoperative complications surgically induced astigmatism

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Evaluation of the efficacy of laser peripheral iridoplasty in reversing the darkroom provocative test result in Chinese patients with primary angle closure status post laser iridotomy

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International Journal of Ophthalmology(English edition) 2015年第3期8卷 580-584页

作者： Ping Huang Ling-Ling Wu Department of Ophthalmology Peking University Third Hospital Key Laboratory of Vision Loss and RestorationMinistry of Education

AIM: To investigate the efficacy and safety of krypton laser peripheral iridoplasty(LPIP) for Chinese patients with primary angle closure(PAC) or primary angle-closure glaucoma(PACG) status post laser iridotomy in reversing the positive results of the dark room provocative test(DRPT).METHODS: This study was prospective, noncomparative,interventional case series. Thirty-three patients(thirty-eight eyes) with PAC or PACG status post patent laser iridotomy and maintained normal intraocular pressure(IOP) but with positive DRPT results were enrolled. All the subjects were treated with krypton LPIP. DRPT was repeated after krypton LPIP. Results of DRPT were recorded. The visual acuity, IOP and gonioscopy were analyzed before and after krypton LPIP. A minimum time limit for follow-up was ***: Thirty-three patients(thirty-eight eyes)were followed for 17.7 ±8.37mo(range 7-41mo) after LPIP. Positive results of DRPT decreased from 38 eyes to9 eyes(23.7%) after LPIP. Peripheral anterior synechiae of angle in 34 of 38 eyes(89.5%) remained unchanged at dynamic gonioscopy throughout the follow-up period after ***: LPIP decreased positive rates of the DRPT significantly. The mechanism may be that LPIP minimized contact between the peripheral iris and trabecular meshwork, which is a key factor for developing peripheral anterior synechiae.

关键词： iridoplasty angle-closure glaucoma laser

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