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trabeculectomy with Ex-PRESS implant versus Ahmed glaucoma valve implantation-a comparative study

International Journal of Ophthalmology(English edition) 2016年第10期9卷 1415-1420页

作者： Michael Waisbourd Naomi Fischer Hadas Shalev Oriel Spierer Elad Ben Artsi Rony Rachmiel Gabi Shemesh Shimon Kurtz Department of Ophthalmology Tel-Aviv Medical CenterAffiliated to the Sackler Faculty of Medicine Tel-Aviv University Tel-Aviv 64239 Israel Wills Eye Glaucoma Research Center Philadelphia PA19107 USA

AIM：To compare the surgical outcomes of trabeculectomy with Ex-PRESS implant and Ahmed glaucoma valve（AGV） implantation. METHODS： Patients who underwent trabeculectomy with Ex-PRESS implants or AGV implantation separately were included in this retrospective chart *** outcome measures were surgical failure and *** was defined as intraocular pressure（IOP）〉21 mm Hg or 〈5 mm Hg on two consecutive visits after 3mo,reoperation for glaucoma,or loss of light *** that had not failed were considered as complete success if they did not required supplemental medical ***： A total of 64 eyes from 57 patients were included： 31 eyes in the Ex-PRESS group and 33 eyes in the AGV *** mean follow-up time was 2.6 ±1.1y and 3.3±1.6y,*** in the AGV group had significantly higher baseline mean IOP（P =0.005）,lower baseline mean visual acuity（VA）（P =0.02）,and higher proportion of patients with history of previous trabeculectomy（P 〈0.0001）.Crude failure rates were 16.1%,n =5/31 in the Ex-PRESS group and 24.2%,n =8/33 in the AGV *** cumulative proportion of failure was similar between the groups,P =*** proportion of eyes that experienced postoperative complications was32.3% in the Ex-PRESS group and 60.1% in the AGV group（P =0.0229）.CONCLUSION： trabeculectomy with Ex-PRESS implant and AGV implantation had comparable failure *** AGV group had more post-operative complications,but also included more complex cases with higher baselinemean IOP,worse baseline mean VA,and more previous glaucoma ***,the results are limited to the cohort included in this study.

关键词： Ex-PRESS glaucoma implant trabeculectomy Ahmed glaucoma valve implantation

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trabeculectomy with large area mitomycin-C application as a first-line treatment in advanced glaucoma: retrospective review

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International Journal of Ophthalmology(English edition) 2014年第1期7卷 104-109页

作者： Zeynep Aktas Safak Korkmaz Murat Hasanreisoglu Merih Onol Berati Hasanreisoglu Department of Ophthalmology Gazi University Medical Faculty Department of Ophthalmology Duzce Ataturk State Hospital Wold Eye Hospital

AIM: To evaluate the outcomes of trabeculectomy with large area mitomycin-C(MMC) application as a first line treatment in advanced glaucoma. ·METHODS: The records of 55 patients with severe visual field defects undergoing trabeculectomy were retrospectively reviewed. The patients were classified as first-line therapy to either early trabeculectomy(initial trabeculectomy-Group 1) or long term medical therapy followed by trabeculectomy(primary trabeculectomy-Group 2). trabeculectomy was performed with large-area MMC application. Intraocular pressure(IOP) values,visual acuities,mean deviations,morphology and function of the blebs,necessity for anti-glaucomatous medications and surgical complications were reported. ·RESULTS: There were 20 eyes of 18 patients in Group 1 and 37 eyes of 37 patients in Group 2. The mean preoperative IOPs in Groups 1 and 2 were 40.2±10.0mmHg(27-68mmHg) and 29.0±4.4mmHg(21-41mmHg),respectively(P=0.001). Average preoperative mean deviations(MD) in Groups 1 and 2 were 17.4±2.8dB(13.3-23dB) and 17.9± 2.4dB(13.7-23.2dB),respectively(P=0.441). Postoperative IOPs significantly decreased and were comparable in both Groups. The mean number of medications was significantly higher in Group 2(P =0.005). No cystic bleb formation was observed in Group 1,whereas 4 patients from Group 2(10.8%) developed cystic bleb(P =0.040). No visually devastating complication has occurred in both Groups. ·CONCLUSION: Initial trabeculectomy with large areaMMC application might be applied in patients with advanced glaucoma with low complication rates. Long-term topically applied anti-glaucomatous medications seem to increase the risk of cystic bleb formation.

关键词： trabeculectomy advanced glaucoma large area mitomycin-C application

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Study of self-made freeze-dried bilayered fibrin-binding amniotic membrane in ocular trabeculectomy in rabbits

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International Journal of Ophthalmology(English edition) 2011年第6期4卷 582-589页

作者： Wan Li, Ming-Chang Zhang Department of Ophthalmology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 Hubei Province China Department of Orthopedics Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 Hubei Province China

AIM: To investigate the antifibrotic effect of freeze-dried bilayered fibrin-binding amniotic membrane on trabeculectomy in a rabbit model. METHODS: Twenty-four Japanese white rabbits were randomized into three groups: the experimental group (ocular trabeculectomy in combination with freeze-dried bilayered fibrin-binding amniotic membrane transplantation), the control group (ocular trabeculectomy in combination with natural bilayered fibrin-binding amniotic membrane) and the blank group (single trabeculectomy). Clinical observation, hematoxylin-eosin staining, Massion staining, real-time PCR and immunohistochemistry for alpha -SMA were performed on days 7, 14, 21 and 30 following surgery. RESULTS: Statistical differences were noted in survival. analysis and intraocular pressure(IOP) among groups on days 7, 14, 21 and 30 following surgery. Histology, immunohistochemistry and real-time PCR further demonstrated that trabeculectomy in combination with freeze-dried bilayered fibrin-binding amniotic membrane resulted in good wound healing and no scar formation. CONCLUSION: Self-made freeze-dried bilayered fibrin-binding amniotic membrane may inhibit the formation of scarring in glaucoma after trabeculectomy.

关键词： freeze-dried fibrin-binding amniotic membrane trabeculectomy

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Inhibition of post-trabeculectomy fibrosis via topically instilled antisense oligonucleotide complexes co-loaded with fluorouracil

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Acta Pharmaceutica Sinica B 2020年第9期10卷 1754-1768页

作者： Kuan Jiang Junyi Chen Lingyu Tai Chang Liu Xishan Chen Gang Wei Weiyue Lu Weisan Pan Key Laboratory of Smart Drug Delivery Ministry of EducationDepartment of PharmaceuticsSchool of PharmacyFudan UniversityShanghai 201203China Department of Ophthalmology Eye&ENT HospitalFudan UniversityShanghai 200031China School of Pharmacy Shenyang Pharmaceutical UniversityShenyang 110016China The Institutes of Integrative Medicine of Fudan University Shanghai 200040China Shanghai Engineering Research Center of Immunotherapeutics Shanghai 201203China

trabeculectomy is the mainstay of surgical glaucoma treatment,while the success rate was unsatistying due to postoperative scarring of the filtering *** countermeasures for scar prevention are intraoperative intervention or repeated subconjunctival ***,we designed a codelivery system capable of transporting fluorouracil and anti-TGF-β2 oligonucleotide to synergistically inhibit fibroblast proliferation via topical *** co-delivery system was built based on a cationic dendrimer core(PAMAM),which encapsulated fluorouracil within hydrophobic cavity and condensed oligonucleotide with surface amino groups,and was further modified with hyaluronic acid and cell-penetrating peptide *** co-delivery system was self-assembled into nanoscale complexes with increased cellular uptake and enabled efficient inhibition on proliferation of fibroblast *** vivo studies on rabbit trabeculectomy models further confirmed the anti-fibrosis efficiency of the complexes,which prolonged survival time of filtering blebs and maintained their height and extent during wound healing process,exhibiting an equivalent effect on scar prevention compared to intraoperative infiltration with *** observation by immunohistochemistry staining and quantitative analysis by Western blotting both suggested that TGF-β2 expression was inhibited by the co-delivery *** study provided a potential approach promising to guarantee success rate of trabeculectomy and prolong survival time of filtering blebs.

关键词： trabeculectomy Fibrosis prevention Gene delivery Penetratin Fluorouracil

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Deep sclerectomy-trabeculectomy with mitomycin C in treating glaucoma:postoperative long-term results

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International Journal of Ophthalmology(English edition) 2022年第12期15卷 1951-1959页

作者： Chung Shen Chean Li Jiang Gayathri Kanchana Niroshani Pati Arambage Punithawathy Ranjit Ophthalmology Department Royal Stoke University HospitalNewcastle RoadStoke-on-Trent ST46QGUnited Kingdom

AIM:To determine the long-term postoperative outcomes of deep sclerectomy-trabeculectomy(DST)with mitomycin C(MMC)in the treatment of ***:Patients who underwent DST with MMC between 2010 and 2017 were included in this retrospective observational *** success was defined as postoperative intraocular pressure(IOP)≤21 mm Hg or 30%reduction of IOP from baseline without any topical IOP-lowering agent,and qualified success defined as IOP≤21 mm Hg or 30%reduction of IOP from baseline with/without single topical *** evaluated the surgical success rates and complication rates of this procedure,as well as described the IOP profiles,best corrected visual acuity(BCVA)profiles and mean deviations(MD)of Humphrey visual field(HVF)24-2 performance at each follow-up time *** linear regression models were constructed to determine estimated predictive values of demographic data,use of topical IOPlowering agents,baseline and postoperative IOP and optical profiles(e.g.,BCVA and MD).RESULTS:Totally 98 eyes(mean postoperative followup 67.5mo)showed mean IOP reduction at every followup *** median BCVA and MD of visual fields were maintained throughout the follow-up intervals when comparing to *** number of IOP-lowering medications decreased from 2.8±0.8 to 0.3±0.7(P=0.068).Totally 84(85.7%)eyes achieved complete success at final *** hyphaema and transient choroidal effusion developed in 15 eyes(15.3%)and 11 eyes(11.2%)*** complications included shallow anterior chamber in 5 eyes(5.1%),bleb leak in 4 eyes(4.1%),bleb revision in 7 eyes(7.1%),bleb needling in 9 eyes(9.2%)and repeat trabeculectomy in 1 eye(1.0%).There was no endophthalmitis,blebitis or macular *** was no significant correlation between postoperative IOP control and postoperative ***:DST with MMC demonstrates effective and sustained long-term outcomes in the treatment of glaucoma with no major complication.

关键词： glaucoma surgical outcome deep sclerectomy trabeculectomy mitomycin C

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Outcomes of 1.8-3.0 mm incision phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma with cataract

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International Journal of Ophthalmology(English edition) 2020年第2期13卷 246-251页

作者： Qing Wang Zheng-Xuan Jiang Rong-Feng Liao Department of Ophthalmology the First Affiliated Hospital of Anhui Medical UniversityHefei 230031Anhui ProvinceChina Department of Ophthalmology the Fourth Affiliated Hospital of Anhui Medical UniversityHefei 230012Anhui ProvinceChina Department of Ophthalmology the Second Hospital of Anhui Medical UniversityHefei 230601Anhui ProvinceChina

●AIM:To compare efficacy of coaxial microincisions(1.8 mm,2.2 mm)and small incisions(3.0 mm)on phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma(PACG)with cataract.●METHODS:Ninety-six patients(96 eyes)with PACG and cataract were recruited and randomly divided into three groups between January 2015 and June *** A(3.0 mm incision),B(2.2 mm incision),and C(1.8 mm incision)comprised 30,34 and 32 eyes *** cases were treated with clear corneal incision phacoemulsification combined with *** including best corrected visual acuity(BCVA),corneal astigmatism,corneal endothelial cell counts(CECC),intraocular pressure(IOP),and complications were collected before the operation,and at postoperative 1 d,1 and 3 mo.●RESULTS:All the patients were successfully treated with *** BCVA of groups B and C were significantly improved as compared to group A at postoperative 1 d,1 and 3 mo(all P0.05).The corneal astigmatism of group A was statistically higher than that of group B(P=0.026);corneal astigmatism of group B was statistically higher than that of group C at postoperative 1 d(P=0.006).The corneal astigmatism of group A at postoperative 3 mo was significantly higher than that before operation(P=0.003).At postoperative 1 and 3 mo,corneal astigmatism of groups B and C were significantly lower than that of group A(all Ptrabeculectomy for PACG with cataract has bett

关键词： coaxial microincision glaucoma cataract phacoemulsification trabeculectomy

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Posterior scleral application of a mitomycin C-soaked sponge during trabeculectomy

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International Journal of Ophthalmology(English edition) 2023年第7期16卷 1071-1077页

作者： Kun Hu Yun-He Song Feng-Bin Lin Ying-Zhe Zhang Ling Jin Meng-Yin Liang Robert N.Weinreb Xiu-Lan Zhang State Key Laboratory of Ophthalmology Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangdong Provincial Key Laboratory of Ophthalmology and Visual ScienceGuangdong Provincial Clinical Research Center for Ocular DiseasesGuangzhou 510060Guangdong ProvinceChina Hamilton Glaucoma Center Shiley Eye InstituteViterbi Family Department of OphthalmologyUC San DiegoLa JollaCA 92093USA

AIM:To evaluate the safety and efficacy of posterior scleral application(a modified technique)of an antimetabolite mitomycin C-soaked sponge in trabeculectomy for patients with ***:This retrospective study included 101 patients(115 eyes)with glaucoma(aged 12–83y)who underwent trabeculectomy using a modified mitomycin C-soaked sponge placement method.A piece of 3.5×10 mm2 sponge was placed vertically and posteriorly with the long side perpendicular to the *** mitomycin C concentration and exposure time were 0.2–0.5 mg/m L and 1–5min,*** pressure,bestcorrected visual acuity,and hypotensive medications were recorded at baseline and at the final ***,interventions required,and bleb morphology were recorded *** primary outcome was trabeculectomy safety,including complications and bleb morphology;the secondary outcome was the trabeculectomy success ***:At the final follow-up[median 28mo,range 7–67mo and interquartile range(IQR)13mo],the qualified(cumulative)success rate was 93.0%and the complete success rate was 60.0%.No bleb-related complications were *** mean height,extent,and vascularity grades were 0.6±0.9,1.1±0.4,and 2.4±0.9,*** Seidel tests were *** mean posteriority grade was 0.8±***:trabeculectomy with the long side of a mitomycin C-soaked sponge placed perpendicular to the corneal limbus is safe and effective.

关键词： glaucoma mitomycin C posterior scleral application trabeculectomy bleb morphology

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Therapeutic effect analysis on the treatment of congenital glaucoma through modified combined trabeculotomy-trabeculectomy

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International Journal of Ophthalmology(English edition) 2016年第2期9卷 243-248页

作者： Zhen-Kai Wu Jing Wu Qian Tan Jian Jiang Wei-Tao Song Xiao-Bo Xia Department of Ophthalmology Xiangya Hospital Central South University Department of Ophthalmology First People's Hospital of Changde City

AIM： To evaluate the therapeutic effect and the safety of the treatment of congenital glaucoma through modified combined trabeculotomy-trabeculectomy. METHODS： The clinical data of 27 cases （altogether 42 eyes）, which included 7 cases of infants （10 eyes） and 20 cases of teenagers （32 eyes）, of congenital glaucoma undertook modified combined trabeculotomy trabeculectomy were analyzed retrospectively. The parameters evaluated included the post operation visual acuity, the anterior chamber, the filtering bleb, the intraocular pressure, the C/D ratio, visual field, the retinal nerve fiber layer changes and the complications. RESULTS： The follow-up period was 1 to 29mo, averaging 13.3 ±7.7mo. Upon the last visit after the operation, functional filtering blebs developed in all the involved eyes. The intraocular pressure was controlled under 21 mm Hg, which was decreased by 60% when compared with that before the operation, without using any medication. There were no significant changes in the post operation visual acuity and the retinal nerve fiber layer thickness before and after the operation in teenager group （P〉0.05）, and both the post operation C/D ratio and the visual field mean defect （MD） were reduced compared with those before the operation （P〈0.05）. There were no severe complications in any of the patients. CONCLUSION： The modified combined trabeculotomy- trabeculectomy can effectively reduce the intraocular pressure and control the development of glaucoma in cases of congenital glaucoma. It is a safe and effective operative method for the treatment of congenital glaucoma

关键词： congenital glaucoma trabeculotomy trabeculectomy

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Outcomes and risk factors for failure of trabeculectomy in glaucomatous patients in Southwest China:a 325 eyes analysis

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International Journal of Ophthalmology(English edition) 2023年第3期16卷 367-374页

作者： Zuo-Xin Qin Xi Ying Qing Han Lu Wang Lian Tan Yu-Fei Xu Qiu-Xiang You Nan Wu Yong Liu Southwest Hospital/Southwest Eye Hospital Third Military Medical University(Army Medical University)Chongqing 400038China Key Lab of Visual Damage and Regeneration&Restoration of Chongqing Chongqing 400038China

AIM:To evaluate the outcomes and elucidate the failure factors for trabeculectomy with mitomycin C(MMC)in Southwest Chinese ***:A retrospective correlational study was conducted on the glaucomatous patients who underwent initial trabeculectomy with MMC in Southwest Hospital and had been followed up for 1-3y.A complete success for surgery is defined as a postoperative intraocular pressure(IOP)>5 and≤21 mm Hg and 20%reduction of IOP compared to preoperative,without IOP-lowering medications.A qualified success for surgery is defined as the abovementioned postoperative IOP with or without IOP-lowering *** primary outcomes were IOP,the number of IOP-lowering medications,and cumulative success *** secondary outcomes included best corrected visual acuity(BCVA),mean deviation(MD)of visual field,major complications,and risk factors for surgical ***:A total of 325 eyes of 261 glaucomatous patients had been included in our *** the mean IOP and the number of IOP-lowering medications were significantly decreased from 32.9±12.0 to 16.4±5.7 mm Hg(Ptrabeculectomy were comparable with those of ***(HR=1.904,P=0.011),encapsulated bleb(HR=2.756,Ptrabeculectomy with MMC in glaucomatous patients in the cohort is 92.0%at 1-year,and 77.7%at 3-year follow ***,encapsulated bleb,and more preoperative topical medications are associated with surgical failure.

关键词： glaucoma trabeculectomy outcomes risk factors

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Conjunctival flap advancement with or without scleral graft for hypotony maculopathy after trabeculectomy

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International Journal of Ophthalmology(English edition) 2020年第7期13卷 1079-1086页

作者： Abdelhamid Shaker Elhofi Mohamed Fahmy Doheim Amir AbouSamra Department of Ophthalmology Faculty of MedicineAlexandria UniversityAlexandria 21131Egypt Faculty of Medicine Alexandria UniversityAlexandria 21131Egypt

AIM: To investigate the outcomes of adaptive conjunctival flap advancement surgical techniques with or without scleral graft for patients undergoing revision surgery after ***: This retrospective study included 28 eyes of 28 subjects from December 2015 to April 2018. A group of 15 eyes underwent conjunctival advancement only while the other 13 eyes did conjunctival advancement with partial thickness scleral graft. In both study groups, we considered the intraocular pressure(IOP) as our primary outcome and visual acuity(VA) as our secondary outcome. Both were assessed pre-and post-operatively till the last followup possible point. Additionally, we classified the patients according to complete and qualified success ***: The mean age of the conjunctival advancement group was 36.87±19.25 y, while it was 44.08±18.04 in the other group. In both study groups, the mean IOP significantly increased after revision surgery at 1, 2, 3 mo and the last follow-up visit when compared to prior the surgery(P<0.001). Moreover, VA was significantly improved(P=0.03) in the final follow-up for both surgical techniques. When we compared the change from baseline in both groups, there was no significant difference between IOP improvement in 1 mo(P=0.263), while the difference was significant in 2 mo(P=0.03), 3 mo(P=0.02) and in the final follow-up visit postoperatively. However, this difference was not significant regarding VA(P=0.5).CONCLUSION: The both adaptive techniques of conjunctival advancement and conjunctival advancement with scleral graft are effective for treating patients with lateonset hypotony. Yet, more prospective studies are needed to assert upon these results.

关键词： trabeculectomy scleral melting revision surgery hypotony maculopathy

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