The described technique is remarkably accurate and does not require any specially designed implants. It is highly recommended for cases of myopic macular hole retinal detachment with atrophic background and deep posterior staphyloma and for recurrent cases after vitrectomy with or without silicone oil.
Précis: Combined trabeculotomy-trabeculectomy (CTT) has a significantly better hypotensive effect than trabeculectomy and a higher success rate in cases of silicone oil–induced ocular hypertension. Purpose: To compare the ocular hypotensive effect of CTT with mitomycin-C (MMC) to that of trabeculectomy with MMC in cases of silicone oil–induced ocular hypertension. Patients and Methods: Thirty eyes of 30 patients with high intraocular pressure (IOP) after vitrectomy and silicone oil injection (followed by silicone oil removal) were randomly allocated to 2 groups in this randomized trial. Group A was composed of 15 cases who underwent combined CTT with MMC while group B cases contained 15 cases undergoing trabeculectomy with MMC. Patients were followed up for 12 months. We included patients above 18 years old, having performed vitrectomy and silicone oil injection followed by oil removal, and having IOP >21 mm Hg uncontrollable by antiglaucoma medications. Results: The postoperative IOP drop was significantly greater in group A than in group B at all follow up visits (P<0.05). Compared with preoperative IOP, both surgeries produced a significantly lower postoperative IOP at all follow-up visits (P<0.05). For group A, complete success rates (IOP≤21 mm Hg without ocular hypotensive medications) and qualified success rates (IOP≤21 mm Hg with or without ocular hypotensive medications) were both higher than for group B. Conclusion: Both surgeries effectively reduce IOP in cases of silicone oil–induced ocular hypertension, but CTT has a significantly better hypotensive effect and a higher success rate on the long-term.
Background Primary congenital glaucoma (PCG) is a leading cause of childhood blindness in Egypt. The discovery of the underlying genetic causes has led to far greater understanding of disease mechanisms. Cytochrome P450, family 1, subfamily B, polypeptide 1(CYP1B1) gene mutations usually inherited in an autosomal recessive manner are one of the major etiologies behind PCG. Gene screening aids early diagnosis of PCG which is a key factor in managing and preventing blindness from the disease. Aim This study aims to screen for CYP1B1gene mutations in PCG patients and study its possible impact on surgical outcome of PCG. Methods Twenty-four PCG patients enrolled in this study underwent trabeculotomy, and were followed up at a 3 month interval for a year. Patients’ demographic details were recorded, and their genomic DNA was screened for CYP1B1 mutations. Genotypic impact on surgical outcome was compared between the group of patients who harbored mutations and the group unsolved with mutations. Results Six different disease causing CYP1B1 mutations were identified in 13 (54.17 %) of affected patients who exhibited more surgical failure at the last follow up visit. Conclusion This study further endorses CYP1B1 mutations as a possible etiological and prognostic factor for PCG.
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