Early choroidal detachment after trabeculectomy

Popovic, Vladislav

doi:10.1034/j.1600-0420.1998.760325.x

Cited by 16 publications

(10 citation statements)

References 10 publications

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“…24 In the study of Vesti25cataract was more accelerated in exfoliation than in primary open angle glaucoma. The criteria for acceleration of cataract in the above cited study25 were the number of cases with cataract extraction, the shift of refraction to myopia, and increase in the lens opacity value measured with a Lens Opacity Meter 701.…”

Section: Discussionmentioning

confidence: 99%

Course of exfoliation and simplex glaucoma after primary trabeculectomy

Popovic

Sjöstrand

1999

British Journal of Ophthalmology

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Aim-To study the course of exfoliation and simplex glaucoma with respect to intraocular pressure (IOP) regulation and visual field survival after primary trabeculectomy. Methods-Postoperative IOP regulation and complications were analysed prospectively in 95 patients. Mean follow up was 46 months. Visual field survival was studied by high pass resolution perimetry (HRP) in a subsample of 28 patients. Results-Medical treatment was reinstated in 42% of exfoliation and in 36% of simplex glaucoma. In these patients, mean medicine free survival time, last untreated IOP, and mean IOP at the end of follow up were similar for both glaucoma types. Among patients with controlled postoperative IOP without added medication, mean IOP at the end of follow up was significantly lower in exfoliation glaucoma. Visual field deterioration and the pattern of complications were similar for both glaucoma types. Conclusion-The eVect of trabeculectomy on IOP regulation was good in both types of glaucoma, and somewhat better in exfoliation glaucoma. The magnitude of IOP lowering could not separate patients with continued visual field deterioration from those in whom visual fields remained stable. Visual field preservation was similar for both glaucoma types. (Br J Ophthalmol 1999;83:305-310) Trabeculectomy is the method of choice for surgical treatment of chronic open angle glaucoma. Long term follow up shows that this procedure alone can control intraocular pressure (IOP) for 10 years postoperatively in about 60% of cases.1 With medical treatment, the success rate for IOP control increases to over 90%. Exfoliation glaucoma causes about one half of all cases of chronic open angle glaucoma in Scandinavia.3 Its prognosis on medical treatment is worse in comparison with simplex glaucoma. [4][5][6][7] Argon laser trabeculoplasty (ALT) has better short term eYcacy in exfoliation glaucoma, but the long term results do not diVer between the two glaucoma types.8 9 The poorer response to medical treatment in exfoliation glaucoma explains the larger proportion of this glaucoma type among patients undergoing surgical treatment.Trabeculectomy has been reported to be eVective in exfoliation glaucoma. 10 However, there are only a few studies in which the results of trabeculectomy in exfoliation and simplex glaucoma are compared. Törnqvist and Drolsum 11 and Konstas et al 12 found the response to trabeculectomy better in exfoliation than in simplex glaucoma. The follow up period in the study by Konstas et al 12 was 6 months. In the study by Törnqvist and Drolsum, 11 in which follow up time was <10 years, no analysis was made of preoperative variables and their relation to the outcome of the operation.The aim of the present study was to assess the regulation of IOP and the survival of visual field in exfoliation and simplex glaucoma after primary trabeculectomy. In addition, the following question was to be answered: is there any postoperative IOP that may separate patients at risk for continued visual field deterioration after operation from...

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Section: Discussionmentioning

confidence: 99%

Course of exfoliation and simplex glaucoma after primary trabeculectomy

Popovic

Sjöstrand

1999

British Journal of Ophthalmology

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“…In the present study, complication rates during surgery and the postoperative period were few and comparable with those of other studies (Popovic 1995; Popovic & Sjöstrand 1999). Choroidal detachment has been described in 22–59% of patients after trabeculectomy (Popovic 1995, 1998). Leyland et al.…”

Section: Discussionmentioning

confidence: 99%

“…2001) Success rates have been satisfactory, but complications such as hypotony, cataract, blebitis, endophthalmitis, suprachoroidal haemorrhage, and early and late filtration failures occur occasionally (Watson et al. 1990; Popovic & Sjöstrand 1991; Popovic 1995, 1998; Mochizuki et al. 1997; Popovic & Sjöstrand 1999; Singh et al.…”

Section: Introductionmentioning

confidence: 99%

Trabeculectomy with an active postoperative regimen: results and resource utilization

Taube¹,

Niemelä²,

Alm³

2009

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate intraocular pressure (IOP) and resource utilization after trabeculectomy, using an active postoperative regimen, in a Swedish population. Methods: A retrospective analysis was performed on the patient charts of all patients who underwent trabeculectomy in a Swedish university hospital during 1 year (November 2000-December 2001. Trabeculectomy was performed in 34 eyes and trabeculectomy in combination with phacoemulsification in 10 eyes. Intraocular pressure, visual acuity, complications and numbers of injections of 5-fluorouracil, suture removal, needling procedures and visits to ophthalmologists were recorded for 2 years. Results: Mean IOP before surgery was 30.4 mmHg (standard deviation [SD] 9.5) in eyes with capsular glaucoma and 28.7 mmHg (SD 9.3) in eyes with primary open-angle glaucoma. Mean IOP after 2 years was 15.3 mmHg (SD 3.9) in all eyes. Intraocular pressure of < 18 mmHg was achieved in 65% of the eyes after 2 years, as was IOP £ 13 mmHg in 37%. Flap or suture manipulation was performed in 41 of 44 eyes. Needling procedures were carried out a mean of 2.3 times in 31 eyes. The mean number of visits to an ophthalmologist was 14.1 during the first postoperative year and 4.4 during the second. Conclusions: The results were encouraging, with few complications and modest resource utilization.

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“…It is usually detected early in the postoperative period [23], though cases of late onset choroidal effusion up to 26 months posttrabeculectomy have been reported [24]. Choroidal effusion has been reported to be associated with hypotony and anterior chamber shallowing [25].…”

Section: Discussionmentioning

confidence: 97%

Comparison of 90-s versus 5-min intraoperative 5-fluorouracil in trabeculectomy

2009

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To compare the relative efficacy of trabeculectomy surgery with 90-s and 5-min intraoperative exposure time to 5-fluorouracil. This was a retrospective, non-randomized comparative study. 41 eyes of 33 consecutive patients in the study group were compared to 40 eyes of 30 consecutive patients in the historical control group. Both groups were exposed to 5-fluorouracil (50 mg/ml) during trabeculectomy surgery. The exposure time was 90 s for the study group and 5 min for the control group. Three criteria were used to define surgical success: IOP (intraocular pressure) less than 21 mmHg; IOP less than 21 mmHg with more than 30% reduction in pressure; and IOP less than 15 mmHg with more than 30% reduction. The number of antiglaucoma medications, visual acuity, complications, and interventions were recorded at regular intervals. Mean preoperative IOP was 21.6 +/- 4.8 in the 90-s group and 21.2 +/- 4.9 in the 5-min group. Mean follow-up was 28.2 +/- 5.1 months in the 90-s group and 48.0 +/- 4.9 months in the 5-min group. During the first 30 postoperative months, there were no statistically significant differences in IOP and requirement for antiglaucoma medications between the two groups. The 90-s group had shorter survival rates using the 1st success criteria, but no significant difference was detected when the more stringent 2nd and 3rd criteria were applied. Choroidal effusions were significantly less common in the 90-s group (P = 0.0076). The results of this small study suggest that a 90-s application of 5-fluorouracil may be as effective as a 5-min one in trabeculectomy.

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Early choroidal detachment after trabeculectomy

Cited by 16 publications

References 10 publications

Course of exfoliation and simplex glaucoma after primary trabeculectomy

Course of exfoliation and simplex glaucoma after primary trabeculectomy

Trabeculectomy with an active postoperative regimen: results and resource utilization

Comparison of 90-s versus 5-min intraoperative 5-fluorouracil in trabeculectomy

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