Intracorneal hematoma after canaloplasty and clear cornea phacoemulsification: surgical management

Freiberg, Florentina Joyce; Salgado, Josefina; Grehn, Franz; Klink, Thomas

doi:10.5301/ejo.5000132

Cited by 14 publications

(10 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While dilating Schlemm canal with viscoelastics, a detachment of Descemet membrane may occur. An intracorneal hematoma is a rare complication following Descemet detachment and can be removed by partial-thickness paracentesis [22]. Descemet detachment was not encountered in our study.…”

Section: Discussionmentioning

confidence: 58%

Comparison of phacotrabeculectomy versus phacocanaloplasty in the treatment of patients with concomitant cataract and glaucoma

et al. 2013

Self Cite

View full text Add to dashboard Cite

BackgroundCataract and glaucoma are both common comorbidities among older patients. Combining glaucoma surgery with minimal invasive phacoemulsification (phaco) is a considerable option to treat both conditions at the same time, although the combination with filtration surgery can produce a strong inflammatory response. Combined non-penetrating procedures like canaloplasty have shown to reduce intraocular pressure (IOP) comparable to trabeculectomy without the risk of serious bleb-related complications. The purpose of this retrospective study was to compare the outcomes of phacotrabeculectomy and phacocanaloplasty.MethodsThirty-nine eyes with concomitant cataract and glaucoma who underwent phacotrabeculectomy (n = 20; 51.3%) or phacocanaloplasty (n = 19; 48.7%) were included into this trial on reduction of IOP, use of medication, success rate, incidence of complications and postsurgical interventions. Complete success was defined as IOP reduction by 30% or more and to 21 mmHg or less (definition 1a) or IOP to less than 18 mmHg (definition 2a) without glaucoma medication.ResultsOver a 12-month follow-up, baseline IOP significantly decreased from 30.0 ± 5.3 mmHg with a mean of 2.5 ± 1.2 glaucoma medications to 11.7 ± 3.5 mmHg with a mean of 0.2 ± 0.4 medications in eyes with phacotrabeculectomy (P < .0001). Eyes with phacocanaloplasty had a preoperative IOP of 28.3 ± 4.1 mmHg and were on 2.8 ± 1.1 IOP-lowering drugs. At 12 months, IOP significantly decreased to 12.6 ± 2.1 mmHg and less glaucoma medications were necessary (mean 1.0 ± 1.5 topical medications; P < .05). 15 patients (78.9%) with phacotrabeculectomy and 9 patients (60.0%) in the phacocanaloplasty group showed complete success according to definition 1 and 2 after 1 year (P = .276). Postsurgical complications were seen in 7 patients (36.8%) of the phacocanaloplasty group which included intraoperative macroperforation of the trabeculo-Descemet membrane (5.3%), hyphema (21.1%) and bleb formation (10.5%). Although more complications were observed in the phacotrabeculectomy group, no statistically significant difference was found.ConclusionsPhacocanaloplasty offers a new alternative to phacotrabeculectomy for treatment of concomitant glaucoma and cataract, although phacotrabeculectomy yielded in better results in terms of IOP maintained without glaucoma medications.

show abstract

Section: Discussionmentioning

confidence: 58%

Comparison of phacotrabeculectomy versus phacocanaloplasty in the treatment of patients with concomitant cataract and glaucoma

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…The same concept may be applied to monitor the effects of minimally invasive nonpenetrating glaucoma procedures and implantation of devices designed to bypass the trabecular network. [23][24][25][26][27][28][29][30] Cadaveric models suggested that TM expansion into SC would be observed with IOP elevation. 15 Mathematical modeling of the outflow system also predicts compression of SC in response to IOP elevation.…”

Section: Discussionmentioning

confidence: 99%

IOP Elevation Reduces Schlemm's Canal Cross-Sectional Area

Kagemann

Wang

Wollstein

et al. 2014

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

PURPOSE. Previously, we demonstrated reduced Schlemm's canal cross-sectional area (SC-CSA) with increased perfusion pressure in a cadaveric flow model. The purpose of the present study was to determine the effect of acute IOP elevation on SC-CSA in living human eyes. METHODS.The temporal limbus of 27 eyes of 14 healthy subjects (10 male, 4 female, age 36 6 13 years) was imaged by spectral-domain optical coherence tomography at baseline and with IOP elevation (ophthalmodynamometer set at 30-g force). Intraocular pressure was measured at baseline and with IOP elevation by Goldmann applanation tonometry. Vascular landmarks were used to identify corresponding locations in baseline and IOP elevation scan volumes. Schlemm's canal CSA at five locations within a 1-mm length of SC was measured in ImageJ as described previously. A linear mixed-effects model quantified the effect of IOP elevation on SC-CSA.RESULTS. The mean IOP increase was 189%, and the mean SC-CSA decrease was 32% (P < 0.001). The estimate (95% confidence interval) for SC-CSA response to IOP change was À66.6 (À80.6 to À52.7) lm 2 /mm Hg.CONCLUSIONS. Acute IOP elevation significantly reduces SC-CSA in healthy eyes. Acute dynamic response to IOP elevation may be a useful future characterization of ocular health in the management of glaucoma.

show abstract

“…1,2 In addition, these conditions are associated with similar insults to the cornea such as corneal grafting, infection, inflammatory corneal diseases, intraocular surgery, extraocular surgery, ocular trauma, and, in human beings, contact lens irritation. [7][8][9] In many cases, ICH resolves spontaneously over time with or without the use of specific topical treatments. 2,10 According to literature describing human ICH, severe cases may require surgical drainage of the hemorrhage or corneal transplantation to salvage normal function of the eye.…”

Section: Introductionmentioning

confidence: 99%

Intracorneal stromal hemorrhage in dogs and its associations with ocular and systemic disease: 39 cases

Violette

Ledbetter

2016

Veterinary Ophthalmology

View full text Add to dashboard Cite

show abstract

Intracorneal hematoma after canaloplasty and clear cornea phacoemulsification: surgical management

Abstract: This operation was a minimally invasive technique to remove intrastromal hematocornea after viscocanaloplasty.

Cited by 14 publications

References 8 publications

Comparison of phacotrabeculectomy versus phacocanaloplasty in the treatment of patients with concomitant cataract and glaucoma

Comparison of phacotrabeculectomy versus phacocanaloplasty in the treatment of patients with concomitant cataract and glaucoma

IOP Elevation Reduces Schlemm's Canal Cross-Sectional Area

Intracorneal stromal hemorrhage in dogs and its associations with ocular and systemic disease: 39 cases

Contact Info

Product

Resources

About