Mini-trabeculectomy in eyes with high risk of scarring: midterm follow-up

Ophir, Avinoam; Pikkel, Joseph

doi:10.1016/s0002-9394(00)00637-1

Cited by 11 publications

(14 citation statements)

References 14 publications

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“…[1][2][3][4][5][6][7][8][9][10][11] During the first postoperative phase, leakage from the wound site (Seidel test) was not detected in any of the eyes in the current study. This is similar to others that use the tunnel approach, [15][16][17][18][19][20] but in contrast to studies in which the standard trabeculectomy was used with a fornix-based conjunctival flap. 17,[24][25][26] The difference may be attributed to the tunnel approach, lack of scleral radial incisions and the short and tight closure of the conjunctival flap, as previously discussed.…”

Section: Postoperative Complicationssupporting

confidence: 76%

“…15 Briefly, the surgical procedure consists of a 3-mm fornix-based conjunctival flap. A Weck cell sponge, soaked with 0.4 mg/ml MMC was applied on both the scleral wound and the distal exposed bare sclera for 2 (in first-time surgery cases) or 3 min (in eyes with high-risk of postoperative scarring).…”

Section: Surgical Techniquementioning

confidence: 99%

“…17,[24][25][26] The difference may be attributed to the tunnel approach, lack of scleral radial incisions and the short and tight closure of the conjunctival flap, as previously discussed. 15 This pilot study provides information regarding the association of protection of the inner wall of the fornixbased conjunctival flap from MMC contact during tunnel-trabeculectomy with a vascularized, thick bleb after 24-32 months of follow-up. Further controlled prospective studies are required to consolidate the association of protective measures from MMC touch on the prevention of late thin, avascular, cystic bleb formation and its consequences.…”

Section: Postoperative Complicationsmentioning

confidence: 99%

“…The sclerocorneal tunnel approach, a modifications of Cairns trabeculectomy, 14 gained popularity in recent years and several reports and modifications of it were reported. 11,[15][16][17][18][19][20] In the present study, protective measures were taken during fornix-based-flap tunnel-trabeculectomy (3-mm width), 15 to prevent the internal wall of the flap from MMC touch both at time of its application and washout. As far as we are aware, based on Med-Line search, this has not previously reported.…”

Section: Introductionmentioning

confidence: 99%

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Protection of the conjunctival flap from contact with mitomycin C during tunnel-trabeculectomy

Ophir

Karataş

2006

Eye

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Aim The mid-term appearance of the filtering bleb and surgical outcome following tunneltrabeculectomy, in which protective measures were carried out to avoid contact between the mitomycin C (MMC) and the conjunctival flap, are presented. Methods In a retrospective study the records of 20 consecutive patients who had undergone tunnel-trabeculectomy Z24 months earlier, using fornix-based conjunctival flap and MMC (0.4 mg/ml) application were evaluated. Inclusion criteria were patients in whom: (I) the MMC-socked sponge was applied without contact with the conjunctival flap; (II) during MMC washout, a second Weck cell sponge was held anterior to the conjunctival flap, to protect the flap from mitomycin contact during its back-flow. Excluded were five patients who either did not complete 24 months of follow-up (n ¼ 4) or underwent an intraocular surgery during that period (n ¼ 1). Results After 24-32 (26.972.2) months, the filtering bleb was completely vascularized and thick in 13/15 patients (86.7%), mostly vascularized with some para-limbal thick cysts in one and avascular and cystic in another. Mean intraocular pressure (IOP) dropped from a preoperative level of 25.377.0 mmHg with 3.570.9 hypotensive medications to 13.972.9 mmHg with 0.971.1 medications (Po0.0001, Wilcoxon test). Of the five excluded patients, the IOP ranged between 10 and 16 mmHg with 0-1 medications at the last examination, 1-15 months postoperatively. Conclusion In this pilot study, an intraoperative protection of the conjunctival flap from mitomycin contact was mostly associated with a vascularized and thick filtering bleb after mid-term follow-up.Further controlled prospective studies are required to confirm these observations.

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Section: Postoperative Complicationssupporting

confidence: 76%

Section: Surgical Techniquementioning

confidence: 99%

Section: Postoperative Complicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Protection of the conjunctival flap from contact with mitomycin C during tunnel-trabeculectomy

Ophir

Karataş

2006

Eye

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“…In the past years there have been some reports in which surgeons tried to do simpler and more reliable filtering procedures [11][12][13][14]. The main aim of these approaches was to reduce the complication of trabeculectomy, especially complications related to overdrainage and hypotony.…”

Section: Introductionmentioning

confidence: 99%