Moving the Goal Posts

Rotchford, Alan P; King, Anthony J

doi:10.1016/j.ophtha.2009.06.014

Cited by 61 publications

(12 citation statements)

References 102 publications

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“…2A and 2B) may lead to failure if proper management is not done on time. As shown in a recently published study by Rotchford and King,5 there exist currently 92 different IOP-based definitions of success 3. In our study, we considered Trab as success when the IOP was less than 18 post surgery.…”

Section: Discussionmentioning

confidence: 93%

Appraisal of Bleb Using Trio of Intraocular Pressure, Morphology on Slit Lamp, and Gonioscopy

2016

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PURPOSEThe aim of this study was to assess bleb function using Wuerzburg bleb classification score (WBCS) for bleb morphology on slit lamp, intraocular pressure (IOP), and gonioscopy.METHODSA total of randomly selected 30 eyes posttrabeculectomy were assessed for bleb function with the trio of bleb morphology, IOP, and gonioscopy. Bleb was assessed using the WBCS of 0–12 on slit lamp, IOP was assessed using applanation tonometry, and visualization of inner ostium and iridectomy were assessed using gonioscopy. Postoperative patients of less than six weeks were excluded from the study.RESULTSThe correlation between WBCS and the duration of trabeculectomy was found to be highly significant (P value = 0.029). The correlation of IOP with WBCS was also found to be strongly positive (P = 0.000). IOP was found to be highly associated with peripheral iridectomy (P = 0.000), internal window (P = 0.001), and bleb characteristics.

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Section: Discussionmentioning

confidence: 93%

Appraisal of Bleb Using Trio of Intraocular Pressure, Morphology on Slit Lamp, and Gonioscopy

2016

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“…Therefore, the success after TE can be measured by the achievement of a certain level of IOP. As shown in a recently-published study by Rotchford et al , there exist currently 92 different IOP-based definitions of success [38]. For our study, we defined ‘success’ concerning IOP as reaching a target pressure of less or equal to 21 mmHg and IOP reduction of at least 20% of the preoperative level without any antiglaucoma medication and without any additional interventions.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of filtering blebs using the ‘Wuerzburg bleb classification score’ compared to clinical findings

et al. 2012

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BackgroundTo determine the agreement between intraocular pressure and the ‘Wuerzburg bleb classification score’, as well as between single items of the score and intraocular pressure. Interobserver variability was analyzed.Methods57 post-trabeculectomy eyes were included. Colour photographs were used to score the filtering bleb in accordance to the Wuerzburg bleb classification score by two different examiners. At the same visit, clinical data such as intraocular pressure, best corrected visual acuity, slit lamp biomicroscopy and medical history were obtained by another examiner.ResultsAfter trabeculectomy, 42 out of 57 eyes (73.7%) reached the target pressure (≤21mmHg, and intraocular pressure reduction of at least 20%, without antiglaucoma medication, and without any additional intervention). Fair agreement was found between intraocular pressure and Wuerzburg bleb classification score ≥8 points and ≥7 points (kappa 0.24 and 0.27, respectively). Analyzing the subgroups of the morphological criteria, best agreement was found between occurrence of microcysts and target intraocular pressure (к 0.22 – 0.34).ConclusionsEvaluating filtering blebs after trabeculectomy by using the Wuerzburg bleb classification score is a good technique for predicting intraocular pressure control in eyes attaining a minimum score of seven points. The presence of microcysts on the filtering bleb predicts that the eye is likely to attain target pressure.

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“…Trabeculectomy is a classic treatment for PACG, but traditional trabeculectomy is associated with a high risk of postoperative complications, such as malignant glaucoma, bleb-related infections, and surgical failure [3]. Trabeculectomy can also increase the risk of cataract formation and progression [4]. e treatment of medically uncontrolled PACG after initial trabeculectomy is more complicated.…”

Section: Introductionmentioning

confidence: 99%

Effect of Phacoemulsification on Anterior Chamber Angle in Eyes with Medically Uncontrolled Filtered Primary Angle-Closure Glaucoma

Chen

Liang

Guo

et al. 2020

Journal of Ophthalmology

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Purpose. To evaluate the effect of phacoemulsification and intraocular lens (IOLs) implantation in eyes with medically uncontrolled primary angle-closure glaucoma (PACG) previously treated with trabeculectomy and to quantify the anatomical changes in the anterior chamber angle by ultrasound biomicroscopy (UBM). Methods. Forty-four eyes of 37 consecutive patients with medically uncontrolled PACG coexisting cataracts with a surgical history of trabeculectomy were included in this study. Each patient underwent phacoemulsification and IOL implantation. Indentation gonioscopy and UBM were performed preoperatively and then again 3 months after surgery. The main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucoma medications and anatomical changes in the anterior chamber angle. Results. The mean logarithm of the minimum angle of resolution BCVA significantly improved from 0.52 ± 0.30 preoperatively to 0.26 ± 0.23 postoperatively (p<0.001). The mean IOP significantly decreased from 24.33 ± 9.65 mmHg preoperatively to 18.04 ± 7.86 mmHg postoperatively (p<0.05). 001). The median number of antiglaucoma medications decreased from 2 preoperatively to 1 postoperatively (p<0.001). There was no significant difference in the extent of peripheral anterior synechia after the surgery (p>0.05). Some parameters, including anterior central chamber depth, angle opening distance at 500 μm, trabecular-iris angle, and scleral ciliary process angle, were significantly higher after than before surgery (p<0.001). However, the crystalline lens rise was significantly smaller following the surgery (p<0.001). Conclusions. Phacoemulsification and IOL implantation reduced the IOP and improved vision in eyes with medically uncontrolled filtered PACG. The mechanism underlying the outcomes observed following surgery might be related to the anterior chamber deepening, widened drainage angle, and improved aqueous fluid flow to the trabecular meshwork.

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Moving the Goal Posts

Cited by 61 publications

References 102 publications

Appraisal of Bleb Using Trio of Intraocular Pressure, Morphology on Slit Lamp, and Gonioscopy

Appraisal of Bleb Using Trio of Intraocular Pressure, Morphology on Slit Lamp, and Gonioscopy

Evaluation of filtering blebs using the ‘Wuerzburg bleb classification score’ compared to clinical findings

Effect of Phacoemulsification on Anterior Chamber Angle in Eyes with Medically Uncontrolled Filtered Primary Angle-Closure Glaucoma

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