Viscocanalostomy for open-angle glaucoma in black African patients

Stegmann, Robert; Pienaar, Anc; Miller, David

doi:10.1016/s0886-3350(99)80078-9

Cited by 387 publications

(304 citation statements)

References 6 publications

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“…Viscoelastic is also injected into the region of excised sclera, or scleral lake, to prevent healing. 10 Both deep sclerectomy and viscocanalostomy involve fashioning of a partial thickness scleral flap, removing a second layer of sclera deep to the initial flap, and exposing Descemet's membrane. Schlemm's canal is unroofed during removal of the second, deep scleral layer.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound biomicroscopy in deep sclerectomy

Khairy

Atta

Green

et al. 2005

Eye

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Purpose To evaluate by ultrasound biomicroscopy (UBM) the anatomical characteristics and the intraocular pressure (IOP) lowering mechanisms of deep sclerectomy after long-term follow-up. Methods In all, 22 eyes of 21 consecutive patients who had deep sclerectomy were examined by UBM. Several UBM variables were prospectively evaluated, including the presence and maximum length and height of the intrascleral space, the minimum thickness of residual trabeculo-Descemet membrane (TDM), the presence and type of subconjunctival filtering bleb, and the presence of other possible drainage sites, for example suprachoroidal. Surgical success was considered to be achieved when the IOP was o22 mmHg and the IOP was lowered by more than 20% without the use of any medication. The possible association between UBM variables and the surgical outcome was determined. Results The mean time between surgery and the UBM examination was 12.075.3 months. The mean IOP decreased significantly from a preoperative value of 23.774.0 to 16.073.9 mmHg at the time of UBM (Po0.01). There was a poor correlation between the level of IOP at the time of UBM and the length of intrascleral space (r 2 ¼ 0.0016), the height of the intrascleral space (r 2 ¼ 0.136), or the thickness of remaining TDM (r 2 ¼ 0.0009). The presence and type of filtering bleb were not associated with the success. Conclusions In patients undergoing deep sclerectomy, UBM examination after long-term follow-up showed the presence of an intrascleral space and a filtering bleb in most patients. The surgical outcome was not associated with the UBM variables of the surgical area.

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Section: Introductionmentioning

confidence: 99%

Ultrasound biomicroscopy in deep sclerectomy

Khairy

Atta

Green

et al. 2005

Eye

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“…Many glaucoma surgical techniques have been developed in response to needs for achieving a lower pressure in glaucomatous patients (5,(26)(27)(28)(29)(30)(31)(32)(33)(34) . However, not only the mechanisms by which outflow facility is increased but also where exactly the flow is going remain a subject of intense study.…”

Section: Discussionmentioning

confidence: 99%

The influence of thalamosinusotomy under different constant intraocular pressures on aqueous outflow facility in isolated porcine eyes

Mérula

Haefliger

Cronemberger

et al. 2008

Rev. bras.oftalmol.

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RESUMOObjetivo: Avaliar o efeito da thalamosinusotomia ab interno, que é um procedimento cirúrgico experimental similar a esclerotalamotomia ab interno, na drenagem do humor aquoso. Métodos: Olhos de porco enucleados foram perfundidos com solução fisiológica de Krebs-Ringer e azul de tripan, sob diferentes pressões constantes de perfusão, após o procedimento cirúrgico experimental. A facilidade de drenagem e os tecidos corados/não corados foram medidos. Resultados: A facilidade de drenagem e a área sob a curva (fluxo) aumentaram com o aumento do número de incisões da thalamosinusotomia (0 a 4). Olhos submetidos a thalamosinusotomia apresentaram mais tecido corado (conjuntiva, superfície externa e interna da esclera) que olhos submetidos a cirurgia sham, com diferença estatisticamente significativa (p< 0,05). Conclusões: Os resultados sugerem que a facilidade de drenagem aumenta com o aumento do número de thalamus, diferente vias de drenagem são estimuladas após a thalamosinusotomia, e a drenagem uveoscleral pode ser uma via importante após o procedimento cirúrgico experimental.

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“…Subsequently, various modifications were proposed, [3][4][5] yielding controversial results: several studies have shown that DS is comparable or less effective, [6][7][8][9][10][11] others that it is superior to standard TE in the treatment of open-angle glaucoma. 2,3 All authors described fewer early postoperative complications using this nonpenetrating technique than with TE. 3,[5][6][7]11 The dissection of the deep corneoscleral lamella is the most difficult part of the procedure.…”

Section: Introductionmentioning

confidence: 95%

Long-term results of Erbium YAG-laser-assisted deep sclerectomy

Klink

Schlunck

Lieb

et al. 2006

Eye

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Purpose To evaluate the long-term results of Erbium YAG-laser-assisted deep sclerectomy (DS). In this procedure, the delicate dissection of a deep corneoscleral lamella is greatly simplified by using the Erbium YAG-laser. Methods Data of 14 consecutive patients (10 male, four female, age 67.7710.4 years), who underwent surgery from 1999 to 2000 were analysed retrospectively. The procedure was begun as a standard DS. The deep corneoscleral lamella was dissected with a pulsed Erbium YAG-laser (energy: 40-100 mJ, frequency: 5-10 Hz). Schlemm's canal was unroofed and the lamella thinned until aqueous percolated continuously through the membrane. Results The mean follow-up time was 50.476.8 months. The mean preoperative intraocular pressure (IOP) was 37.7710.5 mmHg. The mean postoperative IOP was 16.173.9 mmHg at 1 month, 15.174.3 mmHg at 3 months, 16.474.5 mmHg at 12 months, and 17.678.7 mmHg at 50.5 months. The complete success rates (IOPp21 mmHg þ IOP reduction X20% without glaucoma medication) were 83.3% at 3 months and 50% at 12 and 50.5 months. Rates for qualified success (IOPp21 mmHg þ IOP reduction X20% with glaucoma medication) were 91.7% at 3 months, 92.9% at 12 months, and 78.6% at 50.5 months. The number of glaucoma medications was reduced from 3.0770.92 preoperatively to 1.1471.41 at 50.5 months. A single case of anterior-chamber penetration, requiring iridectomy, was the only intraoperative complication. Conclusions Erbium YAG-laser-assisted DS has the advantage of a greatly simplified dissection, while offering a successful long-term IOP control comparable to conventional DS.

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Viscocanalostomy for open-angle glaucoma in black African patients

Abstract: Viscocanalostomy produced an encouraging long-term reduction in the IOP of black African patients with glaucoma who would otherwise have had a poor prognosis.

Cited by 387 publications

References 6 publications

Ultrasound biomicroscopy in deep sclerectomy

Ultrasound biomicroscopy in deep sclerectomy

The influence of thalamosinusotomy under different constant intraocular pressures on aqueous outflow facility in isolated porcine eyes

Long-term results of Erbium YAG-laser-assisted deep sclerectomy

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