Aims To evaluate the surgical success results of Ahmed glaucoma valve (AGV) and Molteno single-plate implant (MSPI) in cases of neovascular glaucoma (NVG). Methods Between May 1997 and May 2002, 38 of 38 NVG patients that underwent implantation of AGV and 27 eyes of 27 NVG patients that underwent MSPI (a total 65 eyes of 65 patients) included to the study. Results The cumulative probabilities of success were 63.2% at 1 year, 56.2% at 2 years, 43.2% at 3 years, 37.8% at 4 years, and 25.2% at 5 years in AGV group whereas the cumulative probabilities of success were 37.0% at 1 year, 29.6% at 2 years, 29.6% at 3 years, 29.6% at 4 years, and 29.6% at 5 years in MSPI group (P ¼ 0.141). Preoperative visual acuity o2/200 (P ¼ 0.003), diagnosis of diabetes mellitius (P ¼ 0.050), and preoperative IOP Z35 mmHg (P ¼ 0.038) were found to be poor prognostic factors for surgical success. Conclusions Both AGV and single plate MSPI were successful for early and intermediate-term of IOP control but in long term both implants were failed to achieve control of IOP in patients with NVG.
Aims In this retrospective study, we aimed to evaluate the results of glaucoma surgery in patients with nanophthalmos. Methods Twenty-eight bilateral nanophthalmic patients, of whom 20 patients underwent trabeculectomy þ Mitomycin-C (MMC) þ inferior sclerotomy between 1996 and 2004, were included in this study. Records of patients with nanophthalmos were reviewed. Intraocular pressure (IOP), glaucoma medications, surgical success, visual acuity and complications were analyzed. Results The mean IOP was 34.675.3 mm Hg preoperatively. At the final follow-up visit, the mean IOP dropped to 21.4177.34 mm Hg (Po0.05). The cumulative probability of success was 85% at 1 year, 78.5% at 2 years, 76.9% at 3 years, 70.6% at 4 years and 47% at 5 years after surgery. Visual acuity decreased in 13 (65%) patients but no eye lost vision. Sequels of choroidal detachment (five patients 25%) and retinal folds (four patients 20%) were the most frequent reason for visual decrease. Uveal effusion (10 patients 50%) and cataract formation (seven patients 35%) were major late postoperative complications. Conclusions Results indicate that trabeculectomy þ MMC þ inferior sclerotomy procedure was effective and safe for glaucoma control in patients with nanophthalmos, but uveal effusion is a major problem and cataract surgery is expected in the long run.
Primary trabeculectomy lowered IOP more than viscocanalostomy in POAG patients. However, the complication rate was lower in the viscocanalostomy group.
Purpose:The purpose of this study is to evaluate and to compare the results of primary and secondary scleral-fixated posterior chamber intraocular lens (PCIOL) implantations in adult patients.Materials and Methods:A retrospective analysis of scleral-fixated PCIOLs-implanted during (primary group) or after (secondary group) cataract surgery was performed. The median follow-up time of 96 patients was 6 months (minimum: 6; maximum: 35 months). Outcome measures were indications, corrected distance visual acuity (CDVA), change in visual acuity and complications.Results:A total of 37 patients (38.5%) had primary implantations and 59 (61.5%) had secondary implantations. Penetrating keratoplasty was combined with secondary implantation in 13 cases. The median post-operative CDVA was 0.5 in decimal notation in both groups (P = 0.576). The CDVA improved by at least one Snellen line or remained unchanged in 35 eyes (94.6%) in the primary group and in 52 eyes (88.1%) in the secondary group (P = 0.263). Eyes with CDVA of 0.5 or higher were 62.2% (n = 23) in the primary group and 67.8% (n = 40) in the secondary group post-operatively (P = 0.066). The difference in early and late complications were not statistically significant between groups (P = 0.637, P = 0.154, respectively). Regarding late complications, 30 eyes (81%) in the primary group and 40 eyes (67.9%) in the secondary group had no complications (P = 0.154).Conclusion:Both primary and secondary scleral-fixated PCIOL implantations can provide favorable visual outcomes with lower complication rates. An important consideration is the appropriate timing for scleral fixation, taking into account the patient's characteristics and the course of the operation.
Aims To determine the efficacy and safety of trabeculotomy in congenital glaucoma patients operated on within first 3 months of birth. Methods A total of 36 eyes of 24 patients with congenital glaucoma, who underwent primary trabeculotomy within first 3 months of birth were included. Preoperative and postoperative intraocular pressures (IOP), corneal clarity, diameter, axial length, success rates, and complications were evaluated in this study.Results The mean follow-up was 38.38711.77 months (range 12-48 months). Mean IOP was 33.1677.28 mmHg (range 23-50 mmHg) preoperatively. At the final follow-up visit, the mean IOP was 21.4177.34 mmHg (range 8-38 mmHg). Pre-and postoperative IOP differences were statistically significant at all examination periods (Po0.001). A12-, 24-, and 36-month success rates were 92, 82, and 74%, respectively. Survival analysis regarding to gender, preoperative corneal diameter and consaguinity were not statistically significant. Only preoperative axial length was a statistically significant parameter (P ¼ 0.024) for success. Postoperatively normal corneal clarity was achieved in 29 eyes (80.5%). The main complications were shallow anterior chamber in one (4.2%) eye and detachment of Descement's membrane in two (8.4%) eyes. Conclusions Primary trabeculotomy is a safe and effective procedure for congenital glaucoma patients when operated within 3 months of birth. It has a favourable IOP control and a low rate of complications in three year period.
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