Changes in keratometry following trabeculectomy.

Hugkulstone, Charles E.

doi:10.1136/bjo.75.4.217

Cited by 75 publications

(74 citation statements)

References 5 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, we observed a steady decline of astigmatism with time, independent of suture removal. Surgery induced a decrease in vertical and an increase in horizontal corneal radii in both groups of our study as expected [3, 4]. Cunliffe et al [3] reported a full recovery of the corneal radii to preoperative values, which we only detected for the horizontal radii whereas the vertical corneal radius remained decreased.…”

Section: Discussionsupporting

confidence: 48%

“…Cunliffe et al [3] and Hugkulstone [4] proposed the surgically created cleft between the cornea and sclera as a cause for postoperative astigmatism, while others assumed that astigmatism is induced by wet field cautery and consecutive shrinkage of the sclera [5,6,7,8]. Suture-related astigmatism is another possibility [4,6,7,8,9] as sutures of the scleral flap and limbal sutures in trabeculectomies with a fornix-based conjunctival flap could conceivably induce astigmatism. We favor a fornix-based conjunctival flap and close the conjunctival wound with a 10-0 nylon running mattress suture in a meander-like fashion [10, 11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

Klink¹,

Rauch²,

Klink³

et al. 2008

Ophthalmologica

View full text Add to dashboard Cite

Background: To evaluate the influence of early conjunctival suture removal following trabeculectomy on postoperative outcome. Methods: In a prospective randomized clinical trial 73 eyes of 69 consecutive patients eligible for primary trabeculectomy were included in the study. Eyes were randomly assigned to a control or intervention group. Trabeculectomy was performed with a fornix-based conjunctival flap and a conjunctival running mattress-suture. In the intervention group, the conjunctival suture was removed 4 weeks postoperatively, in the control group the suture remained in place. Both groups were followed for up to 12 months and best corrected visual acuity (BCVA), refraction, corneal topography, intraocular pressure (IOP), anterior segment and fundus were assessed preoperatively and within a week, 1, 3, 6 and 12 months after surgery. Statistical analysis was performed using SPSS for Windows (t test for independent samples). Results: Trabeculectomy induced similar astigmatism in both groups. Compared to the control group, suture removal seemed to improve BCVA at 6 and 12 months. This was associated with a significantly lower IOP at 6 and 12 months and a significantly higher complete success rate at 12 months (94 vs. 65%, p < 0.001). Astigmatism was not significantly altered by suture removal. Conclusion: Conjunctival suture material appears to hamper trabeculectomy success and postoperative visual acuity. This is independent of postoperative astigmatism. Early removal of conjunctival sutures is advisable.

show abstract

Section: Discussionsupporting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

Klink¹,

Rauch²,

Klink³

et al. 2008

Ophthalmologica

View full text Add to dashboard Cite

show abstract

“…The first study to report the changes in corneal curvature following trabeculectomy was done by Hugkulstone (1991). He used an automated keratometer which recorded a mean induced with the rule astigmatic induction of 1 D at 7 weeks following a traditional sized procedure (5x5 mm scleral trap door) and sclera flap secured by use of 9/0 virgin silk suture in 10 eyes.…”

Section: Discussionmentioning

confidence: 99%

Keratometric astigmatism evaluation after trabeculectomy

Kumari¹,

Saha²,

Puri³

2013

Nep J Oph

View full text Add to dashboard Cite

Introduction: Post-operative astigmatism is one of the most important causes for diminution of vision after trabeculectomy. Objective: To evaluate the induced corneal astigmatism following trabeculectomy with the use of 8-0 silk suture. Materials and methods: A prospective interventional study was done including 100 consecutive eyes of 84 patients who underwent trabeculectomy with the use of 8-0 silk suture. The postoperative induced astigmatism on the 1 st post-operative day, 3 rd week and after 6 months was determined. Statistics: Vector analysis was performed on the data using a computerized method for calculating the surgically induced astigmatism (SIA) for each eye at every time point postoperatively. In order to analyze group changes, we also performed vector decomposition which gave us a mathematical expression of the changes in astigmatism "with the rule" (WTR) or "against the rule" (ATR). Results: The mean age of all the patients was 53.31 11.39 years. The mean 1 st post-operative surgically induced astigmatism (SIA) was 2.73 D ( 99 degree ) which reduced to 0.41 D ( 58 degree) at the 3 rd week and 0.43 ( 21 degree) at 6 months. The mean WTR astigmatism was 4.46 D and ART astigmatism was 1.42 D on the 1 st post-operative day which was significantly high ( p<0.0001). At the 3 rd week and 6 months WTR astigmatism ( 1.40 D and 1.08D ) and ATR astigmatism (1.27 D and 1.10 D) showed no significant changes (p=0.69,0.97 respectively. Conclusion: Trabeculectomy with the use of 8/0 silk sutures showed significantly high 1 st post-operative day SIA which nevertheless perished fast to a minimum amount at just 3 weeks.

show abstract

“…[3][4][5][6][7][8] However, studies on corneal astigmatism induction after a combined operation were few, and comparison among studies was limited by the different surgical techniques used. 8 9 Hong et al reported a shift of astigmatism at the vertical meridian from +2.17 dioptre to 21.72 dioptre over 12 months after a combined operation with the extracapsular cataract extraction technique that required a 10 mm corneoscleral incision and multiple sutures for wound closure.…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports have also shown that there is induced corneal astigmatism after trabeculectomy and combined operation with various surgical techniques. [3][4][5][6][7][8][9] According to an evidence based review of the surgical techniques and adjuvant used in combined operation, the strongest evidence of efficacy exists for using mitomycin C, separating the incisions for cataract and glaucoma surgery, and removing the nucleus by phacoemulsification. 10 It is unclear whether combined operation with this technique will induce a change of AL and corneal astigmatism, and affect the postoperative refraction.…”

mentioning

confidence: 99%

365 Effects of Combined Cataract Surgery and Trabeculectomy With Mitomycin-C on Ocular Dimensions

2005

View full text Add to dashboard Cite

Aims: To characterise changes in ocular dimensions after combined cataract operation and trabeculectomy with mitomycin C using separate incisions (combined operation). Methods: 24 consecutive eyes that had combined operation and 16 eyes that had cataract operation alone were enrolled. The axial lengths before and after operations were determined with non-contact optical coherence biometry. The intraocular pressures (IOP), axial lengths, corneal curvatures, and the expected and observed refractive errors before and after operations were compared. Results: After a combined operation, mean IOP was significantly reduced from 16.6 (SD 5.8) mm Hg to 10.9 (4.1) mm Hg (p,0.00001), and mean axial length was significantly shortened from 24.10 (0.98) mm to 23.98 (0.96) mm (p,0.00001). The mean axial length reduction after combined operation (117 (57) mm) was significantly larger than the reduction after cataract operation alone (75 (38) mm, p,0.02), and correlated significantly with the postoperative IOP (p,0.002). There was a mean with the rule surgically induced corneal astigmatism of 0.44 (0.83) dioptre by vector analysis, and a significant increase of mean keratometry reading of 0.23 (0.46) dioptre after a combined operation. However, there was no significant difference between the expected and observed refractive errors. Conclusions: Despite an alteration of the axial length and corneal curvature, the refractive outcome after a combined operation did not differ significantly from the predicted refraction.

show abstract

Changes in keratometry following trabeculectomy.

Cited by 75 publications

References 5 publications

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

Keratometric astigmatism evaluation after trabeculectomy

365 Effects of Combined Cataract Surgery and Trabeculectomy With Mitomycin-C on Ocular Dimensions

Contact Info

Product

Resources

About