The Development Encapsulated Filtering Blebs

Richter, Claudia U.; Shingleton, Bradford J.; Bellows, A. Robert; Hutchinson, B. Thomas; O’Connor, Thomas A.; Brill, Ilene

doi:10.1016/s0161-6420(88)33041-1

Cited by 109 publications

(39 citation statements)

References 12 publications

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“…This only occurred in 2% of the patients in this series as opposed to the 13% reported by Richter et al 34 This possibly reflects the differences in the population served in the two series and by the amount of preoperative medication given. It was noted that the inabil ity to detect a bleb in this series was not equa ted with failure to control the intraocular pressure.…”

Section: Discussioncontrasting

confidence: 69%

The complications of trabeculectomy (a 20-year follow-up)

Watson

Jakeman

Öztürk

et al. 1990

Eye

228

129

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SummaryThe complications of trabeculectomy were studied in two groups of patients taken from a stable white population. The first group who had had their operation when it was first introduced 22 years ago, had been previously treated with prolonged medi cation, the second group had been operated upon recently and had had short-term pre-operative medication. This study confirmed that trabeculectomy predictably reduces the intraocular pressure to within the accepted normal range and that the pressure level below which the intraocular pressure could not be expected to fall was £: 14 mm/Hg. It also revealed that although some post operative abnormality was noted in two-thirds of the patients there were no long term problems which could be related to any operative or immediately post-operative complications, including shallow anterior chambers, uveitis and hyphaema. However, there was a long term reduction in the visual acuity and visual fields of about one-third of the patients, which was not related to cataract formation, macular problems, the height of the preoperative intraocular pressure, the amount by which this fell as a result of the surgery, or the amount, length or type of preoperative medication given before the operation. Although there was some increase in cataracts throughout the whole long term group this was mainly in those who had cataract prior to surgery; the increase was not related to operations or any other factor other than corneo-Ienticular contact post-operatively.

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Section: Discussioncontrasting

confidence: 69%

The complications of trabeculectomy (a 20-year follow-up)

Watson

Jakeman

Öztürk

et al. 1990

Eye

228

129

View full text Add to dashboard Cite

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“…Even though there did not appear to be any significant difference as regards the development of cataract between the two groups (p = 0.107), the cataract formation that did arise may be related to hypotony [29]. The encapsulated bleb consists of fibroblastic overgrowth that results in a tense, domelike bleb with a thick wall in direct communication with the anterior chamber; this incidence was greater for cases of juvenile glaucoma [30]and appears in 4–5% of patients undergoing trabeculectomy with mitomycin C [10, 16]. No encapsulated blebs appeared to develop for patients in the mitomycin C group as our results revealed, our explanation being that the effect of inhibiting fibroblast proliferation by the application of mitomycin C, which resulted in a diffuse bleb in most cases, may actually decrease the incidence of an encapsulated bleb developing.…”

Section: Discussionmentioning

confidence: 99%

Trabeculectomy with Mitomycin C versus Trabeculectomy Alone for Juvenile Primary Open-Angle Glaucoma

et al. 2003

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Purpose: We compare the intermediate-term outcome of initial trabeculectomy with adjunctive mitomycin C use versus initial trabeculectomy alone for juvenile primary open-angle glaucoma. Methods: This retrospective consecutive analysis included 44 eyes from 36 patients with juvenile primary-open angle glaucoma, all of whom underwent either initial trabeculectomy with adjunctive mitomycin C use (15 eyes) or initial trabeculectomy alone without mitomycin C use (29 eyes). We compared the success rate and complications between the two groups in a three-year follow-up period following surgery. Results: Three years subsequent to surgery, the cumulative success probability was 73% for the mitomycin C group and 68% for the control group, there being no real difference between the two groups (p = 0.89). A greater incidence of hypotony maculopathy was found amongst the mitomycin C group than was the case for the control group (20 versus 0%, respectively, p = 0.034). A lower intraocular pressure amongst the mitomycin C group was noted as compared with the control group (10.8 ± 3.0 versus 13.3 ± 3.8 mm Hg, respectively, p = 0.017) amongst the successfully treated patients. Conclusions: Despite the lower intraocular pressure level for the successfully treated patients from the trabeculectomy with mitomycin C group, and a greater incidence of resultant hypotony maculopathy for this group as compared with the trabeculectomy alone group, there appeared to be no significant difference in the cumulative success probability for this group as compared with the trabeculectomy alone group. Therefore, we caution against the use of an initial trabeculectomy with mitomycin C for juvenile primary open-angle glaucoma.

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“…Long term topical medication, however, seems to have a negative influence on surgery (Richter et al 1988;Lavin et al 1990;Broadway et al 1994). A laser trabeculoplasty secondary to maximal medical treatment will result in an extended duration of combined topical therapy before subsequent operation may become necessary, with increased risk of encapsulation (Broadway et al 1994).…”

Section: Discussionmentioning

confidence: 99%

The medium and long‐term efficacy of primary argon laser trabeculoplasty in avoiding topical medication in open angle glaucoma

Odberg

Sandvik

1999

Acta Ophthalmologica Scandinavica

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Results: The probability of treatment success (no medication required) was for chronic open angle glaucoma 77% after 2 years, 67% after 5 years and 67% after 8 years. Corresponding numbers for pseudoexfoliation glaucoma were 80%, 54% and 36%. Prelaser IOP higher than 31 mmHg, pretreatment visual field defect and sparse pigmentation of the trabecular meshwork were independent predictors of failure. Conclusion: Primary argon laser trabeculoplasty gives a long-lasting and favourable effect in chronic open angle glaucoma where 2/3 of the eyes still managed without additional medication for 8 years. The success in pseudoexfoliation glaucoma was even higher the first 3 years, and kept above 50% for 5 years. This makes laser a valuable option as first choice of therapy in glaucoma.Key words: open angle glaucoma -pseudoexfoliation glaucoma -argon laser trabeculoplastyprimary treatment -long-term results -quality of life.

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The Development Encapsulated Filtering Blebs

Cited by 109 publications

References 12 publications

The complications of trabeculectomy (a 20-year follow-up)

The complications of trabeculectomy (a 20-year follow-up)

Trabeculectomy with Mitomycin C versus Trabeculectomy Alone for Juvenile Primary Open-Angle Glaucoma

The medium and long‐term efficacy of primary argon laser trabeculoplasty in avoiding topical medication in open angle glaucoma

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