Visual Function Following Trabeculectomy

Dietze, Paul J.; Oram, Osman; Kohnen, Thomas; Feldman, Robert M.; Koch, Douglas D.; Gross, Ronald L.

doi:10.1097/00061198-199704000-00005

Cited by 51 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies using conjunctival mattress sutures for wound closure reported the induction of a mean astigmatism of –1.2 ± 1.2 D (the time of follow-up was not reported) [10, 11], which is slightly higher than reported in trabeculectomy with purse-string sutures [7, 9]. This is in line with our results 4 weeks after surgery (before suture removal), measuring –0.9 ± 1.72 D in objective refraction, while corneal topography revealed a higher mean induced astigmatism of –1.39 ± 2.06 D in our study.…”

Section: Discussionmentioning

confidence: 89%

“…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: Discussionmentioning

confidence: 89%

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

“…2 Although research has proposed the significant reduction of IOP as the main contributing factor to biometry changes; induction of corneal changes through the creation of the scleral flap, use of sutures and wound gape have also been indicated in several studies. 9,15,16 within a relatively short period in the majority of trabeculectomy patients. 17 This suggests that optimal refractive outcomes may be achieved through sequential cataract and glaucoma procedures and once biometry values are stable.…”

Section: Discussionmentioning

confidence: 99%

<p>Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent <em>Inject</em>) with Cataract Extraction in Open-Angle Glaucoma</p>

Ioannidis

Töteberg‐Harms

Hamann

et al. 2020

OPTH

View full text Add to dashboard Cite

Purpose: Simultaneous cataract and glaucoma surgery has traditionally been challenging for the anterior segment surgeon. The introduction of minimally invasive glaucoma surgery (MIGS) in conjunction with cataract surgery appears safe and effective in lowering intraocular pressure. Although a significant visual impact leading from the combined procedure is unexpected, we aim to describe the refractive outcomes in a cohort of patients undergoing simultaneous cataract removal and iStent inject and discuss the potential implications of combined surgery in patients with co-existent glaucoma. Patients and Methods: This is a retrospective consecutive case series inclusive of patients undergoing combined femtosecond laser-assisted cataract surgery and the insertion of two trabecular micro-bypass stents (iStent inject). Visual acuity, refraction and astigmatic vector analysis were collated and analysed from the preoperative and 4 weeks postoperative visits. Results: One hundred and six eyes of 89 patients from 2 surgeons were included in the original cohort. The mean absolute difference from target refraction was 0.36 ± 0.25D. 73.9% of eyes were within ± 0.5D of the refractive target and 98.9% of eyes were within ± 1.00D. 73.8% of eyes had 0.5D or less residual refractive astigmatism following the procedure. Conclusion: We present a novel cohort of glaucoma patients undergoing combined trabecular micro-bypass stents (iStent inject) and cataract surgery achieving excellent refractive outcomes. The results of this study indicate that this second-generation device is refractively neutral.

show abstract

“…Nepal J Ophthalmol 2013;5 (10):215-219 A number of suggestions have been put forward to explain the WTR astigmatism induced by the trabeculectomy procedure. Hugkulstone (and later Dietze et al, 1997) mentioned the possibility of tight sutures and suggested a"posteriorly placed wound gape" from the internal sclerostomy as the cause. Cunliffe et al (1992) suggested that the internal sclerostomy allowed the corneal edge of the trabeculectomy to sink slightly thus decreasing the vertical radius of the cornea.…”

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

Visual Function Following Trabeculectomy

Cited by 51 publications

References 0 publications

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

<p>Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent <em>Inject</em>) with Cataract Extraction in Open-Angle Glaucoma</p>

Keratometric astigmatism evaluation after trabeculectomy

Contact Info

Product

Resources

About