Limits...
Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae.

Mirshahi A, Raak P, Ponto K, Stoffelns B, Lorenz K, Scharioth GB - J Ophthalmol (2015)

Bottom Line: Results.No case required further glaucoma surgery.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Dardenne Eye Hospital, 53177 Bonn, Germany ; Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, Germany.

ABSTRACT
Purpose. To report one-year results of phacoemulsification combined with deep sclerectomy and goniosynechiolysis ab interno for chronic glaucoma associated with peripheral anterior synechiae (PAS). Methods. We retrospectively analyzed medical charts of 16 patients (20 eyes) treated by one-site combined phacoemulsification and deep sclerectomy with goniosynechiolysis ab interno. PAS were transected by a spatula introduced into the anterior chamber through a paracentesis. To account for the correlation of right and left eyes a linear mixed model with unstructured covariance structure was calculated. Results. The mean preoperative intraocular pressure (IOP) was 20.3 ± 5.2 mmHg with 2.4 ± 1.0 medications. One year postoperatively, the mean IOP was 15.3 ± 3.3 mmHg (P = 0.004, paired t-test) with 0.6 ± 1.0 medications. A postoperative IOP of ≤21 mmHg without medication was achieved in 17 of 19 eyes (89.5%) and in 12/19 eyes (63.2%) at 3 and 12 months after surgery, respectively. In the remaining eyes (10.5% at 3 months and 36.8% at 12 months), additional medication led to an IOP ≤21 mmHg or the target pressure. No case required further glaucoma surgery. In one eye, conversion of the surgery to trabeculectomy was necessary due to Descemet's window rupture. Conclusions. With goniosynechiolysis ab interno, effective and safe nonpenetrating glaucoma surgery is possible in presence of PAS.

No MeSH data available.


Related in: MedlinePlus

Scatterplot preoperative versus postoperative IOP. Change in number of medication in brackets.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4493305&req=5

fig3: Scatterplot preoperative versus postoperative IOP. Change in number of medication in brackets.

Mentions: The mean preoperative IOP was 20.3 ± 5.2 mmHg (median 20, range 12–30) on 2.4 ± 1.0 medications (median 2, range 0–5). The course of IOP was as follows (Figures 2 and 3): at day 1, mean IOP was 11.7 ± 6.1 mmHg (median 11, range 2–21); at week 1, mean IOP was 13.2 ± 6.7 mmHg (median 13.5, range 2–24); at month 1, mean IOP was 12.7 ± 3.5 mmHg (median 12, range 6–21); and at month 3, mean IOP was 14.2 ± 4.2 mmHg (median 14, range 6–21). One year postoperatively, the mean IOP was 15.3 ± 3.3 mmHg (median 16, range 10–20) with 0.6 ± 1.0 medication, which was significantly different from preoperative IOP (P = 0.004). Within the linear mixed model only time had an influence with the mean IOP being lowered by 5.96 mmHg, 95% confidence interval [2.83; 9.09], P = 0.001. This linear mixed model also showed that the results were not influenced by the inclusion of both eyes in 4 patients.


Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae.

Mirshahi A, Raak P, Ponto K, Stoffelns B, Lorenz K, Scharioth GB - J Ophthalmol (2015)

Scatterplot preoperative versus postoperative IOP. Change in number of medication in brackets.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4493305&req=5

fig3: Scatterplot preoperative versus postoperative IOP. Change in number of medication in brackets.
Mentions: The mean preoperative IOP was 20.3 ± 5.2 mmHg (median 20, range 12–30) on 2.4 ± 1.0 medications (median 2, range 0–5). The course of IOP was as follows (Figures 2 and 3): at day 1, mean IOP was 11.7 ± 6.1 mmHg (median 11, range 2–21); at week 1, mean IOP was 13.2 ± 6.7 mmHg (median 13.5, range 2–24); at month 1, mean IOP was 12.7 ± 3.5 mmHg (median 12, range 6–21); and at month 3, mean IOP was 14.2 ± 4.2 mmHg (median 14, range 6–21). One year postoperatively, the mean IOP was 15.3 ± 3.3 mmHg (median 16, range 10–20) with 0.6 ± 1.0 medication, which was significantly different from preoperative IOP (P = 0.004). Within the linear mixed model only time had an influence with the mean IOP being lowered by 5.96 mmHg, 95% confidence interval [2.83; 9.09], P = 0.001. This linear mixed model also showed that the results were not influenced by the inclusion of both eyes in 4 patients.

Bottom Line: Results.No case required further glaucoma surgery.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Dardenne Eye Hospital, 53177 Bonn, Germany ; Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, Germany.

ABSTRACT
Purpose. To report one-year results of phacoemulsification combined with deep sclerectomy and goniosynechiolysis ab interno for chronic glaucoma associated with peripheral anterior synechiae (PAS). Methods. We retrospectively analyzed medical charts of 16 patients (20 eyes) treated by one-site combined phacoemulsification and deep sclerectomy with goniosynechiolysis ab interno. PAS were transected by a spatula introduced into the anterior chamber through a paracentesis. To account for the correlation of right and left eyes a linear mixed model with unstructured covariance structure was calculated. Results. The mean preoperative intraocular pressure (IOP) was 20.3 ± 5.2 mmHg with 2.4 ± 1.0 medications. One year postoperatively, the mean IOP was 15.3 ± 3.3 mmHg (P = 0.004, paired t-test) with 0.6 ± 1.0 medications. A postoperative IOP of ≤21 mmHg without medication was achieved in 17 of 19 eyes (89.5%) and in 12/19 eyes (63.2%) at 3 and 12 months after surgery, respectively. In the remaining eyes (10.5% at 3 months and 36.8% at 12 months), additional medication led to an IOP ≤21 mmHg or the target pressure. No case required further glaucoma surgery. In one eye, conversion of the surgery to trabeculectomy was necessary due to Descemet's window rupture. Conclusions. With goniosynechiolysis ab interno, effective and safe nonpenetrating glaucoma surgery is possible in presence of PAS.

No MeSH data available.


Related in: MedlinePlus