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1.
Diagnostics (Basel) ; 13(11)2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37296795

RESUMO

AIM: To determine the clinical risk factors that may increase the occurrence of intraocular lens (IOL) calcification in patients who had undergone pars plana vitrectomy (PPV). METHODS: The medical records of 14 patients who underwent IOL explantation due to clinically significant IOL opacification after PPV were reviewed. The date of primary cataract surgery, technique and implanted IOL characteristics; the time, cause and technique of PPV; tamponade used; additional surgeries; the time of IOL calcification and explantation; and IOL explantation technique were investigated. RESULTS: PPV had been performed as a combined procedure with cataract surgery in eight eyes and solely in six pseudophakic eyes. The IOL material was hydrophilic in six eyes, hydrophilic with a hydrophobic surface in seven eyes and undetermined in one eye. The endotamponades used during primary PPV were C2F6 in eight eyes, C3F8 in one eye, air in two eyes and silicone oil in three eyes. Two of three eyes underwent subsequent silicone oil removal and gas tamponade exchange. Gas in the anterior chamber was detected in six eyes after PPV or silicone oil removal. The mean interval between PPV and IOL opacification was 20.5 ± 18.6 months. The mean BCVA in logMAR was 0.43 ± 0.42 after PPV, which significantly decreased to 0.67 ± 0.68 before IOL explantation for IOL opacification (p = 0.007) and increased to 0.48 ± 0.59 after the IOL exchange (p = 0.015). CONCLUSIONS: PPV with endotamponades in pseudophakic eyes, particularly gas, seems to increase the risk for secondary IOL calcification, especially in hydrophilic IOLs. IOL exchange seems to solve this problem when clinically significant vision loss occurs.

4.
J Glaucoma ; 32(6): 497-500, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-36847666

RESUMO

PRCIS: Gonioscopy-assisted transluminal trabeculotomy (GATT) provided effective intraocular pressure (IOP) control in primary congenital glaucoma (PCG). Also, approximately two third of patients did not need antiglaucoma medication at an average follow-up of 1 year after surgery. PURPOSE: The purpose of this study was to assess the safety and efficacy of GATT surgery in eyes with PCG. MATERIALS AND METHODS: This study is a retrospective review of patients who underwent GATT surgery for PCG. Outcome measures were changes in IOP and number of medications at all time points (1, 3, 6, 9, 12, 18, 24, and 36 mo after surgery), and success rates. Success was defined as IOP<21 mm Hg with at least a 30% reduction from the baseline, complete if without medications, or qualified if with or without medications. Cumulative success probabilities were analyzed using the Kaplan-Meier survival analyses. RESULTS: Twenty-two eyes of 14 patients diagnosed with PCG were enrolled in this study. The mean IOP reduction was 13.1 mm Hg (57.7%) with a mean decrease of 2 glaucoma medications at the final follow-up. All mean IOP readings during postoperative follow-up were significantly lower than baseline ( P <0.05 for all). Cumulative probability of qualified success was 95.5% and the cumulative probability of complete success was 66.7%. CONCLUSION: GATT was safe and successfully lowered IOP in patients with PCG with the advantage of avoiding conjunctival and scleral incisions.


Assuntos
Glaucoma de Ângulo Aberto , Glaucoma , Hipotensão Ocular , Trabeculectomia , Humanos , Pressão Intraocular , Resultado do Tratamento , Seguimentos , Glaucoma de Ângulo Aberto/cirurgia , Gonioscopia , Glaucoma/cirurgia , Hipotensão Ocular/cirurgia , Estudos Retrospectivos , Esclera
5.
Eye (Lond) ; 37(7): 1371-1376, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-35739244

RESUMO

BACKGROUND/OBJECTIVES: To determine the role of vitreoretinal surgery (VRS) for two different forms of posterior persistent fetal vasculature syndrome (PFVS); with tent-shaped tractional retinal detachment (TRD) and closed funnel-shaped TRD. SUBJECTS/METHODS: Retrospective, single surgeon, consecutive case series of 52 eyes of 44 patients with posterior PFVS who underwent VRS. Cases were divided into "tent-shaped TRD" and "funnel-shaped TRD" groups based on the preoperative TRD configuration. Associated anomalies, functional and anatomical outcomes were evaluated. The cosmetic appearance was defined as poor if there was phthisis bulbi, gross buphthalmos, or corneal opacification; acceptable if there was apparent leukocoria; and excellent if none were noted at the last follow-up. RESULTS: Thirty eyes of 29 patients presented with tent-shaped TRD; 70% of which obtained counting fingers or better vision and 90% showed significant reversal of tenting achieving retinal reattachment. The cosmetic appearance was excellent in 87%. Two eyes (7%) became phthisic. Twenty-two eyes of 15 patients presented with funnel-shaped TRD and leukocoria; 45% achieved LP vision and 70% of patients with bilateral pathology had LP in at least one eye. The cosmetic appearance was acceptable to excellent in 73%. Three eyes (14%) became phthisic, one (5%) of which required enucleation. The median follow-up time was 16 (6-71) months. CONCLUSIONS: VRS often provides functional vision and anatomy in posterior PFVS with tent-shaped TRD morphology. In the funnel-shaped TRD morphology, where no treatment has historically been recommended, surgery may be considered with an aim of restoring light perception and globe preservation, particularly in bilateral cases.


Assuntos
Doenças da Íris , Vítreo Primário Hiperplásico Persistente , Descolamento Retiniano , Doenças Retinianas , Humanos , Vítreo Primário Hiperplásico Persistente/complicações , Vítreo Primário Hiperplásico Persistente/cirurgia , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Vitrectomia
6.
J Curr Glaucoma Pract ; 17(4): 167-168, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38269261

RESUMO

How to cite this article: Bhartiya S, Aktas Z, Ichhpujani P. Is GATT the Answer? J Curr Glaucoma Pract 2023;17(4):167-168.

7.
Turk J Ophthalmol ; 52(5): 352-355, 2022 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-36317826

RESUMO

Here we present a case of intermittent bleb leakage with increased intraocular pressure (IOP) during recovery periods that was treated with gonioscopy-assisted transluminal trabeculotomy (GATT) combined with avascular bleb excision. A 60-year-old woman exhibiting simultaneous leaking bleb and glaucoma underwent GATT and bleb revision. At her final visit, the bleb leakage had resolved and IOP was under control without any further antiglaucoma medication. GATT may be useful for glaucoma patients exhibiting intermittent bleb leakage after failed trabeculectomy.


Assuntos
Glaucoma de Ângulo Aberto , Glaucoma , Trabeculectomia , Feminino , Humanos , Pessoa de Meia-Idade , Seguimentos , Glaucoma/cirurgia , Gonioscopia , Pressão Intraocular , Estudos Retrospectivos , Resultado do Tratamento
8.
Am J Ophthalmol Case Rep ; 28: 101734, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36312790

RESUMO

Purpose: To describe the case of a 9-year-old boy with congenital glaucoma secondary to Klippel - Trenaunay - Weber Syndrome (KTW) with a history of trabeculotomy in both eyes (BE) and further trabeculectomy in the left eye (LE) presented with high intraocular pressure (IOP) and progression in the LE despite maximum tolerated medical therapy. Observations: GATT surgery was performed firstly in the LE, followed by the right eye (RE) two months apart since the IOP in the RE started to increase later on. First post-operative day the IOP was under 15 mmHg. In the last visit, 6 months after the first surgery, IOPs were 10 and 11 mmHg RE and LE, on one fixed combination; slit lamp examinations were normal with wide open angles and a good view of the Schlemm's Canal (SC) posterior wall. Conclusions and Importance: GATT surgery can be done after failed incisional surgery in children with glaucoma secondary to KTW syndrome.

9.
J Glaucoma ; 31(12): 966-971, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-35980847

RESUMO

PRCIS: This study demonstrates that a baseline corneal diameter >12.25, initial age <4 months at diagnosis, higher baseline IOP than 24 mm Hg, bilaterality, or inability to perform circumferential trabeculotomy, increases the risk of surgical failure of trabeculotomy in patients with primary congenital glaucoma (PCG). PURPOSE: The aim of this study was to identify clinical predictive factors for surgical failure and to evaluate potential prognostic factors affecting surgical success in patients with PCG who underwent trabeculotomy. PATIENTS AND METHODS: The medical charts of 123 eyes of 75 patients who underwent trabeculotomy surgery for the treatment of PCG were retrospectively reviewed. At baseline and each visit, intraocular pressure (IOP), corneal diameter, cup to disc ratio, axial length, number of medications, and need for further glaucoma surgery were noted. Surgical success was defined as an IOP ≤18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) medication and without any further IOP-lowering surgery. RESULTS: The mean age at surgery was 4.2±6.6 months and the mean follow-up time was 60.0±37.6 months. The receiver operating characteristic curve showed 4 following best cutoff values to predict surgical failure: the first for age at surgery was 4.5 months; the second baseline IOP was 24.0 mm Hg; the third for baseline cup to disc ratio was 0.4; and the fourth for baseline corneal diameter was 12.25 mm. Multivariate logistic regression analysis revealed that baseline IOP more than 24 mm Hg increased the risk of surgical failure by 2 times, baseline mean corneal diameter >12.25 mm did by 4.2 times, younger age than 4 months did by 2.5 times, bilaterality did by 1.5 times. CONCLUSIONS: A higher baseline IOP, younger age, larger corneal diameter, and bilaterality were identified as risk factors for trabeculotomy failure in congenital glaucoma. The presence of one or more of these should be considered in the decision-making process when considering surgical options to manage glaucoma in these patients.


Assuntos
Glaucoma , Trabeculectomia , Humanos , Lactente , Pressão Intraocular , Estudos Retrospectivos , Resultado do Tratamento , Glaucoma/diagnóstico , Glaucoma/cirurgia , Glaucoma/congênito , Córnea , Fatores de Risco
10.
J Glaucoma ; 31(9): 751-756, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35696703

RESUMO

PRCIS: Gonioscopy-assisted transluminal trabeculotomy (GATT) provides greater intraocular pressure (IOP) reduction in pseudoexfoliative glaucoma (PXG) than in primary open angle glaucoma (POAG) in the first year of surgery; however, the difference between groups equalizes in the long term. PURPOSE: To compare outcomes of GATT in eyes with POAG and PXG. METHODS: Single-center, retrospective, comparative case-series. A total of 202 eyes (91 eyes of POAG; 111 eyes of PXG) were included. GATT was performed as a standalone procedure or in combination with cataract extraction. Outcome measures were change in IOP and number of medications at all time points (1, 3, 6, 9, 12, 18, 24, and 36 mo after surgery), success rate (IOP reduction ≥20% from baseline or IOP between 6 and 21 mmHg, without further glaucoma surgery), and complication rate. Cumulative success probabilities were compared using Kaplan-Meier survival analyses. RESULTS: The mean IOP decreased by 8.8 mmHg (34.4%) in the POAG group with a mean decrease of 2 glaucoma medications at final visit. In the PXG group, the mean IOP decreased by 12.8 mm Hg (44.6%) on 2.3 fewer medications. Mean IOP reduction was significantly higher in PXG than POAG at all time points up to 2-year visit ( P <0.05 for all), after which the difference was not significant. Cumulative success probability during the first year was significantly higher in PXG (97.6%) than in POAG (86.8%) ( P =0.01); no significant difference was found at 2-year ( P =0.07) and 3-year visits ( P =0.24). CONCLUSION: GATT was safe and effectively reduced the IOP and medication burden in patients with POAG and PXG. In the first year after GATT, a significantly higher success rate was noted in PXG compared with POAG; however, in subsequent years, the success rate was similar at ~75%.


Assuntos
Síndrome de Exfoliação , Glaucoma de Ângulo Aberto , Hipotensão Ocular , Trabeculectomia , Síndrome de Exfoliação/complicações , Síndrome de Exfoliação/cirurgia , Seguimentos , Glaucoma de Ângulo Aberto/complicações , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/cirurgia , Gonioscopia , Humanos , Pressão Intraocular , Hipotensão Ocular/cirurgia , Polipropilenos , Estudos Retrospectivos , Trabeculectomia/métodos , Resultado do Tratamento
11.
J Adolesc Young Adult Oncol ; 11(3): 252-258, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34342492

RESUMO

Background: Osteosarcoma (OS) is the most common primary bone sarcoma in childhood. High-dose methotrexate, doxorubicine, cisplatin, and/or ifosfamide combinations are used as standard treatment in chemotherapy and could cause serious toxicity. Another alternative chemotherapy protocol is consisting of epirubicin, ifosfamide, and cisplatin (ECI), which we use in our center. The aim of this study was to evaluate the patients with OS who were treated with ECI protocol, retrospectively. Methods: Forty-three patients with OS diagnosed at our center between December 1995 and September 2017 were evaluated retrospectively. Results: The mean follow-up period was 31 months (5-145 months). Recurrence was detected in 15 of 43 patients. When the factors affecting relapse are examined, recurrence was higher in patients who were older than 10 years at the time of diagnosis, upper extremity involvement, osteoblastic, and chondroblastic subgroups, but there was no statistically significant difference. Five-year and 10-year overall survival rates were 67.4% and 58.9%, and event-free survival rates were 54% and 47.3%, respectively. While 5-year overall survival rate was 86.7% in nonrecurrent cases, this rate was 40.9% in recurrent cases and this difference was statistically significant (p = 0.023). Just two patients died because of the toxicity. Conclusion: The prognosis of OS is still poor in relapse cases, so the choice of chemotherapy for neoadjuvant and adjuvant therapy is vital. When the risk of toxicity is also considered, the first step of ECI protocol is seen as a preferable treatment option because the survival rates are similar to the literature.


Assuntos
Neoplasias Ósseas , Osteossarcoma , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/etiologia , Criança , Cisplatino/uso terapêutico , Humanos , Ifosfamida/uso terapêutico , Metotrexato , Recidiva Local de Neoplasia/tratamento farmacológico , Osteossarcoma/tratamento farmacológico , Osteossarcoma/etiologia , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
12.
Ocul Immunol Inflamm ; 30(2): 424-427, 2022 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32966150

RESUMO

PURPOSE: To evaluate the effects of fluorescein fundus angiography (FFA) on semiautomated aqueous flare measurements. METHODS: Laser flare photometer (LFP) measurements was performed at baseline, 30 min, and 4 h after the intravenous administration of sodium fluorescein dye. FFA was performed immediately after the baseline LFP measurement. LFP values at 30 min and 4 h after FFA were compared to baseline values. Mean change in LFP measurements at 30 min and 4 hafter baseline was compared between FFA arm and controls. RESULTS: The mean flare measurement in the FFA and control arm dropped 6% (p value = 0.002) and 9% (p value = 0.04), respectively. Mean change in LFP measurement at 30 min and 4 h after baseline was not significant between FFA arm and controls. CONCLUSIONS: Administration of fluorescein dye does not increase LFP values. The decrease in the LFP measurement following FFA may be attributed to dilation drops.


Assuntos
Humor Aquoso , Uveíte Anterior , Fluoresceína/farmacologia , Angiofluoresceinografia , Humanos , Fotometria , Acuidade Visual
13.
Eur J Ophthalmol ; 32(4): 2291-2297, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34382443

RESUMO

BACKGROUND: To evaluate effect of maximal anterior cortical lens density, iris scatter and anterior chamber depth on laser flare photometry. METHODS: Patients diagnosed with clinical uveitis were enrolled in the study. Clinical flare gradings were recorded upon the Standardization of Uveitis Nomenclature. Aqueous flare was measured with an automated device (Kowa FM-700). Back-scattering from anterior cortical lens and anterior iris surface was calculated from Scheimpflug images. A curvilinear regression model was used to calculate estimated values for each clinical grade. These values were used to split cases in Group I (laser flare photometry lower than estimated) and Group II (laser flare photometry higher than estimated). Mean anterior chamber depth, pupil aperture, maximal anterior cortical lens density and iris scatter values were compared between two groups. A stepwise multiple regression analysis was performed to determine the effect of clinical flare gradings and ocular parameters on aqueous flare measurements. RESULTS: The study included 228 eyes of 114 cases. Scheimpflug images were obtained from 105 eyes. Estimated aqueous flare measurements (in photons/milliseconds) were 4.87, 8.50, 14.81, 25.83, 45.04 and 136.93 for 0, 0.5+, 1+, 1.5+, 2+ and 3+ clinical flare respectively. Group II had higher maximal anterior cortical lens density than Group I (96.6 ± 37.1 vs 77.9 ± 17.1 pixel unit, p = 0.001). The measured aqueous flare was significantly related to clinical flare, maximal anterior cortical lens density and pupil aperture (adjusted R2: 0.480, p < 0.001). CONCLUSION: The back-scattered light from anterior cortical lens could affect laser flare photometry measurements. This effect might be quantified by Scheimpflug imaging.


Assuntos
Uveíte Anterior , Uveíte , Câmara Anterior/diagnóstico por imagem , Humor Aquoso , Humanos , Lasers , Fotometria/métodos , Uveíte/diagnóstico , Uveíte Anterior/diagnóstico
14.
J Curr Glaucoma Pract ; 15(2): 86-90, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34720498

RESUMO

AIM AND OBJECTIVE: To evaluate the relationship between aortic distensibility (AD) and aortic stiffness B index (ASBI) with retinal nerve fiber layer (RNFL) thickness measured with HD-OCT in peripheral arterial disease (PAD) patients. MATERIALS AND METHODS: Twenty-six PAD patients and 22 age-matched healthy control were enrolled. Subjects with PAD were classified into two groups. Patients with diabetes (DM) or hypertension (HT) comprised group I (n = 18) and without DM or HT comprised group II (n = 8). Color Doppler imaging was performed on all patients and PAD was diagnosed by using the ankle-brachial index (ABI). Retinal nerve fiber layer thickness values between control and PAD patients and correlations between RNFL thickness and aortic stiffness parameters (AD and ASBI) were evaluated. RESULTS: The inferior-nasal and inferior-temporal quadrant were the thickest in healthy subjects and the PAD group. Retinal nerve fiber layer thickness significantly decreased in superior-nasal, temporal, inferior-nasal quadrants in group I than healthy subjects (p < 0.001, p = 0.005, p < 0.001). Temporal and inferior-nasal quadrant thicknesses were statistically significantly thinner in group II than controls (p = 0.02, p < 0.001). The nasal RNFL quadrant was significantly thinner in group I than group II (p = 0.014). The correlation between RNFL thickness and aortic elasticity parameters in each group was not found to be significant. CONCLUSION AND CLINICAL SIGNIFICANCE: Isolated PAD without DM or HT may lead to localized RNFL loss in temporal and inferior-nasal quadrants. Aortic elasticity parameters did not seem to be correlated with RNFL thickness in PAD. HOW TO CITE THIS ARTICLE: Kumova D, Aktas Z, Eyiol A, et al. Relationship between Retinal Nerve Fiber Layer Thickness and Aortic Distensibility in Peripheral Arterial Disease Patients. J Curr Glaucoma Pract 2021;15(2):86-90.

15.
J Curr Glaucoma Pract ; 15(2): 99-101, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34720501

RESUMO

AIM AND OBJECTIVE: To report a unique presentation of Gorlin-Goltz syndrome (GGS) with congenital glaucoma. MATERIALS AND METHODS: We report a case of a 3-month-old female patient with bilateral uncontrolled intraocular pressures (IOP), who was already diagnosed with GGS. Examination under anesthesia demonstrated microcornea, iris coloboma, lens subluxation in both eyes, and edematous cornea in the left eye. Intraocular pressure was 17 mm Hg in OD and 35 mm Hg in OS with Icare (Icare® PRO) tonometer on repetitive measurements. On dilated fundus examination, a large chorioretinal coloboma was seen on both eyes. RESULTS: On physical examination, cutaneous, dental, and skeletal anomalies associated with the GGS were found. As previously reported ocular abnormalities associated with the GGS; coloboma and microphthalmia were noted. In addition, congenital glaucoma which is not one of the known associations of GGS was also detected. For treatment, 270° transscleral diode cyclophotoablation was performed for the left eye and medical treatment was reorganized for both eyes. CONCLUSION: Neonatal-onset glaucoma might be one of the important ocular manifestations of GGS. HOW TO CITE THIS ARTICLE: Tefon Aribas AB, Aktas Z, Özdek S. Neonatal Onset Glaucoma in a Case with Gorlin-Goltz Syndrome: An Unusual Association. J Curr Glaucoma Pract 2021;15(2):99-101.

16.
J Curr Glaucoma Pract ; 15(1): 36-39, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34393455

RESUMO

AIM AND OBJECTIVE: To present a case with bleb leakage treated with collagen crosslinking (CXL). BACKGROUND: Bleb-related complications can cause serious problems even a long time after trabeculectomy. In this case report, we present a relatively unknown treatment method for bleb leakage which might be one of the long-term complications of trabeculectomy. CASE DESCRIPTION: A 60-year-old male patient was admitted to our clinic with a decrease in his left vision. The patient had a history of left trabeculectomy. The bleb leakage was observed. Autologous blood was injected into the bleb area as the first line of treatment. Collagen crosslinking was applied to the bleb area upon the recurrence of the leakage. In the 1st week after the CXL, CXL was repeated in the bleb area upon the observation that the leakage recurred. It was observed that the leakage did not recur and bleb vascularization was triggered after CXL. CONCLUSION: Conjunctival CXL might be a non-invasive, viable method in the management of bleb leakage. It might be applied in conjunction with bandage contact lenses for the treatment of late bleb leaks as an alternative treatment method before going into surgical intervention. CLINICAL SIGNIFICANCE: As a result of conjunctival CXL application, collagen permeability reduction and neovascularization secondary to CXL application might be effective in preventing bleb leakage. However, further studies are needed to prove this. HOW TO CITE THIS ARTICLE: Aktas Z, Aribas YK, Bilgihan K, et al. Collagen Crosslinking-assisted Treatment of a Bleb Leak: Enhancement of Vascularization around the Bleb. J Curr Glaucoma Pract 2021;15(1):36-39.

17.
J Curr Glaucoma Pract ; 15(1): 40-43, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34393456

RESUMO

AIM AND OBJECTIVE: To report a case with emulsified silicone oil (SO) droplets in the Schlemm's canal (SC), encountered during prolene hemi-gonioscopy-assisted transluminal trabeculotomy (hemi-GATT). BACKGROUND: In cases with a history of previous pars plana vitrectomy (PPV) with SO tamponade and then SO removal; glaucoma might occur secondary to the presence of emulsified SO droplets. Minimal invasive glaucoma surgeries targeting trabecular meshwork such as GATT surgery might be an ideal treatment option in these cases. CASE DESCRIPTION: A 57-year-old man presented with uncontrolled intraocular pressure (IOP) and topical anti-glaucoma drug intolerance in his left eye. The patient had a history of PPV with SO tamponade and then intravitreal SO removal 5 years ago. He had a history of Ahmed glaucoma valve (AGV) implantation 2 years ago for the treatment of secondary glaucoma but he was still using topical anti-glaucoma medication. However, IOP was measured as 17 in the left eye. Hemi-gonioscopy-assisted transluminal trabeculotomy was performed successfully to get the patient off medication. During the surgery, SC was full of SO droplets. CONCLUSION: The presence of SO droplets in the SC might contribute to the development of secondary glaucoma after PPV and SO removal. This might be another surgical indication for GATT surgery in these risky eyes. HOW TO CITE THIS ARTICLE: Aktas Z, Bölük CE, Gurelik G. Silicone Oil Droplets in the Schlemm's Canal: A Surprise during Prolene Hemi-gonioscopy-assisted Transluminal Trabeculotomy (Hemi-GATT). J Curr Glaucoma Pract 2021;15(1):40-43.

18.
Indian J Ophthalmol ; 69(6): 1425-1429, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34011713

RESUMO

Purpose: To investigate the prognostic factors affecting gonioscopy-assisted transluminal trabeculotomy (GATT) surgical success. Methods: Fifty-three eyes were retrospectively enrolled. Open-angle glaucoma patients with at least 6-month follow-up were included. At baseline, demographic characteristics, intraocular pressure (IOP), number of anti-glaucomatous medications (AG), and glaucoma type were recorded. Postoperatively, IOP, complications, and number of AG were noted. The effects of these parameters on surgical success were investigated. Results: The median follow-up time was 13.7 months. The mean IOP decreased from 25.6 ± 6.2 mm Hg at baseline to 14.6 ± 3.5 mm Hg at final, and the number of AG decreased from 3.2 ± 0.78 to 1.2 ± 1.3. When target IOP was considered as 18 mm Hg and 15 mm Hg, surgical success rates were 81.1% and 60.4%, respectively. When target IOP was considered as 18 mm Hg, a positive effect of the combination with cataract surgery and a negative effect of postoperative macrohyphema on success rates were observed. Other factors did not show any association with the success rates for both target IOP values when analyzed by the Cox proportional hazards regression analysis. Conclusion: Postoperative macrohyphema may affect surgical success rates negatively. The contribution of the combination with cataract surgery is controversial. Glaucoma stage does not seem to affect surgical success.


Assuntos
Glaucoma de Ângulo Aberto , Trabeculectomia , Seguimentos , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/cirurgia , Gonioscopia , Humanos , Pressão Intraocular , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
19.
Eur J Ophthalmol ; 31(4): 1836-1843, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32799547

RESUMO

PURPOSE: To evaluate the prevalence of uveitic glaucoma (UG) in the Turkish population and investigate the primary underlying diseases. METHODS: This multicenter, cross-sectional, prospective study included patients who presented to the glaucoma units of 10 tertiary ophthalmology departments in Ankara, Turkey from 15th March to 16th May 2015 and fulfilled the criteria of UG. Patients were inspected for age, sex, medical history, best corrected visual acuity, biomicroscopic findings, intraocular pressure values, and visual field results. RESULTS: During the study period, 4604 eyes of 2541 patients with glaucoma were screened and 145 eyes of 104 patients (4.1%) were identified as having UG. One hundred and thirty-four eyes (92.4%) had open-angle glaucoma and 11 eyes (7.6%) had closed-angle glaucoma. The mean patient age was 47 ± 16 (6-90) years. Idiopathic uveitis (54 eyes), Behçet's disease (26 eyes), Fuchs heterochromic cyclitis (21 eyes), Herpes Simplex virus infectious uveitis (14 eyes), and ankylosing spondylitis (six eyes) were the leading types of uveitis associated with glaucoma. Acute anterior uveitis was the most common type of uveitis diagnosed in 72 patients (105 eyes), whereas 21 patients (27 eyes) had panuveitis, eight patients (nine eyes) had intermediate uveitis, and three patients (four eyes) had posterior uveitis. The need for surgical intervention was 37.2% among all cases and the most common surgery was trabeculectomy in 45 eyes. CONCLUSION: UG is a vision-threatening complication commonly seen in patients with uveitis. This study demonstrates the epidemiological features and underlying etiologies of UG in the Turkish population. The most common primary causes of UG were Behçet's disease and Fuchs heterochromic cyclitis.


Assuntos
Glaucoma de Ângulo Aberto , Glaucoma , Uveíte , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Glaucoma/epidemiologia , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/epidemiologia , Humanos , Pressão Intraocular , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Turquia/epidemiologia , Uveíte/epidemiologia , Adulto Jovem
20.
J Glaucoma ; 30(3): e114-e118, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33177367

RESUMO

PRCIS: The present study demonstrates that surgical success rates of gonioscopy-assisted transluminal trabeculotomy (GATT) with a target intraocular pressure (IOP)≤21 mm Hg are 93.3% (for qualified success) and 26.7% (for complete success) in vitrectomized patients exhibiting secondary open-angle glaucoma (SOAG) after silicone oil (SO) removal, for an average follow-up of 37.5 months. PURPOSE: To report the long-term outcomes of GATT in vitrectomized patients exhibiting SOAG after SO removal. SETTING: Retrospective case-series study. PATIENT POPULATION: This retrospective case-series study enrolled vitrectomized patients who underwent uneventful GATT surgery between May 2014 and May 2019 at Gazi University Hospital for the treatment of medically uncontrolled SOAG after SO removal. MAIN OUTCOME MEASURES: At baseline and at each postoperative visit, a detailed ophthalmic examination consisting of slit-lamp biomicroscopy, indirect ophthalmoscopy, macular optical coherence tomography, and Goldmann applanation tonometry was performed in all patients. Baseline demographic and clinical characteristics, duration between pars plana vitrectomy and SO removal, duration between SO removal and onset of SOAG, follow-up time, need for antiglaucoma medication, visual acuity, and IOP measurements were noted. Surgical success was defined as an IOP≤21 and ≥6 mm Hg with (qualified success) and without (complete success) IOP-lowering medication. RESULTS: A total of 15 patients had a history of pars plana vitrectomy with 1000 centistoke SO tamponade before the GATT surgery. GATT was performed in all patients with SOAG after SO removal. The mean age and follow-up of the patients were 53.6±11.8 years (range, 34 to 72 y) and 37.5±15.1 months (range, 12 to 61 mo), respectively. The average duration of SO tamponade in the vitreous cavity was 7.5±1.6 months (range, 5 to 10 mo). The average duration between the SO removal and the development of SOAG was 14.1±13.2 months (range, 2 to 46 mo). The mean IOP decreased from 31.0±4.1 mm Hg at baseline to 15.6±4.6 mm Hg at final visit. The mean final logMAR BCVA was 0.92±0.58 (range, 2 to 0.045). Qualified surgical success was achieved in 14 (93.3%) patients, whereas complete success was achieved in only 4 (26.7%) patients (P<0.001). CONCLUSIONS: GATT seems to be safe and successful procedure for controlling IOP in patients exhibiting SOAG after SO removal. However, most patients may require antiglaucoma medication during the follow-up, particularly within the first 2 postoperative years.


Assuntos
Glaucoma de Ângulo Aberto , Trabeculectomia , Seguimentos , Glaucoma de Ângulo Aberto/cirurgia , Gonioscopia , Humanos , Pressão Intraocular , Estudos Retrospectivos , Óleos de Silicone , Resultado do Tratamento
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