Background:Covered sclerotomy was developed as a minimally invasive modification of filtering glaucoma surgery.In this prospective study the clinical results are compared after one year.Patients and Methods:58 eyes wi...Background:Covered sclerotomy was developed as a minimally invasive modification of filtering glaucoma surgery.In this prospective study the clinical results are compared after one year.Patients and Methods:58 eyes with advanced glaucoma were studied.32 eyes had a covered sclerotomy(ST)and 26 had an ST with viscoelastic filling of the anterior chamber in order to reduce the postoperative hypotony rate(ST+ H).The ST procedure consisted in the preparation of a 4 mm corneoscleral tunnel incision with a T-shaped 1.75 mm wide perforation and radial transection of the tunnel floor.Results:The preoperative intraocular pressure(IOP)was on average 30± 8.5 mmHg(ST)and 26± 8.3 mmHg(ST+ H).After 1 year the IOP decreased significantly(P < 0.05)to 17± 3.7 mmHg(ST)and 17± 2.9 mmHg(ST+ H).The mean IOP reduction was 37%(ST)and 30%(ST+ H).Revisions were required in 37%(ST)and 15%(ST+ H)of the cases.The postoperative hypotony rate was 34% in both groups.The number of morphologically functional filtering blebs was 60%(ST)and 70%(ST+ H)after one year.Conclusions:The covered sclerotomy required minimal surgical manipulations of the conjunctiva and sclera.After 1 year a significant reduction of the IOP was achieved.However,the occurrence of bleb scarring could not be lowered compared to trabeculectomy.Therefore further modifications with the primary application of antimetabolites are planned.展开更多
BACKGROUND AND OBJECTIVE: To identify clinical features and evaluate outcomes of vitreoretinal surgery in eyes with retained non-metallic and non-magnetic metallic intraocular foreign bodies (IOFBs). PATIENTS AND METH...BACKGROUND AND OBJECTIVE: To identify clinical features and evaluate outcomes of vitreoretinal surgery in eyes with retained non-metallic and non-magnetic metallic intraocular foreign bodies (IOFBs). PATIENTS AND METHODS: Retrospective chart review. Thirty-two eyes (28 patients) with non-metallic and non-magnetic metallic IOFBs underwent removal of IOFBs with intraocular forceps, either via the pars plana in 30 eyes (93.9%) or a limbal approach in 2 eyes (6.25%). The main outcome measures were postoperative visual acuity, rate of retinal break formation, development of retinal detachment, and type of IOFB. RESULTS: IOFBs were non-metallic in 22 eyes (68.7%) and non-magnetic metallic in 10 eyes (31.1%). The average follow-up period was 7.5 months. Overall, final visual acuity was 20/40 or better in 10 eyes (31.1%) and 5/200 to 20/50 in 10 eyes (31.1%). A higher incidence of retinal break formation posterior to the sclerotomy was seen with glass IOFBs (P=.02). Retinal detachment was observed preoperatively in 4 eyes (12.5%) and postoperatively in 2 eyes (6.25%). CONCLUSION: Final visual outcome was independent of size and type of IOFB. Pars plana extractions may be associated with a higher rate of retinal break formation and subsequent retinal detachment, particularly with glass IOFBs.展开更多
文摘Background:Covered sclerotomy was developed as a minimally invasive modification of filtering glaucoma surgery.In this prospective study the clinical results are compared after one year.Patients and Methods:58 eyes with advanced glaucoma were studied.32 eyes had a covered sclerotomy(ST)and 26 had an ST with viscoelastic filling of the anterior chamber in order to reduce the postoperative hypotony rate(ST+ H).The ST procedure consisted in the preparation of a 4 mm corneoscleral tunnel incision with a T-shaped 1.75 mm wide perforation and radial transection of the tunnel floor.Results:The preoperative intraocular pressure(IOP)was on average 30± 8.5 mmHg(ST)and 26± 8.3 mmHg(ST+ H).After 1 year the IOP decreased significantly(P < 0.05)to 17± 3.7 mmHg(ST)and 17± 2.9 mmHg(ST+ H).The mean IOP reduction was 37%(ST)and 30%(ST+ H).Revisions were required in 37%(ST)and 15%(ST+ H)of the cases.The postoperative hypotony rate was 34% in both groups.The number of morphologically functional filtering blebs was 60%(ST)and 70%(ST+ H)after one year.Conclusions:The covered sclerotomy required minimal surgical manipulations of the conjunctiva and sclera.After 1 year a significant reduction of the IOP was achieved.However,the occurrence of bleb scarring could not be lowered compared to trabeculectomy.Therefore further modifications with the primary application of antimetabolites are planned.
文摘BACKGROUND AND OBJECTIVE: To identify clinical features and evaluate outcomes of vitreoretinal surgery in eyes with retained non-metallic and non-magnetic metallic intraocular foreign bodies (IOFBs). PATIENTS AND METHODS: Retrospective chart review. Thirty-two eyes (28 patients) with non-metallic and non-magnetic metallic IOFBs underwent removal of IOFBs with intraocular forceps, either via the pars plana in 30 eyes (93.9%) or a limbal approach in 2 eyes (6.25%). The main outcome measures were postoperative visual acuity, rate of retinal break formation, development of retinal detachment, and type of IOFB. RESULTS: IOFBs were non-metallic in 22 eyes (68.7%) and non-magnetic metallic in 10 eyes (31.1%). The average follow-up period was 7.5 months. Overall, final visual acuity was 20/40 or better in 10 eyes (31.1%) and 5/200 to 20/50 in 10 eyes (31.1%). A higher incidence of retinal break formation posterior to the sclerotomy was seen with glass IOFBs (P=.02). Retinal detachment was observed preoperatively in 4 eyes (12.5%) and postoperatively in 2 eyes (6.25%). CONCLUSION: Final visual outcome was independent of size and type of IOFB. Pars plana extractions may be associated with a higher rate of retinal break formation and subsequent retinal detachment, particularly with glass IOFBs.
