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Marcelo T Nicolela

Publications and source records attributed to Marcelo T Nicolela.

15 recordsLinked to original sources
PubMed2006

Effect of moderate intraocular pressure changes on topographic measurements with confocal scanning laser tomography in patients with glaucoma.

OBJECTIVE: To evaluate optic disc topography changes after intraocular pressure (IOP) modulation in patients with glaucoma. METHODS: Twenty-three patients with glaucoma were studied. Three mean optic disc topography images were obtained with the Heidelberg Retina Tomograph II at baseline and weeks 1, 2, 4, and 8 (visits 1, 2, 3, 4, and 5, respectively). Topical medications were discontinued in the study eye after visit 1 and resumed after visit 4 but maintained in the contralateral control eye. Central corneal thickness was measured at the last visit. Topographic changes were determined by stereometric parameters (rim area and mean cup depth) and at discrete topographic locations using the Topographic Change Analysis program (from the Heidelberg Retina Tomograph II). RESULTS: In the study eyes, IOP increased significantly (5.4 mm Hg at visit 4; P<.001) after withdrawal of topical medications but returned to baseline levels after resuming medications; no statistically significant topographic changes, however, were observed. Moreover, no relationship between change in IOP and stereometric parameters was observed. Central corneal thickness was not associated with changes in optic disc topography induced by IOP modulation. CONCLUSION: In patients with glaucoma, significant but relatively moderate IOP increases and decreases on the order of 5 mm Hg did not appear to have an effect on optic disc topography.

Adult↗
PubMed2006

The letter contrast sensitivity test: clinical evaluation of a new design.

PURPOSE: To compare the reliability, validity, and responsiveness of the Mars Letter Contrast Sensitivity (CS) Test to the Pelli-Robson CS Chart. METHODS: One eye of 47 normal control subjects, 27 patients with open-angle glaucoma, and 17 with age-related macular degeneration (AMD) was tested twice with the Mars test and twice with the Pelli-Robson test, in random order on separate days. In addition, 17 patients undergoing cataract surgery were tested, once before and once after surgery. RESULTS: The mean Mars CS was 1.62 log CS (0.06 SD) for normal subjects aged 22 to 77 years, with significantly lower values in patients with glaucoma or AMD (P<0.001). Mars test-retest 95% limits of agreement (LOA) were +/-0.13, +/-0.19, and +/-0.24 log CS for normal, glaucoma, and AMD, respectively. In comparison, Pelli-Robson test-retest 95% LOA were +/-0.18, +/-0.19, and +/-0.33 log CS. The Spearman correlation between the Mars and Pelli-Robson tests was 0.83 (P<0.001). However, systematic differences were observed, particularly at the upper-normal end of the range, where Mars CS was lower than Pelli-Robson CS. After cataract surgery, Mars and Pelli-Robson effect size statistics were 0.92 and 0.88, respectively. CONCLUSIONS: The results indicate the Mars test has test-retest reliability equal to or better than the Pelli-Robson test and comparable responsiveness. The strong correlation between the tests provides evidence the Mars test is valid. However, systematic differences indicate normative values are likely to be different for each test. The Mars Letter CS Test is a useful and practical alternative to the Pelli-Robson CS Chart.

Adult↗
PubMed2005

Effect of cataract extraction on the visual fields of patients with glaucoma.

OBJECTIVE: To investigate the effect of cataract extraction on the visual fields of patients with open-angle glaucoma. METHODS: Patients in a prospective cohort study in a tertiary center underwent standard automated perimetry every 6 months. We compared the mean results of the 2 examinations immediately before and 2 examinations immediately after phacoemulsification cataract extraction and intraocular lens implant (effect analysis) and the mean results of the first 2 and last 2 examinations from 4 consecutive examinations obtained more than 1 year after the cataract surgery (control analysis). RESULTS: Our sample contained 34 eyes of 26 patients (mean +/- SD age, 69.2 +/- 10.8 years). While the mean logMAR best-corrected visual acuity improved significantly by approximately 2 Snellen lines after surgery (P < .001), the average change in mean deviation in both the effect and control analyses was less than 0.1 dB and not statistically significant (P = .85). There was a strong correlation between change in foveal sensitivity and change in mean deviation in the effect analysis but not in the control analysis (r = 0.76 [P < .001] and r = 0.30 [P = .08], respectively). There was no relationship between change in visual acuity or initial mean deviation and change in mean deviation in either analysis. Change in pointwise total deviation was not systematically related to the respective baseline value in either analysis; however, the variance of the distribution of change in total deviation was significantly higher in the effect analysis (P < .001). CONCLUSION: While there was an improvement in best-corrected visual acuity after cataract surgery, the changes in the visual field as a group were negligible.

Aged↗
PubMed2005

Glaucomatous visual field progression with frequency-doubling technology and standard automated perimetry in a longitudinal prospective study.

PURPOSE: To compare frequency-doubling technology (FDT) perimetry with standard automated perimetry (SAP) for detecting glaucomatous visual field progression in a longitudinal prospective study. METHODS: One eye of patients with open-angle glaucoma was tested every 6 months with both FDT and SAP. A minimum of 6 examinations with each perimetric technique was required for inclusion. Visual field progression was determined by two methods: glaucoma change probability (GCP) analysis and linear regression analysis (LRA). For GCP, several criteria for progression were used. The number of locations required to classify progression with FDT compared with SAP, respectively, was 1:2 (least conservative), 1:3, 2:3, 2:4, 2:6, 2:7, 3:6, 3:7, and 3:10 (most conservative). The number of consecutive examinations required to confirm progression was 2-of-3, 2-of-2, and 3-of-3. For LRA, the progression criterion was any significant decline in mean threshold sensitivity over time in each of the following three visual field subdivisions: (1) all test locations, (2) locations in the central 10 degrees and the superior and inferior hemifields, and (3) locations in each quadrant. Using these criteria, the proportion of patients classified as showing progression with each perimetric technique was calculated and, in the case of progression with both, the differences in time to progression were determined. RESULTS: Sixty-five patients were followed for a median of 3.5 years (median number of examinations, 9). For the least conservative GCP criterion, 32 (49%) patients were found to have progressing visual fields with FDT and 32 (49%) patients with SAP. Only 16 (25%) patients showed progression with both methods, and in most of those patients, FDT identified progression before SAP (median, 12 months earlier). The majority of GCP progression criteria (15/27), classified more patients as showing progression with FDT than with SAP. Contrary to this, more patients showed progression with SAP than FDT, when analysed with LRA; e.g., using quadrant LRA 20 (31%) patients showed progression with FDT, 23 (35%) with SAP, and only 10 (15%) with both. CONCLUSIONS: FDT perimetry detected glaucomatous visual field progression. However, the proportion of patients who showed progression with both FDT and SAP was small, possibly indicating that the two techniques identify different subgroups of patients. Using GCP, more patients showed progression with FDT than with SAP, yet the opposite occurred using LRA. As there is no independent qualifier of progression, FDT and SAP progression rates vary depending on the method of analysis and the criterion used.

Disease Progression↗
PubMed2005

Threshold and variability properties of matrix frequency-doubling technology and standard automated perimetry in glaucoma.

PURPOSE: To compare test results from second-generation Frequency-Doubling Technology perimetry (FDT2, Humphrey Matrix; Carl-Zeiss Meditec, Dublin, CA) and standard automated perimetry (SAP) in patients with glaucoma. Specifically, to examine the relationship between visual field sensitivity and test-retest variability and to compare total and pattern deviation probability maps between both techniques. METHODS: Fifteen patients with glaucoma who had early to moderately advanced visual field loss with SAP (mean MD, -4.0 dB; range, +0.2 to -16.1) were enrolled in the study. Patients attended three sessions. During each session, one eye was examined twice with FDT2 (24-2 threshold test) and twice with SAP (Swedish Interactive Threshold Algorithm [SITA] Standard 24-2 test), in random order. We compared threshold values between FDT2 and SAP at test locations with similar visual field coordinates. Test-retest variability, established in terms of test-retest intervals and standard deviations (SDs), was investigated as a function of visual field sensitivity (estimated by baseline threshold and mean threshold, respectively). The magnitude of visual field defects apparent in total and pattern deviation probability maps were compared between both techniques by ordinal scoring. RESULTS: The global visual field indices mean deviation (MD) and pattern standard deviation (PSD) of FDT2 and SAP correlated highly (r > 0.8; P < 0.001). At test locations with high sensitivity (>25 dB with SAP), threshold estimates from FDT2 and SAP exhibited a close, linear relationship, with a slope of approximately 2.0. However, at test locations with lower sensitivity, the relationship was much weaker and ceased to be linear. In comparison with FDT2, SAP showed a slightly larger proportion of test locations with absolute defects (3.0% vs. 2.2% with SAP and FDT2, respectively, P < 0.001). Whereas SAP showed a significant increase in test-retest variability at test locations with lower sensitivity (P < 0.001), there was no relationship between variability and sensitivity with FDT2 (P = 0.46). In comparison with SAP, FDT2 exhibited narrower test-retest intervals at test locations with lower sensitivity (SAP thresholds <25 dB). A comparison of the total and pattern deviation maps between both techniques showed that the total deviation analyses of FDT2 may slightly underestimate the visual field loss apparent with SAP. However, the pattern-deviation maps of both instruments agreed well with each other. CONCLUSIONS: The test-retest variability of FDT2 is uniform over the measurement range of the instrument. These properties may provide advantages for the monitoring of patients with glaucoma that should be investigated in longitudinal studies.

Aged↗
PubMed2005

Visual field progression in glaucoma: total versus pattern deviation analyses.

PURPOSE: To compare visual field progression with total and pattern deviation analyses in a prospective longitudinal study of patients with glaucoma and healthy control subjects. METHODS: A group of 101 patients with glaucoma (168 eyes) with early to moderately advanced visual field loss at baseline (average mean deviation [MD], -3.9 dB) and no clinical evidence of media opacity were selected from a prospective longitudinal study on visual field progression in glaucoma. Patients were examined with static automated perimetry at 6-month intervals for a median follow-up of 9 years. At each test location, change was established with event and trend analyses of total and pattern deviation. The event analyses compared each follow-up test to a baseline obtained from averaging the first two tests, and visual field progression was defined as deterioration beyond the 5th percentile of test-retest variability at three test locations, observed on three consecutive tests. The trend analyses were based on point-wise linear regression, and visual field progression was defined as statistically significant deterioration (P < 5%) worse than -1 dB/year at three locations, confirmed by independently omitting the last and the penultimate observation. The incidence and the time-to-progression were compared between total and pattern deviation analyses. To estimate the specificity of the progression analyses, identical criteria were applied to visual fields obtained in 102 healthy control subjects, and the rate of visual field improvement was established in the patients with glaucoma and the healthy control subjects. RESULTS: With both event and trend methods, pattern deviation analyses classified approximately 15% fewer eyes as having progressed than did the total deviation analyses. In eyes classified as progressing by both the total and pattern deviation methods, total deviation analyses tended to detect progression earlier than the pattern deviation analyses. A comparison of the changes observed in MD and the visual fields' general height (estimated by the 85th percentile of the total deviation values) confirmed that change in the glaucomatous eyes almost always comprised a diffuse component. Pattern deviation analyses of progression may therefore underestimate the true amount of glaucomatous visual field progression. CONCLUSIONS: Pattern deviation analyses of visual field progression may underestimate visual field progression in glaucoma, particularly when there is no clinical evidence of increasing media opacity. Clinicians should have access to both total and pattern deviation analyses to make informed decisions on visual field progression in glaucoma.

Adult↗
PubMed2004

Cystoid macular edema in a low-risk patient after switching from latanoprost to bimatoprost.

PURPOSE: To report a case of angiographically documented cystoid macula edema occurring after switching a pseudophakic patient from latanoprost to bimatoprost. DESIGN: Observational case report. METHODS: A 68-year-old man developed intense conjunctival hyperemia and cystoid macula edema after switching from latanoprost to bimatoprost 9 months after cataract surgery in an eye at low-risk for this cystoid macular edema. RESULTS: Bimatoprost was discontinued and diclofenac initiated. After 2 months, visual acuity and ocular hyperemia returned to baseline levels. Fundus examination revealed resolution of cystoid macula edema. CONCLUSION: It is possible that pseudophakic eyes that develop intense conjunctival hyperemia associated with ocular hypotensive lipids might be at higher risk for developing cystoid macula edema.

Aged↗
PubMed2004

Factors associated with optic disc hemorrhages in glaucoma.

PURPOSE: To evaluate factors associated with optic disc hemorrhages (ODHs) in patients with open-angle glaucoma. DESIGN: Cohort study. PARTICIPANTS: One hundred thirty-seven patients with open-angle glaucoma, with an initial mean age of 60.0 years (standard deviation [SD], 11.0 years) followed up for a mean of 9.5 years (SD, 5.0 years). METHODS: The association between ODHs and various patient-related variables (diabetes, systemic hypertension, heart disease, hypercholesterolemia, migraine, hypothyroidism, use of platelet antiaggregant agents) and eye-related variables (mean and range of intraocular pressure, refractive error, and severity of disease) was investigated using multivariate time-to-event analyses in patients with open-angle glaucoma. To determine the influence of the level of intraocular pressure (IOP) on the occurrence of ODHs, we compared the IOP at the time the first ODH was noted with the mean IOP of the previous 3 visits. As a control, a similar analysis was performed on the same eyes using a randomly selected visit before the occurrence of the first ODH. MAIN OUTCOME MEASUREMENTS: Patient-related and eye-related variables associated with ODHs and the comparative level of IOP in which these ODHs were observed. RESULTS: Fifty eyes of 38 patients (28%) had 1 or more ODHs during the follow-up period. The ODHs were associated with presence of diabetes (hazard ratio, 4.43; 95% confidence interval [CI], 1.8-10.50; P = 0.001) and use of aspirin (hazard ratio, 2.30; 95% CI, 1.2-4.6; P = 0.019). The IOP at the time of the first ODH was, on average, 1.4 mmHg lower than the mean IOP of the 3 previous visits (95% CI, -2.2 to -0.6 mmHg; P<0.001), whereas in the control analysis, the respective value was 0.3 mmHg lower (95% CI, -1.0 to 0.5; P = 0.410). CONCLUSIONS: Optic disc hemorrhages were associated with diabetes and aspirin use and were observed at relatively lower IOP during follow-up.

Adult↗
PubMed2003

Comparison of data analysis tools for detection of glaucoma with the Heidelberg Retina Tomograph.

PURPOSE: To evaluate the performance of three linear discriminant functions (LDFs) and the Moorfields Regression Analysis (MRA) in classifying optic disc topography images obtained with the Heidelberg Retina Tomograph (HRT) from patients with open-angle glaucoma and normal controls. Furthermore, to investigate whether the classification of glaucomatous eyes is related to the severity of visual field loss or to optic disc size. DESIGN: Prospective comparative observational case series. PARTICIPANTS: One eye of 104 patients with a diagnosis of open-angle glaucoma (mean age, 63.2; range, 30-88 years) and 48 normal controls (mean age, 52.4; range, 33-75 years). TESTING: Subjects were examined with the HRT. MAIN OUTCOME MEASURES: Diagnostic performance was calculated for the LDFs published by Mikelberg et al (LDF1), Burk (LDF2), and Bathija et al (LDF3) and for the MRA. RESULTS: Large differences in sensitivity and specificity were found among the different analyses when using the originally suggested cutoff criteria. When specificity was equalized to 90%, the sensitivities were more similar (LDF1, 55%; LDF2, 61%; and LDF3, 67%). At 95% specificity, the sensitivities decreased further (LDF1, 39%; LDF2, 55%; LDF3, 44%). When treating the "borderline" outcomes as test positives, MRA sensitivity and specificity were 78% and 81%, respectively. When treating the "borderline" outcomes as test negatives, the MRA gave a sensitivity of 58%, with a specificity of 96%. In glaucoma patients, the correlation between the severity of visual field damage, as measured by the mean deviation index, and the outcome of the classification systems was low to moderate (Spearman's r between 0.26 and 0.39). When the entire sample was stratified into equal thirds on the basis of optic disc size, large discs (area > 2.10 mm(2)) tended to be classified with a higher sensitivity but lower specificity than small discs (area < 1.73 mm(2)) with all methods except LDF3. Using a multiple regression model controlling for mean deviation, LDF1, and LDF2, but not LDF3, were significantly influenced by disc size. CONCLUSIONS: The 4 methods of analysis had similar sensitivities once their specificities were equalized. In this sample, the LDFs and MRA generally did not discriminate between glaucoma patients and controls as well as reported in the original respective studies that described the methods.

Adult↗
PubMed2003

Visual field and optic disc progression in patients with different types of optic disc damage: a longitudinal prospective study.

OBJECTIVE: To evaluate the incidence of visual field and optic disc progression in glaucoma patients with distinct patterns of optic disc damage. DESIGN: Prospective, observational case series. PARTICIPANTS: One hundred five patients with open-angle glaucoma. METHODS: Baseline optic disc photographs of 105 study eyes of 105 patients were reviewed by 2 masked observers and classified according to patterns of disc damage into the following categories: focal, myopic, senile sclerotic, and generalized disc damage. Patients were followed up every 6 months with standard automated perimetry (SAP), high-pass resolution perimetry (HRP), and scanning laser tomography (SLT) with the Heidelberg Retina Tomograph. MAIN OUTCOME MEASURES: Visual field (SAP and HRP) and optic disc (SLT) progression were determined according to predefined criteria. RESULTS: Twenty-four eyes were classified into the focal, 8 into the myopic, 12 into the senile sclerotic, and 28 into the generalized group. Eyes from 33 patients could not be classified by the observers into any of these groups and were excluded from further analysis. Although intraocular pressure during follow-up was similar among the four groups, some differences in frequency of progression were observed. Patients with senile sclerotic discs had the lowest rates of visual field progression (both with SAP and HRP) and optic disc progression, although the differences were significant only for optic disc progression (P = 0.05). CONCLUSIONS: Patients with senile sclerotic discs showed a tendency towards less visual field and optic disc progression when compared with patients with other types of disc damage.

Aged↗
PubMed2003

Retinal arterial diameter changes in progressive and nonprogressive glaucoma.

PURPOSE: To determine if the degree of retinal arterial diameter change is different between patients with progressive and nonprogressive open-angle glaucoma. MATERIAL AND METHODS: In this prospective cohort study, 44 eyes of 44 open-angle glaucoma patients (mean age, 67.5 years; age range, 52-84 years; mean follow-up period, 4.9 years; follow-up range, 1.3-7.5 years) were included. The change in arterial diameter between the baseline and the most recent follow-up optic disc photograph was determined. The diameter of the 4 major arteries was measured at the optic disc margin and at the thinnest and broadest locations within 1 optic disc diameter from the disc margin. Patients were stratified into progressing and nonprogressing groups according to visual field and optic disc criteria. RESULTS: Visual field progression was observed in 13 (30%) patients and optic disc progression in 24 (55%) patients. On average, the arterial diameters at the edge of the optic disc decreased significantly by 2.37% (95% CI, -3.31% to -1.41%) per year of follow-up (P<0.001). No significant difference in generalized or focal arterial narrowing was observed between progressive and nonprogressive groups regardless of the criterion used (P>0.462). With this sample, the power to detect a 10% difference in arterial narrowing between the 2 groups was 66%. There was no relationship between the rates of visual field progression and arterial diameter change in the whole group (P = 0.171) or in groups segregated into progressing and nonprogressing patients (P>0.104). CONCLUSION: Arterial diameters decreased in both progressive and nonprogressive glaucoma. In this study, there was little evidence that arterial narrowing was more pronounced in progressive disease.

Aged↗
PubMed2003

Effects of blur and repeated testing on sensitivity estimates with frequency doubling perimetry.

PURPOSE: To investigate the effect of blur and repeated testing on sensitivity with frequency doubling technology (FDT) perimetry. METHODS: One eye of 12 patients with glaucoma (mean deviation [MD] mean, -2.5 dB, range +0.5 to -4.3 dB) and 11 normal control subjects underwent six consecutive tests with the FDT N30 threshold program in each of two sessions. In session 1, blur was induced by trial lenses (-6.00, -3.00, 0.00, +3.00, and +6.00 D, in random order). In session 2, only the effects of repeated testing were evaluated. The MD and pattern standard deviation (PSD) indices were evaluated as functions of blur and of test order. By correcting the data of session 1 for the reduction of sensitivity with repeated testing (session 2), the effect of blur on FDT sensitivities was established, and its clinical consequences evaluated on total- and pattern-deviation probability maps. RESULTS: FDT sensitivities decreased with blur (by <0.5 dB/D) and with repeated testing (by approximately 2 dB between the first and sixth tests). Blur and repeated testing independently led to larger numbers of locations with significant total and pattern deviation. Sensitivity reductions were similar in normal control subjects and patients with glaucoma, at central and peripheral test locations and at locations with high and low sensitivities. However, patients with glaucoma showed larger deterioration in the total-deviation-probability maps. CONCLUSIONS: To optimize the performance of the device, refractive errors should be corrected and immediate retesting avoided. Further research is needed to establish the cause of sensitivity loss with repeated FDT testing.

Adult↗
PubMed2003

Effects of cold-induced vasospasm in glaucoma: the role of endothelin-1.

PURPOSE: Vasospasm has been associated with glaucoma, but its mechanisms have not been elucidated. The present study was designed to evaluate the role of endothelin (ET)-1, a potent endogenous vasoconstrictor, in the genesis of vasospasm in glaucoma. METHODS: Our sample contained patients with open-angle glaucoma (n = 43) and subjects with normal nonglaucomatous eyes and without acral vasospasm (n = 27). After the eligibility visit, all subjects underwent a provocative cooling test, consisting of wearing for 30 minutes a head-vest cooling garment containing coolant fluid. Blood was collected before and after cooling, and plasma ET-1 was determined by immunoassay. In addition, visual fields and retinal blood flow, measured with a confocal scanning laser and Doppler flowmeter, were measured before and after cooling. Peripheral finger flow, skin temperature, and blood pressure were monitored during the experiment. A recovery visit was performed within 1 month, when visual field and retinal blood flow measurements were repeated. RESULTS: Baseline plasma ET-1 levels were similar between patients with glaucoma and control subjects (mean +/- SD: 2.81 +/- 1.29 and 2.56 +/- 1.36 pg/mL, respectively, P = 0.465). Patients with glaucoma, however, had a significant increase in plasma ET-1 after cooling (mean +/- SD increase of 34% +/- 52%, P = 0.001), not observed in control subjects (mean +/- SD increase of 7% +/- 43%, P = 0.750). No significant change in visual fields or retinal blood flow was observed after cooling in either group. Patients with glaucoma who had evidence of acral vasospasm, however, were more likely to show deterioration in visual fields after cooling than patients without acral vasospasm (P = 0.007). CONCLUSIONS: Patients with glaucoma have an abnormal increase in plasma ET-1 after the body cools. It is possible that at least in some patients, increased levels of ET-1 in response to vasospastic stimuli may be involved in the pathogenesis of glaucomatous damage.

Adult↗
PubMed2002

Combined Baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma.

PURPOSE: To describe the surgical technique and clinical outcomes of a procedure for refractory glaucoma, concurrent Baerveldt glaucoma implant (BGI) and trabeculectomy with mitomycin C. MATERIALS AND METHODS: Medical records of all patients who underwent combined Prolene-ligated BGI and trabeculectomy with mitomycin C were retrospectively reviewed. Main outcome measures were intraocular pressure (IOP), number of glaucoma medications, visual acuity, and complications. Kaplan-Meier survival analysis was used to determine success, defined as IOP < 22 mm Hg, no reoperation for glaucoma, and no loss of light perception vision. RESULTS: The mean +/- SD follow-up period for 38 eyes of 36 patients was 34 +/- 36 months (range, 3-121 months), during which 18 of 38 eyes (47%) required laser suture lysis of the Prolene suture. Intraocular pressure was reduced from a mean (+/- SD) preoperative value of 35.7 +/- 12.8 to 12.7 +/- 4.7 mm Hg at 1-year follow-up and 11.9 +/- 5.5 mm Hg at the last follow-up visit ( < 0.001). Number of medicines used for glaucoma was reduced from a mean +/- SD preoperative value of 2.5 +/- 0.9 to 0.5 +/- 0.6 at 1-year follow-up and 0.6 +/- 0.8 at the last follow-up visit ( < 0.001). LogMar visual acuity remained stable at mean of 1.15 +/- 0.85 preoperatively, compared with 1.14 +/- 1.05 at 1-year follow-up, but declined to 1.61 +/- 1.01 at the last follow-up visit, a loss of an average of four lines of vision ( = 0.004). Cumulative success was 91% at year 1, 86% at year 2, and 81% at year 3. Three eyes (8%) had suprachoroidal hemorrhages, one eye (3%) needed reoperation for an extruded implant, one (3%) eye had poor vision due to chronic hypotony, three eyes (8%) required additional glaucoma surgery during the postoperative period, and one eye (3%) needed revision of the implant for pressure control. CONCLUSIONS: Combined BGI and mitomycin C trabeculectomy provides excellent postoperative IOP control in patients with refractory glaucoma.

Adult↗