SEARCH · Search PubMed

Results for “Filtering Surgery”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources

PubMed2000

Sinusotomy and deep sclerectomy.

Non-penetrating filtering surgery (NPFS) started in 1962 with the first sinusotomy performed by Kraznov. At that time, the author of this new technique believed that the outflow resistance in the majority of cases of primary open-angle glaucoma was located at the level of scleral aqueous drainage veins and not in the trabeculum. He therefore developed a safe NPFS technique, leaving in place the trabeculum and the inner wall of Schlemm's canal. Because of difficulties with the microsurgical technique and the small reduction in intraocular pressure (IOP) compared with trabeculectomy, sinusotomy was abandoned. In the last decade, with the widespread use of operating microscopes, NPFS has been the subject of renewed interest. IOP reduction with the new NPFS techniques is comparable to that obtained with trabeculectomy, with significantly lower pre- and post-operative complications. The new NPFS techniques such as deep sclerectomy, ab externo trabeculectomy and viscocanalostomy present definitively different mechanisms of filtration compared with early sinusotomy. This article will review the history of NPFS as well as describing the different new non-penetrating filtering surgeries.

Filtering Surgery↗

PubMed2000

[Histopathological evaluation of vitamin E derivatives effects on the healing process of a model of filtration surgery].

PURPOSE: To describe the effect of alpha-tocopherol derivatives (acetate and acid succinate) on the histopathological characteristics of the surgical fistulae in an experimental model of filtering surgery. METHODS: 30 pigmented rabbits were randomly divided into 3 study groups. Twenty-four hours before surgery the animals were injected subconjunctivally with 0.5 ml of solution: group I (n=10) 0.75% ethanol in balanced saline solution (BSS), group II (n=10) 100 microgrs alpha-tocopherol acetate (AT) in 0.75% ethanol in BSS, group III (n=10) 100 microgrs alphatocopherol acid succinate (ST) in 0.75% ethanol in BSS. Histological findings were evaluated 30 days after surgery. RESULTS: The groups treated with alpha-tocopherol derivatives showed a higher percentage of fistular persistence and smaller wound healing areas. There was a subconjunctival cellular infiltrate of mononuclear and eosinophilic cells. CONCLUSIONS: Histological findings support the clinical use of alpha tocopherol derivatives, AT and ST. to inhibit the wound healing processes associated to filtering surgery failure.

Animals↗

PubMed1989

Low-dose 5-fluorouracil and glaucoma filtration surgery.

We show that a 40-mg total dose of subconjunctival 5-fluorouracil after glaucoma filtering surgery can provide a success rate comparable to that demonstrated in prior studies employing a higher dose. Sixty-four eyes with poor prognoses underwent filtering surgery with postoperative subconjunctival injections of 5 mg of 5-fluorouracil daily for seven days followed by one injection 1 week later. In 75% percent of the eyes intraocular pressure stabilized at 21 mm Hg or less regardless of medications used. The majority of failures occurred within 6 months of treatment. Postoperative corneal epithelial defects occurred in 30% of the cases, conjunctival wound leaks in 6.3%. A 40-mg dose of subconjunctival 5-fluorouracil appears to be effective and may be associated with a lower incidence of postoperative complications than higher doses.

Adolescent↗

PubMed1986

Prevention and management of delayed suprachoroidal hemorrhage after filtration surgery.

We report two new cases of massive delayed nonexpulsive suprachoroidal hemorrhage (DNSH) following a filtering operation in the aphakic eyes of elderly patients with glaucoma. A timely surgical drainage resulted in full recovery of preoperative visual acuity in both of our patients. As we combine our cases with a series of 18 similar cases of others in the literature, the following conclusions emerge. Limited DNSH does not require surgical intervention for a favorable visual outcome. Massive DNSH, however, requires timely and appropriate surgical intervention to achieve a favorable visual outcome and to avoid persistent hypotony. The most effective surgical intervention is drainage of the suprachoroidal hemorrhage and re-formation of the anterior chamber, but without concomitant vitrectomy. In both limited and massive DNSH, the final visual outcome is not determined by the worst vision at the time of DNSH. Some of the known and suspected risk factors of DNSH following filtering surgery are old age, aphakia, postoperative hypotony, a history of vitreous manipulation or complication, general anesthesia, increased venous pressure, use of fluorouracil, and high myopia. In view of these risk factors, we recommend several preventive measures for decreasing the incidence of DNSH following filtering surgery.

Aged↗

PubMed2000

Paired parallel locking forceps.

We describe an instrument used to prevent contact between an antimetabolite and the conjunctiva-Tenon's wound edge in filtering surgery. Paired parallel locking forceps were used to keep the everted conjunctival-Tenon's wound edge from touching the antimetabolite sponge during limbal-based filtering surgery while enabling manipulation of the antimetabolite sponge. This allows the surgeon to more easily avoid the conjunctival edge, making antimetabolite touch easier and safer.

Alkylating Agents↗

PubMed1976

Modified trabeculectomy incision for c ataract extraction.

Preservation of the fistula site from previous filtering surgery for glaucoma at the time of cataract surgery is difficult. A modified trabeculectomy incision for cataract extraction following successful filtering surgery for glaucoma is described.

Aged↗

PubMed1991

Regulating the dose of 5-fluorouracil to prevent filtering bleb scarring.

Repeated doses of 5mg of 5-fluorouracil (5-FU) were injected subconjunctivally in 25 poor-prognosis glaucomatous eyes after filtering surgery to prevent filtering bleb scarring. The frequency (1-2 times a day) and duration (minimum, 7 days) of injections were determined by the degree of the anterior chamber reaction and/or conjunctival hyperemia at the filtering bleb site. Punctate corneal erosions or filaments were not considered a contraindication to continuation of 5-FU treatment. After 12 months, intraocular pressure (IOP) of 16 mmHg or less without medical treatment was found in 19 (76%) eyes. In 16 of these (64%), the IOP was 12 mmHg or less. In two (8%) other eyes, it was 20 mmHg or less with medication. We believe that the comparatively low IOP levels achieved without medical treatment in 76% of the eyes in our study can be attributed in part to our therapeutic approach with 5-FU.

Adolescent↗

PubMed1993

Trabeculotomy in juvenile primary open-angle glaucoma.

Long-term results of trabeculotomy in juvenile primary open-angle glaucoma (JPOAG) were investigated based on a follow-up study of 16 eyes in 11 patients, diagnosed when they were between 10 and 45 years old. Preoperative visual field defects were found in 75% (12/16) of the eyes. After a mean follow up of 7 years (range, 1 to 18 years), 88% (14/16) of the eyes had an intraocular pressure (IOP) of 21 mm Hg or less (peak pressure at diurnal curves). Nine of these were receiving no medical treatment and five were being treated with beta-blockers and/or dipivefrin. The best results were in the younger patients; the success rate of those under age 40 years was 100%. After normalization of IOP, visual field testing showed no progression in defects. We conclude that trabeculotomy rather than filtering surgery should be used to treat JPOAG, because the success rate of filtering surgery decreases with decreasing age. Also, the good functional results achieved in these patients after normalization of IOP may indicate that ocular hypertension is the only risk factor in JPOAG.

Adolescent↗

PubMed1998

The effects of RGD (Arg-Gly-Asp) peptides on glaucoma filtration surgery in rabbits.

BACKGROUND AND OBJECTIVE: Integrins are the main mediators of the interaction between fibroblasts and extracellular matrix (ECM) during scar formation. The adhesion motive RGD (Arg-Gly-Asp) is contained in the ECM and is recognized by the integrin receptor. Soluble peptides containing the RGD sequence can compete with -RGD- contained in the ECM for binding to the integrin receptor and thus prevent cell adhesion and scar formation. MATERIALS AND METHODS: The peptides RGD (p602), GRGDSP (p603), GRGDSPCA (p604), and GGRGDSPCA (p605) were used in 25 glaucoma filtering surgeries in rabbits (five eyes per peptide and five with saline). RESULTS: Postoperative subconjunctival injections of peptides were given at days 0, 4, 8, 12, and 16. Bleb size, bleb survival, and signs of toxicity were examined. The GRGDSPCA and GGRGDSPCA showed an increase in bleb formation, size, and survival with no clinical signs of toxicity compared with controls (P < .008). Histopathologic evaluation confirmed inhibitory effects in scar formation with bleb formation, and transmission electron microscopy demonstrated that there was no toxicity to the ciliary body. CONCLUSION: These peptides were effective in controlling scar formation in glaucoma filtering surgery.

Animals↗

PubMed1995

[Posterior chamber intraocular lens implantation in filtered glaucoma eyes].

PURPOSE: To investigate the method of cataract extraction with posterior chamber intraocular lens implantation in eyes that had undergone glaucoma filtering surgery and its effect on filtering bleb. METHODS: Extracapsular cataract extraction with posterior chamber intraocular lens implantation was performed in 21 eyes with a preexisting filtration bleb, in which a lateral and inferior lateral limbal incison was selected, the pupil sphinctor was cut and the iris was sew for the small and fixed pupil. RESULTS: the postoperative visual acuity of all patients was improved in different degrees, with 0.5 or better in 76.19% of the eyes. The postoperative IOP increased by 0.41 kPa. The functional filtering bleb was not apparently cicatrized. CONCLUSIONS: Filtered glaucoma eyes with cataract can improve visual acuity and maintain the functional filtered bleb by extracapsular cataract extraction with posterior chamber intraocular lens implantation with lateral or inferior lateral limbal incision.

Aged↗

PubMed1999

Clinical phenotype of juvenile open-angle glaucoma linked to chromosome 1q in a Danish family.

PURPOSE: To describe in a Danish family the phenotype of members with autosomal dominant juvenile open-angle glaucoma linked to chromosome 1q, GLCA1, and to assess possible biometric differences between the eyes of affected and unaffected subjects. METHODS: Thirty-five subjects in a six generation family were examined. The records of five additional affected family members were available. Records from former examinations and treatments were also obtained. In 18 affected subjects and 13 unaffected subjects above 24 years biometric parameters were assessed and compared between the groups. RESULTS: The age at diagnosis of glaucoma was on average 18 years (range 8 to 33 years). Bilateral intraocular pressure was high at the time of diagnosis (mean 37 mmHg, range 28-69 mmHg). All subjects except two needed filtering surgery shortly after diagnosis (mean 1 year, range 0-8 years). Gonioscopy displayed open chamber angle and goniodysgenesis in all affected subjects, but no dysgenesis in unaffected subjects. A comparison of biometric parameters of affected and unaffected subjects showed a deeper anterior chamber, but no other differences were found. CONCLUSION: The phenotype of the affected family members is characterized by juvenile onset of glaucoma, open chamber angle with goniodysgenesis, high initial intraocular pressure, and the need for filtering surgery to control pressure. The deeper anterior chamber in affected subjects could indicate more extensive maldevelopment in affected subjects.

Adolescent↗

PubMed1987

Adjusting the dose of 5-fluorouracil after filtration surgery to minimize side effects.

The antimetabolite 5-fluorouracil (5-FU) was used as adjunctive treatment in glaucomatous eyes with poor prognoses undergoing filtering surgery. By adjusting the frequency of postoperative 5-FU subconjunctival injections according to the clinical response, the author thought it might be possible to reduce episcleral fibroproliferation and maintain a patent filter while reducing complications. Sixty-three eyes underwent filtering surgery with subsequent subconjunctival injections of 5.0 to 7.5 mg 5-FU for 14 days. The antimetabolite was not administered if there was evidence of corneal toxicity as demonstrated by epithelial defects or filaments, flat anterior chamber, or a conjunctival wound leak. By adjusting the injections in this fashion, the total amount of 5-FU administered ranged between 17.5 and 62.5 mg (34.4 +/- 11.6 mg). After 1 year, successful surgical outcomes were observed in 13/15 eyes with aphakia (87%), 11/17 eyes with neovascular glaucoma (65%), 11/12 eyes with at least two previous failed filters (92%), and 5/6 eyes with inflammatory glaucoma (83%). Eyes with epithelial downgrowth and cicatrizing diseases of the conjunctiva also were treated. Overall, conjunctival wound leaks were observed in 24% of the eyes and 29% had detectable changes in their corneal epithelium with corneal defects and filaments. Although adjusting the dose of 5-FU appears to be safe and effective, this can be determined clearly only by a controlled randomized clinical trial.

Adult↗

PubMedDate not supplied

Effect of cytokines on regulation of the production of transforming growth factor beta-1 in cultured human Tenon's capsule fibroblasts.

PURPOSE: Transforming growth factor-beta1 (TGF-beta1) is thought to play a pivotal role in the regulation of the wound healing process after glaucoma filtering surgery. The aim of the present study was to investigate whether platelet-derived growth factor isoforms (PDGF-AA, PDGF-BB), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), interleukin-1beta (IL-1beta) and transforming growth factor-beta1 (TGF-beta1) modulate the production of latent and/or active TGF-beta1 by cultured human Tenon's capsule fibroblasts (HTF). METHODS: Human Tenon's capsule fibroblasts were seeded at two different densities (30 cells/mm2 and 150 cells/mm2) and stimulated for five days with PDGF-AA, PDGF-BB, bFGF, EGF, IL-1beta and TGF-beta1. Control cells were treated with serum-free medium (WM/F12). The concentrations of latent and active TGF-beta1 in the medium were determined using an immunoassay before and after activation of TGF-beta1 by transient acidification. RESULTS: The concentration of latent TGF-beta1 in conditioned media from HTF seeded at high density (150 cells/mm2) significantly increased after stimulation with 5 ng/ml TGF-beta1 (151.5 +/-41.7 pg/ml) or 10 ng/ml IL-1beta (45.7+/-8.1 pg/ml). The concentration of active TGF-beta1 in conditioned media also significantly increased after stimulation of HTF with 5 ng/ml TGF-beta1 (48.4+/-27.5 pg/ml). CONCLUSIONS: The present results indicate that TGF-beta1 is the most potent inducer of its own synthesis in HTF. Activation of an autocrine TGF-beta1 loop may play a role in the wound healing response after glaucoma filtering surgery.

Cells, Cultured↗

PubMed1996

Effect of fibrostatin C, an inhibitor of prolyl 4-hydroxylase, on collagen secretion by human Tenon's capsule fibroblasts in vitro.

PURPOSE: To investigate the effect of fibrostatin C, a prolyl 4-hydroxylase (PH) inhibitor produced by Streptomyces catenulae subsp. griseospora, on type I collagen secretion by human Tenon's capsule fibroblasts (TCFs) in vitro, as an indication of the potential therapeutic efficacy of this compound in antifibrotic therapy after glaucoma filtering surgery. METHODS: The concentrations of type II procollagen COOH-terminal peptide (PIP) in culture medium or cell lysate were determined by immunoassays. For comparison with its effect on PIP secretion, we determined the effects of the agent on the secretion of other peptides, including laminin, vitronectin receptor, and a metalloproteinase inhibitor. The expression of collagens I and III, fibronectin, and PH by TCFs was examined by immunohistochemistry, and cellular ultrastructure was evaluated by transmission electron microscopy. RESULTS: Fibrostatin C (50 microM) significantly reduced the concentration of PIP in culture medium and increased its concentration in the cell lysate in a dose-dependent manner, but it had no effect on the secretion of other peptides. Cell viability and proliferation were not affected by fibrostatin C. Fibrostatin C also increased the number of cytoplasmic granules immunoreactive with antibodies to collagen I or III, but had no effect on fibronectin or PH immunoreactivity. Ultrastructurally, cisternae of the endoplasmic reticulum were dilated in fibrostatin C-treated TCFs, consistent with the retention of underhydroxylated collagen precursors in this organelle. CONCLUSIONS: Fibrostatin C inhibits the secretion of type I collagen by cultured TCFs. This agent may thus prove therapeutically beneficial for inhibiting the excess fibrosis in the wound of filtering surgery.

Aged↗

PubMed1983

Early and late failures of argon laser trabeculoplasty.

Sixty-five eyes in 52 patients with open-angle glaucoma were treated with argon laser trabeculoplasty (ALT). Although a majority of the eyes showed a decrease in intraocular pressure (IOP) of 5 mm Hg or more, eight eyes required filtering surgery within one year of treatment, and extensive peripheral anterior synechiae and persistent elevation of IOP developed in an additional two eyes that did not undergo surgery. In four of six eyes with juvenile glaucoma that were treated with ALT, complications developed and/or filtering surgery was required. A rise in IOP more than a year after treatment was noted in two eyes that had shown an initial satisfactory response to ALT. Although ALT seems to be a valuable addition to glaucoma therapy, the potential exists for both early and late complications and failures.

Glaucoma, Open-Angle↗

PubMed1999

[The use of antimetabolites in the treatment of glaucoma].

Many adjunctive therapies have been proposed to increase the success and prevent or reduce the incidence of complications associated with filtering surgery. Intraoperative or postoperative use of an antimetabolite has found a place as adjunctive therapy for eyes with otherwise pour prognosis following glaucoma filtering surgery.

Antimetabolites↗

PubMed1998

The contribution of phacoemulsification to combined cataract and glaucoma surgery.

The refinements of small incision cataract surgery by phacoemulsification with foldable intraocular lens implantation and the pharmacologic modulation of wound healing have brought new options for the combined procedure. Phacoemulsification combined with filtering surgery has the potential advantage of requiring a smaller conjunctival and scleral incision, which may reduce inflammation and bleb scarring with the possibility of enhanced bleb formation and long-term intraocular pressure control. The smaller phacoemulsification incision also helps to reduce postoperative astigmatism and improve visual results. Following combined phacoemulsification and filtering surgery, a larger area of undisturbed or virginal tissue in the conjunctiva and at the limbus is spared for further glaucoma surgeries or revision if the initial procedure fails. The risk of suprachoroidal hemorrhage during phacoemulsification in this susceptible group of patients is minimized by maintaining a closed chamber during the procedure.

Antimetabolites↗

PubMed1991

Risk factors associated with late infection of filtering blebs and endophthalmitis.

Late infection of filtering blebs and endophthalmitis are hazardous complications of glaucoma filtering surgery frequently associated with bleb failure and loss of functional vision. To determine possible risk factors for the development of these complications, characteristics of nine eyes of nine patients after filtering surgery in whom late endophthalmitis developed were compared with those in patients who had received a comparable operation at the same time in whom endophthalmitis did not develop. An average of 7.7 +/- 6.2 years (range, 6 months to 18 years) elapsed between the time of the filtering procedure and the initial appearance of endophthalmitis. Factors associated with increased risk were: increased axial length, thin and leaky bleb, conjunctivitis, upper respiratory infection, and the winter season.

Adolescent↗