Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Trabeculectomy”

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.

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

At least 289 records · Page 16Linked to original sources
PubMed1992

[Results of trabeculectomy in congenital glaucoma].

Congenital glaucoma has a very serious prognosis. It represents the first cause of blindness in Tunisian children. Trabeculectomy introduced by Cairns in 1968, was initially proposed as second-line treatment in congenital glaucoma surgery. It has now become more frequently used as first-line treatment in this indication. We have already used this technique directly in 35 children suffering from congenital glaucoma with a total of 54 eyes. Forty four eyes underwent a single operation, ten eyes underwent two to four trabeculectomies. Then study of these cases with a mean follow up of 24 months shows an overall success rate of 64% after one trabeculectomy, with or without additional medical treatment. The study of tonometric diagrams shows that the successful results obtained after 3 months persisted in the long term. Trabeculectomy gives better results in congenital glaucoma with intraocular pressure greater than 40 mmHg. Repeated operations are sometimes necessary. In these cases, postoperative subconjunctival 5 fluorouracil (SFU) did not improve the surgical outcome.

Child↗
PubMedDate not supplied

[The influence of the fixation of the scleral flap on the hypotensive effect of trabeculectomy].

The author analyzes 60 trabeculectomies with fixation of the superficial scleral flap by three nodular sutures (n = 24) and by one nodular suture (n = 36). He comes to the conclusion that trabeculectomy with scleral flap fixation by one nodular suture is preferable to its fixation with three sutures, for it creates better conditions for the formation of filtration pad and provides a more stable hypotensive effect, as evidenced by the results of three-year follow-up (75% vs. 41.6%). Nonetheless the author claims that fixation of the scleral flap with 3-4 sutures is desirable in cases when filtering trabeculectomy variants are deliberately employed or when trabeculectomy modifications with uveoscleral discharge stimulation are used.

Aged↗
PubMed1997

[Primary trabeculectomy in the surgery of primary open angle glaucoma].

OBJECTIVE: Comparative analysis of the results of trabeculectomy in the surgery of primary open angle glaucoma (POAG) as the primary therapeutical approach and after the medical treatment failure. MATERIALS AND METHOD: Retrospective study including two therapeutical groups: A (59 patients) with primary trabeculectomy; and B (60 patients) with trabeculectomy following a medical treatment failure; mean follow-up period was 3 years and 5 months. RESULTS: Postoperative drop in intraocular pressure was similar in the two groups; there is no statistical significant difference between the two groups regarding stationary disease (76.27% in group A, versus 73.33% in group B), regressive disease (6.8% versus 6.7% respectively) and progressive disease (18.6% in group A, versus 21.6% in group B). At an intraocular pressure < or = 21 mmHg 13.6% of glaucoma cases do progress. The rate of peroperative and postoperative complications is similar in the two groups. CONCLUSIONS: The prior medical treatment of glaucoma doesn't affect the evolution of operated POAG. Primary trabeculectomy is indicated for non-compliant patients and for patients in whom administration of combined medical treatment for short time periods doesn't lower the intraocular pressure at safe levels. Surgical treatment has the advantage of an important and constant lowering of the intraocular pressure which is an absolute requirement for an efficient control of advanced glaucoma.

Aged↗
PubMed2004

[The influence of cataract surgery on the efficacy of trabeculectomy in patients with open-angle glaucoma].

PURPOSE: To study the influence of cataract surgery on the intraocular pressure decreasing effect of trabeculectomy in patients with open angle glaucoma. METHOD: Retrospective study that included two groups: --32 patients with open angle glaucoma, their intraocular pressure being controlled after filtering surgery; they were subject to cataract surgery at least 6 months after the trabeculectomy (the CT group)--44 patients with open angle glaucoma (primary or secondary) with intraocular pressure controlled after trabeculectomy (the T group). The evaluation included: preoperative intraocular pressure, early (at 2 months) and late (at 18 months) postoperative intraocular pressure, intra- and postoperative complications of the cataract surgery, the need for antiglaucoma medication. RESULTS: The cataract surgery in patients with trabeculectomy increases the intraocular pressure (initial mean IOP = 15.31 mmHg, final mean IOP = 18.53 mmHg, mean IOP = 3.22 mmHg). The intraocular pressure increase is more important after extracapsular extraction than after phacoemulsification (3.7 vs. 2.01 mmHg). Qualified therapeutical success was obtained in 81.25% of CT patients. In the T group the postoperative intraocular pressure maintained constant throughout the entire follow-up period. The number of additional antiglaucoma drugs was larger in the T group (0.7 versus 0.5). The patients that suffered intra and postoperative complications had increased intraocular pressure when compared to those without complications (mean IOP early = 3.1 mmHg, mean IOP late = 1.1 mmHg). CONCLUSIONS: Cataract surgery in patients with previous filtering surgery increases the intraocular pressure and the need for antiglaucoma drugs. The intraocular pressure rise was more important after extracapsular extraction than after phacoemulsification. Intra and postoperative complications result in a more important increase in intraocular pressure, in the first months after the cataract operation.

Aged↗
PubMed2004

[Evaluation of retinal nerve fiber layer thickness in eyes with juvenile glaucoma after trabeculectomy].

PURPOSE: To examine the influence of intraocular pressure (IOP) decreasing after trabeculectomy on the retinal nerve fiber layer thickness (RNFL) in glaucoma in the youth. MATERIAL AND METHODS: Nineteen eyes of 12 patients at the age from 10 to 18, mean 13.6 years, treated for juvenile glaucoma were examined. All of them were operated on performing trabeculectomy. Before trabeculectomy and mean 14.9 months after operation IOP was measured and the RNFL thickness with laser scanning polarimeter GDx was estimated. RESULTS: Values of IOP before surgery ranged from 23 to 28, mean 25.3 mmHg and after surgery ranged from 12 to 24, mean 14.3 mmHg. Symmetry and superior integral did not change, p = 0.96 after surgery. Average thickness of RNFL before operation was 60.61 microm and after surgery 63.09 microm, p = 0.06, superior average 74.14 microm and 78.33 microm, p = 0.06, inferior average 70.54 microm and 72.42 microm relatively p = 0.14. CONCLUSIONS: Decreasing IOP after trabeculectomy allows to maintain preoperative values of retinal nerve fiber layer thickness in eyes with juvenile glaucoma.

Adolescent↗
PubMed1992

The protective effect of early intraoperative injection of viscoelastic material in trabeculectomy.

In a prospective study, we evaluated the effect of intracameral injection of sodium hyaluronate (HA) in trabeculectomy on short- and long-term results, including the effect on the corneal endothelium. Twenty-two patients were randomly assigned into two groups: group A, consisting of 11 patients, underwent standard trabeculectomy; in group B (11 patients), additionally, HA was injected into the anterior chamber immediately following paracentesis in an attempt to minimize shallowing of the chamber after the subsequent trabeculectomy. Both groups had comparable age distributions, preoperative intraocular pressures (IOPs), preoperative endothelial cell counts, postoperative IOPs after 3 months, and glaucoma medication indices. The reduction in the number of endothelial cells after 1 month was significantly greater in group A than in group B (16.1% vs 6.7%). Also, significantly more shallow anterior chambers occurred in group A (three eyes vs one eye). However, 1 day postoperatively, the average IOP was 16.4 mm Hg in group A, as compared with 25 mm Hg in group B. Thus, although HA, injected early in trabeculectomy, appeared to protect against corneal endothelial loss and flat anterior chamber, it also seemed to be associated with early IOP spikes.

Aged↗
PubMed2005

[Clinical results of fornix-based trabeculectomy with a scleral tunnel].

PURPOSE: To evaluate retrospectivery the efficacy and safety of fornix-based trabeculectomy with a scleral tunnel. PATIENTS AND METHODS: We studied the records of 204 eyes of 156 patients who underwent fornix-based trabeculectomy with mitomycin C as their primary surgery between 2000 and 2002 and had a follow-up period of 6 months or more. A 3.5 or 4 mm rectangular double scleral flap incision was made and a scleral tunnel was fashioned by removing the second flap to allow the aqueous to flow into the fornix side. RESULTS: The mean intraocular pressure was significantly decreased from 22.2 +/- 7.8 (mean +/- standard deviation) mmHg to 12.4 +/- 3.9 mmHg 2 years after surgery (p < 0.0001). When the target pressure was defined as 15 mmHg, the 2-year survival rate using the Kaplan-Meier survival analysis was 69.1 %. Early wound leakages occurred in 16 eyes (7.8%) and additional sutures were needed on 13 eyes. The visual acuity of 22 eyes (11.0%) decreased by at least 2 lines. CONCLUSION: Although there are some complications specific to trabeculectomy, fornix-based trabeculectomy with a scleral tunnel appears to be an effective method of decreasing intraocular pressure.

Adult↗
PubMed2004

[The influence of viscoelastic's maintenance in the anterior chamber on early results and complications after trabeculectomy].

PURPOSE: The evaluation of intraocular pressure and number of complications in the early postoperative period in patients after trabeculectomy with viscoelastic agent used to recreate the anterior chamber at the end of procedure. MATERIAL AND METHODS: Between November 2001 and February 2002, in 56 patients (58 eyes) with primary open-angle glaucoma trabeculectomy was performed. Patients were divided into two groups. Trabeculectomy was performed with leaving the viscoelastic agent (Provisc) in the anterior chamber at the end of surgery in 29 eyes of 28 patients (Group A), while in 28 patients (29 eyes) the anterior chamber was filled with Ringer solution (Group B). Preoperative IOP in group A ranged from 19 to 48 mmHg, mean--28.41 mmHg. In group B it ranged between 19 and 41 mmHg, mean--25.07 mmHg. The follow-up time was 1 month in every case. RESULTS: The mean IOP on the first, fifth, 14th and 30th day after surgery was 14.0 mmHg, 13.2 mmHg, 12.03 mmHg and 11.76 mmHg respectively in group A, while in group B corresponding values were: 9.0 mmHg, 8.97 mmHg, 8.83 mmHg and 8.9 mmHg. The shallowing of anterior chamber and choroidal detachment were observed in 4 eyes (13.8%) in group A and in 8 eyes (27.6%) in group B postoperatively. The increased IOP during first days after surgery was observed in 3 cases (10.3%) in group A. CONCLUSIONS: The viscoelastic agent left in the anterior chamber at the end of trabeculectomy significantly decreases the frequency of anterior chamber shallowing and choroidal detachment and reduces number of cases with hypotony.

Adjuvants, Immunologic↗
PubMed1987

Primary congenital glaucoma clinical presentation and evaluation of modified trabeculectomy.

Primary congenital glaucoma is a relatively rare condition. A study on this subject to observe the mode of clinical presentation in our country and to evaluate the role of modified technique of trabeculectomy was undertaken. 30 eyes of 17 patients having primary congenital glaucoma were studies. The examination under general anaesthesia included (a) Anterior segment examination under operating microscope, (b) Corneal diameter measurement, (c) Fundus examination (d) IOP measurement and (e) Gonioscopy. The patients were subject to modified trabeculectomy operation. The assessment of the surgery was done during post-operative examination carefully. This paper includes an analysis of various clinical features of this condition. The observations revealed that the presenting symptoms are slightly different in our country compared to those in the developed countries. The overall success rate with our modified technique of trabeculectomy was 72.4 percent. Since most of our patients present with corneal opacity, we feel that modified trabeculectomy is a very effective surgical method for such cases.

Child, Preschool↗
PubMed1993

A modified removable suture in trabeculectomy.

We modified the closure of the scleral flap in trabeculectomy by using an externalized hemibow tie, easily removable in the early postoperative period. We used this externalized knot in 20 eyes of 17 patients undergoing trabeculectomy and in eight eyes of seven patients undergoing combined trabeculectomy and cataract extraction with intraocular lens implantation. The sutures were removed between 2 and 72 days after surgery (16.75 +/- 14.49 days). With a mean follow up of 11.36 months, the overall success rate was 78.6%. The sutures of nine eyes (32%) were removed due to elevated intraocular pressure and/or decreased bleb size. The immediate and long-term efficacies were 77% and 56%, respectively. The trabeculectomies we performed using this safe and simple technique, as compared with those using other methods of scleral flap closure, provided a lower incidence of postoperative complications due to overfiltration, and made it possible to increase the degree of filtration when needed during the early postoperative period.

Aged↗
PubMed1993

Trabeculectomy with 5-fluorouracil vs single-plate Molteno implantation.

We compared the results achieved in 22 consecutive patients who underwent single-plate Molteno implantation, with those achieved in a matched group who had trabeculectomy with postoperative 5-fluorouracil. Six months following surgery, the average intraocular pressure (IOP) in the Molteno group was 15.4 +/- 8.0 mm Hg, and in the trabeculectomy group, 16.1 +/- 5.6 mm Hg (P = .920). A mean of 1.4 antiglaucoma medications were being used in each group (P = .776). Complications following Molteno implantation included six tube revisions and three flat anterior chambers; following trabeculectomy, eight serous choroidal detachments and nine positive Seidel tests. This study suggests that Molteno implantation and trabeculectomy with adjunctive 5-fluorouracil provide similar IOP control, but that the two procedures are associated with different types of complications.

Adult↗
PubMed1996

Topical cyclosporine as a possible new antimetabolite in trabeculectomy.

BACKGROUND AND OBJECTIVE: The authors conducted a randomized, prospective, and controlled clinical and transmission electron microscopic study to investigate the possible role of cyclosporine in trabeculectomy as an antimetabolite agent. PATIENTS AND METHODS: Twelve patients underwent trabeculectomy with topical cyclosporine and another 12 patients had trabeculectomy without cyclosporine. RESULTS: There was a statistically significant decrease in the postoperative intraocular pressure (P < .05) and in the number of medications needed postoperatively (P < .01) in the cyclosporine group. There were no significant complications in either group. Transmission electron microscopic examinations of the excised trabecular scleral tissue showed that cyclosporine caused inhibition of fibroblasts and led to a disruption in collagen organization at the level of the surgical dissection. Middle scleral layers were generally not affected except in some cyclosporine-treated eyes, which showed only a mild cytopathic effect. CONCLUSION: This study showed that topical cyclosporine was safe and effective for use as an antimetabolite in trabeculectomy. Further studies are needed to substantiate the adjuvant role of cyclosporine in glaucoma filtering operations.

Administration, Topical↗
PubMed1995

[Effect of local medications on intraocular pressure control following trabeculectomy].

Longterm administration of topical antiglaucoma therapies had been indicated to be a serious risk for failure of trabeculectomy through inducing a subclinical inflammation of conjunctival tissues and stimulating secondary fibroblastic proliferation. Our study had 3 main aims: (1) to check if this pejorative effect is present in our population of glaucomatous patients, (2) in order to improve the rate of surgical success in theoretically high risk patients (duration of topical treatment longer than 36 months), to determine the usefulness of the following actions: suppression of beta blocking agents 8 days before surgery, suppression of miotics and eventual topical administration of fluorometholone one month before surgery. (3) to correlate the observed clinical results to the cellular profile of preoperative conjunctival biopsies. We presented in a first step the results of a retrospective analysis including 88 trabeculectomies performed between January '93 and April '95 in 62 GCAO patients older than 40 years and without any previous ocular surgery. The mean age of patients was 66,8 years (41 to 87 years). Patients were classified into "complete success", "qualified success" and "failures" according to the "target" IOP was or was not reached in the last examination. Mean follow up was 5,8 months (1 to 26 months). The second prospective part of our study included 20 trabeculectomies performed in 16 patients we chose according to the nature, the duration of the preoperative topical therapy and the preoperative eventual preparation of the conjunctiva. This study also included a semiquantitative count of the different conjunctival cellular colonies in peroperative biopsies. Mean follow up of this study was 2,3 months (1 to 5 months). 31 "complete success", 52 "qualified success" and 5 "failure" were observed in the retrospective study. The reduction of IOP following trabeculectomy was statistically significant at all examinations (mean IOP in the last examination: 14,9 +/- 4,3 mmHg) but the level of success was not significantly different according to the nature, (mono against polytherapy), the duration of preoperative medical topical treatment, as well as the preoperative actions in order to improve the operative success in high risk patients. Preliminary results of our second prospective study did not yet show any failure and did not exhibit any clear correlation between the counts of the different cellular colonies and the level of operative success on one hand and the different topical therapies in the other hand. The results and limitations of this study were compared to those of the literature.

Adrenergic beta-Antagonists↗
PubMed1996

Trabeculectomy--success rates in a Singapore hospital.

Previously published papers on the success of trabeculectomy as a treatment for glaucoma show success rates between 67% and 84%. The success rate of trabeculectomy in Afro-Carribean patients was observed to be lower than in Caucasian patients. It has been commonly believed that the success rate of trabeculectomy in Oriental/Asian eyes would lie somewhere between these. We reviewed the records of 51 consecutive trabeculectomies performed in the National University Hospital, Singapore and found that our success rate was lower-43.1% overall and 48.7% for primary glaucomas.

Adult↗
PubMed1996

Surgical results and complications of trabeculectomy with intraoperative application of mitomycin C.

Trabeculectomy is reportedly less effective in aphakic eyes, secondary glaucoma, juvenile patients, and eyes with a history of unsuccessful glaucoma surgery. We evaluated the surgical effects and complications of trabeculectomy with the adjunctive use of mitomycin C, an antiproliferative drug, in a number of refractory cases. Forty patients (50 eyes) with refractory glaucoma were treated with trabeculectomy and the adjunctive use of mitomycin C and were followed postoperatively for at least 3 months. The mean follow-up period was 13.6 +/- 7.5 months (range: 3 to 31 months). In 43 eyes (86%), intraocular pressure was well controlled at < or = 21 mmHg. Complications included corneal epithelial damage (30 eyes), shallow anterior chamber (20 eyes), hyphema (19 eyes), choroidal detachment (18 eyes), leakage of aqueous humor from the conjunctival wound (4 eyes), and endophthalmitis (1 eye). The results of trabeculectomy with intraoperative use of mitomycin C in this series of procedures demonstrates that this can be a useful and effective treatment; however, mitomycin C may cause transient decreased visual acuity due to inhibited wound healing and the resultant overfiltration.

Adolescent↗
PubMed1996

The results of ab interno laser thermal sclerostomy combined with cataract surgery versus trabeculectomy combined with cataract surgery 6 to 12 months postoperatively.

BACKGROUND AND OBJECTIVE: When cataract surgery and glaucoma surgery are combined, the theoretical advantages of pressure control, removal of the visual impairment, and protection against an increase in intraocular pressure (IOP) in the immediate postoperative period are gained. The authors' objective was to determine whether ab interno laser thermal sclerostomy (LTS) combined with cataract surgery would be as effective as trabeculectomy combined with cataract surgery. PATIENTS AND METHODS: Ab interno LTS was compared with trabeculectomy, retrospectively, for patients who had undergone combined cataract and glaucoma surgery. RESULTS: There was no significant difference in the numbers of patients using no medications or fewer medications at 6 and 12 months. There was a greater reduction in IOP in the LTS group. CONCLUSIONS: LTS may be better than trabeculectomy in combined cataract and glaucoma surgery because it reduces the IOP more. Compared with trabeculectomy, LTS is simpler to perform and adds less operating time to cataract surgery. Continued follow-up is recommended.

Adult↗
PubMed1997

Trabeculectomy with mitomycin-C for postkeratoplasty glaucoma: a preliminary study.

BACKGROUND AND OBJECTIVE: To evaluate the safety and efficacy of trabeculectomy with mitomycin-C in the management of postkeratoplasty glaucoma. PATIENTS AND METHODS: Included in this study were 16 eyes of 16 patients who underwent trabeculectomy with mitomycin-C for medically uncontrolled postkeratoplasty glaucoma, each having at least 6 months of follow-up. RESULTS: The mean pretrabeculectomy intraocular pressure (IOP) with maximal medical therapy was 34.6 mm Hg (range 24-45 mm Hg). The mean IOP following trabeculectomy with mitomycin-C was 14.2 mm Hg (range 8-36 mm Hg) by the end of a mean follow-up of 14.2 months (range 8-32 months). Fourteen eyes (87.5%) had complete success, 1 eye (6.25%) had qualified success, and 1 eye (6.25%) had failure. All the patents had the same or better visual acuity, compared with the preoperative value. None of the patients had postoperative complications, such as shallow anterior chamber, epithelial defect, or hypotony. CONCLUSIONS: Trabeculectomy with mitomycin-C is a safe and effective modality in the management of medically uncontrolled postkeratoplasty glaucoma.

Administration, Topical↗
PubMed1997

Midterm reversible failure in trabeculectomies with adjunctive mitomycin-C.

BACKGROUND AND OBJECTIVES: Trabeculectomies usually fail early (< 21 days) or late (> 6 months) when no antifibrotic agent is used. Failure is uncommon during the midterm period, between 3 weeks and 6 months. The purpose of this study is to verify the incidence of failure of trabeculectomies with mitomycin-C (MMC) during the midterm period and to evaluate the safety and efficacy of laser suture lysis (LSL) for reversing it. PATIENTS AND METHODS: The authors reviewed the records of 130 consecutive patients who underwent trabeculectomy with adjunctive MMC. RESULTS: Fourteen patients (15 eyes) had increased intraocular pressure (IOP), between 21 and 185 days (median 41 days). LSL was effective in decreasing the IOP to acceptable levels in 10 (66.6%) of the 15 eyes. No complications related to LSL were noticed. CONCLUSION: The reversibility of midterm failure seems to be a unique feature of trabeculectomies with MMC.

Adult↗