Search PubMed⌕ Search

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.

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

At least 307 records · Page 17Linked to original sources
PubMed1997

Lack of corneal toxicity of interferon Alpha-2b administered subconjunctivally after sclerectomy.

PURPOSE: To evaluate the corneal toxicity of subconjunctival injection interferon alpha-2b at filtering bleb after sclerectomy in white rabbits. METHODS: Eight rabbits which had been performed sclerectomy were randomly divided into two groups. Each group consisted of four rabbits. Eight eyes in group 1 were subconjunctivally received interferon alpha-2b 5 x 10(5) IU/0.2 ml into filtering bleb from the edge of the filtering site immediately after operation and every postoperative day. The other eight eyes in group 2 were injected with 0.2 ml normal saline. All of the eyes underwent daily examination by slip-lamp microscopy and direct ophthalmoloscopy. Sodium fluorescein was used to assess corneal epithelial integrity. On day 3, 4, 7 and 14, every two rabbits (group 1 and 2 each, respectively) were killed and removed cornea immediately to take examination of the viability of corneal endothelium by dual staining with typan blue and alizanin red S. RESULTS: No sign of toxicity in corneal epithelium and endothelium were found following continuously injection interferon alpha-2b at filtering bleb 3-14 days totally for selected doses. CONCLUSION: Subconjunctivally administered interferon alpha-2b at filtering bleb after glaucoma filtering surgery may be a safe drug-applied method.

Animals↗
PubMed2001

[Glaucoma after extremely severe chemical and thermal eye burns. Surgical possibilities].

BACKGROUND: Late secondary glaucomas after severe chemical or thermal eye burns are associated with diagnostic and surgical difficulties. Routine filtering surgery (trabeculectomy) has a low success rate. In these eyes aqueous shunt implantation and cyclophotocoagulation are alternative procedures. PATIENTS: In our retrospective study, the records of 12 patients with 14 severe eye burns (grade IV) were analyzed. Nine eyes were treated with an aqueous shunt device (six von Denffer and three Ahmed implants). Diode laser cyclophotocoagulation (Iris Medical Instruments) was performed in five eyes. The mean time interval between surgery and accident was 88.3 months (aqueous shunt) and 32.8 months (cyclophotocoagulation). RESULTS: The mean follow-up was 45 +/- 36 months (von Denffer implant), 38 +/- 5 months (Ahmed implant), and 11 +/- 8 months (cyclophotocoagulation). Intraocular pressure (IOP) was reduced from 39 +/- 7 to 23 +/- 6 (von Denffer implants) and from 38 +/- 3 to 8 +/- 10 (Ahmed implants). Mean IOP before treatment with cyclophotocoagulation was 33 +/- 8 and 18 +/- 2 after treatment. Systemic carbonic anhydrase inhibitors were stopped in all patients. Visual acuity deteriorated in five of nine eyes treated with aqueous shunt devices and was unchanged or better in all eyes treated with cyclophotocoagulation. Multiple re-operations were necessary after aqueous shunt implantation. Severe complications leading to failure in these eyes were encapsulated bleb in four eyes, expulsive hemorrhage in one eye, and phthisis in one eye. Cyclophotocoagulation was repeated in two eyes. Severe complications were not observed. CONCLUSION: IOP reduction was effective and comparable in both procedures. Because of the high incidence of severe complications after shunt surgery, we prefer cyclophotocoagulation for the treatment of intractable glaucoma after severe eye burns.

Adult↗
PubMed1999

Effect of the cytostatic agent idarubicin on fibroblasts of the human Tenon's capsule compared with mitomycin C.

BACKGROUND/AIMS: To investigate the in vitro effect of a short time exposure to the anthracycline idarubicin on proliferation, protein synthesis, and motility of human Tenon's capsule fibroblasts in comparison with the antitumour antibiotic mitomycin C. METHODS: After determination of effective concentrations of idarubicin, fibroblasts of the human Tenon's capsule were exposed to idarubicin or mitomycin C at concentrations ranging from 0.1 microg/ml to 1 microg/ml or from 2.5 microg/ml to 250 microg/ml, respectively, for 0.5, 2, or 5 minutes and cultured for 60 days. Cell death by apoptosis caused by idarubicin treatment was confirmed by Hoechst 33258 staining. Further proliferation was explored by cell counting and by (3)H-thymidine uptake. Protein synthesis was measured by (3)H-proline uptake and motility was assessed by agarose droplet motility assay. RESULTS: Idarubicin is able to exert toxicity and to induce apoptosis during a short time exposure of 0.5 minutes at concentrations of 0.3-1 microg/ml resulting in a significant reduction in cell number compared with the control after 60 days. For mitomycin C, higher concentrations and longer expositions were necessary. Even after treatment with 1 microg/ml idarubicin or 250 microg/ml mitomycin C a few cells were able to incorporate (3)H-thymidine. (3)H-proline uptake up to 10 days after exposure to 0.3 microg/ml idarubicin was found not to be decreased. Cell motility was reduced after treatment with 1 microg/ml idarubicin for 5 minutes or with 250 microg/ml mitomycin C for 2 or 5 minutes. For low mitomycin C concentrations, an increase in motility was found during the first 10 days. CONCLUSION: Idarubicin reduces proliferation of human Tenons's capsule fibroblasts after incubation for 0.5 minutes at concentrations as low as 0.3-1 microg/ml. In comparison, mitomycin C requires longer exposure times and higher doses for equal results. Therefore, idarubicin may be useful in the prevention of glaucoma filtering surgery failure.

Antibiotics, Antineoplastic↗
PubMed2003

Five year results of viscocanalostomy.

AIM: To prospectively study the success rate and complications of viscocanalostomy, a non-penetrating glaucoma surgery. METHODS: Prospective non-randomised consecutive case series of 57 eyes (57 patients) with medically uncontrolled primary and secondary open angle glaucoma. Viscocanalostomy was performed on all participants with injection of viscoelastic in the surgically created ostia of Schlemm's canal as well as in the scleral bed, the superficial scleral flap was loosely sutured. Intraocular pressure, visual acuity, and number of goniopunctures were measured. RESULTS: The mean follow up period was 34.1 months. The mean preoperative intraocular pressure (IOP) was 24.6 mm Hg; while the mean postoperative IOP was 5.6 mm Hg at day 1 and 13.9 mm Hg at 36 month. Patients who achieved IOP below 21 mm Hg with or without medication were 90% at 60 months, complete success rate (IOP<21 mm Hg without medication) was 60% at 60 months. 21 patients (37%) needed Nd:YAG goniopuncture postoperatively to control raised IOP, mean time for goniopuncture application was 9.4 months, mean pre-goniopuncture IOP was 20.4 mm Hg and mean postgoniopuncture IOP was 12.6 mm Hg (p <0.0001). CONCLUSION: Viscocanalostomy appears to be a promising modification of filtering surgery.

Aged↗
PubMedDate not supplied

[Experimental study of cytokines complex inhibitory effect on wound healing after glaucoma filtering operations: histopathological and immunochemical findings].

Experiments on a model of glaucoma filtering operation in 25 rabbits showed that the natural cytokine complex inhibited the operation wound healing in comparison with the control. The complex was prepared by an original method (culturing peripheral blood leukocytes) at Immunology Department of the Russian State Medical University. Histopathological study revealed delayed formation of cicatricial tissue under the effect of cytokines. Decreased proliferation of fibroblasts and their decreased functional activity (decreased synthetic activity of glycosaminoglycanes and collagen) was detected in cicatricial tissue. Immunohistochemical studies showed that in remote periods (after 3-8 months) type IV membrane collagen formed in new cicatricial tissue, while in the control, types III and I collagens predominated in cicatricial tissue. Immunohistochemical structure of the cicatrix in experiment correlated with fine fibrous structure of cicatricial tissue, characterized by high permeability. Possible mechanisms of the inhibitory effect of the natural cytokine complex on the course of operation wound healing after glaucoma-filtering surgery are discussed.

Animals↗
PubMed2000

Risk factors for glaucoma filtering bleb infections.

OBJECTIVE: To determine risk factors for bleb-related ocular infection after glaucoma filtering surgery. METHODS: A case-control study comparing all consecutive cases of glaucoma filtering bleb-related infections (55 eyes of 55 patients) with matched control eyes between January 1, 1990, and June 30, 1998, was performed. Bleb-related infection was classified as blebitis when a mucopurulent infiltrate was identified within the bleb and associated with mild to moderate anterior segment inflammation. Eyes with endophthalmitis had hypopyon, cells in the anterior vitreous cavity, or a positive vitreous biopsy sampling result. A control was selected for each case based on matching of the surgeon, date and type of glaucoma surgery, and type of antifibrotic agent used. Multivariate, matched, case-control logistic regression analysis was performed using age, race, sex, diagnosis, number of previous incisional operations, filtering bleb location, and presence of bleb leak to determine which variables were associated with bleb-related infection. RESULTS: The odds of an eye with a bleb-related infection being seen with a concomitant late-onset bleb leak are 25.8 times the odds of a noninfected eye having a late-onset bleb leak at any time in the postoperative period (P<.001; 95% confidence interval, 2.3-294.1). Other risk factors for bleb-related infection included younger age (P = .05), black race (P = .03), diagnosis of primary open-angle glaucoma (P = .03), and inferior location of the filtering bleb (P = .04). CONCLUSIONS: Late-onset bleb leakage is a significant risk factor for bleb-related infection. The risk of infection may warrant closure of late-onset bleb leaks in selected eyes.

Aged↗
PubMed1998

[Ocular tissue concentrations and results of filtration surgery after topical use of mitomycin C in rabbits].

We measured mitomycin C (MMC) concentrations in rabbit ocular tissues, using high-performance liquid chromatography, after the subconjunctival application of surgical sponges which had absorbed various doses (0.1, 0.2 or 0.4 mg) of MMC and with varying duration of application (1, 3, or 5 minutes). MMC concentrations at the administered site showed a significant correlation with the dose and duration of application. In multiple regression analysis the MMC concentration (microgram/g) in the conjunctiva was -6.73 + 67.4 x dose (mg) + 1.66 x time (minutes) (R-square 0.65); in the sclera, -1.85 + 38.2 x dose + 0.927 x time (R-square 0.63); and in the corena, -0.727 + 8.44 x dose (R-square 0.46). We also compared the results of filtering surgery on rabbits using 0.2 mg MMC intraoperative exposure of 1, 3, 5 minutes or 5-minute application of distilled water (control). The duration of maintained intraocular pressure reduction and filtering bleb was significantly longer in MMC-treated group (1 minute; 15 +/- 7.1, 3 minutes; 27 +/- 14.3, 5 minutes; 29 +/- 18.6 days, mean +/- standard deviation) than in the control group (7 +/- 3.7 days). Among the MMC-treated groups, good results were maintained significantly longer in the 3- or 5-minute application groups than in the 1-minute group. There was no difference between the 3-minute group and the 5-minute group.

Animals↗
PubMedDate not supplied

Trabeculectomy in the management of Posner-Schlossman syndrome.

Posner-Schlossman syndrome (glaucomatocyclitic crisis) is a condition of unknown etiology. Patients present with blurred vision, show minimal anterior chamber activity, and raised intraocular pressure (IOP). Corneal edema may cause colored halos. The condition tends to be recurrent, usually responding to a topical steroid and ocular hypotensives. The eyes appear normal between attacks. We present a patient who had bilateral Posner-Schlossman syndrome and underwent filtering surgery to control raised intraocular pressure in both eyes. During the follow up of more than 4 years, the control of IOP was good and he had no further attacks.

Adult↗
PubMed2001

Effect of cataract surgery on intraocular pressure in eyes with previous trabeculectomy.

PURPOSE: To determine the course of the intraocular pressure in eyes in which cataract surgery was performed after trabeculectomy. METHODS: This was a retrospective study of consecutive patients who were scheduled for routine cataract surgery. The patients had previously undergone glaucoma filtering surgery. Pre- and postoperative data were evaluated. Both the status of glaucoma and the increase in visual acuity were monitored. RESULTS: Patients operated on over a six-year period were enrolled. The mean interval between glaucoma surgery and cataract surgery was 58.1 months. The mean duration of follow-up after cataract surgery was 31.4 months, with a minimum of 12 months. The mean central visual acuity increased by 4 lines. Before cataract surgery, 53% of the eyes had complete success (group 1), while 28% had qualified success (group 2) and the remaining 19% were failures (group 3). From group 1, 61% remained a complete success until the last visit. No eye of group 1 developed a failure. In group 2, 23% were a complete success at the final follow-up, while 4% failed. In group 3, only 35% were failures while the remaining 65% were a complete or qualified success. CONCLUSIONS: Eyes with a well-controlled intraocular pressure following trabeculectomy seem to have a favorable prognosis after subsequent cataract surgery. Eyes with qualified success or failure before cataract surgery have a slight chance of improvement in intraocular pressure control. Cataract surgery had no markedly negative effect on the intraocular pressure overall. Performing trabeculectomy and cataract surgery at different times may still be a feasible option as opposed to combined procedures.

Adult↗
PubMed1991

Cytokines, fibrosis and the failure of glaucoma filtration surgery.

Current therapies for the prevention of fibrosis after glaucoma filtering surgery can be effective but often produce unwanted side effects. An understanding of the cellular basis of the fibrotic reaction may lead to better treatments. Wound repair revolves around angiogenesis and the activation of fibroblasts by cytokines. These peptides, a number of which have been described, act together in intricately complicated networks to encourage fibroblast chemotaxis, proliferation and contractility, as well as to stimulate the production of glycosaminoglycans and collagen. Since interferons seem to inhibit many of these responses, they deserve further evaluation in the treatment of ocular fibrosis.

Cytokines↗
PubMed1994

Depot drug delivery system for 5-fluorouracil after filtration surgery in the rabbit.

We investigated the potential value of 50:50 poly (DL glycolic acid-lactic acid) (PGLA) copolymer as a degradable depot delivery system for 5-fluorouracil (5-FU) after filtration surgery. Analysis of retrieved discs after implantation in 22 eyes of 22 pigmented rabbits showed a dual drug release profile and polymer mass loss characteristics. In a second group of pigmented rabbits implantation of PGLA discs impregnated with 5-FU (22 eyes) significantly lengthened the survival time of filtration fistulae compared with discs without 5-FU (18 eyes) or no disc (10 eyes) (p < 0.0001). Use of PGLA copolymer impregnated with 5-FU could prove valuable for patients undergoing glaucoma filtering surgery.

Animals↗
PubMedDate not supplied

Postsurgical hypotony: relationship to fistulization, inflammation, chorioretinal lesions, and the vitreous.

Hypotony is a natural occurrence, symptom, and complication of surgical treatment. With more sophisticated and aggressive techniques, postsurgical hypotony recently has been given increased attention as an obstacle to success of surgery for glaucoma and retinal detachment. Whereas two standard deviations below normal pressure (15.9-5.8 = 10.1 mm Hg) can be called hypotonous, most eyes, depending on scleral rigidity, lid pressure, eye rubbing, or corneal or retinal edema, will be symptomatic at < 5 mm Hg. Hypotony can be defined as the low pressure (whether acute, transient, chronic or permanent) which, in an individual eye, leads to functional changes (whether asymptomatic or symptomatic) and structural changes (whether reversible or irreversible). Depending on its duration and degree, postsurgical hypotony produces characteristic tissue changes that often are modified by, but separate from, the tissue changes caused by an underlying disease or its surgical treatment. This review summarizes the situations, variably associated with hypotony, that occur after such interventions as cataract extraction, filtering surgery, cyclodialysis, cyclodestruction, and vitreoretinal surgery, in addition to the reported pathomechanisms of hypotony and its proposed treatments.

Choroid Diseases↗
PubMed1998

Post-penetrating keratoplasty glaucoma: risk factors, management and visual outcome.

PURPOSE: To evaluate the incidence, associated risk factors, graft status and treatment modalities in patients with post-penetrating keratoplasty glaucoma. METHODS: A retrospective analysis of 747 consecutive penetrating keratoplasties was undertaken at a tertiary eye care centre. The frequency of post-penetrating keratoplasty glaucoma was determined and correlated with the pre-operative corneal diagnosis, lens status and associated surgeries performed during penetrating keratoplasty. The response to antiglaucoma therapy (i.e. medical, surgical or cyclo-destructive procedures) and graft outcome was also evaluated. RESULTS: The incidence of post-penetrating keratoplasty glaucoma was 10.6% (79/747). Pre-operative corneal diagnosis of adherent leucomas was significantly associated with the development of postoperative glaucoma. Post-penetrating keratoplasty glaucoma was significantly higher in aphakes (odds ratio (OR) 6.6; confidence interval (CI) 3.81-11.69) compared with phakic or pseudophakic eyes. Associated vitrectomy (OR 2.32; CI 1.16-4.73) and anterior segment reconstruction (OR 3.31; CI 1.43-7.72) were other high-risk factors. Most patients responded to medical therapy (41/79; 51.9%), whereas filtering surgery and cyclo-destructive procedures were performed in 29.1 (23/79) and 19% (15/79) of eyes, respectively. Despite clear grafts in 39 eyes (49.4%), visual acuity of 6/18 or better was achieved in 15 eyes (18.9%). CONCLUSIONS: A high incidence of post-penetrating keratoplasty glaucoma occurs in eyes with adherent leucomas. Anterior vitrectomy and associated surgeries further accentuate the risk Anti-glaucoma therapy may not achieve optimum visual outcome, despite a clear graft.

Antihypertensive Agents↗
PubMed2001

Is Posner Schlossman syndrome benign?

PURPOSE: To determine the clinical course of patients with Posner Schlossman syndrome (PSS). DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Fifty-three eyes of 50 patients. METHODS: The case notes of all patients with PSS seen at the Uveitis Clinic of Singapore National Eye Centre were reviewed for evidence of glaucoma damage and risk factors. MAIN OUTCOME MEASURES: Visual field and optic disc changes consistent with glaucoma. RESULTS: There were 28 men and 22 women, and their mean age at onset was 35 years. Fourteen eyes (26.4%) were diagnosed to have developed glaucoma as a result of repeated attacks of PSS. Patients with 10 years or more of PSS have a 2.8 times higher risk (95% confidence interval 1.19-6.52) of developing glaucoma compared with patients with less than 10 years duration of the disease. Nine eyes (17%) underwent glaucoma filtering surgery with antimetabolites. Their postoperative follow-up ranged from 15 to 50 months (mean, 37 months). Four eyes continued to have episodes of iritis after surgery, and one of these eyes had elevated intraocular pressure during the event. CONCLUSIONS: A significant number of patients with PSS have glaucoma develop over time, and they need to have their optic disc appearance and visual fields carefully monitored.

Adolescent↗
PubMed1997

[Injectable bioerodible polymer with 5-fluorouracil used in filtration surgery in rabbits].

OBJECTIVE: A prospective randomized and placebo-controlled study was performed to evaluate the effect and toxicity of injectable bioerodible polymer with 5-fluorouracil (5-Fu) on the filtration surgery in rabbits. METHODS: Posterior lip sclerectomies were performed on both eyes of 23 rabbits. Injectable bioerodible polymer impregnated with 2.5% 5-Fu 10 mg was injected subconjunctivally in 16 eyes, and 2.5% 5-Fu 10 mg was injected subconjunctivally in 14 eyes every other day for three times in the first week and every two days for three times in the second week post-operatively. Another 16 eyes received the drug-free polymer after surgery and served as controls. RESULTS: The bleb in the eyes treated with drug-free polymer failed in the postoperative 7 days and the bleb in the eyes treated with 5-Fu injection failed in 20-30 days, while the bleb in the eyes treated with 5-Fu polymer remained successful throughout the experimental period. From 7 to 30 postoperative days, the rate of scleral fistula occlusion was 6.7% in the eyes treated with 5-Fu polymer, 41.7% in the eyes treated with 5-Fu injection and 100% in the eyes treated with drug-free polymer. Corneal epithelial defects appeared in 3 eyes treated with 5-Fu polymer, in 8 eyes treated with 5-Fu injection and in 2 eyes treated with drug-free polymer. CONCLUSION: Injectable bioerodible polymer with 5-Fu may significantly prevent bleb scarring and subsequent blockage of the filtering tract, enhance success rate of filtering surgery in rabbits and reduce the toxicity of 5-Fu. This drug delivery system has considerable value for clinical use.

Animals↗
PubMed2001

[The expression of growth factors in filtering area following sclerectomy and the interaction between growth factors and interferon].

OBJECTIVE: To study the expression of beta-Fibroblastic Growth Factor (bFGF) and Transforming Growth Factor beta 1 (TGF beta 1) in filtering area following sclerectomy and the interaction between growth factors and interferon alpha-2b (IFN alpha-2b). METHODS: Immunohistochemical technique were applied to test the expression bFGF and TGF beta 1 in frozen sections of filtration area following sclerectomy on postoperative day three, five, seven and 14 in white rabbits, respectively. 16 eyes of eight rabbits in all were randomly and equally divided into two groups. The experimental eyes had subconjunctivally been administered IFN alpha-2b 5 x 10(5) IU 0.2 ml each time at filtering bleb following operation whereas the control eyes hadn't taken. RESULTS: In control group, positive cell and substance expressing bFGF and TGF beta 1 on postoperative day three were revealed in the filtration area, on postoperative day five and seven, they were gradually increased. On the postoperative day 14, all significant cells and substance markly decreased. In experimental group only small amount of positive cell and bFGF or TGF beta 1-expressing substance were sparely distributed in the filtration area. CONCLUSION: The filtration area after glaucoma filtering surgery was "bathed" in growth factors such as bFGF and TGF beta 1 which well-known play an important role in stimulating wound healing response, IFN alpha-2b had an inhibitory effect on bFGF or TGF beta 1 expression in wound environment.

Animals↗
PubMed1996

Effects of apraclonidine on short-term outcome of glaucoma surgery.

We evaluated the influence of apraclonidine on the outcome of filtering surgery. Patients treated with apraclonidine who underwent a guarded filtration procedure were retrospectively evaluated and compared to a control group. Complications were more frequent in patients treated with apraclonidine than in the control group, but the difference was not statistically significant. We encourage further studies regarding the effects of apraclonidine in filtering procedures.

Adrenergic alpha-Agonists↗
PubMed1999

Filtration procedures supplemented with mitomycin C in the management of childhood glaucoma.

AIMS: To evaluate the outcome of filtering procedures supplemented with mitomycin C in children with glaucoma. METHODS: All patients aged 17 or younger with glaucoma who underwent filtering surgery supplemented with mitomycin C at a tertiary care centre (n = 21) during a 5 year interval (1992 and 1996) were included. One eye for each patient was entered into the analysis. The postoperative intraocular pressure (IOP), use of antiglaucoma medications, clinical stability of glaucoma, complications, and visual acuity were retrospectively evaluated. Kaplan-Meier survival curves were used to estimate the probability of success. RESULTS: At the time of surgery mean age was 5.7 (SD 5.0) years. The most common diagnoses were trabeculodysgenesis (n = 6) and aphakic glaucoma (n = 8). Mean IOP before surgery was 35.7 (10.5) mm Hg. Average length of follow up was 18.6 (14.7) months. The probability of having IOP less than 21 mm Hg with no antiglaucoma medications and with clinically stable glaucoma 1 year after surgery was 76.9% in phakic eyes (n = 13) and 0% in aphakic eyes (n = 8). A phakic patient with Sturge-Weber's syndrome had choroidal effusion after surgery that resolved spontaneously. In the aphakic group one patient had retinal detachment and another developed an encapsulated bleb. Visual acuity deteriorated in one patient. CONCLUSION: A guarded filtration procedure with mitomycin C is relatively successful in phakic children with glaucoma, but unsuccessful in aphakic ones.

Adolescent↗