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 685 records · Page 38Linked to original sources
PubMed1995

[A case of encapsulated filtering bleb after trabeculectomy].

A case of encapsulated filtering bleb after trabeculectomy is reported. A 57-year-old man with primary open angle glaucoma underwent a trabeculectomy one year ago. Six months after the operation the filtering bleb began to shrink and intraocular pressure (IOP) began to rise. It was suspected that the trabeculectomy site was obstructed by scarring, and so sclerostomy ab interno was performed in the site with a Nd: YAG laser. The IOP was higher elevated, however, and the bleb remained unchanged with severe conjunctival injection and aqueous inflammation. The next day trabeculectomy was performed in a new site and two weeks later a dome-shaped, prominent bleb was observed with an increase in the IOP. This was diagnosed as an encapsulated filtering bleb (Tenon's capsule cyst). Cystectomy of the bleb failed and it recurred, therefore, another trabeculectomy was added and the IOP was kept at a reasonable value. We believe that it is important to pay attention to an encapsulated filtering bleb as a complication of filtering surgery after laser therapy to the anterior chamber angle.

Conjunctiva↗
PubMed1996

Effects of dopamine antagonists and agonist on cultured human Tenon's fibroblast cells.

It was found that long-term therapy with topical antiglaucoma drugs may increase the number of fibroblasts and inflammatory cells in the conjunctiva and Tenon's capsule then decrease the success of glaucoma filtering surgery. Since some dopamine antagonists and agonists are reported to have ocular hypotensive effects, they could potentially be used as clinical antiglaucoma agents in future. In this study, several dopamine antagonists and agonists were evaluated in their effects on the fibroblast proliferation of ocular tissues with cultured human ocular Tenon's fibroblast cells. It was found that dopamine antagonists inhibited [3H]-thymidine uptake to 10.8%, 14.4%, 42.2% and 72.4% of control in domperidone, 28.6%, 67.7%, 96.9% and 99.2% in haloperidol, 9.8%, 18.9%, 103.5% and 104.6% in moperone and 9.8%, 24.7%, 70.8% and 96.9% in loxapine respectively, while the 0.5% concentration of drugs were dissolved in dimethyl sulfoxide (DMSO) followed by dilution in culture medium to final concentrations ranging from 0.05%, 0.005%, 0.0005% to 0.00005%. In the case of dopamine agonist, bromocriptine, the proliferation of cultured human Tenon's fibroblast cells was also inhibited for 25.1% of the control at 0.05% concentration and 92.3% of the control at 0.00005% concentration. These results indicate that these dopamine drugs have a potential long-term application in the treatment of glaucoma without having the stimulating effect on the proliferation of human Tenon's fibroblast cells.

Cells, Cultured↗
PubMed1997

Erbium:YAG laser sclerectomy with a sapphire optical fiber.

BACKGROUND AND OBJECTIVE: Laser sclerectomy may offer advantages to conventional glaucoma filtering surgery by minimizing conjunctival manipulation and subsequent subconjunctival scarring and by providing easier access to difficult locations. It has been theorized that minimizing collateral thermal damage may enhance the success rate and reduce complications associated with laser sclerectomy. The thermal damage induced by the pulsed erbium:yttrium aluminum garnet (Er:YAG) laser is notably less than that of other laser modalities, including neodymium:YAG (1.06 microns), Er:YSGG (2.79 microns), holmium: YAG (2.10 microns), and holmium: YSGG (2.10 microns). A major obstacle to the clinical use of the Er:YAG laser has been the lack of an efficient and reliable delivery system. The single-crystal sapphire optical fiber has an acceptable attenuation rate and favorable characteristics for delivery of the Er:YAG wave-length in a clinical setting. MATERIALS AND METHODS: An Er:YAG laser (2.94 microns) focused into a 300-micron, single-crystal sapphire fiber was used to create ab-externo sclerectomies with varying energy levels and pulse rates in each eye of six anesthetized rabbits and six human cadaver eyes. Specimens then underwent histopathologic analysis and determination of the thermal damage zone. RESULTS: For the rabbit sclerectomies, there was a significant positive correlation between energy per pulse and the diameter of the thermal damage zone, which averaged 22.0 +/- 12.7 microns for all energy levels. For the human sclerectomies, a positive correlation existed between the total energy delivered (mJ/pulse x total pulses) and the thermal damage zone, with the mean thermal damage zone, being 25.0 +/- 9.0 microns. CONCLUSION: The Er:YAG laser with a sapphire optical fiber delivery system is an effective means of creating ab-externo sclerectomies with minimal thermal damage.

Animals↗
PubMed1997

[Treatment of refractory glaucomas by transscleral cyclophotocoagulation using semiconductor diode laser. Analysis of 50 patients followed-up over 19 months].

PURPOSE: To evaluate the effects of transscleral cyclophotocoagulation with the diode laser for refractory glaucoma with respect to intra-ocular pressure, reduction of medical therapy and complications. METHODS: The diode laser system (Iris Medical Instrument, Oculight SLX) was used to treat 50 eyes of 47 patients with therapy resistant glaucoma and a poor prognosis with filtering surgery. All eyes had maximal hypotonic therapy and 40 (82%) patients were using carbonic anhydrase inhibitors. Laser energy was delivered to the eye through a quartz glass fiber optic probe [13 to 20 spots over 270 degrees using 3.5 J (1.75 W x 2.0 sec)]. The mean follow-up was 19.4 +/- 9.1 months (from 12 to 29 months). RESULTS: Intra-ocular pressure significantly decreased from mean baseline 32.4 +/- 9.1 mmHg to 19.7 +/- 8.1 mmHg at the end of the follow-up (p < 0.001). An intra-ocular-pressure below 20 mmHg was obtained in 66% of the eyes. In 13 patients the carbonic anhydrase inhibitors were discontinued. Six of the 8 painful eyes had pain relief. Visual acuity decreased in 17 (34%): cataract progression in 5 eyes, uncontrolled intra-ocular-pressure in 4 eyes, glaucoma progression despite controlled intra-ocular-pressure in 3 eyes, corneal dystrophy in 3 eyes. Chronic uveitis occurred in 5 (10%) eyes. No conjonctival, scleral or direct lens damage was detected. CONCLUSION: Contact transscleral cylophotocoagulation with the diode laser system can be successfully used to reduce intra-ocular-pressure in therapy resistant glaucoma. The incidence of complications is low with no loss of vision related to cyclodestruction.

Adolescent↗
PubMedDate not supplied

The features of Tenon's capsule at the limbus.

Glaucomatous optic neuropathy is a multifactorial disease, whose most important risk is high intraocular pressure. Filtering surgery, i.e. trabeculectomy, is the operation of choice to lower pressure, allowing the aqueous to outflow from the anterior chamber under the conjuctiva and Tenon's capsule. Failure to establish a filtration bleb is due in most cases to subconjunctival fibrosis, leading to bleb encapsulation (Tenon's cyst). Our study aimed to locate the best cleavage plane for aqueous drainage. Based on histological data, the subtenonian space appears to satisfy this requirement, due to low scarring aptitude and low resistance.

Adult↗
PubMed1997

Biometric study of acute primary angle-closure glaucoma.

We investigated the biometric characteristics of acute primary angle-closure glaucoma (PACG) patients and sought guidelines to predict subjects at high risk of acute attack. We enrolled 80 patients who suffered acute attack of angle-closure glaucoma and 60 nonglaucoma subjects. The biometric data, measured with A scan ultrasonography, and the outcomes after various treatments were analyzed. Six patients were excluded because they were lost to follow-up. In the acute PACG patients, the axial length (mean +/- standard deviation) was 22.25 +/- 0.77 mm, the anterior chamber depth (corneal thickness included) was 2.28 +/- 0.23 mm, and the lens thickness was 4.94 +/- 0.28 mm. In the nonglaucoma subjects, the axial length was 23.26 +/- 0.76 mm, the anterior chamber depth (corneal thickness included) was 3.11 +/- 0.25 mm, and the lens thickness was 4.48 +/- 0.30 mm. An anterior chamber depth of less than 2.70 mm was the most sensitive (94%) and specific (94%) parameter to differentiate acute PACG patients from nonglaucoma subjects. The intraocular pressure was controlled within the satisfactory range in 58 patients by laser iridectomy, with or without antiglaucoma medication. Eight patients needed additional gonioplasty and eight required filtering surgery to control the intraocular pressure. Our findings provide useful information about the biometric data of eyes of patients with acute angle-closure glaucoma and offer a useful guide to predict those patients at high risk of acute attack.

Acute Disease↗
PubMed1996

Results of combined trabeculectomy and phacoemulsification via tunnel incision.

Currently a cataract is usually surgically treated by phacoemulsification via tunnel incision. In cases of coexisting cataract and glaucoma a combined surgical procedure is desirable. We combine cataract and filtering surgery by simply dissecting a 1 x 1-mm piece from the inner tunnel lamella of a standard corneoscleral tunnel. The results of treatment of the first 20 eyes by the proposed combined procedure were compared with the results of traditional phacoemulsification and traditional trabeculectomy. With regard to visual acuity, combined surgery was as good as traditional phacoemulsification via tunnel incision. In terms of the regulation of intraocular pressure, combined surgery was as good as traditional trabeculectomy. As with trabeculectomy, mild early postoperative complications occur frequently, which require intensive post-operative care. Thus, the combination of trabeculectomy and phacoemulsification via tunnel incision proved to be a successful technique for the surgical treatment of combined cataract and glaucoma.

Aged↗
PubMed1998

Indirect mitogenic effect of transforming growth factor-beta on cell proliferation of subconjunctival fibroblasts.

PURPOSE: To understand the mechanism of fibrosis after filtering surgery for glaucoma, the effect of transforming growth factor-beta (TGF-beta) was studied in subconjunctival fibroblasts (SCFs). TGF-beta, universal inhibitor of cell proliferation, stimulates the cell proliferation of fibroblasts. SCFs were evaluated for their production of TGF-beta and fibroblast growth factor 2 (FGF-2) to determine whether TGF-beta may be an indirect mitogen acting through the induction of an endogenous growth factor, or factors, that then acts as the direct mitogen in an autocrine manner. METHODS: Cell proliferation was determined either by counting cell numbers or by analyzing the incorporation of [3H]thymidine into DNA. The synthesis of TGF-beta and FGF-2 was analyzed by immunoprecipitation and immunoblotting. RESULTS: TGF-beta 1, TGF-beta 2, and TGF-beta 3 stimulated the cell proliferation of SCFs in a dose-dependent manner. The media conditioned by SCFs, which were subsequently activated by acid, stimulated cell proliferation of corneal stromal fibroblasts. When the acid-activated media conditioned by SCFs were immunoprecipitated, respectively, either with anti-TGF-beta 1 and TGF-beta 2 antibodies or with anti-TGF-beta 3 antibody, TGF-beta s, with an apparent molecular size of 25 kDa, were detected, whereas SCFs produced an 80-kDa latent form of TGF-beta 1. Interestingly, SCFs produced and secreted an 18-kDa extracellular isoform of FGF-2, the synthesis of which is further stimulated by TGF-beta 1 and TGF-beta 3, respectively, whereas the neutralizing antibody to FGF-2 and the FGF-2-specific antisense oligonucleotide primers inhibited the stimulatory activities of TGF-beta 1 in SCFs. CONCLUSIONS: These findings indicate that SCFs produce TGF-beta and FGF-2 and that FGF-2 seems to be the direct stimulator of TGF-beta-mediated cell proliferation in SCFs.

Animals↗
PubMed1998

[A case of congenital uveal ectropion with glaucoma].

A case of 21-year-old man with a rare congenital syndrome of uveal ectropion with glaucoma is described. The visual acuity was 1.0 with correction cyl. -1.0 axis 100 degrees. The highest intraocular pressure was 55 mm Hg. The optic nerve was damaged with glaucomatous cupping (cup/disc ratio 0.8). The visual field presented adequate few insular scotomas. The glaucoma filtering surgery was performed: goniotrepanatio by Fronimopoulos. After the surgery in one year observation intraocular pressure was about 15 mm Hg. The perimetry showed no increase in optic disc damage. We wanted to present this case because of its rare occurrence and good results of the surgery.

Adult↗
PubMed2001

The use of leucocyte-depleting and conventional arterial line filters in cardiac surgery: a systematic review of clinical studies.

Although various forms of arterial line filter have been available for use during cardiopulmonary bypass (CPB) for 30 years, their use is not universal. The aim of this review was to seek evidence of the clinical benefit of using conventional or leucocyte-depleting arterial line filters during bypass. A literature search revealed 28 relevant clinical studies. Despite the wide variety of patient populations, types of filter and outcome measures utilized in studies, a few conclusions are possible. Whereas conventional filtration has the definite effect of reducing neuropsychological deficit post-CPB, the results of studies using the leucocyte-depleting filter are less clear cut. Leucocyte-depleting filters have potential for reducing inflammatory mediated heart and lung injury, however it is recommended that any additional benefit of leucocyte-depleting filters over conventional filters should be further tested by randomized controlled trials of sufficient size.

Cardiopulmonary Bypass↗
PubMed2004

Clinical evaluation of a new fat removal filter during cardiac surgery.

OBJECTIVES: Fat microemboli are generated during cardiac surgery that are associated with post-operative organ injury. Recently, a fat removal filter has been developed, based on a polyester leukocyte depletion filter. However, the efficacy of such a filter in a clinical setting is unknown. In this study we tested the efficacy of this filter. METHODS: Coronary artery bypass patients were randomly divided into two groups. Group I: filtration of cardiotomy suction blood during cardiopulmonary bypass with a fat removal filter (n=14). Group II: control patients without filtration (n=14). Filter efficacy was evaluated in group I using biochemical assays and thin layer chromatography of blood samples taken simultaneously before and after the filter. In addition, clinical and biochemical markers for organ injury were determined in both groups. RESULTS: The fat filter removed triglycerides (0.9+/-0.08 vs. 0.63+/-0.08 mmol l(-1), P=0.004, paired t-test), leukocytes (4.3+/-0.8 x 10(9) vs. 2.3+/-0.6 x 10(9)l(-1), P=0.03), and platelets (116+/-26 x 10(9) vs. 75+/-21 x 10(9)l(-1), P=0.003) from the blood samples taken before and after the filter. Chromatography showed a significant reduction in free fatty acids, phospholipids and triglycerides. Clinically, leukocyte counts were similar, but platelet counts were higher (181+/-14 x 10(9) vs. 117+/-8.6 x 10(9)l(-1) control, P<0.001) in group I on the first postoperative day. CONCLUSIONS: The fat filter removed 40% fat, leukocytes and platelets from cardiotomy suction blood during cardiac surgery. A larger scale study is necessary to determine clinical effects on organ damage.

Aged↗
PubMed2006

Mitomycin C augmented glaucoma surgery: evolution of filtering bleb avascularity, transconjunctival oozing, and leaks.

AIMS: To prospectively study the evolution of possible high risk features of conjunctival filtration blebs like avascularity, transconjunctival oozing (TCO), and leaks after mitomycin C (MMC) enhanced glaucoma surgery. METHODS: Single observer, 2 year prospective study on bleb characteristics of 125 eyes of 125 consecutive patients who had MMC augmented glaucoma surgery with initially successful filtration. MMC (0.2 mg/ml for 2 minutes in most cases) was applied on the area of the scleral flap before dissection. Glaucoma surgeries included were trabeculectomy, deep sclerectomy, and combined procedures. A dry fluorescein strip was applied on the avascular part of the bleb and observed for aqueous egress with flow (point leak, PL) or without (TCO). RESULTS: The mean time (95% CI) for observing bleb avascularity, TCO, and bleb leaks were 106 days (69 to 143), 208 days (155 to 261), and 609 days (559 to 659), respectively. Bleb leaks were observed in 17 eyes (13.6%)-15 (24.6%) in the trabeculectomy group and two (3.1%) in the deep sclerectomy group (p = 0.003). Kaplan-Meier survival analyses showed that the probability of observing bleb avascularity at sixth, 12th, and 24th month after surgery was 56%, 71%, and 73%, respectively. In eyes with avascular blebs, the probability of developing TCO and leaks was 77% and 1% at 6 months, 81% and 12% at 12 months, and 95% and 26% at 24 months, respectively. Cox's regression analyses and log rank tests showed that eyes with larger avascular blebs (>4 mm) were more likely to develop TCO (hazard ratio 3.77, p = 0.001) and delayed bleb leaks were more likely to be seen in eyes of the trabeculectomy group rather than the deep sclerectomy group (hazard ratio 0.06, p = 0.0006). CONCLUSIONS: MMC application over the area of scleral flap dissection during glaucoma surgery is associated with a high incidence of bleb avascularity, TCO, and delayed bleb leaks. Most eyes developed bleb avascularity within the first year after surgery. TCO will eventually be seen in all eyes with avascular blebs and the incidence of leaks gradually increases with time. This study shows that patients with eyes undergoing glaucoma surgery with MMC and avascular blebs should be monitored indefinitely.

Aged↗
PubMed2005

Microbial analysis of the autogenous bone collected by bone filter during oral surgery: a clinical study.

PURPOSE: The purposes of the study presented are to identify the microbial content of the collected bone debris and to determine the antibacterial efficiency of chlorhexidine mouth rinse in reducing the microbial content of the collected bone debris. PATIENTS AND METHODS: Twenty-five patients who had asymptomatic fully impacted mandibular third molars bilaterally underwent surgical removal for prophylactic and orthodontic considerations. Immediately before surgery all patients rinsed with 10 mL of their assigned solution (chlorhexidine or sterile saline) for 2 minutes. Before surgical removal of the teeth, bone debris was collected with a stringent aspiration protocol from the ramus by bone filter. The microbial content of the bone debris was assessed and the bacterial levels between the 2 groups were compared statistically. RESULTS: All samples from both groups (chlorhexidine or sterile saline) yielded viable microorganisms. There was no significant difference between the mean/median colony-forming units (CFU)/g values of both group samples, for aerobes (Streptococcus salivarius) and anaerobes (Bacteroides, Peptococcus, Peptostreptococcus, and Veillonella species). With regard to total microorganisms, the mean CFU/g derived from the chlorhexidine group samples were 1.5 x 10(8) CFU/g per bone sample compared with 1.5 x 10(9) CFU/g for the sterile saline control group (P < .05). CONCLUSION: Although chlorhexidine rinsing immediately before surgery reduced the levels of total microorganisms when compared with stringent aspiration protocol alone, it has not been found effective on aerobic Streptococcus salivarius and, importantly, on anaerobes. The reduced bacterial levels may still carry high infectious risk and may lead to failure in autogenous grafting procedures in oral surgery.

Adolescent↗
PubMed2003

Emboli capture using the Embol-X intraaortic filter in cardiac surgery: a multicentered randomized trial of 1,289 patients.

BACKGROUND: Particulate emboli are thought to play a significant role in the development of cardiac surgical complications. Intraaortic filtration of particulate emboli may reduce the burden of this morbidity in cardiac patients. METHODS: A multiinstitutional randomized trial was designed and enrolled 1,289 patients at 22 centers. Six hundred forty-five patients were assigned to the treatment arm and received the Embol-X intraaortic filter, whereas 644 patients were assigned to the control arm. The endpoints examined were mortality, stroke, transient ischemic attack, renal insufficiency/failure, myocardial infarction, gastrointestinal complications, and limb-threatening ischemia. All filters were examined for histologic evidence of particulate emboli. RESULTS: Particulate emboli were identified in 598 (96.8%) of 618 filters successfully deployed. Composite event rates for the clinical endpoints were similar in both the filtered and nonfiltered arm (110/645 = 17% vs 122/644 = 19%, respectively). Individual event rates were also similar in both arms. A post hoc comparison of patients with moderate or greater preoperative risk scores demonstrated event reduction favoring the filtered group for renal complications (17/124 = 14% vs 28/117 = 24%, p = 0.04) and for the composite endpoint (30/124 = 24% vs 42/117 = 36%, p = 0.047). No clinically evident complications attributed to the use of the filter were identified. CONCLUSIONS: The use of the Embol-X intraaortic filter is both safe and effective, as demonstrated by the emboli capture rate of 97%. In addition, post hoc analysis indicates a reduction in postoperative renal complications for patients with moderate or greater preoperative risk. Further study of high-risk patients is warranted.

Aged↗
PubMed1990

Limbal-based vs fornix-based conjunctival flaps in combined extracapsular cataract surgery and glaucoma filtering procedure.

Extracapsular cataract extractions and posterior chamber intraocular lens implantations combined with glaucoma filtering procedures were done in 47 eyes of 43 consecutive patients who had coexisting cataract and glaucoma. A limbal-based conjunctival flap was used in 22 patients and a fornix-based flap was used in 25 patients; the surgical technique was otherwise identical in all patients. Patients were followed up for a minimum of six months (mean, 18 months). Long-term intraocular pressure control and visual acuity were similar in the two groups, although the limbal-based group had significantly better early postoperative intraocular pressure control. Because control of intraocular pressure during the early postoperative period is a principal benefit of combined cataract and glaucoma surgery, we prefer the limbal-based conjunctival flap.

Aged↗