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G L Spaeth

Publications and source records attributed to G L Spaeth.

At least 19 recordsLinked to original sources
PubMed1992

Argon laser trabeculoplasty controls one third of cases of progressive, uncontrolled, open angle glaucoma for 5 years.

Seventy-eight patients (109 eyes) with progressive glaucoma had argon laser trabeculoplasty as a substitute for filtration surgery and were then followed up for a minimum of 5 years. One hundred spots were placed at the anterior margin of the posterior trabecular meshwork over 360 degrees. Consecutive cases between 1980 and 1985 were reviewed, 95% of treated cases being included in the final analysis. Eighty-two eyes had primary open angle glaucoma. If only the group with primary open angle glaucoma is considered, the failure rate the first year was 19%. After that, the failure rate was approximately eight per year. At the end of 5 years, 65% of all eyes had failed. At the end of 10 years, data were available on 84 of the original 109 treated eyes; in 80 treatment had failed, and four were still receiving medical therapy.

Adult↗
PubMed1992

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Humans↗
PubMed1992

Intraobserver and interobserver reproducibility of the Nidek EAS-1000 Anterior Eye Segment Analysis System.

The NIDEK EAS-1000 is a camera and computer system designed to facilitate measurement and analysis of the anterior segment of the eye. To evaluate the interobserver reproducibility of the system, three examiners assessed the anterior chamber depth and peripheral angle measurement in 20 disease-free eyes. Intraobserver reproducibility was determined by each investigator's photographing and analyzing the same eye on three different occasions. Interobserver correlation for the anterior chamber depth (using the first three readings of the same eye made by each examiner) was 0.97, with an 95% CI of 0.94 to 0.98. Interobserver correlation for angle measurement (again using the first three readings of the same eye made by each examiner) was 0.89, with a 95% confidence interval (CI) of 0.81 to 0.95. Intraobserver correlations for anterior chamber depth were 0.98 for each of the three examiners (mean, 0.98), wiht a 95% CI of 0.91 to 0.99. Intraobserver correlations for anterior chamber depth were 0.98 for each of the three examiners (mean, 0.98), with a 95% CI of 0.91 to 0.99. The intraobserver CI for angle measurement was 0.97 (range, 0.95 to 0.99). The intraobserver and interobserver reproducibility of the NIDEK EAS-1000 system was excellent.

Adult↗
PubMed1992

Surgical and medical management of patients with narrow anterior chamber angles: comparative results.

We retrospectively reviewed case records of 70 patients (114 eyes) to assess long-term outcome of surgical and medical treatment of narrow anterior chamber angles. Fifty eyes had undergone a peripheral iridectomy, incisional or laser; 64 had been treated medically, without surgery. The two groups were not strictly comparable. (It is assumed but not proven that, since iridectomy was considered necessary in one group and not in the other, the surgically-treated patients were more seriously diseased.) Comparing clinical data obtained at the first visit with data obtained at the last visit, the eyes receiving iridectomies, as compared with those receiving medical treatment alone, showed a greater number of improved anterior chamber configurations (74% vs 28%), had a lower incidence of peripheral anterior synechiae (2% vs 10%), and required fewer glaucoma medications (30% fewer vs 10% fewer). The percentage of eyes with increased intraocular pressure was similar in both groups (36% vs 28%), as was the percentage of those with decreased visual field (17% vs 21%) and decreased visual acuity (66% vs 60%). No significant complications occurred in the eyes receiving laser iridectomies; however, one of the incisionally-treated eyes lost nine Snellen lines of vision.

Anterior Chamber↗
PubMed1991

Conjunctival impression cytology in patients with glaucoma using long-term topical medication.

Increasing evidence indicates that long-term use of topically administered medications can induce changes in the conjunctiva and ocular surface. We used the technique of conjunctival impression cytology to evaluate the conjunctival changes that develop with long-term use of topically administered antiglaucoma medications. Patients with glaucoma who were on a stable regimen of one, two, or three topically administered medications were recruited for study; glaucoma suspects who were not using topically administered medications served as controls. Eyes with clinical or historical evidence of external eye disease or conjunctival surgery were excluded. Impression cytology specimens, collected from the bulbar and palpebral conjunctiva, were coded and subsequently graded by a masked observer. We examined specimens from 72 eyes by using this technique. Aggregate scores for the bulbar conjunctiva were compiled, using a previously described grading system with a range of 0 (normal) to 3 (diffuse, severe metaplasia). The results show statistically significant degrees of conjunctival metaplasia associated with the number of glaucoma medications used. These results suggest that the long-term use of antiglaucoma medications induces changes in the conjunctival surface. These changes may be related to the medications themselves, the preservatives in the commercial preparations, or the duration of topical treatment. The clinical relevance of these changes remains unknown.

Administration, Topical↗
PubMed1991

Long-term efficacy of repeat argon laser trabeculoplasty.

The role of repeat argon laser trabeculoplasty (RALT) in the management of open-angle glaucoma is controversial. To determine the long-term efficacy of RALT, the authors reviewed case records of 44 patients (50 eyes) who received RALT for uncontrolled glaucoma at the Wills Eye Hospital before 1986. Success was defined as a 3 mmHg or greater decrease in intraocular pressure (IOP) to less than 22 mmHg, and no further surgical intervention. By life table analysis, RALT was successful in 35% of eyes at 6 months, in 21% at 12 months, in 11% at 24 months, and in 5% at 48 months. Thirty-three percent of eyes in which primary ALT was successful for 1 year were successful 12 months after RALT. Complications included IOP spikes in 12%. In conclusion, RALT was generally not effective for long-term control of open-angle glaucoma, but may be useful as a temporizing measure. However, this use of RALT must be weighed against the risks of complications and the additional progression of disease before more definitive surgical intervention.

Adult↗
PubMed1991

The effects of postoperative corticosteroids on trabeculectomy and the clinical course of glaucoma: five-year follow-up study.

A randomized, prospective study on 68 eyes of 54 patients with progressive, uncontrolled, noninflammatory open-angle glaucoma showed that eyes that received topical prednisolone 1% had a lower intraocular pressure (IOP) 18 months following trabeculectomy than the eyes that received no prednisolone. The addition of systemic prednisone had no definite further effect. In the present study, we reevealuated 58 eyes of 45 of these patients 5 years after the time of initial surgery. The number of cases lost to follow up was similar in the steroid and the nonsteroid-treated groups. Mean IOP of the steroid-treated patients was 14.5 +/- 1.8 mm Hg, and of the nonsteroid-treated patients, 19.3 +/- 2.1 mm Hg. Visual field, optic disc, and IOP were stabilized in 94% of the steroid-treated cases and in 43% of the nonsteroid-treated cases. Thus, postoperative steroids significantly increased the success rate of trabeculectomy in these eyes, and the eyes with lower IOPs had a significantly better prognosis than those with higher IOPs.

Adult↗