Five-year follow-up of LSL trabeculectomies with low dosage mitomycin-C in primary open-angle glaucoma.
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Aged↗
Biomedical subjects
M G Uva
Publications and source records attributed to M G Uva.
[Evaluation of the filtering bleb using ultrasound biomicroscopy].
BACKGROUND: Sometimes in glaucomatous patients treated with trabeculectomy there is not a correlation between bleb shape and intraocular pressure. So we studied the functional anatomy of the filtering bleb by a ultrasound biomicroscope, using high frequency (50 Mhz) probe, which provides high resolution images of filtering blebs. MATERIALS AND METHODS: A total of 46 filtering blebs of 46 patients after trabeculectomy were analyzed by ultrasound biomicroscopy (50 Mhz). Dimensions, shapes and structure of blebs were evaluated in 2 groups of patients. RESULTS: It was possible to obtain longitudinal or transverse images of filtering blebs, to measure the height, to evaluate the reflectivity inside and to follow the route under the scleral flap. Blebs with lower reflectivity and a visible route under the scleral flap had a lower intraocular pressure while the height was not important for a good intraocular pressure. CONCLUSIONS: So ultrasound biomicroscopy can be a useful method to study filtering blebs and also to explain the mechanisms of filtering structures in patients who underwent trabeculectomy.
Aged↗
Ultrasound-biomicroscopic evaluation of filtering blebs after laser suture lysis trabeculectomy.
UNLABELLED: Sometimes in glaucomatous patients treated with trabeculectomy there is no correlation between bleb shape and intra-ocular pressure (IOP). In this study we evaluated the ultrasound biomicroscopy (UBM) features of filtering blebs after laser suture lysis (LSL) trabeculectomy in order to analyse whether its ultrasound-biomicroscopic image can predict the function (IOP). METHODS: The Humphrey ultrasound biomicroscope, using a high-frequency (50-Mhz) probe, provides high-resolution images of filtering blebs. A total of 103 filtering blebs after LSL trabeculectomy were analysed by UBM. Taking into account the characteristics of internal reflectivity and scleral flap, we classified the blebs into three groups (good, fair, poor) that indicate the bleb function and correlated this UBM pattern with the IOP control (good, borderline, failure). RESULTS: There was a statistically significant corelation between the UBM classification of function and the IOP control level. Both well-functioning and failed trabeculectomies could be identified by UBM. The UBM images of eyes with good IOP control are characterized by better visibility of the route under the scleral flap and a low reflectivity inside the bleb. CONCLUSIONS: In accordance with previous studies, we believe that UBM can be a useful method to study and explain the mechanisms of filtering structures and, together with IOP control, to evaluate the bleb function.
Adult↗
2% dorzolamide and cornea: an ultrabiomicroscopic study.
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Carbonic Anhydrase Inhibitors↗
Evaluation of central and peripheral corneal thickness with ultrasound biomicroscopy in normal and keratoconic eyes.
PURPOSE: Our study was designed to calculate central and peripheral corneal thickness in patients affected with early stages of keratoconus and in normal subjects using ultrasound biomicroscopy (UBM). To obtain an objective and reliable assessment of the corneal thinning in affected eyes, we developed a keratoconus index (KI) by means of the UBM measurements. METHODS: By means of the commercial version of the ultrasound biomicroscope (system model 840; Zeiss-Humphrey Instruments, San Leandro, CA, USA) using a 50-MHz probe, we studied 30 normal and affected eyes. In keratoconic eyes, we measured the thinnest corneal thickness (TCT) at the apex of the conus and at four peripheral sites at a distance of 2.5 mm from the central site (peripheral corneal thickness: PCT). The same procedure was performed in the normal eyes. To obtain an objective and reliable assessment of the corneal thinning, we calculated the ratio between the mean PCT and the mean TCT (Keratoconus Index: KI = PCT/TCT), in keratoconic eyes. In normal eyes, the KI was calculated on the basis of the ratio between the mean PCT and the mean central corneal thickness (CCT). RESULTS: In keratoconic eyes, the mean corneal thickness at the thinnest part of the conus was significantly different from the CCT in normal patients (Student's t test, p < 0.001). The peripheral measurements were not significantly different from keratoconic and normal eyes. The mean KI was 1.482 (SD, 0.095) in the keratoconic eyes, whereas it was 1.189 (SD, 0.086) in the normal subjects. The statistical analysis of the KI calculated on the basis of the UBM measurements showed that the KI values are significantly different from healthy subjects and from keratoconic patients (Student's t test, p < 0.001). CONCLUSIONS: UBM can be considered a useful tool in the study of keratoconus. We believe that calculation of the KI by means of UBM gives the possibility of obtaining an objective assessment of corneal thinning. Therefore this parameter can be useful in the staging and in the follow-up of these patients.
Adolescent↗
[Controlled trabeculectomy and incidence of postoperative choroidal detachment].
In this study the authors report their experience with titrated trabeculectomy. It is performed as follows: tight scleral flap trabeculectomy, five or more 10/0 nylon sutures, argon laser lysis of one or more sutures (depending on the eye's postoperative condition) by means of the Hoskins lens. The aim of this technique, performed by the authors for 3 years, is to decrease atalamia and choroidal detachment. Results obtained in 70 eyes of 62 patients with chronic open-angle glaucoma are compared by means of statistical analysis with those in 70 eyes of 66 patients operated on by means of the traditional technique. The incidence of choroidal detachment is significantly reduced (P < 0.001). There is no important difference in ocular pressure and visual acuity. In conclusion, this technique is very useful in controlling and titrating the filtration rate, avoiding an excessive lowering of IOP after trabeculectomy and decreasing the complications.
Adult↗
[Experiences with sclerostomy with the Holmium laser].
The THC-YAG laser (holmium laser) war used to perform ab externo sclerostomies in patients affected by various types of glaucoma. This approach was employed in 48 eyes with diagnoses of medically uncontrolled chronic open angle glaucoma, plateau iris or neovascular glaucoma. Post-operatively, 5-FU was injected. At the tend of the follow-up (mean 10.22 +/- 3.4 months), in 25 eyes (52.1%) the IOP was under control without medical therapy. In 12 eyes (25.0%) it was necessary to use antiglaucomatous topical therapy, and in 11 eyes (22.9%) the IOP was uncontrolled despite therapy. The authors stress the importance of a correct pharmacological protocol before and after operation and describe the surgical technique. They confirm the validity of this approach, owing to its minical invasiveness, the possibility of repeating the procedure, and the low complication rate.
Aged↗
[Determination of contrast sensitivity in patients with silicone oil tamponade].
UNLABELLED: The issue of whether silicone oil has a toxic effect on the retina is still being debated. In order to verify possible retinotoxic effects, the authors studied the variations of retinal function by means of computerized perimetry on patients who had undergone a vitreoretinal operation with injection of silicone oil in the vitreous cavity. Silicone oil remained in the eyes for a period of 120 days +/- 15. PATIENTS AND METHODS: 14 patients under treatment for vitreoretinal pathologies sparing the macula underwent five examinations (Macular Threshold Test of the Humphrey Field analyzer): two examination during the period silicone oil was in the vitreous cavity (30 days after injection and 10 days before removal) and three examinations after its removal (at 30, 90, and 180 days). RESULTS: When the paired t-test and ANOVA test were applied to our results, there were no significant differences in the light-difference sensitivity. CONCLUSIONS: These data do not indicate that silicone oil a retinotoxic effect (revealed by means of computerized perimetry) when it is removed within 4 months.
Adult↗
Surgical management of closed angle glaucoma: our experience.
In this paper we present our experience of the last three years in the surgical treatment of eyes with closed angle glaucoma. We have performed an extracapsular lens extraction and posterior chamber intraocular lens implantation on 34 eyes of 34 patients. All of them were affected by closed angle glaucoma with variable control after a Yag laser iridotomy: 6 eyes had high I.O.P. notwithstanding maximal therapy, 11 eyes had I.O.P. under control (less than 21 mmHg) without therapy, 9 with I.O.P. controlled with topical therapy, 8 with I.O.P. controlled with maximal therapy (C.A.I. included). The cases with well controlled glaucoma were operated on because of the presence of a more or less significant lens opacities. After a follow-up of up to 40 months (mean = 20.3, range = 1-40), all eyes show satisfactory intraocular pressure and no eye needed a filtering procedure. The results of our studies are as follows (values are mean +/- SD). In the group of 6 eyes with high I.O.P., the mean pre-operative intraocular pressure was 29.7 +/- 5.6 mmHg and the mean post-operative I.O.P. was 15.1 +/- 1.4 mmHg. The mean reduction was 14.5 +/- 6.6 mmHg (p < 0.005). In the 28 eyes with pre-operative I.O.P. under control (17.5 +/- 1.6), the mean post-operative I.O.P. was 14.4 +/- 2.3 mmHg, with a mean reduction of 3.1 +/- 3.1 mmHg (p < 0.005). Before the E.C.C.E., 11 eyes had I.O.P. less than 21 mmHg without anti-glaucoma medication, whereas after the E.C.C.E. 28 eyes did not need such a medication.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
[A new surgical procedure in angle block glaucoma].
Authors show the results obtained in 29 eyes of 29 patients with closed angle glaucoma operated with ECCE plus posterior chamber IOL implantation. After a follow up varying from 1 to 35 months (mean = 20.7) all eyes are under good control (25 without therapy, 4 with topical therapy) of I.O.P. Authors report on the "rationale" of their surgical approach: particular anatomo-functional features of the eyes affected by closed angle glaucoma. Pre-op. and post-op. biometrical and gonioscopical findings are described and discussed.
Aged↗
Laser and glaucoma: our experience.
The authors present some guidelines on laser therapy (Argon and/or Yag) application on the different types of glaucomatous pathology. These therapeutic guidelines are the result of a 3-year experience of constant laser therapy application on glaucoma. The case reports include 196 A-laser trabeculoplasties, 34 A-laser iridotomies, 158 Yag-laser iridotomies, 31 gonioplasties, plus numberless combined treatments (iridotomy-trabeculoplasty, gonio-trabeculoplasty, gonioplasty-ciliary body photocoagulation, and so on). The authors conclude by reaffirming the considerable reliability of these techniques, given a prolonged follow-up; they also advance some new therapeutic hypotheses on laser operation in glaucomas.
Glaucoma↗