PubMed · 1106762
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G C Sood, S Kapoor, G Krishnamurthy, M Sood. 1975. A new suturing needle.. https://doi.org/10.1136/bjo.59.9.514
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OBJECTIVE: To compare the outcomes of conjunctival advancement and nonincisional management of late-onset glaucoma filtering bleb leak. DESIGN: Retrospective, nonrandomized, comparative interventional trial. PARTICIPANTS: Fifty-one eyes of 48 persons who underwent management of late-onset glaucoma filtering bleb leak from December 1986 through December 1999 were included. Thirty-seven eyes were included in the nonincisional treatment group (aqueous suppression with lubrication or patching, bandage contact lenses, cyanoacrylate glue, autologous blood injection, or a combination thereof) and 34 eyes were included in the surgical revision group (conjunctival advancement with preservation of the preexisting bleb). Twenty eyes underwent nonincisional treatment before surgical revision and were included in each treatment group. METHODS: Retrospective chart review of bleb leaks occurring at least 2 months after trabeculectomy. Successful treatment was defined as the resolution of the bleb leak, a final intraocular pressure (IOP) of 21 mmHg or less, and no significant complications such as blebitis, endophthalmitis, or bleb dysesthesia requiring a bleb revision. MAIN OUTCOME MEASURES: Cumulative success of closure of the filtering bleb leak, complications resulting from the intervention, IOP before and after treatment, and number of glaucoma medications before and after treatment. RESULTS: The Kaplan-Meier cumulative probability of success at 12 and 24 months were 0.45 and 0.42, respectively, for the nonincisional treatment group and 0.80 and 0.80, respectively, for the surgical revision group. The overall difference between the cumulative success of surgical and nonincisional treatment was statistically significant (P = 0.0001, log-rank test). In the nonincisional treatment group, only 20 of 37 eyes (54%) achieved initial sealing of the bleb leak after the treatment, and of those, almost half (8/20) eventually failed. Reasons for failure included persistent or recurrent leak (n = 21), blebitis or endophthalmitis (n = 6, including 4 with persistent leak), and bleb dysesthesia (n = 2). All eyes in the surgical group achieved closure of the leak, however 7 eventually failed because of leak recurrence (n = 2), elevated IOP (n = 3), or bleb dysesthesia (n = 2), and 11 required additional glaucoma medications. CONCLUSIONS: Patients with late bleb leaks managed with conjunctival advancement were more likely to have successful outcomes and less likely to have serious intraocular infections than those managed more conservatively.
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OBJECTIVE: To report the first use of a noninvasive conjunctival oxygen monitor in neonates. We wished to investigate if measuring the partial pressure of oxygen directly from the conjunctiva could track hyperoxia and hypoxia as well as, or better than, pulse oximetry. This has the potential to reflect brain oxygenation while yielding important systemic information. STUDY DESIGN: Criteria standard. SETTING: Tertiary care hospital neonatal intensive care unit. PATIENTS: Ten newborns monitored with pulse oximetry. INTERVENTION: The conjunctival oxygen monitor was studied for effectiveness and safety and compared to pulse oximetry. RESULTS: The device remained on the eyes up to 120 minutes. The correlation coefficient between conjunctival oxygen tension and pulse oximetry was significant for all readings (p<0.001) and for pulse oximetry measurements below 100% (p=0.024). One infant developed eyelid edema, which subsided when the device was removed and one sustained a small corneal abrasion that healed overnight. CONCLUSION: This initial pilot report suggests that the conjunctival oxygen monitor is effective and relatively safe in neonates. The device holds promise to indicate a tissue oxygen reading, which may provide neonatologists with more information about systemic oxygenation.