SEARCH · PubMed Health

Results for “Filtering Surgery”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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

At least 91 records · Page 5Linked to original sources

PubMed1992

Improved suture for fornix-based conjunctival flap in filtering surgery.

Major problems in the early postoperative phase in filtering surgery are hypotony, flattening of the anterior chamber and choroidal detachment. We describe a new suture technique for the closure of the conjunctiva in goniotrephination with a fornix-based conjunctival flap which is helpful in reducing these complications. After dissecting the conjunctiva from the limbus, a shallow groove is cut directly behind the former conjunctival insertion. At the end of the operation the conjunctiva is sutured into this groove using a running 10.0 nylon suture in a meander-like fashion. A very tight wound closure results. We used this technique in 104 consecutive goniotrephinations. We found a low incidence of only mild external fistulation, hypotony, flattening of the anterior chamber and choroidal detachment. Astigmatism induced by the operation was -1.2 +/- 1.2 D, usually with the rule.

Aged↗

PubMedDate not supplied

Trabeculocyclostomy--a new modified filtering surgery for primary simple glaucoma.

A new modified 'INTERNAL' filtering surgery, Trabeculocyclostomy (TC) is described in 24 eyes of Primary open angle glaucoma. The importance of controlled drainage of aqueous into the suprachoroidal space and its absorption by the well vascularised choroidal tissue is highlighted. Out of the 24 eyes operated by this technique, in 20 eyes (83.3%) no further treatment was required for a mean follow up period of 18 months. In majority of the cases i.e. 19 eyes the anterior chamber reformed from the first day itself and remained so throughout the follow up period. With this in mind Trabeculocyclostomy may be a valuable procedure in cases of pseudophakic glaucoma (usually pre-existent) especially where an anterior chamber intraocular lens implantation has been done or is being done as a combined procedure. Minimum complications have been encountered to date.

Adult↗

PubMed1995

Modeling the effects of anterior chamber fluid viscosities on intraocular pressure following glaucoma filtering surgery.

BACKGROUND: Hypotonia, flat anterior chamber, and choroidal effusion are not infrequent and undesirable consequences of glaucoma filtering surgery. Methods developed so far to prevent or combat these complications have only been moderately successful. Viscous fluids admixed to the aqueous humor are known to influence fluid dynamics and hence intraocular pressure during variable time intervals following surgery. It was the intention of the authors to develop a mathematical model which predicts the influence of sodium hyaluronate determining the intraocular pressure following injection into the anterior chamber. METHODS: The model is based on first-order approximations and derives from the theory of rheology and fluid dynamics in narrow tubes, and is essentially based on Hagen-Poiseuille's law. RESULTS: The predictions of the model (to be published in a paper to follow) were verified in experiments on owl monkeys and showed a high degree of predictive power. CONCLUSIONS: One may conclude that sodium hyaluronate, injected once or repeatedly with fine canulas into the anterior chamber, qualifies as an important tool to maintain normal on near-normal intraocular pressure in the immediate and late postoperative phase following surgery.

Anterior Chamber↗

PubMed1995

Long-term results of non-filtering surgery for the treatment of primary angle-closure glaucoma.

BACKGROUND: We previously reported the effectiveness of goniosynechialysis and trabeculotomy ab externo for adult-onset glaucoma. In this study, we performed non-filtering surgery on patients with primary angle-closure glaucoma and studied the long-term outcome of this treatment. METHODS: Included in this study were 35 eyes of 25 patients with primary angle-closure glaucoma, each of which had an intraocular pressure greater than 20 mmHg with maximal tolerated antiglaucoma medication, even after laser iridotomy or surgical iridectomy. Of these 35 eyes, 22 underwent trabeculotomy and 13 underwent goniosynechialysis. All patients were followed up for at least 18 months. RESULTS: In 21 (95%) of 22 eyes after trabeculotomy, and in 12 (92%) of 13 eyes after goniosynechialysis, intraocular pressures were well controlled at or below 21 mmHg at the final examination. However, in two of the 21 eyes in which trabeculotomy was a success, and in four of the 12 eyes in which goniosynechialysis was successful, the procedure had to be repeated before adequate control of pressure was achieved. CONCLUSION: Our results show that intraocular pressure in most cases of primary angle-closure glaucoma can be controlled by restructuring of the physiologic aqueous outflow route by means of goniosynechialysis or trabeculotomy, and that filtering surgery is not necessary.

Aged↗

PubMed1997

[Mitomycin C in glaucoma filtering surgery].

Authors evaluate application of mitomycin C (0.2-0.4 mg/ml) on the sclera during glaucoma filtering surgery. Mean follow-up was 19.5 months in the group of 67 patients (75 eyes). The most serious complication was an early endophthalmitis in 2 cases with the loss of residual visual field and vision, 1x hemophthalmus followed with the development of traction retinal detachment, 1x hypotonic maculopathy, 1x traction retinal detachment for progression of proliferative vitreoretinopathy of neovascular glaucoma. Higher rate of the complications was noted in the group of mitomycin C 0.4 mg/l. Visual acuity was better one line Snellen optotypes in 3 cases, and worse in 26 cases. Intraocular pressure (IOP) compensation up to 20 mmHg was reached in 32 cases without therapy (45.1%), in 28 cases therapy, (39.6%). IOP above 20 mmHg was in 11 cases (15.4%) and the data are not known in 4 cases (5.41%). IOP was compensated after mitomycin C application in 84.7%.

Adolescent↗

PubMed1985

Permeability of uveal vessels after experimental filtering surgery in rabbits.

In adult albino rabbits, an opening wound was made in the central area of the cornea in one eye and the anterior chamber was made flat for 48 hours. Fluorescein-labeled dextran with a molecular weight of 70,000 was injected intravenously, and the uveal tissues were examined by fluorescence microscopy. A marked leakage of fluorescein-dextran was seen to occur from the vessels of the iris, ciliary body, anterior choroid and also even in the posterior choroid. The degree of leakage was similar during the period from 30 minutes to 48 hours after the surgery. In the fellow normal eyes, the leakage was minimal. In some eyes, the aqueous humor was aspirated and subsequently the anterior chamber was reformed spontaneously; the leakage of fluorescein-dextran determined 6 hours later was much less than after the filtering surgery. Some eyes were pretreated by topical 0.3% flurbiprofen solution or 0.3% indomethacin oil drop before the filtering surgery was performed. The pretreatment significantly reduced leakage of fluorescein-dextran from the uveal vessels, but the pretreatment with topical 0.1% betamethasone had only a slight effect.

Animals↗

PubMed2000

Pathologic findings in late endophthalmitis after glaucoma filtering surgery.

OBJECTIVE: To report the clinicopathologic features of four eyes enucleated for late-onset bleb-related endophthalmitis. STUDY DESIGN: Retrospective case series. MATERIALS: Four enucleated eyes. METHODS: The clinical and histopathologic features of four patients who underwent enucleation for late-onset endophthalmitis after glaucoma filtering surgery were reviewed. RESULTS: The eyes were enucleated for endophthalmitis one to five years after trabeculectomy. Two of the four eyes had trabeculectomy with adjunctive mitomycin-C. All four eyes had streptococci cultured from the aqueous and/or vitreous. Common pathologic features included inflammation involving the anterior segment, lens and choroid. One eye exhibited focal granulomatous uveitis. CONCLUSIONS: Late-onset endophthalmitis after glaucoma filtering surgery is often due to streptococcal species and rapidly progresses over a few days. Phacoanaphylaxis with associated granulomatous uveitis may contribute to the poor prognosis in this setting.

Aged↗

PubMed1995

The effect of reducing the exposure time of mitomycin C in glaucoma filtering surgery.

BACKGROUND: The use of adjunctive intraoperative mitomycin C has considerably improved the success rate of glaucoma filtering surgery. However, the ideal concentration and exposure time of mitomycin C is unknown. The purpose of this study is to determine whether a satisfactory surgical outcome can be achieved with a lower incidence of adverse side effects by using a shorter exposure time of mitomycin C than has been recommended previously. METHODS: Twenty-five eyes of 25 consecutive patients who were considered to be at high risk for surgical failure because of their age (< 55 years), previous failure of trabeculectomy, previous cataract surgery, or traumatic glaucoma received a single intraoperative application of mitomycin C (0.2 mg/ml for 2 minutes). They were case-matched with a group of 48 consecutive patients who received a single intraoperative application of mitomycin C (0.2 mg/ml for 5 minutes) by using age, race, type of refractory glaucoma, and preoperative intraocular pressure (IOP) as variables. RESULTS: Eighteen months after surgery, 22 (88%) patients in the 2-minute group and 21 (84%) patients in the 5-minute group had an IOP less than 21 mmHg with or without treatment. No significant differences were found in the complication rate: in 2 (8%) of 25 eyes of the 2-minute group, chronic hypotony developed compared with 3 (12%) of 25 eyes in the 5-minute group. Hypotony-related maculopathy developed in one eye in the 5-minute group. A cystic bleb was found in 15 (60%) eyes in the 2-minute group compared with 19 (76%) eyes in the 5-minute group, although this difference was not statistically significant. Two (8%) eyes in the 2-minute group and one eye (4%) in the 5-minute group had a bleb-related infection. In one (4%) patient in each group, late severe endophthalmitis developed. CONCLUSION: These results suggest that a 2-minute intraoperative application of 0.2 mg/ml mitomycin C is as effective as a 5-minute exposure, but the complication rate remains unaltered.

Adult↗

PubMed2001

[Incidence of encapsulated bleb after filtering surgery].

OBJECTIVE: To determine the incidence of encapsulated bleb (EB) after filtering surgery, and the risk factors for the development of this complication, especially those related with the surgical procedure. METHODS: Ninety eyes that were submitted to trabeculectomy were prospectively studied. Lens extraction was associated in 56 eyes (62.9%). All patients were followed up for at least 3 months. RESULTS: There were clinical characteristics of encapsulation in 29 eyes (32.3%) and EB with a peak IOP of 25 mmHg or higher in 14 eyes (15.7%). The incidence of EB formation was 20.5% in men and 11.8% in women (p.044). The incidence of EB was higher in the trabeculectomy group alone (24.2%) than in the group in which it was associated to cataract surgery (10.5%) (p.003). There were clinical characteristics of encapsulation in 40.7% of primary open angle glaucoma (p.041). EB was significantly associated with an increased failure rate (21.4%) when compared to normal blebs (5.55% failure rate) (p<.001). CONCLUSIONS: The encapsulated bleb is significantly more frequent in the male gender and thick conjunctivas and in trabeculectomy alone versus trabeculectomy associated to cataract surgery. It means a significantly greater risk of failure after surgery in the short term.

Adult↗

PubMed1992

Glaucoma filtering surgery with postoperative 5-fluorouracil in patients with intraocular inflammatory disease.

Twenty-one eyes of 18 patients with uncontrolled glaucoma and intraocular inflammatory disease had glaucoma filtering surgery with postoperative subconjunctival 5-fluorouracil (5-FU). Follow-up for eyes in which intraocular pressure was controlled ranged from 6 to 53 months (mean, 34 months; median, 35 months). Fifteen of 21 eyes (71%) had controlled intraocular pressure (21 mmHg or less). Control was achieved in 9 of 10 (90%) phakic eyes and in 6 of 11 (55%) aphakic or pseudophakic eyes with or without glaucoma medication. Four of six filter failures had a second filtering procedure with 5-FU, and of these four procedures, three were successful. Cataract progression occurred in 9 of 10 phakic eyes, leading to cataract surgery in 7 eyes. Other complications included corneal epithelial defects in 13 eyes, bleb leaks in 3 eyes, choroidal effusions in 13 eyes, 1 choroidal hemorrhage, 1 serous retinal detachment and macular retinal pigment epithelial disturbance associated with hypotony and choroidal effusion. Filtering surgery with postoperative subconjunctival 5-FU can successfully control intraocular pressure in eyes with ocular inflammatory disease.

Adolescent↗

PubMed1984

Glaucoma filtering surgery: factors that determine pressure control.

Factors that determine pressure control after filtering surgery were studied in 194 eyes of 158 patients in a retrospective study. Emphasis was placed on the cumulative probability method of Kaplan and Meier and multiple regression analysis. Aphakia and the presence of a surgical bleb were the most important factors. Age and type of surgical procedure were next. Race and race-sex interaction were the least important. The above factors accounted for only 6% to 16% of the total variance. The difference between eyes of the same patient was less than that between paired eyes of different patients but the former was surprisingly high. In the selected group of successful cases without medication the postoperative pressure was independent of the baseline pressure and choice of surgical procedure.

Adolescent↗

PubMed1984

Glaucoma filtering surgery factors that determine pressure control.

Factors that determine pressure control after filtering surgery were studied in 194 eyes of 158 patients in a retrospective study. Emphasis was placed on the cumulative probability method of Kaplan and Meier and multiple regression analysis. Aphakic and the presence of a surgical bleb were the most important factors. Age and type of surgical procedure were next. Race and race-sex interaction were the least important factors. The above factors accounted for only 6% to 16% of the total variance. The difference between eyes of the same patient was less than that between paired eyes of different patients but the former was surprisingly high. In the selected group of successful cases without medication the postoperative pressure was independent of the baseline pressure and choice of surgical procedure.

Cornea↗

PubMed2004

[Treatment of uveal effusion syndrome after filtering surgery (2 case reports)].

The purpose of this article is to report the surgical treatment of two patients. After the filtering surgery a dehiscence of the conjunctiva emerged and was followed by an extreme hypotony of the eyeball and an extensive uveal effusion. The first patient, 82 years old lady, was treated with the diagnosis of chronic open angle glaucoma for 25 years. The right eye with an absolute glaucoma, the left eye had normal intraocular pressure (IOP) and was after a combined filtering surgical procedure with phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation in 1998. In autumn 2000, the patient suffered conjunctivitis, and the prominent filtering bleb was damaged due to frequent rubbing of the eye because of itching. Severe hypotony of the eyeball with secondary uveal effusion followed. Considering the age of the patient and the only functional eye, an extreme surgery was indicated: PC IOL explantation (removal), pars plana vitrectomy (ppV) with silicone oil implantation. After the surgery the eyeball was anatomically stabilized and the VA (visual acuity) improved from initial uncertain light perception to 0.08 (1/12 or 3/36) and certain light perception. The second patient, 35 years old man suffered in 1995 a serious penetrating injury with an intraocular foreign body of the right globe. During the following five years the patient underwent in altogether six intraocular surgeries due to posttraumatic cataract and rhegmatogenous and tractional detachment of the retina. In the year 2000, trabeculectomy due to secondary glaucoma was indicated and 8 months later, on patients demand an anterior chamber intraocular lens (AC IOL) was implanted. During the first week after the surgery severe hypotonia of the globe and secondary uveal effusion caused by conjunctival dehiscence in the upper nasal quadrant of the eyeball developed. Because of complicated ocular history of the patient who underwent on the whole eight eye surgeries a relative minimal procedure was indicated: AC IOL removal and insufflation of 1 ml of 100% hexafluorosulfide (SF6) expansive gas into the anterior chamber and vitreous cavity. The globe was stabilized and the VA (visual acuity) improved from initial uncertain light perception to 0.25 (6/24 or 20/80) with certain light perception.

Adult↗

PubMed1997

Combined phacoemulsification and filtering surgery with the 'no-stitch' technique.

OBJECTIVE: To determine if intentionally making a radial incision could lead to a lasting decrease in intraocular pressure and the development of filtering blebs. METHODS: Forty-three eyes treated with combined filtering surgery were compared with a control group of 42 eyes treated with cataract surgery (phacoemulsification) alone. All of the patients had advanced chronic open-angle glaucoma. During combined cataract and glaucoma surgery, the tunnel floor was transected with Vannas scissors. RESULTS: One year after surgery, the mean intraocular pressure in the study group decreased 7.6 mm Hg from a preoperative mean (+/-SD) of 25.9+/-5.3 mm Hg. The decrease in the control group was 3.7+/-4.2 mm Hg. The difference between the 2 groups was statistically significant (P<.001). In the study group, an average of 1.5+/-0.8 fewer medications were required 1 year after surgery. In the control group, 0.5+/-0.6 fewer medications were required. CONCLUSIONS: The combined surgical procedure discussed in this article led to a lasting decrease in intraocular pressure. Cataract surgery alone using the no-stitch technique and posterior chamber lens implantation also reduced intraocular pressure, although significantly less.

Aged↗

PubMed2001

Viscoelastic material as an adjunct to dissections and to treat microperforations during nonpenetrating filtering surgery.

A case is described in which viscoelastic material was used in the anterior chamber to minimize or prevent fluid flow through the area of the trabecular meshwork and Schlemm's canal during nonpenetrating filtering surgery. In cases with or without small perforations, the technique minimizes or decreases fluid flow so that the surgeon has a clearer view of these tissues and can perform more thorough and accurate stripping of deeper layers of tissue.

Anterior Chamber↗

PubMed2006

Giant inclusion cyst of the cornea following filtering surgery.

Various trans-conjunctival ophthalmic procedures are reported to cause inclusion cyst of conjunctiva, due to the accidental inclusion of viable conjunctival epithelium, under intact conjunctiva. We report a case of histopathologically confirmed inclusion cyst of the cornea following filtering surgery. There was no recurrence in 24 months of postoperative period.

Corneal Diseases↗

PubMed2005

[Dramatic alteration in optic nerve head topography after filtering surgery in an adult patient with traumatic glaucoma].

PURPOSE: We treated an adult patient with traumatic glaucoma who exhibited dramatic elasticity in the topography of the optic nerve head, as shown in a Heidelberg Retina Tomograph (HRT) examination after filtering surgery. CASE: A 41-year-old man came to us with a right eye injury following an external blow. At the first examination, visual acuity was 0.4 (1.2) and intraocular pressure (IOP) was 11 mmHg in both eyes. Cells in the anterior chamber and angle dialysis were noted in all quadrants of the right eye, but there was no hyphema. Two weeks later, the patient returned to our hospital with pain in the right eye and a headache. Visual acuity in the right eye had decreased to 0.06 (0.1) and IOP was 50mmHg. A cilioconjunctival injection and corneal edema were observed. The patient was treated with medications, but IOP was uncontrollable and the optic disc cupping in the right eye was enlarged. Further, values for Cup Disc Area Ratio (C/D; 0.553) and Cup Volume (CV; 0.548) in the right eye were larger than those of the left (0.287 and 0.168, respectively) in an HRT examination. We performed a non-penetrating trabeculectomy 5 weeks after the injury. Two weeks after surgery, IOP was lowered to 7 mmHg, and C/D 0.122) and CV (0.062) were improved. Six months after the procedure, C/D (0.304) and CV (0.202) were nearly the same as those of the left eye (0.292 and 0.144). CONCLUSION: Although the duration of high IOP was short, high elasticity in the optic disc morphology of this adult case was shown quantitatively in an HRT examination.

Adult↗

PubMed1989

Limbus-based versus Fornix-based conjunctival flap in filtering surgery. A randomized prospective study.

A randomized prospective study was performed to compare the results of filtering surgery using a Limbus-based versus a Fornix-based conjunctival flap. The wound closure of the Fornix-based flap was performed using a running 10/0 nylon suture at the limbus. No statistical significant difference of IOP regulation was found between the two groups. There was a tendency of reduced occurrence of shallow anterior chamber and of less vascularized filtering blebs in the Fornix-based technique.

Conjunctiva↗