SEARCH · PubMed Health

Results for “Choroidal Effusions”

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 127 records · Page 7Linked to original sources

PubMed1994

Intermediate-term results of a randomized clinical trial of the 350- versus the 500-mm2 Baerveldt implant.

BACKGROUND: The Baerveldt glaucoma implant is a large equatorial aqueous shunting device that is installed through a single-quadrant conjunctival incision. The intermediate-term results of a randomized study comparing the 350- and 500-mm2 Baerveldt implants are reported. METHODS: Seventy-three patients with medically uncontrollable, nonneovascular glaucomas associated with aphakia, pseudophakia, or failed filters were enrolled in a randomized, prospective study comparing 350- and 500-mm2 Baerveldt implants. Surgical success was defined as 6 mmHg < or = final intraocular pressure < or = 21 mmHg without glaucoma reoperation or devastating complication. RESULTS: Of patients with 350- and 500-mm2 implants, 93% and 88%, respectively, achieved surgical success (18-month life-table analysis, P = 0.93). The 500-mm2 implants afforded intraocular pressure control with significantly fewer medications (0.7 versus 1.3; P = 0.006). The postoperative visual acuities remained within one line of the preoperative visual acuities or improved in 62% and 66% of patients in the 350- and 500-mm2 groups, respectively (P = 0.93). Complication rates were statistically similar. The most frequent ones in the 350- and 500-mm2 groups, respectively, were serous choroidal effusion (16% and 32%), strabismus (16% and 19%), anterior uveitis (14% and 11%), and corneal or corneal graft edema (11% each). CONCLUSION: The intermediate-term results of the 350- and 500-mm2 Baerveldt implants were statistically comparable with respect to surgical and visual outcomes, as well as complications, although the larger implant was associated with a higher rate of some complications. However, the 500-mm2 Baerveldt implant afforded intraocular pressure control with fewer medications than the 350-mm2 implant.

Adolescent↗

PubMed1994

Initial clinical experience with the baerveldt implant in complicated glaucomas.

BACKGROUND: The Baerveldt glaucoma implant is an aqueous shunting device with a large surface area that is installed through a conjunctival incision in one quadrant of the eye. This study presents the initial results of the first 13 patients who underwent Baerveldt implantation as part of the Food and Drug Administration approval process. METHODS: Thirteen patients with medically uncontrollable complicated glaucomas underwent one-stage implantation of either a 200- or 350-mm2 Baerveldt implant without postoperative systemic antifibrosis therapy. Surgical success was defined as intraocular pressure greater than or equal to 6 and less than or equal to 21 mmHg without glaucoma reoperation or devastating complication. RESULTS: Eight patients (62%) had successful surgical outcomes, with a mean follow-up of 17.3 +/- 7.0 months (+/- standard deviation) (range, 6-24 months). Seven (70%) of the ten patients with glaucomas associated with aphakia or pseudophakia had successful outcomes, whereas only one (50%) of the two patients with neovascular glaucomas had a successful outcome. One patient with glaucoma associated with nanophthalmos and an unsuccessful filtering procedure had a failed outcome. The postoperative visual acuities remained within one line of the preoperative visual acuities or improved in 62% of the patients. The most frequent complications among all patients were transient serous choroidal effusion (23%) and hyphema (15%). CONCLUSION: Initial results of the Baerveldt implant generally are comparable with other implants. It is easier to install and requires less extensive conjunctival dissection than other large implants. Additional studies are needed to evaluate the effectiveness of the Baerveldt implant in affording long-term intraocular pressure control.

Adult↗

PubMed1995

Clinical experience with the Baerveldt glaucoma drainage implant.

PURPOSE: To assess clinical outcomes in patients who were treated with the Baerveldt glaucoma drainage implant. METHODS: The authors performed a retrospective multicenter study of 100 patients (103 eyes) with medically uncontrollable glaucomas who underwent a one-stage implantation with either the 200-, 250-, 350-, or 500-mm2 Baerveldt implant. The authors defined surgical success as 5 mmHg less than intraocular pressure less than 22 mmHg without additional glaucoma surgery and without loss of light perception. RESULTS: With a mean follow-up of 13.6 +/- 0.9 months (range, 4-37 months), 74 eyes (71.8%) had successful outcomes. Cumulative life-table success rates were 90.3% at 3 months (n = 103), 72.6% at 6 months (n = 84), and 60.3% at 24 months (n = 34). Intraocular pressure (IOP) was reduced from a mean of 38.5 +/- 1.4 mmHg with 2.2 +/- 0.1 antiglaucoma medications to 15.1 +/- 0.8 mmHg (P < 0.0005) with 0.5 +/- 0.1 antiglaucoma medications (P < 0.0005). Visual acuity was improved or remained within one line of the preoperative visual acuity in 90 eyes (87.4%). Complications occurred in 74 eyes (71.8%). A significant portion of these complications (45%) was transient, resolving without any intervention. Only 8% were serious sight-threatening complications. The most common complications included shallow anterior chamber or hypotony (32%), choroidal effusion or hemorrhage (20.4%), corneal decompensation or edema (17.5%), hyphema (14.1%), and tube obstruction (12.6%). CONCLUSION: The Baerveldt implant is effective in lowering the IOP in patients with intractable glaucomas. Hypotony and other complications are common, which also have been reported in other nonvalved glaucoma drainage implants. However, the majority of these complications did not affect surgical outcome.

Adolescent↗

PubMed1997

Vitrectomy for retained lens fragments after phacoemulsification.

PURPOSE: Posterior lens fragments after phacoemulsification can be a serious complication of cataract surgery. This study is designed to evaluate the clinical features of eyes after pars plana vitrectomy has been performed to remove posteriorly dislocated lens fragments after phacoemulsification. METHODS: The authors performed a retrospective chart review of 126 consecutive eyes of 126 patients with dislocated lens fragments after phacoemulsification, managed with pars plana vitrectomy at Associated Retinal Consultants of Michigan. These eyes were operated on from January 1986 through January 1996. RESULTS: The relation of the intervals between cataract surgery and vitrectomy to various postoperative clinical parameters was studied. Clinical features at presentation included elevated intraocular pressure (IOP over 25 mmHg) in 52.4% of the eyes, uveitis in 69.6%, and corneal edema in 50.8%. Initial visual acuity was 20/400 or worse in 73.8% of the eyes. The mean preoperative visual acuity was 20/278 (median, 20/400), whereas the mean final visual acuity was 20/40 (median, 20/50) after a mean follow-up of 18.9 months. Retinal detachments were found in 20 eyes: 7 before vitrectomy and 13 during or after it. After surgery, 44% of eyes achieved a final visual acuity of 20/40 or better and 90% were 20/400 or better. The distribution of best-corrected final visual acuities among the eyes showed statistically significant differences based on the type of intraocular lens (IOL) used, with posterior chamber IOL greater than anterior chamber IOL, and anterior chamber IOL greater than aphakia. Reasons for a poor visual outcome included persistent corneal edema (four eyes), retinal detachment (two eyes), central retinal vein occlusion (two eyes), age-related macular degeneration (two eyes) glaucoma (one year), and endophthalmitis (one eye). CONCLUSIONS: There were no statistically significant differences between early (< 7 days) and delayed (8 days or more) vitrectomy when increased IOP, corneal edema, choroidal effusions, cystoid macular edema, and visual acuity were analyzed. The use of vitrectomy to remove posteriorly dislocated lens fragments has been shown to be an effective treatment method that significantly reduces the inflammatory response and hastens visual recovery.

Adult↗

PubMed1997

Limbus- versus fornix-based conjunctival flaps in combined phacoemulsification and mitomycin C trabeculectomy surgery.

PURPOSE: The authors compared the effectiveness of limbus- and fornix-based conjunctival flaps in patients undergoing combined phacoemulsification, intraocular lens implantation, and mitomycin C trabeculectomy. METHODS: The authors conducted a retrospective review of the records of 52 consecutive eyes of 45 patients who underwent combined surgery with limbus- and fornix-based conjunctival flaps. All surgery was by done by one surgeon on predominantly white patients in a suburban glaucoma subspecialty practice. Seven patients had both limbus- and fornix-based surgery, permitting fellow eye comparisons in these patients. All patients had at least 6 months and a median of 17 months follow-up. None of the eyes that were operated on had undergone intraocular surgery previously. RESULTS: No clinically significant difference in postoperative pressure reduction, bleb survival, or visual acuity was seen between the fornix- and limbus-based groups. Results in the fellow eye comparison subgroups were similar. The mean intraocular pressure decreased from 20.4 mmHg before surgery to a mean of 12.4 mmHg at the last follow-up visit. Forty-seven (90.3%) of 52 eyes had a final best-corrected visual acuity of 20/ 40 or better. Forty eyes (76.9%) no longer needed antiglaucoma medications at the end of follow-up. Five eyes had intraoperative posterior capsule rupture; all of these occurred in the limbus-based group. Shallow serous choroidal effusions were more common in the fornix-based group, but none were clinically significant. No difference in postoperative astigmatism between the limbus- or fornix-based group was seen. Intraoperative pupilloplasty, synechialysis, or postoperative neodymium:YAG capsulotomy had no appreciable effect on final intraocular pressure or bleb survival. Endophthalmitis, aqueous misdirection, or hypotony maculopathy did not develop in any patient. CONCLUSION: The effectiveness of limbus- and fornix-based conjunctival flaps appears to be similar. The limbus-based technique may result in a higher incidence of posterior capsular rupture, but the safety of limbus- and fornix-based flaps is otherwise similar. Combined phacoemulsification and mitomycin C trabeculectomy appears to be safe and effective for treating selected patients with coexisting glaucoma and cataract.

Aged↗

PubMed1999

Retinitis pigmentosa, nanophthalmos, and optic disc drusen: a case report.

OBJECTIVE: Although the associations of retinitis pigmentosa (RP) with nanophthalmos/microphthalmos and RP with optic disc drusen have previously been recognized, the concurrence of all three features, as far as the authors are aware, has not previously been reported. DESIGN: Case report. RESULTS: The authors report a sporadic case of nanophthalmos, RP, and optic nerve drusen with the additional complication of chronic angle closure glaucoma. CONCLUSIONS: Visual loss may be secondary to the complications of nanophthalmos, RP, or optic nerve drusen. Chronic angle closure may be caused by choroidal effusion with serous retinal detachment, which may, in turn, cause a pseudo-RP picture. It is therefore important to recognize the possible association of true RP with nanophthalmos as a cause for visual deterioration.

Aged↗

PubMed2000

Foldable silicone versus poly(methyl methacrylate) intraocular lenses in combined phacoemulsification and trabeculectomy.

PURPOSE: To compare the outcome of phacotrabeculectomy with implantation of poly(methyl methacrylate) (PMMA) or foldable silicone intraocular lenses (IOLs). METHODS: Thirty patients were randomized to receive a 5.5 mm PMMA IOL through a 5.0 mm incision or a foldable silicone IOL (Allergan SI-30) through a 3.2 mm incision. Visual acuity, intraocular pressure (IOP), bleb survival, inflammation, endothelial cell changes, and complications were examined at intervals up to 6 months. RESULTS: There was no difference between the 2 groups in final visual outcome, final IOP control, bleb survival, and endothelial cell changes. Two months after surgery, there was significantly more inflammation in the silicone IOL group than in the PMMA group (P <. 05). The silicone group had a significantly higher combined complication rate including iris capture, choroidal effusion, and epiretinal membrane formation (P <.05). CONCLUSIONS: Foldable silicone IOLs were comparable to conventional PMMA lenses in visual outcome, IOP control, bleb formation, and endothelial changes. However, some silicone lenses are associated with an increased risk of recurrence of inflammation and a higher final complication rate in combined cataract and filtration surgery.

Aged↗

PubMed1994

[Postoperative leakage of silicone oil into the anterior chamber].

BACKGROUND: One reason for complications after silicone oil application is the postoperative entrance of silicone oil into the anterior chamber. In a retrospective study, we tried to define risk factors for oil entrance into the anterior chamber. METHODS: 159 Eyes of 148 patients, vitrectomized and filled with silicone oil between 1988 and 1992 were analysed. In 22 eyes (13.8%) silicone oil entered the anterior chamber postoperatively. Eyes with emulsified oil in the anterior chamber and eyes, where the oil entered the anterior chamber during cataract extraction were not included in this group. Diagnoses, postoperative fundus findings and lens status, intraocular pressure, depth of the anterior chamber and time of the oil entrance were analysed. RESULTS: Risk factors in the first 10 postoperative days (14 eyes = 63.6%) seem to be aphakia and choroidal effusions, especially if combined with buckling procedures (encircling bands). In the late postoperative period, i.e. up to 6.5 months (8 eyes = 36.4%), proliferative vitreoretinopathy was responsible for the entrance of silicone oil into the anterior chamber in all cases. The decreased production of aqueous humour combined with hypotony seems also to play an important role in this process. CONCLUSIONS: It seems that in the early postoperative period the frequency of oil entrance into the anterior chamber can only be lowered by a subtotal oil filling in aphakic eyes with accompanying encircling procedures. It remains open if radical amputation of the vitreous base can avoid peripheral reproliferations.

Anterior Chamber↗

PubMed1991

[Implantation of folding posterior chamber lenses].

The implantation of foldable intraocular lenses (IOL) takes advantages of the benefit of small incision cataract surgery provided by phacoemulsification. However, even experienced surgeons may find the new implantation techniques required initially difficult. Advantages of small incision techniques include maintaining stability of the globe during surgery, especially in the case of acute IOP elevation caused by choroidal effusion or expulsive hemorrhage, as well as improved postoperative healing. Small incision surgery minimizes induced astigmatism, to less than 1.0 dpt change. Therefore, the patients physical and visual rehabilitation can be accelerated. Soft IOL's composed of p-HEMA or Silicone materials have been investigated for the past ten years and appear to be well biocompatible. The p-HEMA lens most often implanted is the IO-GEL, manufactured by Alcon. 120 p-HEMA IOL's were implanted in our clinic over the past 2 years. Our experiences with this foldable IOL are reported.

Foreign-Body Reaction↗

PubMed2000

Nonpenetrating filtering surgery in glaucoma.

Since 1967, trabeculectomy has been the standard drainage operation for most cases of medically uncontrolled glaucoma. It is associated with significant risk of hypotony, hyphema, choroidal effusion or hemorrhage, and bleb failure. Toward the goal of a safer and more reproducible glaucoma filtering surgery, nonperforating filtering surgeries are now performed in primary open-angle glaucoma, normal-pressure glaucoma, and most cases of secondary glaucoma. The site of highest resistance to outflow, the juxtacanalicular trabecular meshwork, is bypassed with avoidance of penetration into the anterior chamber. Different techniques of nonpenetrating filtering surgeries are discussed here.

Anterior Chamber↗

PubMed2004

Avoiding and managing complications of glaucoma drainage implants.

PURPOSE OF REVIEW: The incentive for continued interest in aqueous devices in selected cases is mainly the result of the 5% incidence of late "blebitis" and endophthalmitis. The purpose of this review is to cover the most common complications that may arise and to offer strategies and techniques to avoid or rectify the complication. RECENT FINDINGS: Complications of aqueous drainage devices are categorized in three stages: intraoperative, early postoperative (<1 month), and late postoperative (>1 month). Intraoperative complications consist of anterior chamber entry, tube misdirection, and scleral perforation. Early postoperative complication includes hypotony and flat anterior chamber, choroidal effusions, and suprachoroidal hemorrhage. Late postoperative complication comprise tube migration, tube or plate extrusion, motility disturbance, and infection. SUMMARY: Most complications seen in glaucoma drainage implants are self-resolving and rarely threaten visual outcome.

Glaucoma↗

PubMed2004

Trabeculectomy with mitomycin-C in uveitic glaucoma associated with Behçet disease.

PURPOSE: To determine the effect of intraoperative application of Mitomycin-C (MMC) with trabeculectomy in uveitic glaucoma associated with Behçet disease. MATERIALS AND METHODS: Twenty-six eyes of 26 patients with uveitic glaucoma associated with Behçet disease who underwent trabeculectomy with MMC between 1996 and 2001 were reviewed in this retrospective, noncomparative study. Trabeculectomy + MMC in concentration of 0.4 mg/mL for 3 minutes was performed to all patients. Main outcome measures were control of IOP, the number of antiglaucoma medications required to achieve the desired IOP, visual acuity and complications. The surgical success was defined as IOP less than 22 mm Hg and greater than 5 mm Hg without additional further glaucoma surgery or loss of light perception. RESULTS: The cumulative probability of success was 83.3% at 1 year, 76.2% at 2 years, 70% at 3 years, 66.7% at 4 years and 62.5% at 5 years after surgery. The mean follow-up was 40.0+/-18.0 months. At last follow-up 23% of the patients required no antiglaucoma medications. Best-corrected visual acuity improved or remained within two lines of preoperative visual acuity in 19 eyes (73.1%). Glaucomatous (1 eye 3.8%) and nonglaucomatous optic atrophy (3 eyes 11.5%) was the most frequent reason for visual decrease (total 4 eyes 15.2%). The most common complications were cataract formation in 6 eyes (23.1%), bleb leakage in 4 eyes (15.3%) and choroidal effusion in 3 eyes (11.5%). Phthisis bulbi was found in one (3.8%) patient. CONCLUSION: Trabeculectomy and intraoperative application of MMC appears to provide long term safety and effectiveness in uveitic glaucoma associated with Behçet disease.

Adolescent↗

PubMed2006

Outcomes of inferonasal Baerveldt glaucoma drainage implant surgery.

PURPOSE: To determine the outcomes of inferonasal Baerveldt glaucoma implant (BGI) surgery. PATIENTS AND METHODS: A retrospective, non-comparative case series of 182 eyes of 182 patients who underwent inferonasal placement of a Baerveldt glaucoma implant. The main outcome measures included intraocular pressure, number of glaucoma medications, best corrected visual acuity, and complications. RESULTS: Patients were followed for an average (+/- SD) of 19 +/- 15 months. Median Snellen visual acuity was unchanged at last follow-up. Intraocular pressure was reduced from a mean (+/- SD) of 28.6 +/- 11.5 mm Hg preoperatively to 13.4 +/- 5.7 mm Hg at most recent follow-up (P < 0.001). The number of antiglaucoma medications was reduced from a mean (+/- SD) of 2.7 +/- 1.3 preoperatively to 1.1 +/- 1.1 at most recent follow-up. Nineteen eyes met our criteria for failure, yielding a cumulative percent survival of 92% at 12 months, 88% at 24 months, and 77% at 44 months. The most common complications were hyphema (14 eyes, 8%), choroidal effusion (12 eyes, 7%), and corneal decompensation (19 eyes, 10%). Endophthalmitis and diplopia occurred rarely (1 eye, <1%; 3 eyes, 2%, respectively). CONCLUSIONS: Inferonasal Baerveldt glaucoma implant placement appears to be a safe and effective surgical option that may be helpful in certain clinical situations.

Adolescent↗

PubMed2007

Comparison of trabeculectomy with Ex-PRESS miniature glaucoma device implanted under scleral flap.

PURPOSE: To evaluate the Ex-PRESS miniature implant (Model R 50) placed under partial-thickness scleral flap compared with standard trabeculectomy. METHODS: In this retrospective comparative series of 100 eyes, we compared 50 eyes in 49 patients treated with the Ex-PRESS miniature glaucoma implant under a scleral flap with 50 matched control eyes in 47 patients treated with trabeculectomy. Success was defined as intraocular pressure (IOP) > or =5 mm Hg and < or =21 mm Hg, with or without glaucoma medications, without further glaucoma surgery or removal of implant. Early postoperative hypotony was defined as IOP <5 mm Hg during the first postoperative week. RESULTS: The average follow-up was 10.8 months (range 3.5 to 18) for the Ex-PRESS group and 11.2 months (range 3 to 15) for the trabeculectomy group. Although the mean IOP was significantly higher in the early postoperative period in the Ex-PRESS group compared with the trabeculectomy group, the reduction of IOP was similar in both groups after 3 months. The number of postoperative glaucoma medications in both groups was not significantly different. Kaplan-Meier survival curve analysis showed no significant difference in success between the 2 groups (P=0.594). Early postoperative hypotony and choroidal effusion were significantly more frequent after trabeculectomy compared with Ex-PRESS implant under scleral flap (P<0.001). CONCLUSIONS: The Ex-PRESS implant under a scleral flap had similar IOP-lowering efficacy with a lower rate of early hypotony compared with trabeculectomy.

Aged↗

PubMed2006

Pars plana insertion of glaucoma drainage devices for refractory glaucoma.

BACKGROUND: Glaucoma drainage devices are more commonly inserted into the anterior chamber because of the relative ease of this method of insertion. However, in certain cases, posterior placement of the tube may be necessary or may be more desirable. The outcome of a series of patients with glaucoma drainage devices inserted into the pars plana was examined. METHODS: Retrospective chart review of patients who underwent pars plana implantation of Molteno and Baerveldt glaucoma drainage devices at the Sydney Eye Hospital. RESULTS: There were 33 cases reviewed. The mean follow-up period was 30.2 months. The mean final postoperative intraocular pressure was reduced to 13.4 +/- 4.4 mmHg (SD) from 33.06 +/- 8.47 mmHg preoperatively. The mean number of intraocular pressure-lowering medications in use postoperatively was 0.6 +/- 0.8, reduced from 3.6 +/- 1.27 medications in use preoperatively. Sixteen (48.5%) eyes were classified as complete successes, 14 (42.4%) eyes as qualified successes and three eyes (9%) as failures. Kaplan-Meier survival analysis for cumulative success (absence of failure) predicted 61.1% survival at 60 months. Complications included five cases of decompensation of corneas or corneal grafts, one case each of conjunctival wound dehiscence, large choroidal effusion, epiretinal membrane, Molteno plate extrusion and intraocular pressure unresponsive to medical therapy, and three cases of tube blockage. CONCLUSIONS: In this series of patients, pars plana insertion of glaucoma drainage devices has been shown to be an effective alternative for selected cases where anterior chamber tube insertion is not possible or is not ideal.

Adult↗

PubMed2006

Non-penetrating deep sclerectomy for glaucoma associated with Sturge-Weber syndrome.

PURPOSE: To report the results of non-penetrating deep sclerectomy (NPDS) in the treatment of glaucoma associated with Sturge-Weber syndrome (SWS). METHODS: We carried out a retrospective case series analysis of patients who underwent NPDS for glaucoma associated with SWS between 1998 and 2003. The control of glaucoma after NPDS, the results of surgery on intraocular pressure, the need for additional medical treatment and surgical complications were studied. RESULTS: Twelve eyes of nine patients, aged 11 days to 24 years, underwent filtering surgery: nine NPDS procedures were performed and three surgical procedures had to be converted to trabeculectomy because NPDS was not technically achievable. The mean follow-up after surgery was 26.3 months (range 6-48 months). Two trabeculectomies were complicated by choroidal effusion, which resolved in both cases. Good control of glaucoma was obtained during follow-up. CONCLUSIONS: Non-penetrating deep sclerectomy is transiently efficient in the treatment of SWS-associated glaucoma. Further studies of NPDS for the treatment of glaucoma associated with SWS are warranted.

Adolescent↗

PubMed1997

Technique of goniocurettage: a potential treatment for advanced chronic open angle glaucoma.

AIM: To introduce a new concept of anterior chamber angle microsurgery, designed to scrape pathologically altered trabecular meshwork from the scleral sulcus as a potential treatment in primary open angle glaucoma. METHODS: Gonioscopically controlled ab interno abrasion of the trabecular meshwork was performed on six human eye banking eyes for morphological analysis. Thereafter, four eyes suffering from terminal glaucomatous optic nerve atrophy as a result of medically uncontrolled intraocular pressure were also treated by 'goniocurettage'. The newly designed instrument resembles a modified cyclodialysis spatula with a bowl-shaped tip, 300 microns in diameter, and with its edges sharpened. The treatment zone comprised 4-5 clock hours of the chamber angle circumference. RESULTS: Microscopic examination of the treatment zone revealed that in addition to a complete disruption of the trabecular meshwork and internal wall of Schlemm's canal goniocurettage also caused damage to intracanalicular septa. A splitting along the posterior wall of Schlemm's canal was also noted in one specimen. The clinical data of goniocurettage also showed some promising results. Mean pretreatment IOP averaged 40.7 (SD 8.8) mm Hg (range 32-51 mm Hg) and was significantly (p < 0.04) reduced to 18.0 (4.2) mm Hg (12-22 mm Hg) after 6 months, representing an absolute decrease in IOP of 22.7 mm Hg and a mean decrease in IOP of 56%. Clinically significant hyphaema occurred in one eye, caused by introgenic trauma to a prominent chamber angle vessel. In three eyes a minor reflux of blood occurred at the treatment site. However, no hypotony, choroidal effusion, flattened anterior chamber, or cyclodialysis were observed in these patients. CONCLUSION: Morphological analysis of treated postmortem eyes confirmed that goniocurettage completely removed the trabecular meshwork and opened Schlemm's canal, ensuring direct access into the anterior chamber. In a small number of patients over a limited period of time this new surgical procedure resulted in a clinically significant pressure reduction. However, longer term follow up and a greater number of patients are warranted before this experimental procedure is applicable to eyes that would do well with conventional surgery.

Aged↗

PubMed1999

Filtration procedures supplemented with mitomycin C in the management of childhood glaucoma.

AIMS: To evaluate the outcome of filtering procedures supplemented with mitomycin C in children with glaucoma. METHODS: All patients aged 17 or younger with glaucoma who underwent filtering surgery supplemented with mitomycin C at a tertiary care centre (n = 21) during a 5 year interval (1992 and 1996) were included. One eye for each patient was entered into the analysis. The postoperative intraocular pressure (IOP), use of antiglaucoma medications, clinical stability of glaucoma, complications, and visual acuity were retrospectively evaluated. Kaplan-Meier survival curves were used to estimate the probability of success. RESULTS: At the time of surgery mean age was 5.7 (SD 5.0) years. The most common diagnoses were trabeculodysgenesis (n = 6) and aphakic glaucoma (n = 8). Mean IOP before surgery was 35.7 (10.5) mm Hg. Average length of follow up was 18.6 (14.7) months. The probability of having IOP less than 21 mm Hg with no antiglaucoma medications and with clinically stable glaucoma 1 year after surgery was 76.9% in phakic eyes (n = 13) and 0% in aphakic eyes (n = 8). A phakic patient with Sturge-Weber's syndrome had choroidal effusion after surgery that resolved spontaneously. In the aphakic group one patient had retinal detachment and another developed an encapsulated bleb. Visual acuity deteriorated in one patient. CONCLUSION: A guarded filtration procedure with mitomycin C is relatively successful in phakic children with glaucoma, but unsuccessful in aphakic ones.

Adolescent↗