Background/aim: Choroidal expansion with anterior movement of the lens was rec ently proposed as a mechanism for acute primary angle closure (APAC). The aim of this study was to compare the biometric parameters, centr...Background/aim: Choroidal expansion with anterior movement of the lens was rec ently proposed as a mechanism for acute primary angle closure (APAC). The aim of this study was to compare the biometric parameters, central anterior chamber de pth, limbal chamber depth, lens thickness, and lens position, within 24 hours of presentation and 2 weeks later in eyes with APAC. Methods: This was a prospecti ve observational case series of 41 subjects with APAC. Subjects who presented wi th APAC were treated with medical therapy followed by laser iridotomy (LI) in bo th eyes once the acute attack was broken. Ocular biometry was performed in affec ted and fellow eyes before LI (baseline) and then 2 weeks later. Optical pachyme try was used to measure central anterior chamber depth (ACD) and the limbal cham ber depth (LCD) was graded at the slit lamp. A-scan ultrasound was used to measure lens thickness (LT) and axial len gth (AL). Lens position (LP) was defined as ACD +1/2LT. Results: The majority o f subjects were Chinese (83%)and female (61%), and the mean age was 60.4 (SD 1 0.3) years. In affected eyes, the ACD was 1.81 (0.29) mm before and 1.80 (0.28) mm 2 weeks after LI (p=0.63), while in fellow eyes, the ACD was 1.83 (0.29) mm a nd 1.81 (0.38) mm, respectively (p=0.21). There was no significant change in len s position, relative lens position, or axial length in both affected and fellow eyes over the 2 weeks. Conclusions: There was no change observed in central ante rior chamber depth, lens thickness, or lens position at the time of the acute at tack compared to 2 weeks later in both APAC affected and fellow eyes. The findin gs do not support the hypothesis of lens movement due to choroidal expansion in APAC.展开更多
PURPOSE: To evaluate the use of Surodex (Oculex Pharmaceuticals, Sunnyvale, California) a drug delivery system incorporating 60 micrograms of dexamethasone in a pellet, in phacotrabeculectomy surgery. DESIGN: Nonrando...PURPOSE: To evaluate the use of Surodex (Oculex Pharmaceuticals, Sunnyvale, California) a drug delivery system incorporating 60 micrograms of dexamethasone in a pellet, in phacotrabeculectomy surgery. DESIGN: Nonrandomized, prospective, interventional case series. METHODS: Phacotrabeculectomy was performed on 37 Asian subjects with primary open-angle glaucoma (POAG) using a standardized technique. All subjects received a Surodex pellet underneath the scleral flap. Results were compared with those of 31 POAG subjects who had undergone phacotrabeculectomy augmented with 50 mg/ml of intraoperative 5-fluorouracil (5-FU) during the same period. RESULTS: Mean follow-up in months was 19.7±7.9 and 22.1±6.2 for the Surodex and 5-FU groups, respectively (P=.29). Therewas a 20.1%decrease in intraocular pressure in the Surodex group compared with 28.5%decrease in the 5-FU group (P=.6). Postoperative complications occurred in three cases (8.1%) and six cases (19.3%), respectively (P=.04). CONCLUSIONS: Combined phacotrabeculectomy surgery augmented by intra-scleral placement of Surodex results in good control of IOPand a low incidence of complications.展开更多
文摘Background/aim: Choroidal expansion with anterior movement of the lens was rec ently proposed as a mechanism for acute primary angle closure (APAC). The aim of this study was to compare the biometric parameters, central anterior chamber de pth, limbal chamber depth, lens thickness, and lens position, within 24 hours of presentation and 2 weeks later in eyes with APAC. Methods: This was a prospecti ve observational case series of 41 subjects with APAC. Subjects who presented wi th APAC were treated with medical therapy followed by laser iridotomy (LI) in bo th eyes once the acute attack was broken. Ocular biometry was performed in affec ted and fellow eyes before LI (baseline) and then 2 weeks later. Optical pachyme try was used to measure central anterior chamber depth (ACD) and the limbal cham ber depth (LCD) was graded at the slit lamp. A-scan ultrasound was used to measure lens thickness (LT) and axial len gth (AL). Lens position (LP) was defined as ACD +1/2LT. Results: The majority o f subjects were Chinese (83%)and female (61%), and the mean age was 60.4 (SD 1 0.3) years. In affected eyes, the ACD was 1.81 (0.29) mm before and 1.80 (0.28) mm 2 weeks after LI (p=0.63), while in fellow eyes, the ACD was 1.83 (0.29) mm a nd 1.81 (0.38) mm, respectively (p=0.21). There was no significant change in len s position, relative lens position, or axial length in both affected and fellow eyes over the 2 weeks. Conclusions: There was no change observed in central ante rior chamber depth, lens thickness, or lens position at the time of the acute at tack compared to 2 weeks later in both APAC affected and fellow eyes. The findin gs do not support the hypothesis of lens movement due to choroidal expansion in APAC.
文摘PURPOSE: To evaluate the use of Surodex (Oculex Pharmaceuticals, Sunnyvale, California) a drug delivery system incorporating 60 micrograms of dexamethasone in a pellet, in phacotrabeculectomy surgery. DESIGN: Nonrandomized, prospective, interventional case series. METHODS: Phacotrabeculectomy was performed on 37 Asian subjects with primary open-angle glaucoma (POAG) using a standardized technique. All subjects received a Surodex pellet underneath the scleral flap. Results were compared with those of 31 POAG subjects who had undergone phacotrabeculectomy augmented with 50 mg/ml of intraoperative 5-fluorouracil (5-FU) during the same period. RESULTS: Mean follow-up in months was 19.7±7.9 and 22.1±6.2 for the Surodex and 5-FU groups, respectively (P=.29). Therewas a 20.1%decrease in intraocular pressure in the Surodex group compared with 28.5%decrease in the 5-FU group (P=.6). Postoperative complications occurred in three cases (8.1%) and six cases (19.3%), respectively (P=.04). CONCLUSIONS: Combined phacotrabeculectomy surgery augmented by intra-scleral placement of Surodex results in good control of IOPand a low incidence of complications.
