AIM: To evaluate the efficacy of combined treatment of phacoemulsification(PE) and micro-incisional single-port transconjunctival limited pars plana vitrectomy(PPV) in acute angle-closure glaucoma(AACG).METHODS: A ret...AIM: To evaluate the efficacy of combined treatment of phacoemulsification(PE) and micro-incisional single-port transconjunctival limited pars plana vitrectomy(PPV) in acute angle-closure glaucoma(AACG).METHODS: A retrospective study included 26 patients who underwent PE diagnosed with AACG. Among them, 16 patients(16 eyes) underwent PE alone, 10 patients(10 eyes) underwent combined limited vitrectomy and PE. Then we compared intraocular pressure(IOP), anterior chamber angle, anterior chamber depth, central corneal thickness and corneal endothelial cell count before and after surgery, and effective PE time during cataract surgery.RESULTS: Effective PE time was shorter in the combined surgery group than in the single surgery group(P=0.040). There was no statistically significant difference in IOP and best-corrected visual acuity between the two groups postoperatively. At 6 mo postoperatively, there was no difference in the anterior chamber angle, anterior chamber depth, and central corneal thickness between two groups, but corneal endothelial cell count was higher in the combined surgery group than in the single surgery group(P=0.046). No complication such as vitreoretinal disease, endophthalmitis, bullous keratopathy was noted.CONCLUSION: Combined micro-incisional single-port transconjunctival limited PPV and PE are more effective and safer than PE alone because of less operation time and fewer complications for management of AACG.展开更多
Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1,...Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.展开更多
Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1,...Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.展开更多
Dear Sir,We hereby report a case of bilateral acute angle closure glaucoma secondary to a systemic decongestant containing pseudoephedrine freely available over the counter.Acute angle closure glaucoma is an ocular em...Dear Sir,We hereby report a case of bilateral acute angle closure glaucoma secondary to a systemic decongestant containing pseudoephedrine freely available over the counter.Acute angle closure glaucoma is an ocular emergency.Delayed recognition and treatment inevitably leads to permanent visual impairment.Acute angle closure occurs as a result of obstruction to aqueous drainage by blockage of the trabecular meshwork by the iris.Typical presenting symptoms include acute onset of ocular pain,headache and blurred vision.On clinical examination,it is characterized by a markedly raised IOP of above 21 mm Hg together with展开更多
Purpose:To investigate the safety and efficacy of combined trabeculectomy for primary acute angle closure glaucoma with persistent ocular hypertension.Methods:A total of 36 patients.(40 eyes).with primary acute angle ...Purpose:To investigate the safety and efficacy of combined trabeculectomy for primary acute angle closure glaucoma with persistent ocular hypertension.Methods:A total of 36 patients.(40 eyes).with primary acute angle closure glaucoma,who were treated with combined trabeculectomy in the Ophthalmology Unit of our hospital,were selected.Before the procedure,patients were assigned to ocular hypertension group(≥ 40 mm Hg) or control group(< 40 mm Hg) based on intraocular pressure.These two groups were followed up for one year,and compared for post-operative visual acuity,intraocular pressure,filtering bleb,anterior chamber depth,and the occurrence of complications.Results:At 1 week,6 months,and 12 months after the procedure,intraocular pressure was controlled in both the ocular hypertension group and the control group,without significant differences between the two groups(P>0.05).At 1 week,6 months,and 12 months after the procedure,all of the patients,in both groups,had improved in terms of visual acuity,with a significant difference before and after the procedure for the ocular hypertension group(P<0.05).After follow-up at 12 months,the two groups presented no statistically significant differences in anterior chamber depth,filtering bleb survival,or the incidence of post-operative complications(P>0.05 for all).Conclusion:It is feasible,safe,and effective to perform combined trabeculectomy on patients with primary acute angle closure glaucoma complicated by persistent ocular hypertension.展开更多
Purpose: To identify the anterior segment parameters associated to acute primary angle closure. Patients and Methods: Case-control study in 58 primary angle closure suspect eyes (PACS, control group) and in 19 acute p...Purpose: To identify the anterior segment parameters associated to acute primary angle closure. Patients and Methods: Case-control study in 58 primary angle closure suspect eyes (PACS, control group) and in 19 acute primary angle closure fellow eyes, case group. All subjects underwent SL OCT imaging in a dark room. Results: The SS, ACD and ACV measures were significantly smaller in case group than in control group (p = 0.011;p < 0.001;p = 0.007 respectively);while the IT was significantly greater (at 500 and 750 μm) (p = 0.038 and p = 0.050). The difference between quadrants were statistically significant only for control group (p = 0.001;p = 0.003;p = 0.009;p = 0.018;p = 0.002 and p 500, AOD500, AOD750, TISA500, and TISA750 respectively. Conclusion: Acute primary angle closure is associated to the smaller anterior segment dimensions and the thicker iris compared to PACS.展开更多
Dear Editor,Acute primary angle-closure glaucoma(PACG)is an important cause of blindness in East Asia.1 It is estimated that the overall prevalence of PACG will increase from 1.44%to 2.01%from 2020 to 2050.2 Acute PAC...Dear Editor,Acute primary angle-closure glaucoma(PACG)is an important cause of blindness in East Asia.1 It is estimated that the overall prevalence of PACG will increase from 1.44%to 2.01%from 2020 to 2050.2 Acute PACG is typically related to increased high intraocular pressure(IOP),with symptoms including red eye,blurred vision,nausea,vomiting,and headache.Delay in timely IOPlowering treatment can result in permanent optic nerve damage and vision loss.展开更多
Background Argon laser peripheral iridoplasty （ALPI） is proved to be effective in lowering intraocular pressure （lOP） of patients with mild acute primary angle closure （APAC）. It is unclear whether this laser tr...Background Argon laser peripheral iridoplasty （ALPI） is proved to be effective in lowering intraocular pressure （lOP） of patients with mild acute primary angle closure （APAC）. It is unclear whether this laser treatment is equally efficient in managing patients with severe APAC. This study aimed peripheral iridotomy （LPI） on patients with refractory APAC, therapy. to evaluate the IOP-lowering efficacy of ALPI and laser who have previously responded poorly to intensive medical Methods Thirty-six patients （8 men and 28 women） were identified as medically refractory APAC, who still had ocular pain, red eye, hazy cornea, closed anterior chamber （AC） angle, and lOP of not less than 21 mmHg after two days or more of anti-glaucoma medication. All enrolled patients underwent ophthalmologic examinations including measurement of visual acuity （VA）, best corrected VA （BCVA）, lOP, biomicroscopy, and gonioscopy followed by ALPI immediately in the APAC eye and LPI in both eyes. Results All patients were affected unilaterally, with average age of （54.6±11.7） （range, 37.0-75.0） years old. The mean lOP value of the affected eyes dropped from （31.6±7.7） （range, 21.0-39.0） mmHg at enrollment to （18.4±8.7） （range, 10.0-27.0） mmHg 2 hours after ALPI. At follow-up day 7, the mean lOP value maintained at （14.8±4.2） （range, 9.0-21.0） mmHg, which was significantly different （P=0.000） compared with baseline. The average decrease of lOP in the APAC eyes was （16.8±7.4） （range, 12.0-21.0） mmHg. At follow-up three years later, the mean lOP of the APAC eyes stabilized at （16.3±3.2） （range, 9.0-20.0） mmHg with at least 180° of AC angle opened. Conclusion ALPI and LPI lower the lOP of medically refractory cases of APAC though they have responded poorly to anti-glaucoma medication.展开更多
目的探讨急性闭角型青光眼的危险因素及筛查手段,为防治其导致的不可逆盲提供新思路。方法选取2013年3月至2014年10月于我院确诊的急性闭角型青光眼患者临床前期眼24例24眼为研究对象(即临床前期组),另外取我院就诊无前房浅、房角窄、...目的探讨急性闭角型青光眼的危险因素及筛查手段,为防治其导致的不可逆盲提供新思路。方法选取2013年3月至2014年10月于我院确诊的急性闭角型青光眼患者临床前期眼24例24眼为研究对象(即临床前期组),另外取我院就诊无前房浅、房角窄、无葡萄膜炎的43例43眼为对照组,应用光学相干断层扫描仪Topcon 3D 1000 OCT扫描房角,观察两组房角图像特征,并以Schwalbe线(SL线)为解剖标志线的房角开放距离(angle opening distance,SL-AOD)及小梁虹膜间面积(trabecular-iris space area,SL-TISA)定量评估两组房角的宽窄。结果 3D-OCT能清晰显示小梁网的形态为三角形中等强反射区及SL线,在3D-OCT能清晰显示SL线者占94%。临床前期组周边虹膜明显膨隆,小梁网与周边虹膜的间隙明显变窄,对照组周边虹膜轻度膨隆或者平坦,小梁网与周边虹膜的间隙宽。临床前期组的SL-AOD及SL-TISA分别为(0.117±0.047)mm、(0.055±0.023)mm2,均明显小于对照组的(0.371±0.096)mm、(0.121±0.030)mm2,差异均有统计学意义(均为P<0.05)。结论 3D-OCT能清晰扫描到急性闭角型青光眼临床前期房角的改变并定量分析,可能成为筛查急性闭角型青光眼危险因素的实用、可靠的新手段。展开更多
基金Supported by Research Fund from Chosun University,2018
文摘AIM: To evaluate the efficacy of combined treatment of phacoemulsification(PE) and micro-incisional single-port transconjunctival limited pars plana vitrectomy(PPV) in acute angle-closure glaucoma(AACG).METHODS: A retrospective study included 26 patients who underwent PE diagnosed with AACG. Among them, 16 patients(16 eyes) underwent PE alone, 10 patients(10 eyes) underwent combined limited vitrectomy and PE. Then we compared intraocular pressure(IOP), anterior chamber angle, anterior chamber depth, central corneal thickness and corneal endothelial cell count before and after surgery, and effective PE time during cataract surgery.RESULTS: Effective PE time was shorter in the combined surgery group than in the single surgery group(P=0.040). There was no statistically significant difference in IOP and best-corrected visual acuity between the two groups postoperatively. At 6 mo postoperatively, there was no difference in the anterior chamber angle, anterior chamber depth, and central corneal thickness between two groups, but corneal endothelial cell count was higher in the combined surgery group than in the single surgery group(P=0.046). No complication such as vitreoretinal disease, endophthalmitis, bullous keratopathy was noted.CONCLUSION: Combined micro-incisional single-port transconjunctival limited PPV and PE are more effective and safer than PE alone because of less operation time and fewer complications for management of AACG.
文摘Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.
文摘Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.
文摘Dear Sir,We hereby report a case of bilateral acute angle closure glaucoma secondary to a systemic decongestant containing pseudoephedrine freely available over the counter.Acute angle closure glaucoma is an ocular emergency.Delayed recognition and treatment inevitably leads to permanent visual impairment.Acute angle closure occurs as a result of obstruction to aqueous drainage by blockage of the trabecular meshwork by the iris.Typical presenting symptoms include acute onset of ocular pain,headache and blurred vision.On clinical examination,it is characterized by a markedly raised IOP of above 21 mm Hg together with
文摘Purpose:To investigate the safety and efficacy of combined trabeculectomy for primary acute angle closure glaucoma with persistent ocular hypertension.Methods:A total of 36 patients.(40 eyes).with primary acute angle closure glaucoma,who were treated with combined trabeculectomy in the Ophthalmology Unit of our hospital,were selected.Before the procedure,patients were assigned to ocular hypertension group(≥ 40 mm Hg) or control group(< 40 mm Hg) based on intraocular pressure.These two groups were followed up for one year,and compared for post-operative visual acuity,intraocular pressure,filtering bleb,anterior chamber depth,and the occurrence of complications.Results:At 1 week,6 months,and 12 months after the procedure,intraocular pressure was controlled in both the ocular hypertension group and the control group,without significant differences between the two groups(P>0.05).At 1 week,6 months,and 12 months after the procedure,all of the patients,in both groups,had improved in terms of visual acuity,with a significant difference before and after the procedure for the ocular hypertension group(P<0.05).After follow-up at 12 months,the two groups presented no statistically significant differences in anterior chamber depth,filtering bleb survival,or the incidence of post-operative complications(P>0.05 for all).Conclusion:It is feasible,safe,and effective to perform combined trabeculectomy on patients with primary acute angle closure glaucoma complicated by persistent ocular hypertension.
文摘Purpose: To identify the anterior segment parameters associated to acute primary angle closure. Patients and Methods: Case-control study in 58 primary angle closure suspect eyes (PACS, control group) and in 19 acute primary angle closure fellow eyes, case group. All subjects underwent SL OCT imaging in a dark room. Results: The SS, ACD and ACV measures were significantly smaller in case group than in control group (p = 0.011;p < 0.001;p = 0.007 respectively);while the IT was significantly greater (at 500 and 750 μm) (p = 0.038 and p = 0.050). The difference between quadrants were statistically significant only for control group (p = 0.001;p = 0.003;p = 0.009;p = 0.018;p = 0.002 and p 500, AOD500, AOD750, TISA500, and TISA750 respectively. Conclusion: Acute primary angle closure is associated to the smaller anterior segment dimensions and the thicker iris compared to PACS.
基金This work was supported in part by the National Natural Science Foundation of China(NSFC,Grant No.81700882).
文摘Dear Editor,Acute primary angle-closure glaucoma(PACG)is an important cause of blindness in East Asia.1 It is estimated that the overall prevalence of PACG will increase from 1.44%to 2.01%from 2020 to 2050.2 Acute PACG is typically related to increased high intraocular pressure(IOP),with symptoms including red eye,blurred vision,nausea,vomiting,and headache.Delay in timely IOPlowering treatment can result in permanent optic nerve damage and vision loss.
基金This work was supported by grants from National Natural Science Foundation of China （No. 30921064 and No. 90820307）, Ministry of Science and Technology of China （No. 2010IM030800）, and the Beijing Municipal Health Bureau High-level Medical Professionals Promotion Project （No. 2011-3-044）.
文摘Background Argon laser peripheral iridoplasty （ALPI） is proved to be effective in lowering intraocular pressure （lOP） of patients with mild acute primary angle closure （APAC）. It is unclear whether this laser treatment is equally efficient in managing patients with severe APAC. This study aimed peripheral iridotomy （LPI） on patients with refractory APAC, therapy. to evaluate the IOP-lowering efficacy of ALPI and laser who have previously responded poorly to intensive medical Methods Thirty-six patients （8 men and 28 women） were identified as medically refractory APAC, who still had ocular pain, red eye, hazy cornea, closed anterior chamber （AC） angle, and lOP of not less than 21 mmHg after two days or more of anti-glaucoma medication. All enrolled patients underwent ophthalmologic examinations including measurement of visual acuity （VA）, best corrected VA （BCVA）, lOP, biomicroscopy, and gonioscopy followed by ALPI immediately in the APAC eye and LPI in both eyes. Results All patients were affected unilaterally, with average age of （54.6±11.7） （range, 37.0-75.0） years old. The mean lOP value of the affected eyes dropped from （31.6±7.7） （range, 21.0-39.0） mmHg at enrollment to （18.4±8.7） （range, 10.0-27.0） mmHg 2 hours after ALPI. At follow-up day 7, the mean lOP value maintained at （14.8±4.2） （range, 9.0-21.0） mmHg, which was significantly different （P=0.000） compared with baseline. The average decrease of lOP in the APAC eyes was （16.8±7.4） （range, 12.0-21.0） mmHg. At follow-up three years later, the mean lOP of the APAC eyes stabilized at （16.3±3.2） （range, 9.0-20.0） mmHg with at least 180° of AC angle opened. Conclusion ALPI and LPI lower the lOP of medically refractory cases of APAC though they have responded poorly to anti-glaucoma medication.
文摘目的探讨急性闭角型青光眼的危险因素及筛查手段,为防治其导致的不可逆盲提供新思路。方法选取2013年3月至2014年10月于我院确诊的急性闭角型青光眼患者临床前期眼24例24眼为研究对象(即临床前期组),另外取我院就诊无前房浅、房角窄、无葡萄膜炎的43例43眼为对照组,应用光学相干断层扫描仪Topcon 3D 1000 OCT扫描房角,观察两组房角图像特征,并以Schwalbe线(SL线)为解剖标志线的房角开放距离(angle opening distance,SL-AOD)及小梁虹膜间面积(trabecular-iris space area,SL-TISA)定量评估两组房角的宽窄。结果 3D-OCT能清晰显示小梁网的形态为三角形中等强反射区及SL线,在3D-OCT能清晰显示SL线者占94%。临床前期组周边虹膜明显膨隆,小梁网与周边虹膜的间隙明显变窄,对照组周边虹膜轻度膨隆或者平坦,小梁网与周边虹膜的间隙宽。临床前期组的SL-AOD及SL-TISA分别为(0.117±0.047)mm、(0.055±0.023)mm2,均明显小于对照组的(0.371±0.096)mm、(0.121±0.030)mm2,差异均有统计学意义(均为P<0.05)。结论 3D-OCT能清晰扫描到急性闭角型青光眼临床前期房角的改变并定量分析,可能成为筛查急性闭角型青光眼危险因素的实用、可靠的新手段。
