To investigate the changes of pattern electroretinogram (PERG) after intraocul ar pressure lowering in glaucoma patients and normal controls. Interventional re trospective cross-sectional study. Twenty-five patients (...To investigate the changes of pattern electroretinogram (PERG) after intraocul ar pressure lowering in glaucoma patients and normal controls. Interventional re trospective cross-sectional study. Twenty-five patients (49 eyes) with ocular hypertension or glaucoma undergoing topical treatment to lower IOP served as a s tudy group; 22 patients (44 eyes) with ocular hypertension or glaucoma observed without treatment served as a control group for treated glaucoma patients; 9 nor mal subjects (18 eyes) receiving a 250-mg acetazolamide tablet served as a seco nd study group; and 17 normal subjects (34 eyes) from a previous study served as a second control group for treated normal subjects. Pattern electroretinograms were recorded simultaneously from both eyes using skin electrodes and automated analysis. Visual field (VF) analyses were performed with white-on-white standa rd automated perimetry (SAP). Intraocular pressure was measured with Goldmann ap planation tonometry; central corneal thickness was measured with pachymetry. Pat tern electroretinogram amplitude (microvolts), phase (π.rads), and test-retest variability (test 2-to-test 1 ratio, in decibels), SAP mean deviation (decibe ls), and IOP (millimeters of mercury). In 56%of right eyes and 21%of left eyes of the treated glaucoma subgroup, the PERG amplitude and/or phase improved beyo nd the 95%confidence intervals of the test-retest variability of the untreated glaucoma control group. Pattern electroretinogram improvement with IOP lowering occurred in both high-and low-tension glaucoma eyes. Eyes with severely impai red VFs showed little improvement in PERG; however, eyes of normal subjects trea ted with acetazolamide did not show significant PERG changes relative to the tes t-retest variability of normal controls. Retinal ganglion cell function can be at least partially restored after IOP reduction in glaucomatous eyes with early VF impairment.展开更多
Objective: To evaluate the 24- hour efficacy and safety of the latanoprost-timolol maleate-fixed combination vs latanoprost therapy in patients with primary open-angle glaucoma. Methods: A prospective, observer-masked...Objective: To evaluate the 24- hour efficacy and safety of the latanoprost-timolol maleate-fixed combination vs latanoprost therapy in patients with primary open-angle glaucoma. Methods: A prospective, observer-masked, crossover, activecontrolled, randomized comparison in which after a 6- week medicine-free period, patients were randomized to either latanoprost-timolol-fixed combination therapy or latanoprost therapy, both dosed once each evening, alone for 8 weeks. Patients were then switched to the opposite treatment for 8 weeks. At the end of the washout and treatment periods, a 24- hour diurnal curve was performed. Results: The baseline untreated mean± SD diurnal curve in 37 patients who completed the study was 24.2± 2.0 mm Hg. The mean diurnal curve was 19.2± 2.6 mm Hg for those who received latanoprost therapy alone and 16.7 ± 2.1 mm Hg for those who received the fixed combination therapy (P<.001). The fixed combination therapy also provided a lower absolute intraocular pressure level (1.5- 2.9 mm Hg, P<.001) and a greater intraocular pressure reduction from the untreated baseline (P<.001). Stinging was statistically lower with latanoprost therapy alone (P=.04), but itching was statistically increased compared with the fixed combination therapy (P=.04). Conclusion: The result of this study suggests that the latanoprost-timolol-fixed combination compared with latanoprost therapy alone provides improved intraocular pressure reduction over the 24- hour diurnal curve and for each individual time point in patients with primary open-angle glaucoma.展开更多
Purpose:This study was conducted to report the safety and efficacy of pars plana-modified Ahmed Glaucoma Valve PS2 in advanced secondary glaucoma.Methods:We performed a prospective,interventional case series that incl...Purpose:This study was conducted to report the safety and efficacy of pars plana-modified Ahmed Glaucoma Valve PS2 in advanced secondary glaucoma.Methods:We performed a prospective,interventional case series that included patients with advanced secondary glaucoma and uncontrolled intraocular pressure(IOP).Eleven eyes of nine patients with aphakic,neovascular,traumatic,inflammatory and pseudoexfoliation glaucoma were included.All patients had pars plana vitrectomy before tube insertion.Results:One year after surgery,IOP was controlled(21 mmHg or less)in ten of 11 eyes(91%),seven(64%)did not need medical antiglaucoma therapy.Average IOP decreased from 32.2± 8.3 mmHg before surgery to 15.7± 7.7 mmHg postoperatively(P < 0.0001).The average number of topically used medications used decreased from 2.9± 1.2 to 0.545± 0.78(P < 0.0001).Complications included transient hypotony(three eyes-two of them without tube ligature),transient choroidal effusion(three eyes)and an intermediate increase in IOP(seven eyes).Tube exchange was performed in one eye and needling/bleb excision in two patients.Conclusions:Pars plana-modified Ahmed Valve implantation is effective and safe in advanced glaucoma.Partial ligature of the tube is necessary to prevent early hypotony.Close followup of patients is needed to monitor variations of IOP within the first year.展开更多
Background:Excimer laser trabeculotomy(ELT)ab interno is a new surgical technique to reduce intraocular pressure(IOP)in patients with glaucoma or ocular hypertension.Our purpose was to examine IOP reduction and the us...Background:Excimer laser trabeculotomy(ELT)ab interno is a new surgical technique to reduce intraocular pressure(IOP)in patients with glaucoma or ocular hypertension.Our purpose was to examine IOP reduction and the use of antiglaucoma drugs(AGD)in patients treated with ELT and to evaluate the safety of this laser treatment.Methods:To increase the outflow of aqueous humor,ten microperforations of the trabecular meshwork were performed by an endoscope-guided photoablative laser probe(Excimer laser,AIDA,TUI-Laser,Munich;pulse energy:1.2 mJ at fiber tip,pulse duration:60 ns,repetition rate:20 Hz).Average operation time usually was about 2 min.In our pilot study,one group of patients without cataract underwent ELT,the other group with cataract underwent phacoemulsification(PHACO)plus ELT.IOP,visual acuity,and AGD were determined preoperatively(T0)and 2-4 months(T1),5-7 months(T2),11-13 months(T3),and 22-26(T4)months after surgery.Treatment was defined to be successful if(1)postoperative IOP was < 21mmHg,and(2)IOP reduction was at least 20%.Results:ELT reduced the IOP from 24.1± 0.7(n=69)-mmHg preoperatively to 18.8± 0.4(T1,n=66),20.0± 0.5(T2,n=51),18.8± 0.8(T3,n=37),and 16.8± 1.0(T4,n=15)mmHg,respectively.However,28% of the eyes needed repeat surgery due to insufficient IOP reduction.According to Kaplan-Meier statistics,the success rate was 60%(T1),49%(T2),and 46%(T3),respectively.The number of AGD was 1.9± 0.1(T0),1.2± 0.2(T1),1.3± 0.2(T2),1.8± 0.2(T3),and 1.5± 0.3(T4).Combined phacoemulsification plus ELT reduced the IOP from 22.4 mmHg± 0.6(T0,n=57)to 16.5± 0.4(T1,n=52),16.1± 0.5(T2,n=40),16.4± 0.4(T3,n=35),and 12.8± 1.5(T4,n=4)mmHg,respectively;7% of the eyes treated with the combined procedure needed repeat surgery due to insufficient IOP reduction.According to Kaplan-Meier statistics,the success rate was 85%(T1),74%(T2),and 66%(T3),respectively.The number of AGD was 1.1± 0.2(T0),0.9± 0.2(T1),1.1± 0.2(T2),1.2± 0.2(T3),and 1.8± 0.9(T4).Conclusions:ELT,especially in combination with phacoemulsification,is a new,promising,minimally invasive laser treatment to reduce IOP for at least 1-2 years.ELT alone is less effective in IOP reduction.展开更多
文摘To investigate the changes of pattern electroretinogram (PERG) after intraocul ar pressure lowering in glaucoma patients and normal controls. Interventional re trospective cross-sectional study. Twenty-five patients (49 eyes) with ocular hypertension or glaucoma undergoing topical treatment to lower IOP served as a s tudy group; 22 patients (44 eyes) with ocular hypertension or glaucoma observed without treatment served as a control group for treated glaucoma patients; 9 nor mal subjects (18 eyes) receiving a 250-mg acetazolamide tablet served as a seco nd study group; and 17 normal subjects (34 eyes) from a previous study served as a second control group for treated normal subjects. Pattern electroretinograms were recorded simultaneously from both eyes using skin electrodes and automated analysis. Visual field (VF) analyses were performed with white-on-white standa rd automated perimetry (SAP). Intraocular pressure was measured with Goldmann ap planation tonometry; central corneal thickness was measured with pachymetry. Pat tern electroretinogram amplitude (microvolts), phase (π.rads), and test-retest variability (test 2-to-test 1 ratio, in decibels), SAP mean deviation (decibe ls), and IOP (millimeters of mercury). In 56%of right eyes and 21%of left eyes of the treated glaucoma subgroup, the PERG amplitude and/or phase improved beyo nd the 95%confidence intervals of the test-retest variability of the untreated glaucoma control group. Pattern electroretinogram improvement with IOP lowering occurred in both high-and low-tension glaucoma eyes. Eyes with severely impai red VFs showed little improvement in PERG; however, eyes of normal subjects trea ted with acetazolamide did not show significant PERG changes relative to the tes t-retest variability of normal controls. Retinal ganglion cell function can be at least partially restored after IOP reduction in glaucomatous eyes with early VF impairment.
文摘Objective: To evaluate the 24- hour efficacy and safety of the latanoprost-timolol maleate-fixed combination vs latanoprost therapy in patients with primary open-angle glaucoma. Methods: A prospective, observer-masked, crossover, activecontrolled, randomized comparison in which after a 6- week medicine-free period, patients were randomized to either latanoprost-timolol-fixed combination therapy or latanoprost therapy, both dosed once each evening, alone for 8 weeks. Patients were then switched to the opposite treatment for 8 weeks. At the end of the washout and treatment periods, a 24- hour diurnal curve was performed. Results: The baseline untreated mean± SD diurnal curve in 37 patients who completed the study was 24.2± 2.0 mm Hg. The mean diurnal curve was 19.2± 2.6 mm Hg for those who received latanoprost therapy alone and 16.7 ± 2.1 mm Hg for those who received the fixed combination therapy (P<.001). The fixed combination therapy also provided a lower absolute intraocular pressure level (1.5- 2.9 mm Hg, P<.001) and a greater intraocular pressure reduction from the untreated baseline (P<.001). Stinging was statistically lower with latanoprost therapy alone (P=.04), but itching was statistically increased compared with the fixed combination therapy (P=.04). Conclusion: The result of this study suggests that the latanoprost-timolol-fixed combination compared with latanoprost therapy alone provides improved intraocular pressure reduction over the 24- hour diurnal curve and for each individual time point in patients with primary open-angle glaucoma.
文摘Purpose:This study was conducted to report the safety and efficacy of pars plana-modified Ahmed Glaucoma Valve PS2 in advanced secondary glaucoma.Methods:We performed a prospective,interventional case series that included patients with advanced secondary glaucoma and uncontrolled intraocular pressure(IOP).Eleven eyes of nine patients with aphakic,neovascular,traumatic,inflammatory and pseudoexfoliation glaucoma were included.All patients had pars plana vitrectomy before tube insertion.Results:One year after surgery,IOP was controlled(21 mmHg or less)in ten of 11 eyes(91%),seven(64%)did not need medical antiglaucoma therapy.Average IOP decreased from 32.2± 8.3 mmHg before surgery to 15.7± 7.7 mmHg postoperatively(P < 0.0001).The average number of topically used medications used decreased from 2.9± 1.2 to 0.545± 0.78(P < 0.0001).Complications included transient hypotony(three eyes-two of them without tube ligature),transient choroidal effusion(three eyes)and an intermediate increase in IOP(seven eyes).Tube exchange was performed in one eye and needling/bleb excision in two patients.Conclusions:Pars plana-modified Ahmed Valve implantation is effective and safe in advanced glaucoma.Partial ligature of the tube is necessary to prevent early hypotony.Close followup of patients is needed to monitor variations of IOP within the first year.
文摘Background:Excimer laser trabeculotomy(ELT)ab interno is a new surgical technique to reduce intraocular pressure(IOP)in patients with glaucoma or ocular hypertension.Our purpose was to examine IOP reduction and the use of antiglaucoma drugs(AGD)in patients treated with ELT and to evaluate the safety of this laser treatment.Methods:To increase the outflow of aqueous humor,ten microperforations of the trabecular meshwork were performed by an endoscope-guided photoablative laser probe(Excimer laser,AIDA,TUI-Laser,Munich;pulse energy:1.2 mJ at fiber tip,pulse duration:60 ns,repetition rate:20 Hz).Average operation time usually was about 2 min.In our pilot study,one group of patients without cataract underwent ELT,the other group with cataract underwent phacoemulsification(PHACO)plus ELT.IOP,visual acuity,and AGD were determined preoperatively(T0)and 2-4 months(T1),5-7 months(T2),11-13 months(T3),and 22-26(T4)months after surgery.Treatment was defined to be successful if(1)postoperative IOP was < 21mmHg,and(2)IOP reduction was at least 20%.Results:ELT reduced the IOP from 24.1± 0.7(n=69)-mmHg preoperatively to 18.8± 0.4(T1,n=66),20.0± 0.5(T2,n=51),18.8± 0.8(T3,n=37),and 16.8± 1.0(T4,n=15)mmHg,respectively.However,28% of the eyes needed repeat surgery due to insufficient IOP reduction.According to Kaplan-Meier statistics,the success rate was 60%(T1),49%(T2),and 46%(T3),respectively.The number of AGD was 1.9± 0.1(T0),1.2± 0.2(T1),1.3± 0.2(T2),1.8± 0.2(T3),and 1.5± 0.3(T4).Combined phacoemulsification plus ELT reduced the IOP from 22.4 mmHg± 0.6(T0,n=57)to 16.5± 0.4(T1,n=52),16.1± 0.5(T2,n=40),16.4± 0.4(T3,n=35),and 12.8± 1.5(T4,n=4)mmHg,respectively;7% of the eyes treated with the combined procedure needed repeat surgery due to insufficient IOP reduction.According to Kaplan-Meier statistics,the success rate was 85%(T1),74%(T2),and 66%(T3),respectively.The number of AGD was 1.1± 0.2(T0),0.9± 0.2(T1),1.1± 0.2(T2),1.2± 0.2(T3),and 1.8± 0.9(T4).Conclusions:ELT,especially in combination with phacoemulsification,is a new,promising,minimally invasive laser treatment to reduce IOP for at least 1-2 years.ELT alone is less effective in IOP reduction.
