AIM： To compare the long term outcome of trabeculectomy in patients with pseudoexfoliative glaucoma（PEG） and primary open angle glaucoma（POAG） in terms of surgical success. METHODS： The success of the trabeculec...AIM： To compare the long term outcome of trabeculectomy in patients with pseudoexfoliative glaucoma（PEG） and primary open angle glaucoma（POAG） in terms of surgical success. METHODS： The success of the trabeculectomy was evaluated by three criteria. Criterion A： intraocular pressure（IOP） ≤21 mm Hg and decrease in IOP ≥20%; Criterion B： IOP ≤18 mm Hg and decrease in IOP ≥30%; Criterion C： IOP ≤15 mm Hg and decrease in IOP ≥50%. Patients that met these criteria without medical treatment were considered to be completely successful, while those that met these criteria with medical treatment were considered partially successful. Significance levels of differences between the POAG and PEG groups in the Kaplan-Meier survival curves were calculated with the log-rank test. RESULTS： Sixty-four eyes from 64 patients with PEG and 51 eyes from 51 patients with POAG were evaluated. No significant differences were detected between the PEG and POAG groups according to full or partial success relative to each of the three criteria（A： P=0.73, 0.32; B： P=0.73, 0.31; C：P=0.90, 0.27）. CONCLUSION： There is no difference in the long-term success of trabeculectomy between PEG and POAG patients whose clinical characteristics are otherwise the same.展开更多
AIM：To compare the efficacy of single-session 360-degree selective laser trabeculoplasty（SLT） for reduction of intraocular pressure（IOP） in patients with pseudoexfoliative glaucoma（PXFG） and primary open angle ...AIM：To compare the efficacy of single-session 360-degree selective laser trabeculoplasty（SLT） for reduction of intraocular pressure（IOP） in patients with pseudoexfoliative glaucoma（PXFG） and primary open angle glaucoma（POAG）.· METHODS：This is a single-center,prospective,nonrandomized comparative study.Patients older than 18 years of age with uncontrolled PXFG or POAG eyes requiring additional therapy while on maximally tolerated IOP-lowering medications were included.The primary outcome measure changed in IOP from baseline.Success was defined as IOP reduction ≥20%from baseline without any additional IOP-lowering medication.All patients were examined at 1d,1wk,1,3,6,9,12 mo after SLT.· RESULTS：Nineteen patients（20 eyes） with PXFG and27 patients（28 eyes） with POAG were included in the study.In the visual fields mean deviation was-2.88（±1.67）in the POAG and-3.1（±1.69） in the PXFG groups（P=0.3）.The mean（±SD） IOP was 22.9（±3.7） mm Hg in the POAG group and 25.7（±4.4） mm Hg in the PXFG group at baseline and decreased to 18.4（±3.2） and 18.0（±3.9） mm Hg in the POAG group（P〈0.001 and P=0.02）,and to 17.9（±4.0） and 21.0（±6.6） mm Hg in the PXFG group（P〈0.001 and P=0.47） at 6 and 12 mo,respectively.The number of medications was 2.6（±0.8） in the POAG group and 2.5（±0.8） in the PXFG group at baseline,and did not change at all follow-up visits in both groups（P =0.16 in POAG and 0.57 in PXFG）.Based on Kaplan-Meier survival analysis,the success rate was 75%in the POAG group compared to 94.1%in the PXFG group（P=0.08;Log-rank test） at 6mo,and 29.1%and 25.0%at 12 mo,respectively（P=0.9;Log-rank）.· CONCLUSION：The 360-degree SLT is an effective and well-tolerated therapeutic modality in patients with POAG and PXFG by reducing IOP without any change in number of medications.The response was more pronounced early in the postoperative period in patients with PXFG whereas there was no statistically significant difference at 12-month follow-up. 〈/tr〉展开更多
AIM：To compare the effect of phacoemulsification on intraocular pressure（IOP）in patients with primary open angle glaucoma（POAG）and pseudoexfoliation glaucoma（PXG）.METHODS：A retrospective comparative case serie...AIM：To compare the effect of phacoemulsification on intraocular pressure（IOP）in patients with primary open angle glaucoma（POAG）and pseudoexfoliation glaucoma（PXG）.METHODS：A retrospective comparative case series conducted at the Glaucoma Department at the Association to Prevent Blindness in Mexico.The study enrolled consecutive patients having phacoemulsification with intraocular lens（IOL）implantation and a diagnosis of POAG or PXG.Data about IOP values and number of glaucoma medications used was collected at baseline,1,3,6 and12mo postoperatively.RESULTS：The study enrolled 88 patients（88 eyes）.After phacoemulsification,there was a statistically significant reduction in IOP values and glaucoma medications use compared to baseline in both POAG and PXG patients（P〈0.001）.In the POAG group,a 20%decrease in IOP values was evidenced,and a 56.5%reduction in the number of medications used at the one-year follow-up.The PXG group showed a 20.39%,and a 34.46%decrease in IOP and number of medications used,respectively.A significant difference in the meanΔIOP（postoperative changes in IOP）was evidenced between groups（P=0.005）.The reduction of the postsurgical IOP mean values in both groups,the POAG group showed a greater reduction in IOP values compared to the PXG group.CONCLUSION：In both types of glaucoma,phacoemulsification cataract surgery can result in a significant IOP reduction（20%）over a 12mo follow-up period.The number of medications used is also significantly reduced up to 12mo after surgery,especially in the PXG group.展开更多
AIM：To investigate the levels of ghrelin（Gh）,acylated ghrelin（AGh） and AGh/Gh ratio in the humor aqueous（HA） of cases with pseudoexfoliation syndrome（PXS）,pseudoexfoliation glaucoma（PXG）,primary open angle ...AIM：To investigate the levels of ghrelin（Gh）,acylated ghrelin（AGh） and AGh/Gh ratio in the humor aqueous（HA） of cases with pseudoexfoliation syndrome（PXS）,pseudoexfoliation glaucoma（PXG）,primary open angle glaucoma（POAG） and to compare these with control subjects.METHODS：A prospective examination was made of the total Gh,and AGh levels in HA of 67 patients undergoing cataract surgery.Patients were divided into 4 groups.HA samples were aspirated at the beginning of the surgery,stored at -70℃.Gh and AGh quantification was performed with ELISA kits and the AGh/total-Gh ratios were calculated.ANOVA,Kruskal-Wallis,Chi-square and post-hoc tests were used for statistical analysis.RESULTS：Total Gh levels in HA were 189.2±45.6 pg/mL in the control group,199.2±32.9 pg/mL in PXS,180.6±20.9 pg/mL in PXG and 176.8±21.4 pg/mL in POAG groups（P〉0.05）.AGh levels in HA were 23.09±5.01 pg/mL in the control group,24.13±5.22 pg/mL in PXS,22.29±1.55 pg/m L in PXG and 19.69±2.93 pg/mL in POAG groups（P〉0.05）.The ratio of AGh/Gh was 10.3%±2.34% in the control group,13.03%±2.58% in PXS,12.3%±1.54% in PXG and 11.79%±1.41% in POAG groups（P=0.044）.The difference between the PXS and control groups was significant（P=0.03）.CONCLUSION：In spite of statistically insignificant results,the HA total Gh levels were lower than those of the control subjects but not parallel with the AGh levels in glaucoma patients.The relative increase in the AGh/Gh ratio in glaucoma cases supports the view that proportional increases of AGh might play a role in the pathogenesis of glaucoma.展开更多
AIM：To compare the long-term efficacy and safety of Ex Press implantation and standard trabeculectomy in patients with primary open angle glaucoma（POAG）.METHODS：In this retrospective study,we compared 17eyes treat...AIM：To compare the long-term efficacy and safety of Ex Press implantation and standard trabeculectomy in patients with primary open angle glaucoma（POAG）.METHODS：In this retrospective study,we compared 17eyes treated by Ex Press implantation with 23 eyes treated by trabeculectomy.Efficacy was assessed according to the relevant intraocular pressure（IOP）values and success rates during the first year of follow-up.Postoperative corneal endothelial cell loss was also compared.RESULTS：The number of antiglaucoma medications and the IOP reduction were similar between the 2 groups during the follow-up period.Although the mean IOP was similar,the IOP-fluctuation rate during the early postoperative period was significantly lower in the ExPress group than in the trabeculectomy group（P=0.038）.A Kaplan-Meier survival curve analysis showed no significant successrate difference between the groups（P=0.810）.The corneal endothelial cell loss rate,moreover,was significantly lower in the Ex Press group（P=0.05）.CONCLUSION：Ex Press implantation compared with trabeculectomy showed similar IOP-reduction and success rates along with lower IOP fluctuation and endothelial cell loss rates.For this reason,it can be considered to be the treatment of choice for patients with advanced glaucoma or low corneal endothelial cell density.展开更多
AIMTo evaluate the possible relationship of optic disc area with retina nerve fiber layer in different glaucoma subtypes.METHODSOne eye each was chosen from 45 patients with ocular hypertension, 45 patients with prima...AIMTo evaluate the possible relationship of optic disc area with retina nerve fiber layer in different glaucoma subtypes.METHODSOne eye each was chosen from 45 patients with ocular hypertension, 45 patients with primary open angle glaucoma, 45 patients with pseudoexfoliation glaucoma and 45 healthy controls followed in our hospital. The records of the patients were reviewed retrospectively. Optic disc area and circumpapillary retina nerve fiber layer measurements were obtained using optical coherence tomography. Central corneal thickness was measured by ultrasound pachymetry.RESULTSThe median disc area in the patients with primary open angle glaucoma was significantly higher than the patients with ocular hypertension (2.19 vs 1.90 mm<sup>2</sup>, P=0.030). The median retina nerve fiber layer was thinner in the patients with primary open angle glaucoma and pseudoexfoliation glaucoma than the patients with ocular hypertension for superior, inferior and temporal quadrants. After adjustment for age, no difference in central corneal thickness was found between the groups. Greater disc area was associated with thicker retinal nerve fiber layer for superior, inferior and nasal quadrants in the patients with primary open angle glaucoma. There was no correlation between disc area and central corneal thickness measurements of the groups.CONCLUSIONDisc size affects the retinal nerve fiber layer thickness in eyes with primary open angle glaucoma and is a possible risk factor for glaucomatous optic nerve damage.展开更多
AIM： To compare the outcomes of Ex-PRESS implantation in one eye versus trabeculectomy with mitomycin C in the fellow eye in Chinese patients with primary open-angle glaucoma （POAG）. METHODS： This was a prospectiv...AIM： To compare the outcomes of Ex-PRESS implantation in one eye versus trabeculectomy with mitomycin C in the fellow eye in Chinese patients with primary open-angle glaucoma （POAG）. METHODS： This was a prospective, non-randomized comparative study. Forty-eight eyes of 24 patients with bilateral POAG necessitating surgery were included and underwent Ex-PRESS implantation under the scleral flap in one eye and trabeculectomy in the other eye according to patients’ choice. Primary outcome measures included mean intraocular pressure （IOP） and success rate. Secondary outcome measures were aqueous flare, postoperative medication use, visual acuity, and incidence of complications.RESULTS： All 24 patients finished a 1-year follow-up. Both groups maintained significant reductions in IOP after surgery throughout the follow-up period. At any point in time, the IOP of the two groups did not differ significantly. The Kaplan-Meier survival curve analysis showed no significant differences in success between the two groups （P=0.289）. The mean number of anti-glaucoma medicines and visual acuity in both groups were not significantly different. Eyes with Ex-PRESS implantation had lower aqueous flare values on days 1 and 3 （both P〈0.05）. Instances of early postoperative hypotony and choroidal effusion were significantly fewer in frequency after Ex-PRESS implantation under the scleral flap compared with those after trabeculectomy （P〈0.001）. CONCLUSION： Ex-PRESS is comparable to trabeculectomy in terms of IOP, success rate, number of glaucoma medications used, and visual acuity. However, Ex-PRESS resulted in fewer cases of inflammation and a lower rate of complications.展开更多
文摘AIM： To compare the long term outcome of trabeculectomy in patients with pseudoexfoliative glaucoma（PEG） and primary open angle glaucoma（POAG） in terms of surgical success. METHODS： The success of the trabeculectomy was evaluated by three criteria. Criterion A： intraocular pressure（IOP） ≤21 mm Hg and decrease in IOP ≥20%; Criterion B： IOP ≤18 mm Hg and decrease in IOP ≥30%; Criterion C： IOP ≤15 mm Hg and decrease in IOP ≥50%. Patients that met these criteria without medical treatment were considered to be completely successful, while those that met these criteria with medical treatment were considered partially successful. Significance levels of differences between the POAG and PEG groups in the Kaplan-Meier survival curves were calculated with the log-rank test. RESULTS： Sixty-four eyes from 64 patients with PEG and 51 eyes from 51 patients with POAG were evaluated. No significant differences were detected between the PEG and POAG groups according to full or partial success relative to each of the three criteria（A： P=0.73, 0.32; B： P=0.73, 0.31; C：P=0.90, 0.27）. CONCLUSION： There is no difference in the long-term success of trabeculectomy between PEG and POAG patients whose clinical characteristics are otherwise the same.
文摘AIM：To compare the efficacy of single-session 360-degree selective laser trabeculoplasty（SLT） for reduction of intraocular pressure（IOP） in patients with pseudoexfoliative glaucoma（PXFG） and primary open angle glaucoma（POAG）.· METHODS：This is a single-center,prospective,nonrandomized comparative study.Patients older than 18 years of age with uncontrolled PXFG or POAG eyes requiring additional therapy while on maximally tolerated IOP-lowering medications were included.The primary outcome measure changed in IOP from baseline.Success was defined as IOP reduction ≥20%from baseline without any additional IOP-lowering medication.All patients were examined at 1d,1wk,1,3,6,9,12 mo after SLT.· RESULTS：Nineteen patients（20 eyes） with PXFG and27 patients（28 eyes） with POAG were included in the study.In the visual fields mean deviation was-2.88（±1.67）in the POAG and-3.1（±1.69） in the PXFG groups（P=0.3）.The mean（±SD） IOP was 22.9（±3.7） mm Hg in the POAG group and 25.7（±4.4） mm Hg in the PXFG group at baseline and decreased to 18.4（±3.2） and 18.0（±3.9） mm Hg in the POAG group（P〈0.001 and P=0.02）,and to 17.9（±4.0） and 21.0（±6.6） mm Hg in the PXFG group（P〈0.001 and P=0.47） at 6 and 12 mo,respectively.The number of medications was 2.6（±0.8） in the POAG group and 2.5（±0.8） in the PXFG group at baseline,and did not change at all follow-up visits in both groups（P =0.16 in POAG and 0.57 in PXFG）.Based on Kaplan-Meier survival analysis,the success rate was 75%in the POAG group compared to 94.1%in the PXFG group（P=0.08;Log-rank test） at 6mo,and 29.1%and 25.0%at 12 mo,respectively（P=0.9;Log-rank）.· CONCLUSION：The 360-degree SLT is an effective and well-tolerated therapeutic modality in patients with POAG and PXFG by reducing IOP without any change in number of medications.The response was more pronounced early in the postoperative period in patients with PXFG whereas there was no statistically significant difference at 12-month follow-up. 〈/tr〉
文摘AIM：To compare the effect of phacoemulsification on intraocular pressure（IOP）in patients with primary open angle glaucoma（POAG）and pseudoexfoliation glaucoma（PXG）.METHODS：A retrospective comparative case series conducted at the Glaucoma Department at the Association to Prevent Blindness in Mexico.The study enrolled consecutive patients having phacoemulsification with intraocular lens（IOL）implantation and a diagnosis of POAG or PXG.Data about IOP values and number of glaucoma medications used was collected at baseline,1,3,6 and12mo postoperatively.RESULTS：The study enrolled 88 patients（88 eyes）.After phacoemulsification,there was a statistically significant reduction in IOP values and glaucoma medications use compared to baseline in both POAG and PXG patients（P〈0.001）.In the POAG group,a 20%decrease in IOP values was evidenced,and a 56.5%reduction in the number of medications used at the one-year follow-up.The PXG group showed a 20.39%,and a 34.46%decrease in IOP and number of medications used,respectively.A significant difference in the meanΔIOP（postoperative changes in IOP）was evidenced between groups（P=0.005）.The reduction of the postsurgical IOP mean values in both groups,the POAG group showed a greater reduction in IOP values compared to the PXG group.CONCLUSION：In both types of glaucoma,phacoemulsification cataract surgery can result in a significant IOP reduction（20%）over a 12mo follow-up period.The number of medications used is also significantly reduced up to 12mo after surgery,especially in the PXG group.
基金Supported by the Ankara Ophthalmology Society,a branch of the Turkish Society of Ophthalmology
文摘AIM：To investigate the levels of ghrelin（Gh）,acylated ghrelin（AGh） and AGh/Gh ratio in the humor aqueous（HA） of cases with pseudoexfoliation syndrome（PXS）,pseudoexfoliation glaucoma（PXG）,primary open angle glaucoma（POAG） and to compare these with control subjects.METHODS：A prospective examination was made of the total Gh,and AGh levels in HA of 67 patients undergoing cataract surgery.Patients were divided into 4 groups.HA samples were aspirated at the beginning of the surgery,stored at -70℃.Gh and AGh quantification was performed with ELISA kits and the AGh/total-Gh ratios were calculated.ANOVA,Kruskal-Wallis,Chi-square and post-hoc tests were used for statistical analysis.RESULTS：Total Gh levels in HA were 189.2±45.6 pg/mL in the control group,199.2±32.9 pg/mL in PXS,180.6±20.9 pg/mL in PXG and 176.8±21.4 pg/mL in POAG groups（P〉0.05）.AGh levels in HA were 23.09±5.01 pg/mL in the control group,24.13±5.22 pg/mL in PXS,22.29±1.55 pg/m L in PXG and 19.69±2.93 pg/mL in POAG groups（P〉0.05）.The ratio of AGh/Gh was 10.3%±2.34% in the control group,13.03%±2.58% in PXS,12.3%±1.54% in PXG and 11.79%±1.41% in POAG groups（P=0.044）.The difference between the PXS and control groups was significant（P=0.03）.CONCLUSION：In spite of statistically insignificant results,the HA total Gh levels were lower than those of the control subjects but not parallel with the AGh levels in glaucoma patients.The relative increase in the AGh/Gh ratio in glaucoma cases supports the view that proportional increases of AGh might play a role in the pathogenesis of glaucoma.
文摘AIM：To compare the long-term efficacy and safety of Ex Press implantation and standard trabeculectomy in patients with primary open angle glaucoma（POAG）.METHODS：In this retrospective study,we compared 17eyes treated by Ex Press implantation with 23 eyes treated by trabeculectomy.Efficacy was assessed according to the relevant intraocular pressure（IOP）values and success rates during the first year of follow-up.Postoperative corneal endothelial cell loss was also compared.RESULTS：The number of antiglaucoma medications and the IOP reduction were similar between the 2 groups during the follow-up period.Although the mean IOP was similar,the IOP-fluctuation rate during the early postoperative period was significantly lower in the ExPress group than in the trabeculectomy group（P=0.038）.A Kaplan-Meier survival curve analysis showed no significant successrate difference between the groups（P=0.810）.The corneal endothelial cell loss rate,moreover,was significantly lower in the Ex Press group（P=0.05）.CONCLUSION：Ex Press implantation compared with trabeculectomy showed similar IOP-reduction and success rates along with lower IOP fluctuation and endothelial cell loss rates.For this reason,it can be considered to be the treatment of choice for patients with advanced glaucoma or low corneal endothelial cell density.
文摘AIMTo evaluate the possible relationship of optic disc area with retina nerve fiber layer in different glaucoma subtypes.METHODSOne eye each was chosen from 45 patients with ocular hypertension, 45 patients with primary open angle glaucoma, 45 patients with pseudoexfoliation glaucoma and 45 healthy controls followed in our hospital. The records of the patients were reviewed retrospectively. Optic disc area and circumpapillary retina nerve fiber layer measurements were obtained using optical coherence tomography. Central corneal thickness was measured by ultrasound pachymetry.RESULTSThe median disc area in the patients with primary open angle glaucoma was significantly higher than the patients with ocular hypertension (2.19 vs 1.90 mm<sup>2</sup>, P=0.030). The median retina nerve fiber layer was thinner in the patients with primary open angle glaucoma and pseudoexfoliation glaucoma than the patients with ocular hypertension for superior, inferior and temporal quadrants. After adjustment for age, no difference in central corneal thickness was found between the groups. Greater disc area was associated with thicker retinal nerve fiber layer for superior, inferior and nasal quadrants in the patients with primary open angle glaucoma. There was no correlation between disc area and central corneal thickness measurements of the groups.CONCLUSIONDisc size affects the retinal nerve fiber layer thickness in eyes with primary open angle glaucoma and is a possible risk factor for glaucomatous optic nerve damage.
基金Supported by the National Natural Science Foundation of China(No.81670847No.81600728)the Science and Technology Program of Guangzhou,China(No.15570001)
文摘AIM： To compare the outcomes of Ex-PRESS implantation in one eye versus trabeculectomy with mitomycin C in the fellow eye in Chinese patients with primary open-angle glaucoma （POAG）. METHODS： This was a prospective, non-randomized comparative study. Forty-eight eyes of 24 patients with bilateral POAG necessitating surgery were included and underwent Ex-PRESS implantation under the scleral flap in one eye and trabeculectomy in the other eye according to patients’ choice. Primary outcome measures included mean intraocular pressure （IOP） and success rate. Secondary outcome measures were aqueous flare, postoperative medication use, visual acuity, and incidence of complications.RESULTS： All 24 patients finished a 1-year follow-up. Both groups maintained significant reductions in IOP after surgery throughout the follow-up period. At any point in time, the IOP of the two groups did not differ significantly. The Kaplan-Meier survival curve analysis showed no significant differences in success between the two groups （P=0.289）. The mean number of anti-glaucoma medicines and visual acuity in both groups were not significantly different. Eyes with Ex-PRESS implantation had lower aqueous flare values on days 1 and 3 （both P〈0.05）. Instances of early postoperative hypotony and choroidal effusion were significantly fewer in frequency after Ex-PRESS implantation under the scleral flap compared with those after trabeculectomy （P〈0.001）. CONCLUSION： Ex-PRESS is comparable to trabeculectomy in terms of IOP, success rate, number of glaucoma medications used, and visual acuity. However, Ex-PRESS resulted in fewer cases of inflammation and a lower rate of complications.
