ABSTRACT
AIM: To evaluate intraocular pressure (IOP) control and visual rehabilitation after placement of the Ex-press(R)miniature glaucoma shunt with adjunctive amniotic membrane transplantation (AMT) and mitomycin C (MMC) in patients with post-traumatic open-angle glaucoma during 2y of follow up.METHODS: This was an interventional,2-year,observational study.Eighteen eyes were prospectively observed (in 18 patients with traumatic secondary open-angle glaucoma) in which Ex-press miniature glaucoma filtration shunts were implanted with AMT and MMC.The outcome measures included intraocular pressure (IOP),best corrected visual acuity (BCVA),number of antiglaucoma medications,and complications.The progress of all patients was monitored for 24mo.RESULTS: Complete success (IOP <21 mmHg without glaucoma medications) was seen in 15 of the 17 (88.2%) eyes enrolled in the study at 24mo after the operation.IOP decreased from 36.9±4.8 mmHg preoperatively to 15.4±3.5 mmHg at 12mo and 15.5±3.5 mmHg at 24mo postoperatively.Early postoperative hypertension developed in two patients (11.1%) due to postoperative fibrosis.Most of the patients had improved postoperative BCVA values at the final follow-up visit compared to their preoperative measurements.Two patients (11.1%) developed transient hypotony.There were no complications such as hyphema,choroidal effusion,shallow anterior chamber,the device touching the iris,or extrusion of the device.CONCLUSION: The Ex-press miniature glaucoma filtration shunt with adjunctive AMT and MMC is effective and safe in cases of traumatic open-angle glaucoma.Surgical management is an appropriate surgical treatment in this series of cases.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of laser photocoagulation of ciliary processes after pars plana vitrectomy in aphakic glaucoma.</p><p><b>METHODS</b>Twenty patients (20 eyes) of aphakic glaucoma underwent vitrectomy plus laser treatment. During the surgery, after conventional 3-incision pars plana vitrectomy, a probe of semi-conductor diode laser (532 nm) was inserted through the sclera incision, the ciliary processes were then photocoagulated under direct visualization for 180 degree range. Before and after the surgery, the visual acuity, the intraocular pressure (IOP) as well as the outer appearance of the anterior segment were evaluated. The mean follow-up period was 13 months.</p><p><b>RESULTS</b>The IOP at the last visit was (21.35 +/-2.52) mmHg, which was significantly lower than that before the surgery [(39.75 +/-6.27) mmHg, P=0.000]. Atrophy of the ciliary processes was observed 1-3 months after the surgery.</p><p><b>CONCLUSION</b>Pars plana vitrectomy combined with laser coagulation of ciliary processes reduces the IOP in patients with aphakic glaucoma effectively.</p>