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Objective To observe the positional variation of the ciliary body in eyes with acute primary angle-closure glaucoma (APACG) by ultrasound biomicroscopy (UBM),and to analyze the association between anterior chamber angle width and location parameters of the ciliary body in patients with APACG.Methods The subjects were divided into APACG group and normal control group and examined by UBM,and the clearer images were collected for quantitative analysis,followed by measurement of parameters including angle open distance 500 (AOD500),trabecular meshwork-ciliary process distance (TCPD),iris-ciliary process distance (ICPD),sclera-ciliary process angle (SCPA) and ciliary body length 500 (CBL500).Results Totally 89 patients (89 eyes) were enrolled in this study,including 57 patients with APACG (APACG group)and 32 normal controls (normal control group).According to the age-sex paired t test,the average of 23 pairs of measured data showed that the AOD500,TCPD,ICPD,SCPA,and CBL500 were (0.050 4 ± 0.031 0) mm,(0.499 6 ± 0.192 4) mm,(0.112 6 ± 0.089 2)mm,(35.317 0 ±4.575 2)° and (1.060 4 ±0.290 2)mm in the APACG group,and (0.242 6 ±0.078 5)mm,(0.741 7 ±0.240 4) mm,(0.272 6 ±0.218 8) mm,(44.913 0 ±10.089 2) ° and (0.633 0 ± 0.405 4)mm in the normal control group,respectively;and APACG group presented smaller AOD500,TCPD,ICPD and SCPA but larger CBL500 than normal control group,with significant differences (all P ＜ 0.01).Correlation analysis showed that TCPD,ICPD,SCPA and CBL500 were significantly correlated with AOD500 in APACG group.Conclusion Ciliary bodies are more anteriorly rotated in eyes with APACG,and anterior chamber angle width is associated with location parameters of ciliary body.
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?AIM: To evaluate the effect for refractory glaucoma by using Ex - Press miniature implantation with deep sclerectomy.?METHODS: Thirty eyes in 24 patients with refractory glaucoma were treated by Ex- Press miniature ( P50 ) implantation with deep sclerectomy. The patients’ symptom, intraocular pressure ( IOP ) , visual acuity and complications were analyzed in a 12mo follow-up period.?RESULTS: During the follow-up period, all patients’ ocular pain was reduced. The mean IOP before operation and at the last follow-up time were 51. 15 ± 2. 60mmHg (1kPa=7. 5mmHg) and 15. 11 ± 2. 51mmHg, respectively, there was significant difference (P<0. 05). Postoperative visual acuity was improved in 8 eyes, had no significant change in 22 eyes. After operation, hyphema of anterior chamber appeared in 2 eye ( 7%) , which were obsorbed after 1wk.? CONCLUSION: Ex - Press miniature implantation combined with deep sclerectomy surgery is a relatively effective and safe treatment for the patients with refractory glaucoma. This method can significantly degrade the IOP, lessen ocular pain and reduce the complications risk.
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AIM:To compare one-site vs two-site phacotrabe-culectomy in chronic angle-closure glaucoma (CACG) coexisting with cataract.METHODS:This prospective, randomized study included 41 eyes with CACG. One-site approach was performed in 21 eyes and two-site procedure in 20 eyes. Intraocular pressure (IOP), best-corrected visual acuity (BCVA), the number of antiglaucoma medications and complications were observed. All patients were followed up for 9 months.RESULTS:There were no significant differences between the two groups preoperatively. IOP decreased from 22.7±4.9mmHg and 23.7±4.7mmHg preoperatively in one-and two-site groups to 18.0±1.2mmHg and 16.7±1.1mmHg 9 months after operation respectively(P<0.05). There were no significant differences in mean IOP between the two groups at any time (P>0.05). Decrease of the number of antiglaucoma medications and BCVA improvement were similar in both groups 9 months after surgery (P>0.05).There were no significant differences in complications between the two surgical procedures.CONCLUSION:There were no significant differences between the two groups in clinical efficacy and complications.
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Background Neovascular glaucoma is a type of refractory glaucoma.Biological amnion combined with glaucoma valve implantation is a primary therapy and its long-term effectiveness is noticeable. Objective The goal of this Survey was to evaluate the effectiveness of biological amnion combined with glaucoma valve implantation for neovascular glaucoma and compare the clinical outcome with simple glaucoma valve implantation. Methods This was a retrospective observational case series.The clinical data of 44 eyes of 44 patients received biological amnion combined with glaucoma valve implantation for neovascular glaucoma and 43 eyes of 43 patients received simple glaucoma valve implantation for neovascular glaucoma were retrospectively analyzed and compared.The age,sex and disease-cause were matched between these two groups.Patients were followed-up for 24 months after operation.Surgery success was identified as the intraocular pressure(IOP)<21 mmHg after operation.Written informed consent was obtained from each patient prior to the operation.Results The IOP was<21 mmHg throughout the follow-up duration in both groups.No significant difierence was found in the IOP value in 1 week after operation between two groups(t=-5.34,P=0.60).However,IOP values were lower in biological amnion combined with glaucoma valve implantation group in 3,12 and 24 months after operation than those of simple glaucoma valve implantation(t=6.64,t=5.00,t=7.81,P<0.01).Operation successful rates in biological amnion combined with glaucoma valve implantation group were 97.73％.93.18％。90.24％and 82.05％in 1 week,3 months,12 months and 24 months respectively after operation.and those in simple glaucoma valve implantation were 95.35％,71.43％,65.00％and 60.53％in corresponding time points,showing considerably significant differences between two groups (χ2=7.06,χ2=7.47,χ2=4.37,P<0.05).There was no significant difference in Ihe number of eyes with complication between the two groups(P>0.05). Conclusion The biological amnion combined with glaucoma valve implantation surgery may be more effective and safe for the treatment of neovascular glaucoma than with glaucoma va]ve only.
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AIM: To study the effects of geranylgeranylacetone(GGA) on the expression of heat shock protein70(HSP70) on retinal ganglion cells(RGC) in rats with chronic intraocular pressure(IOP) elevation.METHODS: Seventy Wistars were divided into blank control group(10 rats), chronic hypertension group(30 rats) and GGA group(30 rats). Chronic hypertension was created by cauterizing the superficial scleral veins. 800mg/(kg·d)GGA was given by oral daily after cauterization. Immunohistochemistry was used respectively to observe the changes of expression of HSP70 in the model rats and GGA interference rats at different time points during the course of chronic IOP elevation.RESULTS: The successful model was identified as the IOP over 40% of normal rats. The retinal thickness was significantly reduced in model group and model+ GGA group compared with normal rats from 21 days through 28 days after cauterization(P<0.05), and that of model rats was obviously decreased in comparison with model+ GGA rats(P<0.05). The number of ganglion cells was significantly decreased in model rats and model+ GGA rats compared with normal rats from 21 days and 28 days. The stronger expression intensity(IOD) value was seen for HSP70 in the model+ GGA rats by immunochemistry(P<0.01).CONCLUSION: Systemic administration of GGA protects retina from chronic IOP elevation by regulating the expression of HSP70.
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·AIM: To study the expressive variation of Nogo-A on rat retina in the process of chronic ocular hypertension. · METHODS: Thirty-six healthy adult male Wistars were randomly divided into control group (6 rats) and chronic hypertension group (30 rats). Chronic hypertension was created by cauterizing the superficial scleral veins. Immunohistochemistry technique was used to evaluate the expressive varieties of Nogo-A at different time points during the course of chronic ocular hypertension. · RESULTS: The success of the model was indicated by over 40% of increase in the IOP as compared with normal rats. Compared with control group, as time passed chronic hypertension group gradually had detectable morphology changes in the retina. At the 21st day of chronic ocular hypertension, retinas became thinner and the quantity of retinal ganglion cell (RGC) decreased (P<0.05). Assoicated with the morphological changes, the expression of Nogo-A was strongly increased (P<0.05).CONCLUSION: Myelin associated protein Nogo-A plays a part in the process of chronic ocular hypertension.
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AIM: To evaluate the efficacy and tolerability of one-site versus two-site phacotrabeculectomy in the treatment of patients with coexisting cataract and glaucoma. METHODS: A comprehensive literature meta-analysis was performed according to the Cochrane Collaboration methodology to identify controlled clinical trials comparing one-site with two-site phacotrabeculectomy. The studies meeting the predefined criteria were reviewed systematically by meta-analysis. Efficacy estimates were measured by standardised mean difference (SMD) for the percentage intraocular pressure (IOP) reduction from baseline to end point, odds ratio (OR) for the percentage having a best-corrected visual acuity (BCVA) of 0.5 or better after surgery and relative risk (RR) for complete success rates. Tolerability estimates were measured by RR for adverse events. All of outcomes were reported with 95% confidence interval (CI). Data were synthesised by Stata 10.1 for Windows. RESULTS: Two-site phacotrabeculectomy was associated with numerically greater, and significant efficacy than one-site in lowering IOP(SMD,-0.19;95% CI, -0.33 to -0.04; P=0.01). Numerically greater, but nonsignificant proportions of two-site patients than one-site patients had a BCVA of 0.5 or better (OR, 0.65; 95% CI, 0.30 to 1.39; P=0.26).Numerically greater, but nonsignificant proportions of two-site patients than one-site patients achieved the target IOP without anti-glaucoma medication at the end point (RR, 0.94; 95% CI, 0.84 to 1.04; P=0.22). Furthermore, there was no significant difference in adverse events between two surgical procedures.CONCLUSION: The efficacy of two-site phacotrabeculectomy appears to be superior to one-site phacotrabeculectomy. One-site and two-site phacotrabeculectomy are similarly tolerable in postoperative adverse events.
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<p><b>BACKGROUND</b>Phacotrabeculectomy can be performed using one-site or two-site incisions. This meta-analysis evaluated the efficacy and tolerability of one-site versus two-site phacotrabeculectomy in the treatment of patients with coexisting cataract and glaucoma.</p><p><b>METHODS</b>A comprehensive literature search was performed according to the Cochrane Collaboration methodology to identify randomized controlled clinical trials comparing one-site with two-site phacotrabeculectomy. Studies meeting our predefined criteria were included in the meta-analysis. Efficacy estimates were measured by weighted mean difference (WMD) for the percentage intraocular pressure (IOP) reduction from baseline to end point, relative risk (RR) for the proportion of patients with a best-corrected visual acuity (BCVA) of 0.5 or better after surgery and complete success rates. Tolerability estimates were measured by RR for adverse events. All of outcomes were reported with 95% confidence interval (95%CI). Data were synthesised by Stata 10.1 for Windows.</p><p><b>RESULTS</b>Two-site phacotrabeculectomy was associated with greater reductions in IOP than the one-site procedure (WMD: -5.99, 95%CI: -10.74 - -1.24, P = 0.01). A greater proportion of patients also achieved a BCVA of 0.5 or better (RR: 0.91, 95%CI: 0.74 - 1.12, P = 0.36) and the target IOP without anti-glaucoma medication at the study end point (RR: 0.94, 95%CI: 0.83 - 1.07, P = 0.34) after two-site than one-site phacotrabeculectomy, but the differences were not significant. There were no significant differences in adverse events between two surgical procedures.</p><p><b>CONCLUSIONS</b>Two-site phacotrabeculectomy is superior to one-site phacotrabeculectomy in reducing IOP, but other post-operative effects are similar. One-site and two-site phacotrabeculectomies have similar adverse event rates.</p>
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Humans , Trabeculectomy , MethodsABSTRACT
AIM: To study caspase-9 expression on rat retina in the process of chronic elevation of IOP and the changes with the application of amino guanidine (AG), thus to investigate potential protective function of AG to rat retina with chronic elevation of IOP.METHODS: Immunohistochemistry, RT-PCR and Western blot were used to observe retinal morphology and expression of caspase-9 at different time points of rat with chronic IOP elevation, both affected or not affected by the application of AG.RESULTS: Compared with control group, as time passed retina of experimental group gradually had detectable morphological changes. On 21st day of chronic IOP elevation, retinas became thinner and the quantity of retinal ganglion cells (RGCs) decreased; caspase-9 expression increased, consistent with the morphological changes. The group using AG presented relatively smaller morphology changes and less expression of caspase-9.CONCLUSION: Apoptosis-related gene caspase-9 played a part in the process of chronic IOP elevation; AG protects retina by down-regulating expression of caspase-9.