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AIM:To systematically evaluate the efficacy and safety of intravitreal ranibizumab combined with compound trabeculectomy and panretinal photocoagulation(PRP)compared with compound trabeculectomy combined with PRP in the treatment of neovascular glaucoma(NVG).METHODS: Databases including Wanfang database, China National Knowledge Infrastructure(CNKI), PubMed, EMbase, China Biomedical Document Service System(CBM), Clinicalkey, and Cochrane Library were retrieved. Literatures about intravitreal ranibizumab combined with compound trabeculectomy and PRP in the treatment of NVG in the experimental group and compound trabeculectomy and PRP in the treatment of NVG in the control group from creation of database to July 20, 2022 were searched. At the same time, relevant reference were consulted. The best corrected visual acuity, intraocular pressure, occurrence of complications and the success rate of the surgery were systematically evaluated.RESULTS: A total of 8 clinical studies were included, with 864 patients(864 eyes)with NVG. Meta-analysis showed that the intraocular pressure of patients in the experimental group was lower than that in the control group at 1wk, 1 and 3mo after surgery(1wk: MD=-4.00, 95%CI: -4.62～-3.38, P<0.05; 1mo: MD=-4.11, 95%CI: -4.66～-3.56, P<0.05; 3mo: MD=-4.58, 95%CI: -5.61～-3.55, P<0.05). The best corrected visual acuity of the experimental group was better than that of the control group at 1mo after surgery(MD=0.17, 95%CI: 0.11～0.23, P<0.05), but there was no significant difference at 1wk after surgery(MD=0.08, 95%CI: -0.13～0.29, P=0.47). The patients in the experimental group had fewer complications(OR=0.30, 95%CI: 0.18～0.52, P<0.05)and higher surgical success rate(OR=5.15, 95%CI: 2.78～9.53, P<0.05).CONCLUSION:With decreased intraocular pressure, improved visual acuity and surgical success rate, intravitreal ranibizumab combined with compound trabeculectomy and PRP was better than the compound trabeculectomy and PRP in the treatment of NVG.
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@#AIM: To observe the clinical effect of compound trabeculectomy and air filtration injection in the anterior chamber in the treatment of chronic primary angle closure glaucoma, and to evaluate the safety and effectiveness of air filtration injection in the treatment of chronic primary chronic angle closure glaucoma.<p>METHODS: In a retrospective study, 129 patients(183 eyes)with chronic primary chronic angle closure glaucoma admitted to our hospital from September 2015 to June 2017 were divided into air injection group and control group. Patients in the air injection group(68 cases, 97 eyes)were treated with compound trabeculectomy and air filtration injection into the anterior chamber. Patients in the control group(61 cases, 86 eyes)were treated with compound trabeculectomy. The follow-up time was from 3 to 6mo with an average of 4.5mo.The visual acuity, intraocular pressure, bleb formation and complications were observed, and the unplanned reoperation, length of stay and total cost of stay were recorded. <p>RESULTS: The incidence of shallow anterior chamber, malignant glaucoma and unplanned reoperation in the air injection group was lower than that in the control group, the days of hospitalization in the air injection group were shorter than that in the control group, and the cost of hospitalization in the air injection group was lower than that in the control group(<i>P</i><0.05). There was significant difference in intraocular pressure between different groups(<i>F</i>group=42.394, <i>P</i>group<0.001; <i>F</i>time=7.373, <i>P</i>time<0.001; <i>F</i>time×group=23.903, <i>P</i>time×group<0.001). Intraocular pressure at different time points was compared between groups. There was significant difference(<i>P<</i>0.001)in intraocular pressure of 1, 3d and no significant difference(<i>P</i>>0.05)in 3, 7d between the two groups. There was no significant difference(<i>P</i>>0.05)in the flash of anterior chamber of 1, 3, 7d and 1mo between the two groups. There was no significant difference(<i>P</i>>0.05)in the changes of vision and the formation of filtering blebs between the two groups in 3mo(<i>P</i>>0.05).<p>CONCLUSION:Combined trabeculectomy and air filtration in the anterior chamber for chronic primary angle closure glaucoma can reduce the incidence of shallow anterior chamber, malignant glaucoma and unplanned reoperation, not aggravate the inflammatory reaction in the anterior chamber, safely retain the residual visual function of patients, shorten the length of stay in hospital and the total cost of hospitalization, and have no effect on the formation of intraocular pressure, vision and filtering bleb obvious influence.
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@#AIM: To observe the clinical effect of compound trabeculectomy and air filtration injection in the anterior chamber in the treatment of chronic primary angle closure glaucoma, and to evaluate the safety and effectiveness of air filtration injection in the treatment of chronic primary chronic angle closure glaucoma.<p>METHODS: In a retrospective study, 129 patients(183 eyes)with chronic primary chronic angle closure glaucoma admitted to our hospital from September 2015 to June 2017 were divided into air injection group and control group. Patients in the air injection group(68 cases, 97 eyes)were treated with compound trabeculectomy and air filtration injection into the anterior chamber. Patients in the control group(61 cases, 86 eyes)were treated with compound trabeculectomy. The follow-up time was from 3 to 6mo with an average of 4.5mo.The visual acuity, intraocular pressure, bleb formation and complications were observed, and the unplanned reoperation, length of stay and total cost of stay were recorded. <p>RESULTS: The incidence of shallow anterior chamber, malignant glaucoma and unplanned reoperation in the air injection group was lower than that in the control group, the days of hospitalization in the air injection group were shorter than that in the control group, and the cost of hospitalization in the air injection group was lower than that in the control group(<i>P</i><0.05). There was significant difference in intraocular pressure between different groups(<i>F</i>group=42.394, <i>P</i>group<0.001; <i>F</i>time=7.373, <i>P</i>time<0.001; <i>F</i>time×group=23.903, <i>P</i>time×group<0.001). Intraocular pressure at different time points was compared between groups. There was significant difference(<i>P<</i>0.001)in intraocular pressure of 1, 3d and no significant difference(<i>P</i>>0.05)in 3, 7d between the two groups. There was no significant difference(<i>P</i>>0.05)in the flash of anterior chamber of 1, 3, 7d and 1mo between the two groups. There was no significant difference(<i>P</i>>0.05)in the changes of vision and the formation of filtering blebs between the two groups in 3mo(<i>P</i>>0.05).<p>CONCLUSION:Combined trabeculectomy and air filtration in the anterior chamber for chronic primary angle closure glaucoma can reduce the incidence of shallow anterior chamber, malignant glaucoma and unplanned reoperation, not aggravate the inflammatory reaction in the anterior chamber, safely retain the residual visual function of patients, shorten the length of stay in hospital and the total cost of hospitalization, and have no effect on the formation of intraocular pressure, vision and filtering bleb obvious influence.
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OBJECTIVE:To observe the clinical efficacy and safety of cyclocryosurgery,intravitreal injection of conbercept combined with Ahmed glaucoma drainage valve implantation,intravitreal injection of conbercept combined with compound trabeculectomy in the treatment of neovascular glaucoma(NVG). METHODS:A total of 39 NVG patients(40 eyes)selected from Sichuan People's Hospital during Jun. 2014-Aug. 2016 were divided into group A(16 cases,16 eyes),B(13 cases,14 eyes),C (10 cases,10 eyes)according to different treatment methods. Group A received cyclocryosurgery;group B received Ahmed glaucoma drainage valve implantation after given intravitreal injection of Conbercept ophthalmic injection(0.05 mL,for consecutive 7 d);group C received compound trabeculectomy after given intravitreal injection of Conbercept ophthalmic injection (0.05 mL,for consecutive 7 d). The intraocular pressures of 3 groups were observed before and after treatment,and the rate of intraocular pressure control,visual changes and the incidence of complications were observed after treatment. The occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in intraocular pressure among 3 groups(P>0.05). Seven days,one month,three months and six months after treatment,intraocular pressures of 3 groups were decreased significantly compared to before treatment;intraocular pressure of group B was significantly lower than those of group A and C;group C was significantly lower than group A,with statistical significance(P<0.05). There was no statistical significance in intraocular pressure among 3 groups three and six months after treatment(P>0.05). The rates of intraocular pressure control in 3 groups were 62.5%,85.7% and 70.0% six months after treatment. Vision of 16 eyes in group A kept stable;vision of 3 eyes in group B were improved,that of 1 eye was decreased and those of 10 eyes kept stable;vision of 1 eye in group C was improved, that of 1 eye was decreased,and those of 8 eyes kept stable;there was no statistical significance in rate of intraocular pressure or vision among 3 groups(P>0.05).The incidence of exudation of anterior chamber in group A was significantly higher than group B and C,with statistical significance(P<0.05). There was no statistical significance in the incidence of other complications(P>0.05). Two patients of group A suffered from the increase of blood pressure during the operation,and recovered to normal after symptomatic treatment. No obvious ADR was found in other patients during treatment. CONCLUSIONS:Three kinds of therapy plans can effectively reduce intraocular pressure of NVG patients,and do not influence vision with less adverse reactions. Intravitreal injection of conbercept combined with Ahmed glaucoma drainage valve implantation or compound trabeculectomy can effectively reduce intraocular pressure in short time and the fromer is better than the latter. Above 2 regimens cause low incidence of complications.
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·AIM: To observe the efficacy of Bevacizumab intravitreal injection combined with compound trabeculectomy in the treatment of neovascular glaucoma (NVG). · METHODS: The 36 eyes were with bevacizumab intravitreal injection 1wk before surgery, and then were treated with trabeculectomy combined with mitomycin. The visual acuity, intraocular pressure, follicle, anterior chamber, regression of iris neovascularization, the number of anti-glaucoma drugs used and others were observed before injection, 1d after intravitreal injection, 1, 3, 6, and 12mo after surgery, respectively. ·RESULTS: Total success was achieved in 26 eyes, partial success in 7 eyes and failure in 3 eyes at 1a after surgery. The IOP of 1mo (18. 183 ± 6. 993mmHg), 3mo (19.586±6. 198mmHg), 6mo (18. 722±5. 263mmHg) and 12mo ( 19. 089 ± 4. 133mmHg ) after surgery were significantly lower than those before injection ( 39. 997 ± 5. 827mmHg ) and 1d after injection ( 39. 647 ± 5. 690mmHg; all P<0. 05). The IOP of 1mo and 6mo after surgery was significantly lower than that of 3mo after surgery, and the difference was statistically significant (P< 0. 05 ). There was no statistically significant difference between the other two time points postoperatively (all P>0. 05). The LogMAR visual acuity of 1mo (0. 686±0. 202), 3mo (0. 622±0. 157), 6mo (0. 631± 0. 179 ) and 12mo ( 0. 711 ± 0. 177 ) after surgery were significantly higher than that before injection ( 0. 833 ± 0. 207) and 1d after injection (0. 806 ± 0. 188), and the differences were statistically significant (all P<0. 05). The LogMAR visual acuity of 3mo and 6mo after surgery were significantly higher than that of 1mo after surgery (all P<0. 05). The LogMAR visual acuity of 12mo after surgery was significantly worse than that of 3mo and 6mo after surgery (all P<0. 05). There was a significant difference in the number of anti-glaucoma drugs used before and after treatment with this method (t=11. 131, P<0. 05). ·CONCLUSION: The bevacizumab intravitreal injection combined with compound trabeculectomy is effective in the treatment of NVG.
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·AIM: To investigate the effect of phacoemulsification intraocular lens implantation combined with trabeculectomy on ocular surface in the treatment of glaucoma and cataract. ·METHODS: Totally 45 cases of patients with glaucoma and cataract in our hospital from February 2016 to February 2017 were enrolled. All the patients had unilateral disease,and the medical records of the patients were analyzed retrospectively. The sicked eyes were set as the observation group and contralateral eyes were set as the control group. The dry eye score, break-up time (BUT), corneal fluorescein staining score (FL), tear secretion test (S I t) and conjunctival epithelium goblet cell density(CIC) was compared between two groups before operation and at 1wk,1 and 3mo after operation. · RESULTS: The preoperative dry eye score of the observation group had no significant difference with that of the control group (P > 0. 05). At 1wk, 1mo after operation,data of the observation group was significantly higher than that of the control group and before operation, with statistical significance (P < 0. 05), no significant difference was shown at postoperative 3mo (P>0.05). Preoperative BUT of the observation group had no significant difference with that of the control group(P>0.05); at 1 wk,1 and 3mo after operation, data of the observation group was significantly lower than that of the control group and before operation, with statistical significance (P<0.05). The preoperative FL score of the observation group was significantly higher than that of the control group, while the postoperative FL score of the observation group at 1wk,1 and 3mo had sharp difference with that before operation(P<0.05),all were significantly higher than that of the control group,there was statistical significance(P<0.05). There was no significant difference in S I t score between the observation group and the control group preoperatively ( P > 0. 05), and the postoperative S I t scores of the observation group at 1wk,1 and 3mo postoperatively was evidently lower than that of the control group and before operation (P<0.05). There was no significant difference in CIC density between the two groups preoperatively. While the postoperative data of the observation group at 1wk, 1 and 3mo postoperatively was significantly lower than that of the control group and before operation,with statistical points (P<0.05). · CONCLUSION: Phacoemulsification intraocular lens implantation combined with trabeculectomy for treatment of glaucoma and cataract can aggravate dry eye symptoms, as well as reduce tear film stability and tear secretion,impair conjunctival epithelium goblet cell.
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@#AIM: To investigate the effect of compound trabeculectomy in patients with primary acute angle closure glaucoma under persistent high intraocular pressure. <p>METHODS: From February 2015 to February 2016, we selected 62 cases(62 eyes)of primary acute angle closure glaucoma in our hospital, the control group 34 patients 34 eyes(preoperative intraocular pressure control in the normal range, intraocular pressure ≤ 21mmHg), the observation group 28 patients 28 eyes(preoperative intraocular pressure not in the normal range, the intraocular pressure 28-50mmHg and lasted for more than 3d). The two groups were treated with compound trabeculectomy and observed for visual acuity, intraocular pressure and so on. <p>RESULTS: Compared with preoperative, at 3mo postoperatively visual acuity improved, unchanged and decreased rate in observation group were 68%, 21% and 11%, the difference were not statistically significant compared with the control group(<i>P</i>>0.05). The postoperative intraocular pressure of the two groups compared with preoperative significantly decreased(<i>P</i><0.05). The postoperative intraocular pressure of observation group and control group were 11.10±2.20mmHg and 11.73±2.71mmHg, the difference was not statistically significant(<i>P</i>>0.05). The preoperative and postoperative anterior chamber depth of observation group was lower than that in the control group(<i>P</i><0.05). The postoperative anterior chamber depth of the two groups compared with preoperative increased(<i>P</i><0.05). The postoperative axial length of the two groups compared with preoperative decreased(<i>P</i><0.05). The postoperative complication rate of observation group was 14%, and the control group was 18%, the difference was not statistically significant(<i>P</i>>0.05). <p>CONCLUSION: Compound trabeculectomy in patients with primary acute angle closure glaucoma under high intraocular pressure is effective, but there still needs further study.
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AIM:To evaluate the efficacy and safety of Sub-tenon's anesthesia for compound trabeculectomy with high intraocular pressure. METHODS: Forty - six eyes ( 46 cases ) of primary glaucoma received compound trabeculectomy under Sub-tenon's anesthesia, whose preoperative intraocular pressure were higher than normal after 24 to 48h of combined medication. Both efficacy and complication of the anesthesia were studied. RESULTS: One minute after anesthetic injection, all cases were able to achieve the effect of analgesia and eye brake. During the operation, 0 level of anesthesia effect included 35 eyes ( 76%) , 1 level of anesthesia effect included 10 eyes ( 22%) , 2 level of anesthesia effect included 1 eye(2%). Only 1 case of these patients needed to add the surface anesthetic once, and other cases were successfully operatedunder Sub-tenon's anesthesia. The total effective rate was 98%. No anesthesia complications occurred in all cases. CONCLUSION: Sub - Tenon's anesthesia is safe, effective, simple and quick for compound trabeculectomy with high intraocular pressure.
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Abstract?AIM: To observe the clinical efficacy of intravitreal Lucentis injection combined with panretinal photocoagulation ( PPR ) and compound trabeculectomy for neovascular glaucoma ( NVG) .?METHODS:A total of 14 cases (14 eyes) with NVG were collected from January to November 2015.All cases were treated with intravitreal lucentis injection, PPR and compound trabeculectomy by turns.Intraocular pressure ( IOP) , visual acuity and the complications at pre-or post-surgery were recorded, respectively.?RESULTS: Followed up for 3-6mo, the average IOP preoperatively was significantly decreased than that detected at post-operation ( 18.00 ±6.70 vs 41.65 ± 4.07mmHg, t=11.288, P<0.05).IOP less than 21mmHg with or without the usage of anti-intraocular pressure drugs was defined as the sign of successful or effective surgery, respectively.At the ultimate follow-up, 11 cases were successful, 2 cases were effective, and the success rate was 79%, effective rate was 14%.Only 1 case was applied cyclocryotherapy due to the uncontrolled IOP. Moreover, the results of visual acuity detection demonstrated that 6 eyes got a better visual acuity, 7 eyes remained the same condition and 1 case got no light perception. Meanwhile, 13 cases showed none iris neovascularization during the follow-up; 1 case got a reappearance of iris neovascularization on the third month, which was then dissolved subjected to the intravitreal lucentis injection in combination with PPR. One case developed post -operative hyphema and absorbed after 1wk. No shallow anterior chamber and eyeball atrophy happened.?CONCLUSION:Intravitreal lucentis injection combined with PPR and compound trabeculectomy is an effective and safe therapeutic strategy for the treatment of NVG.
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AIM: To evaluate the clinical effects of compound trabeculectomy for primary angle-closure glaucoma with persistent high intraocular pressure. ●METHODS:Thirty-three cases ( 34 eyes ) with primary angle - closure glaucoma were executed compound trabeculectomy. All patients were divided into two groups: group A: 18 cases ( 18 eyes ) were executed compound trabeculectomy under high intraocular pressure higher than 35mmHg after using lOP-lowering medicine for 48-72h; group B: 15 cases (16 eyes) were executed compound trabeculectomy, the intraocular pressure was normal after using lOP-lowering medicine. ●RESULTS:Thirty-four eyes were successfully completed surgery with follow-up of 6 to 18mo and there were no serious complications, including suprachoroidal hemorrhage. The visual acuity before operation in group A and group B were 0. 02 ± 0. 01, 0. 04 ± 0. 02, respectively. And the postoperative visual acuity in group A and group B increased 0.2±0. 06, 0. 3±0. 07, respectively (P ●CONCLUSION: The primary angle-closure glaucoma with persistent high intraocular pressure should be executed compound trabeculectomy decisively, even under high intraocular pressure, which prevent further damage and loss of visual function. As long as to fully consideration the preoperation, intraoperative careful operation, careful nursing, it is safety and effective to have compound trabeculectomy under the continuous high intraocular pressure for primary angle-closure glaucoma.
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AIM: To compared therapeutic effect of compound trabeculectomy in treatment of angle - closure and open angle glaucoma. METHODS: A total of 136 patients ( 136 eyes) with glaucoma from July 2014 to July 2015 were divided into angle-closure glaucoma (ACG) group with 72 cases (72 eyes) and open angle glaucoma ( OAG) group with 64 cases (64 eyes). All the patients were given compound trabeculectomy. The intraocular pressure, shallow anterior chamber, functional follicular and complications were compared between two groups after operation. RESULTS: The intraocular pressure of all patients were significantly decreased at 1 and 3mo after surgery. The intraocular pressure of ACG group were significantly lower than that of OAG group ( t = 11. 037, 12. 660, P CONCLUSION: Compound trabeculectomy can reduce intraocular pressure of ACG and OAG patients safely. The results in ACG patients is better than that in OAG patients.
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To analyze the causes and treatments of high intraocular pressure ( > 21mmHg ) of angle - closure glaucoma underwent compound trabeculectomy 1mo after surgery. ●METHODS: This was a retrospective study of our hospital, from March 2010 to March 2013. Thirty-four (38 eyes) of angle-closure glaucoma patients were collected, who underwent compound trabeculectomy with high intraocular pressure ( > 21mmHg) 1mo after operation. We analyzed the causes and summarized the treatments. ●RESULTS:The causes which lead to early postoperative high intraocular pressure included malignant glaucoma (9 eyes of 8 cases), blood clot and connective tissue block under the scleral flap (15 eyes of 13 cases), hyphema after surgery(5 eyes of 5 cases), sclera flap incision was incarcerated with iris tissue ( 3 eyes of 3 cases ), preoperative high intraocular pressure for a long time(5 eyes of 4 cases), 1 eye of 1 case for unknown reason. After proper treatments, intraocular pressures of all patients were bellowed 21mmHg. ● CONCLUSlON: Early postoperative high intraocular pressure of angle - closure glaucoma underwent compound trabeculectomy is caused by various factors, and the early prevention and timely treatment are key points of a successful operation.
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AlM:To compare the efficacy and complication of extra-trabeculotomy in combination with trabeculectomy and trabeculectomy and compound trabeculectomy in the treatment of primary infantile glaucoma. METHODS: Patients with primary infantile glaucoma undergone one of the three procedures from Jan 2006 to Jan 2014 were selected. Among them, group A ( 20 patients, 31 eyes ) underwent extra- trabeculotomy in combination with trabeculectomy, group B ( 20 patients, 32 eyes ) underwent trabeculectomy, while group C ( 20 patients, 30 eyes) underwent compound trabeculectomyRESULTS:The success rates in group A were 96. 8% at the time of discharge and 90. 3% during follow-up (mean 24mo) ; the rates in group B were 96. 9% and 81. 2%( mean 24mo) the rates in group C were 83. 3% and 76. 7%( mean 24mo ) respectively, the differences being significant (P CONCLUSlON: Extra - trabeculotomy in combination with trabeculectomy is more efficacious and safer than trabeculectomy and compound trabeculectomy in the treatment of primary infantile glaucoma. lt should be the first choice for primary infantile glaucoma.
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Objective To investigate the therapeutic efficacy of refractory glaucoma with compound trabeculectomy.Methods 26 eyes (24 cases ) of refractory glaucoma were treated with compound trabeculectomy.Results Followed up 1 year.There were functional filtering blebs in 20 eyes ;and the IOP was below 21mmHg in 16 eyes without any antiglaucoma drug and in 8 eyes with 1-2 categories of lower IOP drugs after 12 months.The mean IOP at 1 week,1 month,3 months,6months and 12months was (7.9 ± 3.1 ) mm Hg,( 13.5 ± 3.7 ) mm Hg,( 18.2 ±3.8)mm Hg,( 18.1 ±3.5)mm Hg,( 19.1 ±4.8)mm Hg,significantly higher than the IOP preoperatively( 38.2 ±5.6)mm Hg( P ＜0.01 ).Conclusion It was safe and effective of treating refractory glaucoma with compound trabeculectomy.
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Objective To observe clinical effect of treating glaucoma with compound trabeeuleetomy combined with activating blood circulation and promoting diuresis Chinese medicine. Methods 42 cases with glaucoma were randomly divided into two groups by means of random number table. The control group was treated with compound trabeculeetomy, and the treatment group was treated with Chinese medicine after compound trabeeuleetomy. The regular reexamination was performed, and follow-up visit was executed for an average of 12 months. Results Compared with the control group, the postoperative vision in the treatment group increased significantly (λ2=4.511, P<0.05) , and intraocular pressure decreased significantly (λ2=3.638,P< 0.05); The rate of anterior chamber in the treatment group was lower than that of the control group(λ2=4.256 P< 0.05) . Both groups had filtering bleb, and the rate of non-functional filter blebs in the treatment group was lower than that of the control group (λ2=3.054, P< 0.05 ) . Conclusion The therapy of compound trabeculectomy combined with Chinese medicine on glaucoma was better than compound trabeculeetomy only.
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Objective:To analyze the causes and treatment ofshallowanterior chamber in 50 patients(58 eyes)with primary angle closed glaucoma after trabeculectomy.Methods:330 cases(422 eyes)with primary angle closed glaucoma,enrolled from January 2006 to May 2009 in our hospital,were underwent trabeculectomy with application of 0.4 g/L mitomycin C once under and above sclera flap during all filtering surgeries.50 patients(58 eyes)were found with postoperative shallow anterior chamber.Results:The intraocular pressure of all patients were decreased.The incidence of shallow anterior chamber were found 50 patients(58 eyes).The causes were excessive aqueous humor filteration(29 eyes),filter bleb leaks(15 eyes),choroida detachment(5 eyes),malignant glaucoma(3 eyes).Anterior chamber reformed in 8 eyes with surgical procedure and 88 eyes without any surgical procedure.Conclusion:The incidence of shallowanterior chamber is high after trabeculetomy with application of mitomycin C in patients with primary angle closed glaucoma.Most of such cases could be reformed through conservation treatment.