ABSTRACT
PURPOSE: analysis of the influence of peripheral iridectomy on the efficiency and safety of trabeculectomy and phacotrabeculectomy in patients with open-angle glaucoma. METHODS: interventional, prospective, randomized and comparative study with two groups: 44 eyes with trabeculectomy (group 1) and 24 eyes with phacotrabeculectomy (group 2). Each of the two groups was divided into two main subgroups (with and without iridectomy), compared with each other in terms of efficacy and safety of surgical procedure. RESULTS: Iridectomy was performed on 22 eyes in group 1 (subgroup 1A) and on 12 eyes in group 2 (subgroup 2A), the remaining cases in each group forming subgroups without peripheral iridectomy (subgroup 1B, 2B respectively). Statistical analysis reveals that iridectomy does not seem to influence the efficiency of filtration procedure, regardless of the postoperative moment of analysis (early or final). In all four subgroups at 1 year was a significant decreasing of intraocular pressure, with a low rate of complications. CONCLUSIONS: A proper selection of open-angle glaucoma cases allows the abandonment of peripheral iridectomy in trabeculectomy and phacotrabeculectomy.
Subject(s)
Glaucoma, Open-Angle/surgery , Iridectomy , Phacoemulsification , Trabeculectomy , Aged , Aged, 80 and over , Algorithms , Cataract/complications , Female , Glaucoma, Open-Angle/complications , Humans , Intraocular Pressure , Male , Middle Aged , Ophthalmologic Surgical Procedures , Prospective Studies , Treatment Outcome , Visual AcuityABSTRACT
PURPOSE: To evaluate the efficacy and safety of tissue plasminogen activator in management of postoperative fibrinous uveitis. MATERIAL AND METHOD: Prospective study, interventional case series including 13 patients who developed fibrinous membrane in anterior chamber; patients were operated for cataract (4 cases), for cataract and glaucoma (7 cases) and for corneoscleral lacerations (2 cases). Initial treatment consisted of corticosteroid administration (topically, subconjunctival +/- systemic) and mydriatic-cycloplegic drugs. Inadequate response imposed intracavitary administration of tissue plasminogen activator (25 microg/ml, 0.2 ml). The main outcomes were: complete resolution of fibrinous membrane, presence of adverse events and visual rehabilitation. RESULTS: Fibrinous membrane resorption starts in the next hours and complete resolution was proved in all cases after a mean time 53.55 +/- 37.65 (24-146) hours. In 12 patients we used only one administration of tissue plasminogen activator, but in one case we repeated it. It was not signaled any adverse event drug related. It was an important increase of visual acuity in all cases. CONCLUSION: Intracavitary administration of tissue plasminogen activator is a safe and efficient alternative in the management of postoperative fibrinous membrane.
