ABSTRACT
Objetivos Evaluar los resultados de una nueva modificación de la esclerectomía profunda no perforante (EPNP) denominada espolonectomía. Métodos Estudio retrospectivo no aleatorizado y comparativo que incluyó 98 ojos (grupoA) operados con espolonectomía, que consiste en la combinación de la escisión del espolón escleral con EPNP. El grupo control (B) incluyó 53 ojos operados con EPNP clásica. Durante 12meses se estudiaron la presión intraocular (PIO), los medicamentos antiglaucomatosos que requirieron y las complicaciones. Resultados La PIO media disminuyó de 25,69±8,11 preoperatoria a 15,73±4,16mmHg después de la cirugía en el grupoA (p<0,001). En el grupoB disminuyó de 26,66±5,93 preoperatoria a 18,19±5,93mmHg postoperatoria (p<0,001). Las diferencias entre grupos de la PIO postoperatoria fue estadísticamente significativa (p<0,001). A los 12meses después de la cirugía, el 13,27 y el 52,83% de ojos en los gruposA yB requirieron tratamiento antihipertensivo tópico (p<0,001). La tasa de éxito absoluto después de la cirugía fue del 87,5 y del 47,17% en los gruposA yB, con una tasa significativamente mayor de éxito relativo en el grupoB (p<0,001). No hubo diferencias significativas entre los grupos en la tasa de complicaciones (p=0,960). La complicación postoperatoria más frecuente fue la microperforación de la membrana trabeculo-descemética en ambos grupos. Conclusiones La espolonectomía es una técnica segura y eficaz en comparación con la EPNP convencional y parece una alternativa prometedora en el tratamiento quirúrgico del glaucoma, optimizando la eficacia del tratamiento y minimizando las complicaciones (AU)
Purpose To evaluate the outcomes of a novel modification of the non-penetrating deep sclerectomy (NPDS) approach for glaucoma management called spurectomy. Methods Observational comparative non-randomized retrospective study including 98 glaucomatous eyes of 76 patients operated on with the spurectomy technique consisting of the combination of the excision of the scleral spur with NPDS (groupA). A control group (groupB) including 53 glaucomatous eyes of 43 patients operated on with classical NPDS was also included. Changes in intraocular pressure (IOP) and medications required as well as complications were recorded in a 12-month follow-up. Results Mean IOP decreased from 25.69±8.11 preoperatively to 15.73±4.16mm Hg postoperatively in groupA (p<0.001). In groupB, mean IOP decreased from 26.66±5.93 preoperatively to 18.19±5.93mm Hg postoperatively (P<.001). Differences between groups in postoperative IOP was statistically significant (P<.001). At 12months after surgery, 13.27% and 52.83% of eyes in groupsA andB required topical antihypertensive therapy (P<.001). The rate of absolute success after surgery was 87.5% and 47.17% in groupsA andB, with significantly higher rate of relative success in groupB (P<.001). No significant differences among groups were found in the complication rate (P=.960). The most common postoperative complication was microperforation of the trabeculo-descemetic membrane in both groups. Conclusions Spurectomy is a safe and effective technique when compared with conventional NPDS and seems a promising alternative in the surgical management of glaucoma, optimizing the efficacy of the treatment and minimizing complications (AU)
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Glaucoma/surgery , Postoperative Complications/prevention & control , Ophthalmologic Surgical Procedures/methods , Retrospective Studies , Treatment Outcome , Intraocular PressureABSTRACT
PURPOSE: To evaluate the outcomes of a novel modification of the non-penetrating deep sclerectomy (NPDS) approach for glaucoma management called spurectomy. METHODS: Observational comparative non-randomized retrospective study including 98 glaucomatous eyes of 76 patients operated on with the spurectomy technique consisting of the combination of the excision of the scleral spur with NPDS (groupA). A control group (groupB) including 53 glaucomatous eyes of 43 patients operated on with classical NPDS was also included. Changes in intraocular pressure (IOP) and medications required as well as complications were recorded in a 12-month follow-up. RESULTS: Mean IOP decreased from 25.69±8.11 preoperatively to 15.73±4.16mm Hg postoperatively in groupA (p<0.001). In groupB, mean IOP decreased from 26.66±5.93 preoperatively to 18.19±5.93mm Hg postoperatively (P<.001). Differences between groups in postoperative IOP was statistically significant (P<.001). At 12months after surgery, 13.27% and 52.83% of eyes in groupsA andB required topical antihypertensive therapy (P<.001). The rate of absolute success after surgery was 87.5% and 47.17% in groupsA andB, with significantly higher rate of relative success in groupB (P<.001). No significant differences among groups were found in the complication rate (P=.960). The most common postoperative complication was microperforation of the trabeculo-descemetic membrane in both groups. CONCLUSIONS: Spurectomy is a safe and effective technique when compared with conventional NPDS and seems a promising alternative in the surgical management of glaucoma, optimizing the efficacy of the treatment and minimizing complications.
ABSTRACT
The 4-5% of the breast cancer patients have metastases in the eye. We present the case of a 30-year-old woman with an infiltrant duct carcinoma of the breast pT2N2M0 HER2 positive. Six months after primary radical treatment she had a systemic relapse with multiples metastatic sites, so several treatment with trastuzumab in combination with chemotherapy were started. After 4 years patient presented multiple white-coloured micronodules in the iris of the right eye. Only a 3-7.8% of ocular metastases are located in the iris. With mantenaince therapy with trastuzumab natural history of the illness has changed. Several studies had analyzed if metastases in the brain during treatment with trastuzumab have increased in comparison with the pretrastuzumab era. The infrequent presentation of metastases in the anterior uveal makes difficult to establish if it is an spontaneous fact or if it is favoured by trastuzumab treatment.
Subject(s)
Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/secondary , Iris Neoplasms/secondary , Adult , Breast Neoplasms/therapy , Carcinoma, Ductal, Breast/therapy , Female , Humans , Iris Neoplasms/therapyABSTRACT
El 4-5% de las pacientes con cáncer de mama presentan metástasis oculares. Presentamos a una mujer de 30 años con un carcinoma ductal infiltrante de mama pT2N2M0 HER2 positivo. A los seis meses de finalizar el tratamiento presentó una recaída sistémica con múltiples localizaciones metástaticas por lo que inició tratamientos combinados de trastuzumab mantenido y quimioterapia. Tras 4 años con trastuzumab de mantenimiento presenta en iris de ojo derecho multiples micronódulos blanquecinos. Solo un 3-7.8% de las metástasis oculares se localizan en el iris. Con la terapia mantenida con trastuzumab la historia natural de la enfermedad avanzada ha cambiado, diversos estudios analizaron si existe mayor frecuencia de metástasis cerebrales en pacientes tratados con trastuzumab que en la era pretrastuzumab. La infrecuente aparición de metástasis en úvea anterior hace difícil establecer si es un hecho espontáneo o si está favorecido por el tratamiento con trastuzumab
The 4-5% of the breast cancer patients have metastases in the eye. We present the case of a 30-year-old woman with an infiltrant duct carcinoma of the breast pT2N2M0 HER2 positive. Six months after primary radical treatment she had a systemic relapse with multiples metastaticsites, so several treatment with trastuzumab in combination with chemotherapy were started. After 4 years patient presented multiple white-coloured micronodules in the iris of the right eye. Only a 3-7.8% of ocular metastases are located in the iris. With mantenaince therapy with trastuzumab natural history of the illness has changed. Several studies had analyzed if metastases in the brain during treatment with trastuzumab have increased in comparison with the pretrastuzumab era.The infrequent presentation of metastases in the anterior uveal makes difficult to establish if it is an spontaneous fact or if it is favoured by trastuzumab treatment
