ABSTRACT
En el tratamiento del glaucoma de ángulo abierto ha surgido el concepto de cirugía mínimamente invasiva intentando reducir el tratamiento tópico crónico, retrasar cirugía más invasiva y disminuir el número de complicaciones. El XEN45 utiliza la vía de drenaje subconjuntival para reducir la presión intraocular. Presentamos el caso de una paciente que fue sometida a cirugía de facoemulsificación, implante de lente intraocular y dispositivo XEN45. Cuatro días después presentó episodio agudo de glaucoma maligno con atalamia grado 3 que requirió vitrectomía pars plana e implante secundario de válvula de Ahmed. La menor tasa de complicaciones de la cirugía mínimamente invasiva de glaucoma ha incrementado su uso. Sin embargo, no está exenta de complicaciones graves requiriendo incluso un abordaje multidisciplinar como en el caso del glaucoma maligno que presentamos
Minimally invasive glaucoma surgery for chronic open-angle glaucoma treatment tries to reduce the amount of chronic topical drug treatment, delaying invasive glaucoma surgery and diminishing the number of surgical complications. XEN45 uses subconjunctival drainage in order to reduce intraocular pressure. The report is presented of a patient following phacoemulsification, intraocular lens implantation and XEN45 implant. After four days acute malignant glaucoma was observed, with stage 3 athalamia requiring pars plana vitrectomy and secondary Ahmed valve implantation. The lower rate of complications due to minimally invasive glaucoma surgery has increased its use. Nevertheless, it is not free of severe adverse events, even requiring a multidisciplinary approach as in our malignant glaucoma report
Subject(s)
Humans , Female , Aged , Glaucoma/surgery , Glaucoma Drainage Implants , Phacoemulsification/methods , Minimally Invasive Surgical Procedures , Vitrectomy/methods , Glaucoma/complicationsABSTRACT
Minimally invasive glaucoma surgery for chronic open-angle glaucoma treatment tries to reduce the amount of chronic topical drug treatment, delaying invasive glaucoma surgery and diminishing the number of surgical complications. XEN45 uses subconjunctival drainage in order to reduce intraocular pressure. The report is presented of a patient following phacoemulsification, intraocular lens implantation and XEN45 implant. After four days acute malignant glaucoma was observed, with stage 3 athalamia requiring pars plana vitrectomy and secondary Ahmed valve implantation. The lower rate of complications due to minimally invasive glaucoma surgery has increased its use. Nevertheless, it is not free of severe adverse events, even requiring a multidisciplinary approach as in our malignant glaucoma report.
Subject(s)
Glaucoma Drainage Implants/adverse effects , Glaucoma/etiology , Postoperative Complications/etiology , Aged , Female , HumansABSTRACT
PURPOSE: To evaluate the Ahmed valve for decrease elevated pressure associated with black diaphragm lenses for aniridia. METHODS: Drainage devices are useful to obtain good control of intraocular pressure in patients with aniridia and the authors often use them because of the poor results of medical therapy or filtering surgery. However, when the elevated intraocular pressure is associated with black diaphragm lenses for aniridia, most authors decide to carry out a filtering technique. The current authors opted for the implantation of an Ahmed valve in three patients, two with traumatic aniridia and the other with a congenital case. Every patient had a different kind of black diaphragm lens for aniridia. RESULTS: The Ahmed valve controlled the intraocular pressure in levels below 20 mmHg for a follow-up year with no complications derived from its application. CONCLUSIONS: Ahmed valve implantation was the best technique to decrease intraocular pressure in patients with aniridia. The authors have used it successfully for cases with elevated pressure associated with black diaphragm lenses for aniridia.
Subject(s)
Aniridia/surgery , Glaucoma Drainage Implants , Intraocular Pressure , Lens Implantation, Intraocular/adverse effects , Lenses, Intraocular , Ocular Hypertension/surgery , Adult , Female , Humans , Male , Middle Aged , Ocular Hypertension/etiology , Prosthesis Design , Prosthesis ImplantationABSTRACT
PURPOSE: To evaluate the increase in contrast sensitivity to intraocular lens TECNIS Z-9000 (Pfizer) compared with other intraocular lenses. METHOD: We implanted a TECNIS Z-9000 lens in 18 patients who had another type of intraocular lens implanted in their other eye. We then tested contrast sensitivity under both mesopic and photopic conditions using the VCTS (Vision Contrast Test System) provided by Vistech Consultants Inc. RESULTS: There was an improved contrast sensitivity at low and medium frequencies, following TECNIS-Z 9000 lens implantation, however this improvement did not reach statistical significance. There were significant differences at high frequencies, which are directly related to the quality of visual function. CONCLUSIONS: TECNIS Z-9000 lens implantation (with a modified anterior surface) achieves a significant improvement in contrast sensitivity, meaning in practice an increase in the quality of visual function.
Subject(s)
Contrast Sensitivity/physiology , Lenses, Intraocular , HumansABSTRACT
Objetivo: Evaluar el incremento en la sensibilidad al contraste de las lentes TECNIS Z-9000 (Pfizer) respecto a otras lentes.Método: Se implantó la lente TECNIS Z-9000 en 18 pacientes que ya habían sido intervenidos de un ojo con otro tipo de lente intraocular. Se les midió la sensibilidad al contraste en condiciones fotópicas y mesópicas mediante el test VCTS (Vision Contrast Test System) de Vistech Consultants Inc.Resultados: Aunque la tendencia es hacia una mejoría de la sensibilidad al contraste en las frecuencias bajas y media, no existen diferencias significativas. Sí que demuestran de forma significativa la mayor sensibilidad al contraste en las frecuencias altas, que son las que están directamente relacionadas con la calidad de la función visual.Conclusiones: Las lentes TECNIS, mediante una modificación de su cara anterior, consiguen de manera significativa una mejoría de la sensibilidad al contraste, que se traduce en un incremento de la calidad de la función visual
Purpose: To evaluate the increase in contrast sensitivity to intraocular lens TECNIS Z-9000 (Pfizer) compared with other intraocular lenses. Method: We implanted a TECNIS Z-9000 lens in 18 patients who had another type of intraocular lens implanted in their other eye. We then tested contrast sensitivity under both mesopic and photopic conditions using the VCTS (Vision Contrast Test System) provided by Vistech Consultants Inc. Results: There was an improved contrast sensitivity at low and medium frequencies, following TECNIS-Z 9000 lens implantation, however this improvement did not reach statistical significance. There were significant differences at high frequencies, which are directly related to the quality of visual function. Conclusions: TECNIS Z-9000 lens implantation (with a modified anterior surface) achieves a significant improvement in contrast sensitivity, meaning in practice an increase in the quality of visual function
