RESUMO
Age-related macular degeneration (AMD) is the main cause of visual impairment in developed countries. Several improvements in the visualization of posterior segment of the eye together with the introduction of intravitreal anti-VEGF treatment have revolutionized the prognosis of the wet form of AMD (wAMD). Increasing incidence of wAMD together with the limited resources of society and of the healthcare system poses challenges for the provision and development of care. In context of these current aspects, we aimed to set evidence-based medical guidelines for diagnosis, treatment and follow-up of patients with wAMD.
Assuntos
Inibidores da Angiogênese/uso terapêutico , Técnicas de Diagnóstico Oftalmológico , Fotocoagulação a Laser , Fotoquimioterapia , Degeneração Macular Exsudativa/diagnóstico , Degeneração Macular Exsudativa/terapia , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/efeitos adversos , Bevacizumab/efeitos adversos , Bevacizumab/uso terapêutico , Feminino , Finlândia , Seguimentos , Humanos , Injeções Intravítreas , Masculino , Ranibizumab/efeitos adversos , Ranibizumab/uso terapêutico , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Proteínas Recombinantes de Fusão/efeitos adversos , Proteínas Recombinantes de Fusão/uso terapêutico , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologiaRESUMO
PURPOSE: The purpose of this study was to retrospectively evaluate whether it is possible to decrease the risk of Molteno tube erosion through the conjunctiva by using a new technique where the silicone tube is inserted into a scleral tunnel instead of being covered only by the conjunctiva. METHODS: We reviewed Molteno implants carried out at the University Hospital of Oulu, in 332 patients who underwent traditional Molteno implantation between October 1986 and October 1998 and 92 patients who underwent surgery with the new technique between November 1998 and April 2001. RESULTS: With our former technique, conjunctival erosions occurred in 15 eyes of 15 patients (4.5%) after a median follow-up of 3.5 months (range 1-72 months); no conjunctival complications were discovered in patients who underwent surgery using the new technique during a median follow-up of 22 months (range 10-39 months). (p = 0.038, two-sample test of proportions). CONCLUSION: Inserting the Molteno tube into a scleral tunnel prevents tube extrusion through the conjunctiva in eyes with Molteno implants. The technique for making the scleral tunnel is described.
