Different modes of intraocular pressure reduction after three different nonfiltering surgeries and trabeculectomy

Japanese Journal of Ophthalmology - Tập 55 - Trang 107-114 - 2011
Etsuo Chihara1, Ken Hayashi1
1Sensho-kai Eye Institute, Kyoto, Japan

Tóm tắt

To study the mode of intraocular pressure (IOP) reduction based on correlation with the preoperative IOP after filtering and nonfiltering surgeries. Pre- and postsurgical IOPs at 6 months were compared in one eye of each of 789 subjects with primary open-angle glaucoma, pseudoexfoliation glaucoma, or ocular hypertension who underwent trabeculectomy with adjunctive mitomycin C alone (Lectomy-MMC) (n = 145), phaco-viscocanalostomy (Phaco-VCS) (n = 320), phaco-trabeculotomy ab externo (Phaco-lotomy) (n = 116), or phacoemulsification aspiration and intraocular lens implantation alone (PEA+IOL) (n = 208). The correlation between the preoperative and 6-month postoperative IOP was not significant in eyes that underwent Lectomy MMC (r = −0.026, P = 0.7552, IOP reduction 51.9%), but was significant in eyes treated by Phaco-VCS (r = 0.409; IOP reduction, 24.8%) or PEA+IOL alone (r = 0.294; IOP reduction, 9.9%), and was marginal in eyes treated by Phaco-lotomy (P = 0.062; r = 0.174; IOP reduction, 24.1%). Among the four cohorts studied, the variation in the 6-month postoperative IOP was the largest after Lectomy-MMC. After glaucoma surgery, there are two modes of IOP reduction. The postoperative IOP after Lectomy MMC did not correlate with the preoperative IOP, whereas the postoperative IOP levels after Phaco-VCS, Phaco-Lotomy, and PEA+IOL correlated with preoperative IOP levels. We may be able to predict postsurgical IOP after nonfiltering surgery.

Tài liệu tham khảo

Bindlish R, Condon GP, Schlosser JD, et al. Efficacy and safety of mitomycin-C in primary trabeculectomy. Five year follow-up. Ophthalmology 2002;109:1336–1342. Stegmann R, Pienaar A, Miller D. Viscocanalostomy for openangle glaucoma in black African patients. J Cataract Refract Surg 1999;25:316–322. Fyodorov SN. Non-penetrating deep sclerectomy in open angle glaucoma. Eye Microsurg (Russian) 1989;2:52–55. Lewis RA, von Wolff K, Tetz M, et al. Canaloplasty: circumferential viscodilation and tensioning of Schlemm’s canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults: interim clinical study analysis. J Cataract Refract Surg 2007;33:1217–1226. Minckler DS, Baerveldt G, Alfaro MR, et al. Clinical results with the Trabecutome for treatment of open-angle glaucoma. Ophthalmology 2005;112:962–967. Harms H, Dannheim R. Trabeculotomy ab externo. Trans Ophthalmol Soc UK 1970;89:589–590. Chihara E, Nishida A, Kodo M, et al. Trabeculotomy ab externo: an alternative treatment in adult patients with primary open-angle glaucoma. Ophthalmic Surg 1993;24:735–739. Tanito M, Ohira A, Chihara E. Surgical outcome of combined trabeculotomy and cataract surgery. J Glaucoma 2001;10:302–308. Tanito M, Park M, Nishikawa M, Ohira A, Chihara E. Comparison of surgical outcomes of combined viscocanalostomy and cataract surgery with combined trabeculotomy and cataract surgery. Am J Ophthalmol 2002;134:513–520. Chihara E, Dong J, Ochiai H, Hamada S. Effects of Tranilast on filtering blebs: a pilot study. J Glaucoma 2002;11:127–333. Shoji T, Tanito M, Takahashi H, et al. Phacoviscocanalostomy versus cataract surgery only in patients with coexisting normaltension glaucoma: midterm outcomes. J Cataract Refract Surg 2007;33:1209–1216. McEwen W. Application of Poiseuille’s law to aqueous outflow. Arch Ophthalmol 1958;60:290–294. Schwartz AL, Van Veldhuisen PC, Gaasterland DE, Federer F, Sullivan EK, Cyrlin MN, and the AGIS Investigators. The Advanced Glaucoma Intervention Study (AGIS). 5. Encapsulated bleb after initial trabeculectomy. Am J Ophthalmol 1999;127:8–19. Husain R, Clarke JCK, Seah SKL, Khaw PT. A review of trabeculectomy in East Asian people-the influence of race. Eye 2005;19:243–252. Chihara E, Okazaki K, Takahashi H, Shoji T, Adachi H, Hayashi K. Modified deep sclerectomy (D-lectomy MMC) for primary openangle glaucoma: preliminary results. J Glaucoma 2009;18:132–139. Grieshaber MC, Pienaar A, Olivier J, Stegmann R. Clinical evaluation of the aqueous outflow system in primary open-angle glaucoma for canaloplasty. Invest Ophthalmol Vis Sci 2010;51:1498–1504. Roters S, Lueke C, Jonescu-Cuypers CP, et al. Ultrasound biomicroscopy and its value in predicting the long term outcome of viscocanalostomy. Br J Ophthalmol 2002;86:997–1001. Park M, Tanito M, Nishikawa M, et al. Ultrasound biomicroscopy of intrascleral lake after viscocanalostomy and cataract surgery. J Glaucoma 2004;13:472–478. Khairy HA, Atta HR, Green FD, et al. Ultrasound biomicroscopy in deep sclerectomy. Eye 2005;19:555–560. Wishart MS, Dagres E. Seven-year follow-up of combined cataract extraction and viscocanalostomy. J Cataract Refract Surg 2006;32:2043–2049. Levene RZ. Glaucoma filtering surgery: factors that determine pressure control. Ophthalmic Surg 1984;15:475–483. The AGIS Investigators. The Advanced Glaucoma Intervention Study (AGIS). 7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol 2000;130:429–440. Hayashi K, Hayashi H, Nakao F, Hayashi F. Changes in anterior chamber angle width and depth after intraocular lens implantation in eyes with glaucoma. Ophthalmology 2000;107:698–703.