AIM:To compare the surgical outcomes of glaucoma drainage device implantation(GDI)and trans-scleral neodymium:YAG cyclophotocoagulation(CPC)in the management of refractory glaucoma after Descemetstripping automated en...AIM:To compare the surgical outcomes of glaucoma drainage device implantation(GDI)and trans-scleral neodymium:YAG cyclophotocoagulation(CPC)in the management of refractory glaucoma after Descemetstripping automated endothelial keratoplasty(DSAEK).METHODS:This retrospective study on observational case series enrolled 29 patients who underwent DSAEK and posterior anti-glaucoma surgery(15 with GDI and 14 with CPC).The main outcome measures were intraocular pressure(IOP),glaucoma surgery success rate(defined as IOP of 6–21 mm Hg without additional anti-glaucoma operation),number of glaucoma medications,endothelial graft status,and best-corrected visual acuity(BCVA).RESULTS:The mean follow-up time was 34.1 and 21.0mo for DSAEK or glaucoma surgeries,both for the GDI and CPC groups.Both groups showed significant IOP reduction after glaucoma surgery.The GDI group presented a significantly higher success rate in IOP control than the CPC group(60%vs 21.4%,P=0.03).Both procedures significantly decreased the number of glaucoma medications(P=0.03).Forty percent and 57%of cases in the GDI and the CPC group,respectively,experienced endothelial graft failure during follow-up(P=0.36).Significantly worse BCVA after surgery was observed in the CPC group but not in the GDI group.CONCLUSION:Both GDI and CPC significantly decrease IOP in eyes with glaucoma after DSAEK.GDI is preferable to CPC in refractory glaucoma cases after DSAEK,as it manifests a significantly higher success rate for IOP control,similar endothelial graft failure rate,and relatively preserves BCVA than CPC.展开更多
AIM: To detect the relationship between infusion pressure and postoperative ganglion cells function.METHODS: This prospective observational cohort study included sixty-one eyes that underwent uncomplicated cataract su...AIM: To detect the relationship between infusion pressure and postoperative ganglion cells function.METHODS: This prospective observational cohort study included sixty-one eyes that underwent uncomplicated cataract surgery. Patients were divided into two groups according to infusion time(IT) recorded using surgery equipment [Group A: IT>IT_(mean)(27 eyes); Group B: IT<IT_(mean)(34 eyes)]. Best-corrected visual acuity, isolatedcheck visual evoked potential(ic VEP), microperimetry,and optical coherence tomography examinations were performed preoperatively and 1 wk and 1 mo postoperatively. The changes in test results were measured with independentsample t-tests and paired t-tests. Correlation between IT and these changes were analyzed with Pearson's correlation analysis and Spearman correlation analysis.RESULTS: Neither group showed significant postoperative changes in macular ganglion cell-inner plexiform layer(m GC-IPL) thickness(1-week postoperative: Group A P= 0.185, Group B P=0.381; 1-month postoperative: Group A P=0.775, Group B P=0.652). Postoperative m GC-IPL thickness of Group A was not significantly thicker than that of Group B at both post surgery time point(1-week postoperative P=0.913; 1-month postoperative P=0.954). In Group A, the m GC-IPL thickness change 1 wk postoperatively was positively correlated with IT(R^2=0.156, P=0.0198). A suspected progressive deficit in the magnocellular pathway was also found in Group A 1-month postoperatively [individual observed F(IOF)=0.63±0.70]. Significant increases were observed in postoperative retinal sensitivity measured by microperimetry(1-week postoperative: Group A P=0.015, Group B P<0.001; 1-month postoperative: Group AP=0.005, Group B P<0.001). In Group B, IT was negatively correlated with the increase in macular sensitivity(1-week postoperative: R^2=0.372, P<0.001; 1-month postoperative: R^2=0.209, P=0.007).CONCLUSION: Both m GC-IPL thickness and retinal sensitivity increased postoperatively. A suspected progressive deficit in the magnocellular pathway was found in the group with a long IT, which induced more prominent changes.展开更多
文摘AIM:To compare the surgical outcomes of glaucoma drainage device implantation(GDI)and trans-scleral neodymium:YAG cyclophotocoagulation(CPC)in the management of refractory glaucoma after Descemetstripping automated endothelial keratoplasty(DSAEK).METHODS:This retrospective study on observational case series enrolled 29 patients who underwent DSAEK and posterior anti-glaucoma surgery(15 with GDI and 14 with CPC).The main outcome measures were intraocular pressure(IOP),glaucoma surgery success rate(defined as IOP of 6–21 mm Hg without additional anti-glaucoma operation),number of glaucoma medications,endothelial graft status,and best-corrected visual acuity(BCVA).RESULTS:The mean follow-up time was 34.1 and 21.0mo for DSAEK or glaucoma surgeries,both for the GDI and CPC groups.Both groups showed significant IOP reduction after glaucoma surgery.The GDI group presented a significantly higher success rate in IOP control than the CPC group(60%vs 21.4%,P=0.03).Both procedures significantly decreased the number of glaucoma medications(P=0.03).Forty percent and 57%of cases in the GDI and the CPC group,respectively,experienced endothelial graft failure during follow-up(P=0.36).Significantly worse BCVA after surgery was observed in the CPC group but not in the GDI group.CONCLUSION:Both GDI and CPC significantly decrease IOP in eyes with glaucoma after DSAEK.GDI is preferable to CPC in refractory glaucoma cases after DSAEK,as it manifests a significantly higher success rate for IOP control,similar endothelial graft failure rate,and relatively preserves BCVA than CPC.
基金Supported by the Beijing Municipal Commission of Science and Technology(No.Z151100004015073)
文摘AIM: To detect the relationship between infusion pressure and postoperative ganglion cells function.METHODS: This prospective observational cohort study included sixty-one eyes that underwent uncomplicated cataract surgery. Patients were divided into two groups according to infusion time(IT) recorded using surgery equipment [Group A: IT>IT_(mean)(27 eyes); Group B: IT<IT_(mean)(34 eyes)]. Best-corrected visual acuity, isolatedcheck visual evoked potential(ic VEP), microperimetry,and optical coherence tomography examinations were performed preoperatively and 1 wk and 1 mo postoperatively. The changes in test results were measured with independentsample t-tests and paired t-tests. Correlation between IT and these changes were analyzed with Pearson's correlation analysis and Spearman correlation analysis.RESULTS: Neither group showed significant postoperative changes in macular ganglion cell-inner plexiform layer(m GC-IPL) thickness(1-week postoperative: Group A P= 0.185, Group B P=0.381; 1-month postoperative: Group A P=0.775, Group B P=0.652). Postoperative m GC-IPL thickness of Group A was not significantly thicker than that of Group B at both post surgery time point(1-week postoperative P=0.913; 1-month postoperative P=0.954). In Group A, the m GC-IPL thickness change 1 wk postoperatively was positively correlated with IT(R^2=0.156, P=0.0198). A suspected progressive deficit in the magnocellular pathway was also found in Group A 1-month postoperatively [individual observed F(IOF)=0.63±0.70]. Significant increases were observed in postoperative retinal sensitivity measured by microperimetry(1-week postoperative: Group A P=0.015, Group B P<0.001; 1-month postoperative: Group AP=0.005, Group B P<0.001). In Group B, IT was negatively correlated with the increase in macular sensitivity(1-week postoperative: R^2=0.372, P<0.001; 1-month postoperative: R^2=0.209, P=0.007).CONCLUSION: Both m GC-IPL thickness and retinal sensitivity increased postoperatively. A suspected progressive deficit in the magnocellular pathway was found in the group with a long IT, which induced more prominent changes.
