PURPOSE: To describe the incidence of, and risk factors for, surgical complications reported during and within the first post-operative month after trabeculectomy in the Collaborative Initial Glaucoma Treatment Study ...PURPOSE: To describe the incidence of, and risk factors for, surgical complications reported during and within the first post-operative month after trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS). DESIGN: Review of prospectively collected data from a multicenter, randomized clinical trial. METHODS: Complications were tabulated for the 300 CIGTS patients randomized to surgery. Logistic regression analyses were used to identify risk factors for complications. RESULTS: Among the 300 patients randomized to initial surgery, 465 trabeculectomies were performed. Intraoperative complications were reported in 55 eyes (12% ). The most frequent reported complications were anterior chamber bleeding during surgery (37 eyes, 8% ) and conjunctival buttonhole (five eyes, 1% ). Early post-operative complications were reported in 232 eyes (50% ). Complications with a frequency over 10% included shallow or flat anterior chamber (62 eyes, 13% ), encapsulated bleb (56 eyes, 12% ), ptosis (55 eyes, 12% ), serous choroidal detachment (52 eyes, 11% ), and anterior chamber bleeding or hyphema (48 eyes, 10% ). There were three localized suprachoroidal hemorrhages (0.7% ) and no cases of endophthalmitis. Older patients were more likely to experience serous choroidal detachment, new anterior or posterior synechiae, and wound leak. Blacks were less likely to experience anterior chamber bleeding, but more likely to experience post-operative ptosis. The number of subjects experiencing bilateral complications was higher than that which would have been predicted by chance alone. CONCLUSIONS: The incidence of transient and self-limiting complications was high in the perioperative period, but we observed few complications with the potential to cause severe sustained vision loss in this group of previously untreated eyes.展开更多
Objective:To evaluate the 5-year sa fety and efficacy of adjunctive 0.005%latanoprost once daily.Methods:Pa-tients with primary open-angle or exfoliation glaucoma who completed a 3-year,open-label,uncontrolled,prospec...Objective:To evaluate the 5-year sa fety and efficacy of adjunctive 0.005%latanoprost once daily.Methods:Pa-tients with primary open-angle or exfoliation glaucoma who completed a 3-year,open-label,uncontrolled,prospective trial could enter a 2-year extension phase.High-resolution color photographs of irides were tak en at baseline and at 14subsequent visits.Photographs were assessed for change in iris pigmentation compared with baseline.Intraocular pressures and adverse events were re corded.Main Outcome Measure:Development and progression of increased iris pigmentation over 5years.Results:Of the 519original patients,380enrolled in the extension phase with approx-imately 89%having an eye color known to be susceptible to color change.After 5years,most p atients had no in-crease in iris pigmentation,but certain colored irides ex-hibited notably greater susceptibi lity than others.For those whose irides did change,onset occur red during the first 8months in 74%and during the first 24months in 94%.No patient developed an increase in pig mentation after month36;the rate of progression decrease d over time.Adverse event profiles were similar for pati ents with and without increased pigmentation.The overall mean intraocular pressure reduction from baseline of25%was sustained with no need for change in intraocular pre ssure-lowering treat-ment in 70%of the eyes.Conclusion:L atanoprost therapy is safe and well tolerated for long-term treatment of open-angle glaucoma.展开更多
文摘PURPOSE: To describe the incidence of, and risk factors for, surgical complications reported during and within the first post-operative month after trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS). DESIGN: Review of prospectively collected data from a multicenter, randomized clinical trial. METHODS: Complications were tabulated for the 300 CIGTS patients randomized to surgery. Logistic regression analyses were used to identify risk factors for complications. RESULTS: Among the 300 patients randomized to initial surgery, 465 trabeculectomies were performed. Intraoperative complications were reported in 55 eyes (12% ). The most frequent reported complications were anterior chamber bleeding during surgery (37 eyes, 8% ) and conjunctival buttonhole (five eyes, 1% ). Early post-operative complications were reported in 232 eyes (50% ). Complications with a frequency over 10% included shallow or flat anterior chamber (62 eyes, 13% ), encapsulated bleb (56 eyes, 12% ), ptosis (55 eyes, 12% ), serous choroidal detachment (52 eyes, 11% ), and anterior chamber bleeding or hyphema (48 eyes, 10% ). There were three localized suprachoroidal hemorrhages (0.7% ) and no cases of endophthalmitis. Older patients were more likely to experience serous choroidal detachment, new anterior or posterior synechiae, and wound leak. Blacks were less likely to experience anterior chamber bleeding, but more likely to experience post-operative ptosis. The number of subjects experiencing bilateral complications was higher than that which would have been predicted by chance alone. CONCLUSIONS: The incidence of transient and self-limiting complications was high in the perioperative period, but we observed few complications with the potential to cause severe sustained vision loss in this group of previously untreated eyes.
文摘Objective:To evaluate the 5-year sa fety and efficacy of adjunctive 0.005%latanoprost once daily.Methods:Pa-tients with primary open-angle or exfoliation glaucoma who completed a 3-year,open-label,uncontrolled,prospective trial could enter a 2-year extension phase.High-resolution color photographs of irides were tak en at baseline and at 14subsequent visits.Photographs were assessed for change in iris pigmentation compared with baseline.Intraocular pressures and adverse events were re corded.Main Outcome Measure:Development and progression of increased iris pigmentation over 5years.Results:Of the 519original patients,380enrolled in the extension phase with approx-imately 89%having an eye color known to be susceptible to color change.After 5years,most p atients had no in-crease in iris pigmentation,but certain colored irides ex-hibited notably greater susceptibi lity than others.For those whose irides did change,onset occur red during the first 8months in 74%and during the first 24months in 94%.No patient developed an increase in pig mentation after month36;the rate of progression decrease d over time.Adverse event profiles were similar for pati ents with and without increased pigmentation.The overall mean intraocular pressure reduction from baseline of25%was sustained with no need for change in intraocular pre ssure-lowering treat-ment in 70%of the eyes.Conclusion:L atanoprost therapy is safe and well tolerated for long-term treatment of open-angle glaucoma.
