Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1,...Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.展开更多
Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1,...Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.展开更多
AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glauc...AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). ·METHODS: Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation was performed in 32 eyes of 29 patients with PACG. Regular follow-up was performed 1 week and 1 month, 3, and 6 months after surgery to assess complications, intraocular pressure (IOP), anterior chamber depth, visual acuity, and anterior chamber angle. ·RESULTS: Preoperative mean IOP was 24.88±7.22mmHg with pharmacological treatment, and was 13.70 ±4.02, 13.06 ±3.74, 14.29 ±4.70, and 14.33 ±5.01mmHg 1 week, 1 month, 3 months, and 6 months after surgery, respectively. The postoperative decrease in IOP was significant (P < 0.05). The rate for all eyes with IOP of 21mmHg or less was 93.8% (30 eyes) at the final visit without ocular hypotensive agents. The average preoperative anterior chamber depth was 1.60 ±0.64mm, and this value significantly increased to 2.72±0.62, 2.76±0.70, 2.73±0.68, and 2.74 ±0.71mm at 1 week, 1 month, 3 months, and 6 months, respectively. Visual acuity was improved in 28 eyes (87.5% ) at 6 months postoperatively. The anterior chamber angle had increased in 25 eyes (78.1% ) at the final visit; it was adhesive 90°-180° in 6 eyes, 180°-270° in only 1 eye. Two eyes exhibited minimal hyphema in the early postoperative period, but it could gradually be absorbed. Fibrinous reaction was observed in five eyes and spontaneously disappeared within 7 days. No shallow anterior chamber, iridodialysis, choroidal deta-chment, or malignant glaucoma was found in any eyes.CONCLUSION:Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation to manage PACG has several advantages, including optimized visualization, greater accuracy, and improved safety. Our results suggest that it has certain curative effects and clinical application value.展开更多
AIM: To compare the efficacy and safety of phacoemulsification(Phaco) against combined phacotrabeculectomy(Phacotrabe) in primary angle-closure glaucoma(PACG) with coexisting cataract.·METHODS: By searching elect...AIM: To compare the efficacy and safety of phacoemulsification(Phaco) against combined phacotrabeculectomy(Phacotrabe) in primary angle-closure glaucoma(PACG) with coexisting cataract.·METHODS: By searching electronically the Pub Med,EMBASE, Scientific Citation Index and Cochrane Library published up from inception to January 2014, all randomized controlled trials that matched the predefined criteria were included. The quality of included trials was evaluated according to the guidelines developed by the cochrane collaboration. And the outcomes estimating efficacy and safety of two different surgical treatments were measured and synthesised by Rev Man 5.0.· RESULTS: Five randomized controlled trials were selected and included in Meta-analysis with a total of468 patients(468 eyes) with both PACG and cataract. We found that Phacotrabe had a greater intraocular pressure(IOP) lowing effect [preoperative IOP: weighted mean difference(WMD)=0.58, 95% confidence intervals(95% CI,-0.53 to 1.69), P =0.31; postoperative IOP: WMD =1.37,95% CI(0.45 to 2.28), P =0.003], a lower number of antiglaucoma medications [risk ratio(RR)=0.05, 95% CI(0.02 to 0.18), P <0.00001] needed postoperatively and less serious damage of optic nerve [RR =0.48, 95% CI(0.21 to 1.07), P =0.07], but a higher risk of complications[odds ratio(OR)=0.04, 95% CI(0.01 to 0.16), P <0.00001]compared with Phaco. The rest studies indicated that there had no significantly difference between the two surgical methods for postoperative best-corrected visual acuity(BCVA) [WMD =-0.05, 95% CI(-0.14 to 0.05), P =0.32] and loss of visual field [RR=1.06, 95% CI(0.61 to1.83), P =0.83].·CONCLUSION: Phaco alone compared with Phacotrabe had a better effect in IOP reduction, whereas the securitydecline. Considering the number of sample size, our results remains to be further studied.展开更多
AIM: To evaluate the efficacy of combined treatment of phacoemulsification(PE) and micro-incisional single-port transconjunctival limited pars plana vitrectomy(PPV) in acute angle-closure glaucoma(AACG).METHODS: A ret...AIM: To evaluate the efficacy of combined treatment of phacoemulsification(PE) and micro-incisional single-port transconjunctival limited pars plana vitrectomy(PPV) in acute angle-closure glaucoma(AACG).METHODS: A retrospective study included 26 patients who underwent PE diagnosed with AACG. Among them, 16 patients(16 eyes) underwent PE alone, 10 patients(10 eyes) underwent combined limited vitrectomy and PE. Then we compared intraocular pressure(IOP), anterior chamber angle, anterior chamber depth, central corneal thickness and corneal endothelial cell count before and after surgery, and effective PE time during cataract surgery.RESULTS: Effective PE time was shorter in the combined surgery group than in the single surgery group(P=0.040). There was no statistically significant difference in IOP and best-corrected visual acuity between the two groups postoperatively. At 6 mo postoperatively, there was no difference in the anterior chamber angle, anterior chamber depth, and central corneal thickness between two groups, but corneal endothelial cell count was higher in the combined surgery group than in the single surgery group(P=0.046). No complication such as vitreoretinal disease, endophthalmitis, bullous keratopathy was noted.CONCLUSION: Combined micro-incisional single-port transconjunctival limited PPV and PE are more effective and safer than PE alone because of less operation time and fewer complications for management of AACG.展开更多
AIM: To compare the benefits and potential harms of routine phacoemulsification(phaco) alone and combined surgery with goniosynechialysis(GSL) for angle-closure glaucoma(ACG) and coexisting lens opacity, as shown in d...AIM: To compare the benefits and potential harms of routine phacoemulsification(phaco) alone and combined surgery with goniosynechialysis(GSL) for angle-closure glaucoma(ACG) and coexisting lens opacity, as shown in different randomized controlled trials(RCTs).METHODS: A systematic review was conducted searching several databases including PubMed, Cochrane Library, EMBASE, ClinicalTrials.gov from the inception to September 2018 for RCTs with data published on the effects and safety of phaco and intraocular lens implantation combined with GSL or routine cataract surgery alone. Several studies were recruited which reported data at baselines and postoperative follow-up, including the mean values of postoperative intraocular pressure(IOP) and mean numbers of antiglaucoma medications using postoperatively. The numbers of complications happening were also included. Fixedeffect and random-effect models were applied, and the quality of evidence was evaluated.RESULTS: Analysis of the seven included RCTs, with a total number of 321 participants(358 eyes) diagnosed with ACG and cataract, received a solo procedure(phaco group) or a combined surgery(phaco-GSL group) randomly, and follow-up periods ranging from 2 to 12 mo postoperatively. The involved studies showed that the mean value of IOP between the two groups at 3(four studies, one study follow-up at 2 mo postoperative was included), 6, 12 mo postoperative were not significantly different. Only two studies reported the change in IOP value at 12 mo compared with baseline but showed nosignificant differences between the two interventions. Although three studies did not have the significant difference in the number of medications using to reduce IOP at 3 mo postoperatively, two studies reported that the participants using fewer anti-glaucoma medications at 12 mo postoperative in the phaco group than in the phacoGSL surgery group.CONCLUSION: The analysis provides a low to moderatequality evidence that phaco-GSL surgery lead to an equivalent IOP-lowering effect. The phaco-GSL surgery may not help patients to reduce the consumption of antiglaucoma eyedrops in the long period. The results of this analysis suggested that additional GSL may not be necessary for primary angle closure glaucoma(PACG) patients. Further studies, especially RCTs with more participants and longer follow-up time were needed to provide more sufficient data.展开更多
AIM: To compare the safety and effectiveness of phacotrabeculectomy versus sequential surgery in chronic angle-closure glaucoma(CACG) with coexisting cataract.·METHODS: One hundred and sixty-two CACG patients(162...AIM: To compare the safety and effectiveness of phacotrabeculectomy versus sequential surgery in chronic angle-closure glaucoma(CACG) with coexisting cataract.·METHODS: One hundred and sixty-two CACG patients(162 eyes) were retrospectively analyzed. Of them, 87patients(87 eyes) in group A had underwent phacotrabeculectomy with intraocular lens(IOL)implantation, and 75 patients(75 eyes) in group B had underwent sequential surgery with IOL implanted. Best-corrected visual acuity(BCVA), intraocular pressure(IOP), complications and anterior chamber angle(ACA)were measured.· RESULTS: Demographic characteristics of the two groups were similar. A mean follow-up period was 15±6mo(range 13 to 24mo), a mean IOP of 12.14 ±5.32 mm Hg in group A and 11.38 ±4.06 mm Hg in group B(P =0.84) at the last follow up. The Kaplan-Meier analysis revealed that the cumulative probability of success in both groups was similar(P =0.61). Anterior uveitis and hypotony were the most common complications in group A, whereas group B experienced shallow anterior chamber with trabeculectomy. With the exception of anterior uveitis, no complications occurred to 11 trabeculectomized eyes. All postoperative measurements of anterior chamber showed statistically significant differences in each group according to the preoperative data(P <0.05). However,fewer changes occurred in group B than in group A.· CONCLUSION: Phacotrabeculectomy and sequential surgery exhibit similar IOP reduction, visual recovery,and complications when treating CACG patients with cataract. However, for a wider ACA, phacotrabeculectomy has demonstrated higher effectiveness than sequential surgery.展开更多
AIM:To evaluate the efficacy and safety of trabeculectomy,phacotrabeculectomy plus intraocular lens implantation(phacotrab+IOL group) and phacoemulsification with IOL(phaco+IOL) in primary angle-closure glaucoma(PACG)...AIM:To evaluate the efficacy and safety of trabeculectomy,phacotrabeculectomy plus intraocular lens implantation(phacotrab+IOL group) and phacoemulsification with IOL(phaco+IOL) in primary angle-closure glaucoma(PACG).METHODS: It was a systematic review and meta-analysis,randomized controlled trials(RCT) and clinical controlled trials(CCT) were collected through electronic searches of the Cochrane Library,PubMed,EMbase,Wanfang Database online,Chinese journal Full-text Database,Chinese Scientific Journals Full-text Database (from the date of building the database to October 2010) We also checked the bibliographies of retrieved articles.All the related data that matched our standards were abstracted.The quality of included trials was evaluated according to the Dutch Cochrane Centre.RevMan 5.0 software was used for Meta-analysis.RESULTS: A total of 5 RCT and 11 CCT involving 1495 eyes were included.The results of meta-analysis showed that phacotrab+IOL group was superior than trabeculectomy(trab group) (MD -3.93,95%CI [-7.31,-0.54]) which was also superior than phaco+IOL group(MD 0.52,95%CI [0.10,0.95]) in decreasing Intraocular Pressure(IOP).Phacotrab group(MD -1.45,95%CI [-1.68,-1.22])and phaco group (MD-1.12,95%CI [-1.87,-0.37])are both deeper than trab group in the anterior chamber depth.In increasing the coefficient of outflow facility of aqueous humor(C values) there was no statistical difference in the three groups.And there was no statistical difference between phacotrab groups and phaco groups in visual acuity but phacotrab group was superior than phaco group (MD 1.07,95%CI [0.73,1.40])in the use of IOP-lowering drugs.There was no statistical difference among three groups.CONCLUSION: Current evidence suggests that phacotrab+ IOL group was superior than trab group which was also superior than phaco+IOL group in decreasing IOP.Phacotrab group and phaco group are both deeper than trab group in the anterior chamber depth.Phacotrab group was superior than phaco group in the use of IOP-lowering drugs.展开更多
Purpose: To investigate the efficacy of trabeculectomy, phacotrabeculectomy and phaco-emulsification in the management of primary angle closure glaucoma (PACG). Methods: A prospective observational study was performed...Purpose: To investigate the efficacy of trabeculectomy, phacotrabeculectomy and phaco-emulsification in the management of primary angle closure glaucoma (PACG). Methods: A prospective observational study was performed in 88 chronic PACG patients (97 eyes) who were divided into three groups following defined indications to receive different surgical interventions. The indications and clinical outcomes were evaluated. The mean follow-up was (17.7±4.9) months. Results: Success rate in trabeculectomy, phacotrabeculectomy and phacoemulsification group was 81.08%, 78.57‰ and 81.25‰, respectively. The anterior chamber depth was deeper and the angle was wider postoperatively vs. preoperatively both in phaco-trabeculectomy and phacoemulsification group. No obvious changes were seen in trabeculectomy group. The coefficient of outflow facility of aqueous humor (C values) significantly increased in three groups postoperatively (P < 0.01). No severe intra-operative complications were found and the incidence of postoperative complications was low. Five eyes sustained hypotony 3±1.87 months in trabeculectomy group and 1 eye happened malignant glaucoma in phacotrabeculectomy group. The visual acuity in patients with phacotrabeculectomy plus intraocular lens implantation and those only with phacoemulsification plus intraocular lens implantation were improved 78.57% and 93.74%, respectively. No significant improvement was found in trabeculectomy group (χ2 = 47.10, P < 0.001). Conclusion: Three surgical interventions were beneficial to manage PACG and with co-existing cataract. The indication choosing was suggested according to visual acuity, angle closure circumference, cataract, medication requirements and optic nerve damage. Phacotrabeculectomy was recommended for angle closed ≥180° circumference while phacoemulsification for angle closed < 180°.展开更多
AIM: To describe the results of 5 consecutive cases of clear lens extraction in angle closure patients for the treatment of elevated intraocular pressure (IOP). ·METHODS: Retrospective observational case series. ...AIM: To describe the results of 5 consecutive cases of clear lens extraction in angle closure patients for the treatment of elevated intraocular pressure (IOP). ·METHODS: Retrospective observational case series. All angle closure patients were on two or more topical glaucoma medications and had prior laser iridotomy. Eyes underwent clear lens extraction by phacoemu - lsification with intraocular lens implantation. ·RESULTS: All five patients in this case series carried the diagnosis of angle -closure glaucoma and had uncontrolled IOP prior to surgery despite topical medications. After clear lens extraction three of the cases had good IOP control (IOP <22mmHg) without the need for topical medications. In one case the IOP was better controlled after surgery, however, topical medications were required. The desired IOP was not met in one case despite restarting maximum topical therapy. ·CONCLUSION: This case series suggests that there may be a role for therapeutic clear lens extraction in select cases of angle-closure glaucoma.展开更多
AIM: To evaluate the value of quantitative diffusion tensor imaging(DTI) in assessing the axonal and myelin damage of the optic nerves and optic radiations in patients with chronic primary angle-closure glaucoma(PACG)...AIM: To evaluate the value of quantitative diffusion tensor imaging(DTI) in assessing the axonal and myelin damage of the optic nerves and optic radiations in patients with chronic primary angle-closure glaucoma(PACG) by using high-field magnetic resonance(MR)imaging(3T).·METHODS: Twenty patients with bilateral chronic PACG and twenty age- and sex matched disease-free control subjects were enrolled. Conventional MRI and DTI were performed on all subjects using 3T MR scanner.Mean diffusivity(MD), fractional anisotropy(FA), axial diffusivities(AD) and radial diffusivities(RD) of each optic nerve and each optic radiation were measured by using post-processing software of DTI studio 2.3, and then compared between left eyes and right eyes and between patients group and control group. The paired-sample t- test were used.·RESULTS: There was no abnormality in the shape and signal intensity of the optic nerves and optic radiations in patients group and control group on the conventional MRI. No significant differences were observed in the FA,MD, AD and RD between the right and left optic nerves and optic radiations within patients group and control group(P >0.05). The optic nerves and optic radiations of patients with chronic PACG, as compared with control subjects, had significantly higher MD, AD, RD and significantly lower FA(P <0.05).·CONCLUSION: The diffusivity of optic nerves and opticradiations in chronic PACG group showed abnormal and diffusivity parameters could be used markers of axonal and myelin injury in glaucoma.展开更多
AIM:To examine the association between the single nucleotide polymorphisms (SNPs)of matrix metalloprotease-9 (MMP-9) gene and primary angleclosure glaucoma(PACG)in a Chinese Han population.METHODS:DNA samples were ext...AIM:To examine the association between the single nucleotide polymorphisms (SNPs)of matrix metalloprotease-9 (MMP-9) gene and primary angleclosure glaucoma(PACG)in a Chinese Han population.METHODS:DNA samples were extracted from peripheral-blood mononuclear cells of 214 PACG patients and 224 healthy controls.Genotyping of rs3918249,rs3918254,rs17577 and rs3787268 in MMP-9was performed using polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP)analysis and the direct sequencing technique.The association between these genetic polymorphisms and risk of PACG was estimated by χ2 test.RESULTS:The distributions of rs3918249,rs3918254,rs17577 and rs3787268 genotypes among cases and healthy controls were compatible with that from HardyWeinberg equilibrium(HWE,P>0.05).The increased frequency of CC and CT genotypes of rs3918254 were observed in PACG patients compared to healthy controls[P=0.006,P corrected(Pcorr)=0.048].The haplotype analysis showed that the CCGG haplotype was nominal associated with PACG(P=0.015),however,the significant was lost when the Bonferroni correction was used(Pcorr=0.105).CONCLUSION:Our results revealed that rs3918254 in MMP-9 may be a susceptible locus to PACG in China,people with the CC and CT genotypes of rs3918254 are more susceptible to PACG.The susceptibility to PACG inChinese Han patients may be not influenced by SNPs rs3918249,rs3787268 and rs17577 in MMP-9.展开更多
AIM:To evaluate changes of proinflammatory cytokines in aqueous humor of patients with acute primary angleclosure(APAC) and age-related cataracts. METHODS:Twenty eyes of 20 APAC patients and 15 eyes of 15 age-related ...AIM:To evaluate changes of proinflammatory cytokines in aqueous humor of patients with acute primary angleclosure(APAC) and age-related cataracts. METHODS:Twenty eyes of 20 APAC patients and 15 eyes of 15 age-related cataract patients were included in this cross-sectional study. Aqueous humor samples were collected prospectively. The levels of 20 proinflammatory cytokines were evaluated in the aqueous humor of the APAC and cataract patients using the multiplex bead immunoassay technique. Clinical data were collected for correlation analysis.RESULTS:Seven of the 20 proinflammatory cytokines included in the magnetic bead panel were detectable in both APAC eyes and cataract eyes:interleukin(IL)-10, IL-12, IL-15, IL-21, IL-6, chemokine(C-C motif) ligand 20, and tumor necrosis factor alpha(TNF-α). IL-27 was only detectable in APAC eyes. Compared with the cataract eyes, the APAC eyes had significantly elevated concentrations of IL-12(P=0.036), IL-15(P=0.001), IL-6(P=0.012), and IL-27(only detectable in APAC eyes). Age was positively correlated with IL-12(P=0.022) and IL-6(P=0.037), and time elapsed between APAC onset and aqueous humor samples collection was positively correlated with IL-15(P=0.037), IL-27(P=0.040), and TNF-α(P=0.042).CONCLUSION:Several proinflammatory cytokines including IL-12,IL-15, IL-6 and IL-27, were elevated in the APAC eyes and may be implicated in its pathologic mechanism.展开更多
Background: Primary chronic angle-closure glaucoma(PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional tra...Background: Primary chronic angle-closure glaucoma(PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional trabeculectomy is prone to anesthesia-related complications intraoperative and operationrelated complications postoperative in PCACG treatment. Modified minimally invasive trabeculectomy maybe can reduce the incidence of complications.Methods: We conducted a prospective case series study and performed modified fornix-based trabeculectomy in 27 patients(30 eyes) under topical anesthesia; we then observed intraoperative anesthesia and cooperation ef ect, intraoperative and postoperative complications, preoperative and postoperative visual acuity, intraocular pressure(IOP), visual field, and the use of ocular hypotensive drugs. The patients were followed up for at least 12 months.Results: All operations were completed successfully with no intraoperative complications. All 27 patients(30 eyes) were followed up for at least 12 months. No significant decrease in visual acuity was observed at days 1 or 7 and at months 1, 3, 6, and 12 after operation; however, a signii cant decrease in IOP was observed at days 1 and 7 and at months 1, 3, 6, and 12 after operation. Moreover, no significant progression in visual field mean defect was observed at month 12 after operation, and the number of ocular hypotensive drugs required was significantly reduced at months 6 and 12 after operation. By month 12 after operation, the overall success rate was 93.33%(28/30).Conclusions: Modii ed minimally invasive trabeculectomy is safe and ef ective for the treatment of PCACG.展开更多
AIM:To evaluate the morphological changes in anterior segment in Chinese patients with uveal effusion(UE)after the attack of acute primary angle-closure(APAC)using ultrasound biomicroscopy(UBM),and to assess the clini...AIM:To evaluate the morphological changes in anterior segment in Chinese patients with uveal effusion(UE)after the attack of acute primary angle-closure(APAC)using ultrasound biomicroscopy(UBM),and to assess the clinical course and prognosis of the disease.METHODS:In a retrospective case series,26 eyes in 26 consecutive patients diagnosed with UE after the treatment of intraocular pressure(IOP)-lowering medication for the attack of APAC were enrolled. The unaffected fellow eyes served as controls. The morphological changes were observed by ultrasonography,slit lamp microscopy and gonioscopy. UBM was used to assess the degree and extent of effusion based on the analysis of parameters associated with UE.RESULTS:The mean IOP was 9.2(SD 2.1)mm Hg at the diagnosis of UE after IOP-lowering medication,while 14.1(SD,2.6)mm Hg in the fellow eyes(P=0.000). The anterior chamber depth(ACD)(P=0.000),angle opening distance at 500 μm(AOD500)(P<0.01)and anterior chamber angle(ACA)(P<0.05)were decreased significantly,while ciliary body thickness(CBT)(P<0.05)increased significantly in UE eyes. UE grade analysis showed 7 eyes in grade 1,9 eyes in grade 2,and 10 eyes in grade 3. Quadrant scores were performed of 4 eyes in 1 quadrant,3 eyes in 3 quadrants,and 19 eyes in 4 quadrants. There was the positive correlation between grade and quadrant score(R=0.644,P=0.000). The effusion on all eyes were recovered after medication,which mean IOP was 13.9(SD,2.8)mm Hg.CONCLUSION:UE is a frequent complication in Chinese patients after the attack of APAC,partially associated with hypotony. The severity of UE is correlation with height of effusion,extent of detachment,and shallower ACD.展开更多
Objective:To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens(PC-IOL)implantation.Design:Retrospective,noncontrolled interventional case seri...Objective:To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens(PC-IOL)implantation.Design:Retrospective,noncontrolled interventional case series.Participants:In36eyes with angle-closure glaucoma(ACG),there were18eyes with primary acute angle-closure glaucoma(PACG),14eyes with primary chronic angle-closure glaucoma(PCCG),3eyes with secondary acute angle-closure glaucoma(SACG)and 1eye with secondary chronic angle-closure glaucoma(SCCG).Intervention:Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures:Postoperative visual acuity,IOP,axial anterior chamber depth.Results:After a mean postoperative follow-up time of 8.81±7.45months,intraocular pressure was reduced from a preoperative mean of 23.81±17.84mmHg to a postoperative mean of 12.54±4.73mmHg(P=0.001).Mean anterior hamber depth was1.75±0.48mm preoperatively and2.29±0.38mm postoperatively(P=0.000).Best spectacle-corrected visual acuith in 36eyes ranged from0.01to0.7(20/200to20/30)postoperatively,which was better than preoperative VA ranging from hand movement to 0.4(20/50)(P=0.000).Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma,Eye Science 2000;16:22-28.展开更多
AIM: To determine the levels of aquaporin-1(AQP-1) in the lens epithelial cells(LECs) of primary glaucoma and to clarify its correlation with lens thickness.METHODS: This study comprised 64 eyes of 64 patients with pr...AIM: To determine the levels of aquaporin-1(AQP-1) in the lens epithelial cells(LECs) of primary glaucoma and to clarify its correlation with lens thickness.METHODS: This study comprised 64 eyes of 64 patients with primary glaucoma, who were divided into 3 groups: 25 eyes of 25 patients with acute primary angle-closure glaucoma(APACG), 19 eyes of 19 patients with chronic primary angle-closure glaucoma(CPACG) and 20 eyes of 20 patients with primary open angle glaucoma(POAG). This study also included 12 eyes of 12 patients with senile cataract as controls. The levels of AQP-1 in LECs were examined by real-time quantitative polymerase chain reaction(RT-q PCR) and immunohistochemistry. The lens thickness was measured by A-scan ultrasonography. RESULTS: The AQP-1 m RNA levels of LECs were 0.84±0.27, 0.69±0.34, 0.44±0.19 and 0.51±0.21 in APACG, CPACG, POAG and senile cataract group, respectively. The levels of AQP-1m RNA were significantly higher in PACG groups compared with those in senile cataract and POAG group(all P<0.05). The immunohistochemistry showed the AQP-1 expression were strong-positive in PACG groups, but weak-positive in senile cataract and POAG group. A positive correlation was found between AQP-1 m RNA levels and the lens thickness(r=0.645, P<0.001). CONCLUSION: These findings show that the higher expression of AQP-1 in LECs may contribute to increased lens thickness, which might be associated with the occurrence and development of PACG.展开更多
To evaluate post-miosis changes in the anterior chamber structures in various angle-closure glaucomas(ACG). Totally 14 eyes of primary chronic angle-closure glaucoma(PCACG), 12 eyes of lens-induced secondary chronic a...To evaluate post-miosis changes in the anterior chamber structures in various angle-closure glaucomas(ACG). Totally 14 eyes of primary chronic angle-closure glaucoma(PCACG), 12 eyes of lens-induced secondary chronic angleclosure glaucoma(LSACG) and 14 healthy eyes were recruited. After miosis, for PCACG group, intraocular pressure(IOP) and anterior chamber depth(ACD) changed not significantly, while anterior chamber angle widened significantly. LSACG group showed a significant increase in IOP, decrease in ACD, and narrowing in anterior chamber angle. Healthy eyes showed significant decreases in IOP and anterior chamber parameters. Thus, miosis could widen the anterior chamber angle of patients with PCACG, while increase the narrowing of anterior chamber angle and IOP of patients with LSACG. We should pay attention to the distinction between PCACG and LSACG patients and the proper administration of pilocarpine in the treatment of patients with chronic ACG.展开更多
AIM:To assess the refractive status,anterior chamber depth(ACD) and axial length(AL) of patients with primary angle-closure disease(PACD).METHODS: Retrospective cohort. Data was collected from charts of all PACD patie...AIM:To assess the refractive status,anterior chamber depth(ACD) and axial length(AL) of patients with primary angle-closure disease(PACD).METHODS: Retrospective cohort. Data was collected from charts of all PACD patients treated from April 2013 to December 2015. Analysis was done on 137 patient charts with complete biometric data. Patient demographics,PACD type,refractive status(spherical equivalent),ACD and AL were studied.RESULTS: The median age of 137 subjects [53 with primary angle-closure suspects(PACS),27 with primary angleclosure(PAC) and 57 with primary angle-closure glaucoma(PACG)] was 68y(range 21-88y). The majority was Chinese(n=68;49.6%) and most of them were women(n=75;54.7%). The distribution of myopia(n=51; 37.2%) and hyperopia(n=49;35.8%) was similar. The ACD was shallower in myopes compared to hyperopes(P=0.02) and emmetropia(P=0.049) but the AL was not significantly different between groups. There were no patients blind from PACG.CONCLUSION: Both myopia and hyperopia can occur in PACD. Despite a shallower ACD in angle closure myopes,the AL was not different between groups.展开更多
Fourty-three cases (86 eyes) of primary chronic angle-closure glaucoma were randomly selected. An additional 44 cases (77 eyes) of primary acute angle-closure glaucoma and 30 normal subjects (34 eyes) were also random...Fourty-three cases (86 eyes) of primary chronic angle-closure glaucoma were randomly selected. An additional 44 cases (77 eyes) of primary acute angle-closure glaucoma and 30 normal subjects (34 eyes) were also randomly enrolled as control groups for comparison in the clinical study. Ultrasonic biometric measurements of the anterior chamber depth, lens thickness and axial length of the eyeball were performed. Using an potic microgauge attached to the slit-lamp, the entrance of anterior chamber angle was...展开更多
文摘Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.
文摘Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.
文摘AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). ·METHODS: Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation was performed in 32 eyes of 29 patients with PACG. Regular follow-up was performed 1 week and 1 month, 3, and 6 months after surgery to assess complications, intraocular pressure (IOP), anterior chamber depth, visual acuity, and anterior chamber angle. ·RESULTS: Preoperative mean IOP was 24.88±7.22mmHg with pharmacological treatment, and was 13.70 ±4.02, 13.06 ±3.74, 14.29 ±4.70, and 14.33 ±5.01mmHg 1 week, 1 month, 3 months, and 6 months after surgery, respectively. The postoperative decrease in IOP was significant (P < 0.05). The rate for all eyes with IOP of 21mmHg or less was 93.8% (30 eyes) at the final visit without ocular hypotensive agents. The average preoperative anterior chamber depth was 1.60 ±0.64mm, and this value significantly increased to 2.72±0.62, 2.76±0.70, 2.73±0.68, and 2.74 ±0.71mm at 1 week, 1 month, 3 months, and 6 months, respectively. Visual acuity was improved in 28 eyes (87.5% ) at 6 months postoperatively. The anterior chamber angle had increased in 25 eyes (78.1% ) at the final visit; it was adhesive 90°-180° in 6 eyes, 180°-270° in only 1 eye. Two eyes exhibited minimal hyphema in the early postoperative period, but it could gradually be absorbed. Fibrinous reaction was observed in five eyes and spontaneously disappeared within 7 days. No shallow anterior chamber, iridodialysis, choroidal deta-chment, or malignant glaucoma was found in any eyes.CONCLUSION:Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation to manage PACG has several advantages, including optimized visualization, greater accuracy, and improved safety. Our results suggest that it has certain curative effects and clinical application value.
文摘AIM: To compare the efficacy and safety of phacoemulsification(Phaco) against combined phacotrabeculectomy(Phacotrabe) in primary angle-closure glaucoma(PACG) with coexisting cataract.·METHODS: By searching electronically the Pub Med,EMBASE, Scientific Citation Index and Cochrane Library published up from inception to January 2014, all randomized controlled trials that matched the predefined criteria were included. The quality of included trials was evaluated according to the guidelines developed by the cochrane collaboration. And the outcomes estimating efficacy and safety of two different surgical treatments were measured and synthesised by Rev Man 5.0.· RESULTS: Five randomized controlled trials were selected and included in Meta-analysis with a total of468 patients(468 eyes) with both PACG and cataract. We found that Phacotrabe had a greater intraocular pressure(IOP) lowing effect [preoperative IOP: weighted mean difference(WMD)=0.58, 95% confidence intervals(95% CI,-0.53 to 1.69), P =0.31; postoperative IOP: WMD =1.37,95% CI(0.45 to 2.28), P =0.003], a lower number of antiglaucoma medications [risk ratio(RR)=0.05, 95% CI(0.02 to 0.18), P <0.00001] needed postoperatively and less serious damage of optic nerve [RR =0.48, 95% CI(0.21 to 1.07), P =0.07], but a higher risk of complications[odds ratio(OR)=0.04, 95% CI(0.01 to 0.16), P <0.00001]compared with Phaco. The rest studies indicated that there had no significantly difference between the two surgical methods for postoperative best-corrected visual acuity(BCVA) [WMD =-0.05, 95% CI(-0.14 to 0.05), P =0.32] and loss of visual field [RR=1.06, 95% CI(0.61 to1.83), P =0.83].·CONCLUSION: Phaco alone compared with Phacotrabe had a better effect in IOP reduction, whereas the securitydecline. Considering the number of sample size, our results remains to be further studied.
基金Supported by Research Fund from Chosun University,2018
文摘AIM: To evaluate the efficacy of combined treatment of phacoemulsification(PE) and micro-incisional single-port transconjunctival limited pars plana vitrectomy(PPV) in acute angle-closure glaucoma(AACG).METHODS: A retrospective study included 26 patients who underwent PE diagnosed with AACG. Among them, 16 patients(16 eyes) underwent PE alone, 10 patients(10 eyes) underwent combined limited vitrectomy and PE. Then we compared intraocular pressure(IOP), anterior chamber angle, anterior chamber depth, central corneal thickness and corneal endothelial cell count before and after surgery, and effective PE time during cataract surgery.RESULTS: Effective PE time was shorter in the combined surgery group than in the single surgery group(P=0.040). There was no statistically significant difference in IOP and best-corrected visual acuity between the two groups postoperatively. At 6 mo postoperatively, there was no difference in the anterior chamber angle, anterior chamber depth, and central corneal thickness between two groups, but corneal endothelial cell count was higher in the combined surgery group than in the single surgery group(P=0.046). No complication such as vitreoretinal disease, endophthalmitis, bullous keratopathy was noted.CONCLUSION: Combined micro-incisional single-port transconjunctival limited PPV and PE are more effective and safer than PE alone because of less operation time and fewer complications for management of AACG.
文摘AIM: To compare the benefits and potential harms of routine phacoemulsification(phaco) alone and combined surgery with goniosynechialysis(GSL) for angle-closure glaucoma(ACG) and coexisting lens opacity, as shown in different randomized controlled trials(RCTs).METHODS: A systematic review was conducted searching several databases including PubMed, Cochrane Library, EMBASE, ClinicalTrials.gov from the inception to September 2018 for RCTs with data published on the effects and safety of phaco and intraocular lens implantation combined with GSL or routine cataract surgery alone. Several studies were recruited which reported data at baselines and postoperative follow-up, including the mean values of postoperative intraocular pressure(IOP) and mean numbers of antiglaucoma medications using postoperatively. The numbers of complications happening were also included. Fixedeffect and random-effect models were applied, and the quality of evidence was evaluated.RESULTS: Analysis of the seven included RCTs, with a total number of 321 participants(358 eyes) diagnosed with ACG and cataract, received a solo procedure(phaco group) or a combined surgery(phaco-GSL group) randomly, and follow-up periods ranging from 2 to 12 mo postoperatively. The involved studies showed that the mean value of IOP between the two groups at 3(four studies, one study follow-up at 2 mo postoperative was included), 6, 12 mo postoperative were not significantly different. Only two studies reported the change in IOP value at 12 mo compared with baseline but showed nosignificant differences between the two interventions. Although three studies did not have the significant difference in the number of medications using to reduce IOP at 3 mo postoperatively, two studies reported that the participants using fewer anti-glaucoma medications at 12 mo postoperative in the phaco group than in the phacoGSL surgery group.CONCLUSION: The analysis provides a low to moderatequality evidence that phaco-GSL surgery lead to an equivalent IOP-lowering effect. The phaco-GSL surgery may not help patients to reduce the consumption of antiglaucoma eyedrops in the long period. The results of this analysis suggested that additional GSL may not be necessary for primary angle closure glaucoma(PACG) patients. Further studies, especially RCTs with more participants and longer follow-up time were needed to provide more sufficient data.
基金Supported by Projects of State Science and Technology Plans (No. 2009bai79b01-01-02)
文摘AIM: To compare the safety and effectiveness of phacotrabeculectomy versus sequential surgery in chronic angle-closure glaucoma(CACG) with coexisting cataract.·METHODS: One hundred and sixty-two CACG patients(162 eyes) were retrospectively analyzed. Of them, 87patients(87 eyes) in group A had underwent phacotrabeculectomy with intraocular lens(IOL)implantation, and 75 patients(75 eyes) in group B had underwent sequential surgery with IOL implanted. Best-corrected visual acuity(BCVA), intraocular pressure(IOP), complications and anterior chamber angle(ACA)were measured.· RESULTS: Demographic characteristics of the two groups were similar. A mean follow-up period was 15±6mo(range 13 to 24mo), a mean IOP of 12.14 ±5.32 mm Hg in group A and 11.38 ±4.06 mm Hg in group B(P =0.84) at the last follow up. The Kaplan-Meier analysis revealed that the cumulative probability of success in both groups was similar(P =0.61). Anterior uveitis and hypotony were the most common complications in group A, whereas group B experienced shallow anterior chamber with trabeculectomy. With the exception of anterior uveitis, no complications occurred to 11 trabeculectomized eyes. All postoperative measurements of anterior chamber showed statistically significant differences in each group according to the preoperative data(P <0.05). However,fewer changes occurred in group B than in group A.· CONCLUSION: Phacotrabeculectomy and sequential surgery exhibit similar IOP reduction, visual recovery,and complications when treating CACG patients with cataract. However, for a wider ACA, phacotrabeculectomy has demonstrated higher effectiveness than sequential surgery.
基金Supported by the "Evidence-Based Medicine Innovation Project" of Evidence-Based Medicine Center of Lanzhou University, China (No.2010LDEBM-A)
文摘AIM:To evaluate the efficacy and safety of trabeculectomy,phacotrabeculectomy plus intraocular lens implantation(phacotrab+IOL group) and phacoemulsification with IOL(phaco+IOL) in primary angle-closure glaucoma(PACG).METHODS: It was a systematic review and meta-analysis,randomized controlled trials(RCT) and clinical controlled trials(CCT) were collected through electronic searches of the Cochrane Library,PubMed,EMbase,Wanfang Database online,Chinese journal Full-text Database,Chinese Scientific Journals Full-text Database (from the date of building the database to October 2010) We also checked the bibliographies of retrieved articles.All the related data that matched our standards were abstracted.The quality of included trials was evaluated according to the Dutch Cochrane Centre.RevMan 5.0 software was used for Meta-analysis.RESULTS: A total of 5 RCT and 11 CCT involving 1495 eyes were included.The results of meta-analysis showed that phacotrab+IOL group was superior than trabeculectomy(trab group) (MD -3.93,95%CI [-7.31,-0.54]) which was also superior than phaco+IOL group(MD 0.52,95%CI [0.10,0.95]) in decreasing Intraocular Pressure(IOP).Phacotrab group(MD -1.45,95%CI [-1.68,-1.22])and phaco group (MD-1.12,95%CI [-1.87,-0.37])are both deeper than trab group in the anterior chamber depth.In increasing the coefficient of outflow facility of aqueous humor(C values) there was no statistical difference in the three groups.And there was no statistical difference between phacotrab groups and phaco groups in visual acuity but phacotrab group was superior than phaco group (MD 1.07,95%CI [0.73,1.40])in the use of IOP-lowering drugs.There was no statistical difference among three groups.CONCLUSION: Current evidence suggests that phacotrab+ IOL group was superior than trab group which was also superior than phaco+IOL group in decreasing IOP.Phacotrab group and phaco group are both deeper than trab group in the anterior chamber depth.Phacotrab group was superior than phaco group in the use of IOP-lowering drugs.
基金Supported by Guangzhou Scientific Research Fund( No.2006J1-C0051)
文摘Purpose: To investigate the efficacy of trabeculectomy, phacotrabeculectomy and phaco-emulsification in the management of primary angle closure glaucoma (PACG). Methods: A prospective observational study was performed in 88 chronic PACG patients (97 eyes) who were divided into three groups following defined indications to receive different surgical interventions. The indications and clinical outcomes were evaluated. The mean follow-up was (17.7±4.9) months. Results: Success rate in trabeculectomy, phacotrabeculectomy and phacoemulsification group was 81.08%, 78.57‰ and 81.25‰, respectively. The anterior chamber depth was deeper and the angle was wider postoperatively vs. preoperatively both in phaco-trabeculectomy and phacoemulsification group. No obvious changes were seen in trabeculectomy group. The coefficient of outflow facility of aqueous humor (C values) significantly increased in three groups postoperatively (P < 0.01). No severe intra-operative complications were found and the incidence of postoperative complications was low. Five eyes sustained hypotony 3±1.87 months in trabeculectomy group and 1 eye happened malignant glaucoma in phacotrabeculectomy group. The visual acuity in patients with phacotrabeculectomy plus intraocular lens implantation and those only with phacoemulsification plus intraocular lens implantation were improved 78.57% and 93.74%, respectively. No significant improvement was found in trabeculectomy group (χ2 = 47.10, P < 0.001). Conclusion: Three surgical interventions were beneficial to manage PACG and with co-existing cataract. The indication choosing was suggested according to visual acuity, angle closure circumference, cataract, medication requirements and optic nerve damage. Phacotrabeculectomy was recommended for angle closed ≥180° circumference while phacoemulsification for angle closed < 180°.
基金That Man May See, Inc. Research to Prevent Blindness
文摘AIM: To describe the results of 5 consecutive cases of clear lens extraction in angle closure patients for the treatment of elevated intraocular pressure (IOP). ·METHODS: Retrospective observational case series. All angle closure patients were on two or more topical glaucoma medications and had prior laser iridotomy. Eyes underwent clear lens extraction by phacoemu - lsification with intraocular lens implantation. ·RESULTS: All five patients in this case series carried the diagnosis of angle -closure glaucoma and had uncontrolled IOP prior to surgery despite topical medications. After clear lens extraction three of the cases had good IOP control (IOP <22mmHg) without the need for topical medications. In one case the IOP was better controlled after surgery, however, topical medications were required. The desired IOP was not met in one case despite restarting maximum topical therapy. ·CONCLUSION: This case series suggests that there may be a role for therapeutic clear lens extraction in select cases of angle-closure glaucoma.
文摘AIM: To evaluate the value of quantitative diffusion tensor imaging(DTI) in assessing the axonal and myelin damage of the optic nerves and optic radiations in patients with chronic primary angle-closure glaucoma(PACG) by using high-field magnetic resonance(MR)imaging(3T).·METHODS: Twenty patients with bilateral chronic PACG and twenty age- and sex matched disease-free control subjects were enrolled. Conventional MRI and DTI were performed on all subjects using 3T MR scanner.Mean diffusivity(MD), fractional anisotropy(FA), axial diffusivities(AD) and radial diffusivities(RD) of each optic nerve and each optic radiation were measured by using post-processing software of DTI studio 2.3, and then compared between left eyes and right eyes and between patients group and control group. The paired-sample t- test were used.·RESULTS: There was no abnormality in the shape and signal intensity of the optic nerves and optic radiations in patients group and control group on the conventional MRI. No significant differences were observed in the FA,MD, AD and RD between the right and left optic nerves and optic radiations within patients group and control group(P >0.05). The optic nerves and optic radiations of patients with chronic PACG, as compared with control subjects, had significantly higher MD, AD, RD and significantly lower FA(P <0.05).·CONCLUSION: The diffusivity of optic nerves and opticradiations in chronic PACG group showed abnormal and diffusivity parameters could be used markers of axonal and myelin injury in glaucoma.
基金Supported by National Natural Science Foundation of China(No.81270990No.81070723)
文摘AIM:To examine the association between the single nucleotide polymorphisms (SNPs)of matrix metalloprotease-9 (MMP-9) gene and primary angleclosure glaucoma(PACG)in a Chinese Han population.METHODS:DNA samples were extracted from peripheral-blood mononuclear cells of 214 PACG patients and 224 healthy controls.Genotyping of rs3918249,rs3918254,rs17577 and rs3787268 in MMP-9was performed using polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP)analysis and the direct sequencing technique.The association between these genetic polymorphisms and risk of PACG was estimated by χ2 test.RESULTS:The distributions of rs3918249,rs3918254,rs17577 and rs3787268 genotypes among cases and healthy controls were compatible with that from HardyWeinberg equilibrium(HWE,P>0.05).The increased frequency of CC and CT genotypes of rs3918254 were observed in PACG patients compared to healthy controls[P=0.006,P corrected(Pcorr)=0.048].The haplotype analysis showed that the CCGG haplotype was nominal associated with PACG(P=0.015),however,the significant was lost when the Bonferroni correction was used(Pcorr=0.105).CONCLUSION:Our results revealed that rs3918254 in MMP-9 may be a susceptible locus to PACG in China,people with the CC and CT genotypes of rs3918254 are more susceptible to PACG.The susceptibility to PACG inChinese Han patients may be not influenced by SNPs rs3918249,rs3787268 and rs17577 in MMP-9.
基金Supported by the National Natural Science Foundation of China(No.81670847No.81600728)
文摘AIM:To evaluate changes of proinflammatory cytokines in aqueous humor of patients with acute primary angleclosure(APAC) and age-related cataracts. METHODS:Twenty eyes of 20 APAC patients and 15 eyes of 15 age-related cataract patients were included in this cross-sectional study. Aqueous humor samples were collected prospectively. The levels of 20 proinflammatory cytokines were evaluated in the aqueous humor of the APAC and cataract patients using the multiplex bead immunoassay technique. Clinical data were collected for correlation analysis.RESULTS:Seven of the 20 proinflammatory cytokines included in the magnetic bead panel were detectable in both APAC eyes and cataract eyes:interleukin(IL)-10, IL-12, IL-15, IL-21, IL-6, chemokine(C-C motif) ligand 20, and tumor necrosis factor alpha(TNF-α). IL-27 was only detectable in APAC eyes. Compared with the cataract eyes, the APAC eyes had significantly elevated concentrations of IL-12(P=0.036), IL-15(P=0.001), IL-6(P=0.012), and IL-27(only detectable in APAC eyes). Age was positively correlated with IL-12(P=0.022) and IL-6(P=0.037), and time elapsed between APAC onset and aqueous humor samples collection was positively correlated with IL-15(P=0.037), IL-27(P=0.040), and TNF-α(P=0.042).CONCLUSION:Several proinflammatory cytokines including IL-12,IL-15, IL-6 and IL-27, were elevated in the APAC eyes and may be implicated in its pathologic mechanism.
基金supported by Medical Scientific Research Foundation of Guangdong Province,China (B2012264)
文摘Background: Primary chronic angle-closure glaucoma(PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional trabeculectomy is prone to anesthesia-related complications intraoperative and operationrelated complications postoperative in PCACG treatment. Modified minimally invasive trabeculectomy maybe can reduce the incidence of complications.Methods: We conducted a prospective case series study and performed modified fornix-based trabeculectomy in 27 patients(30 eyes) under topical anesthesia; we then observed intraoperative anesthesia and cooperation ef ect, intraoperative and postoperative complications, preoperative and postoperative visual acuity, intraocular pressure(IOP), visual field, and the use of ocular hypotensive drugs. The patients were followed up for at least 12 months.Results: All operations were completed successfully with no intraoperative complications. All 27 patients(30 eyes) were followed up for at least 12 months. No significant decrease in visual acuity was observed at days 1 or 7 and at months 1, 3, 6, and 12 after operation; however, a signii cant decrease in IOP was observed at days 1 and 7 and at months 1, 3, 6, and 12 after operation. Moreover, no significant progression in visual field mean defect was observed at month 12 after operation, and the number of ocular hypotensive drugs required was significantly reduced at months 6 and 12 after operation. By month 12 after operation, the overall success rate was 93.33%(28/30).Conclusions: Modii ed minimally invasive trabeculectomy is safe and ef ective for the treatment of PCACG.
基金Supported by the Key Science and Technology Program of Shaanxi Province,China(No.2015SF146)
文摘AIM:To evaluate the morphological changes in anterior segment in Chinese patients with uveal effusion(UE)after the attack of acute primary angle-closure(APAC)using ultrasound biomicroscopy(UBM),and to assess the clinical course and prognosis of the disease.METHODS:In a retrospective case series,26 eyes in 26 consecutive patients diagnosed with UE after the treatment of intraocular pressure(IOP)-lowering medication for the attack of APAC were enrolled. The unaffected fellow eyes served as controls. The morphological changes were observed by ultrasonography,slit lamp microscopy and gonioscopy. UBM was used to assess the degree and extent of effusion based on the analysis of parameters associated with UE.RESULTS:The mean IOP was 9.2(SD 2.1)mm Hg at the diagnosis of UE after IOP-lowering medication,while 14.1(SD,2.6)mm Hg in the fellow eyes(P=0.000). The anterior chamber depth(ACD)(P=0.000),angle opening distance at 500 μm(AOD500)(P<0.01)and anterior chamber angle(ACA)(P<0.05)were decreased significantly,while ciliary body thickness(CBT)(P<0.05)increased significantly in UE eyes. UE grade analysis showed 7 eyes in grade 1,9 eyes in grade 2,and 10 eyes in grade 3. Quadrant scores were performed of 4 eyes in 1 quadrant,3 eyes in 3 quadrants,and 19 eyes in 4 quadrants. There was the positive correlation between grade and quadrant score(R=0.644,P=0.000). The effusion on all eyes were recovered after medication,which mean IOP was 13.9(SD,2.8)mm Hg.CONCLUSION:UE is a frequent complication in Chinese patients after the attack of APAC,partially associated with hypotony. The severity of UE is correlation with height of effusion,extent of detachment,and shallower ACD.
文摘Objective:To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens(PC-IOL)implantation.Design:Retrospective,noncontrolled interventional case series.Participants:In36eyes with angle-closure glaucoma(ACG),there were18eyes with primary acute angle-closure glaucoma(PACG),14eyes with primary chronic angle-closure glaucoma(PCCG),3eyes with secondary acute angle-closure glaucoma(SACG)and 1eye with secondary chronic angle-closure glaucoma(SCCG).Intervention:Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures:Postoperative visual acuity,IOP,axial anterior chamber depth.Results:After a mean postoperative follow-up time of 8.81±7.45months,intraocular pressure was reduced from a preoperative mean of 23.81±17.84mmHg to a postoperative mean of 12.54±4.73mmHg(P=0.001).Mean anterior hamber depth was1.75±0.48mm preoperatively and2.29±0.38mm postoperatively(P=0.000).Best spectacle-corrected visual acuith in 36eyes ranged from0.01to0.7(20/200to20/30)postoperatively,which was better than preoperative VA ranging from hand movement to 0.4(20/50)(P=0.000).Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma,Eye Science 2000;16:22-28.
基金Supported by the Science and Technology Planning Project of Guangdong Province(No.2012B050600032)the Science and Technology Planning Project of Guangzhou(No.1515000176)
文摘AIM: To determine the levels of aquaporin-1(AQP-1) in the lens epithelial cells(LECs) of primary glaucoma and to clarify its correlation with lens thickness.METHODS: This study comprised 64 eyes of 64 patients with primary glaucoma, who were divided into 3 groups: 25 eyes of 25 patients with acute primary angle-closure glaucoma(APACG), 19 eyes of 19 patients with chronic primary angle-closure glaucoma(CPACG) and 20 eyes of 20 patients with primary open angle glaucoma(POAG). This study also included 12 eyes of 12 patients with senile cataract as controls. The levels of AQP-1 in LECs were examined by real-time quantitative polymerase chain reaction(RT-q PCR) and immunohistochemistry. The lens thickness was measured by A-scan ultrasonography. RESULTS: The AQP-1 m RNA levels of LECs were 0.84±0.27, 0.69±0.34, 0.44±0.19 and 0.51±0.21 in APACG, CPACG, POAG and senile cataract group, respectively. The levels of AQP-1m RNA were significantly higher in PACG groups compared with those in senile cataract and POAG group(all P<0.05). The immunohistochemistry showed the AQP-1 expression were strong-positive in PACG groups, but weak-positive in senile cataract and POAG group. A positive correlation was found between AQP-1 m RNA levels and the lens thickness(r=0.645, P<0.001). CONCLUSION: These findings show that the higher expression of AQP-1 in LECs may contribute to increased lens thickness, which might be associated with the occurrence and development of PACG.
基金Supported by the National Natural Science Foundation of China(No.81471744)
文摘To evaluate post-miosis changes in the anterior chamber structures in various angle-closure glaucomas(ACG). Totally 14 eyes of primary chronic angle-closure glaucoma(PCACG), 12 eyes of lens-induced secondary chronic angleclosure glaucoma(LSACG) and 14 healthy eyes were recruited. After miosis, for PCACG group, intraocular pressure(IOP) and anterior chamber depth(ACD) changed not significantly, while anterior chamber angle widened significantly. LSACG group showed a significant increase in IOP, decrease in ACD, and narrowing in anterior chamber angle. Healthy eyes showed significant decreases in IOP and anterior chamber parameters. Thus, miosis could widen the anterior chamber angle of patients with PCACG, while increase the narrowing of anterior chamber angle and IOP of patients with LSACG. We should pay attention to the distinction between PCACG and LSACG patients and the proper administration of pilocarpine in the treatment of patients with chronic ACG.
文摘AIM:To assess the refractive status,anterior chamber depth(ACD) and axial length(AL) of patients with primary angle-closure disease(PACD).METHODS: Retrospective cohort. Data was collected from charts of all PACD patients treated from April 2013 to December 2015. Analysis was done on 137 patient charts with complete biometric data. Patient demographics,PACD type,refractive status(spherical equivalent),ACD and AL were studied.RESULTS: The median age of 137 subjects [53 with primary angle-closure suspects(PACS),27 with primary angleclosure(PAC) and 57 with primary angle-closure glaucoma(PACG)] was 68y(range 21-88y). The majority was Chinese(n=68;49.6%) and most of them were women(n=75;54.7%). The distribution of myopia(n=51; 37.2%) and hyperopia(n=49;35.8%) was similar. The ACD was shallower in myopes compared to hyperopes(P=0.02) and emmetropia(P=0.049) but the AL was not significantly different between groups. There were no patients blind from PACG.CONCLUSION: Both myopia and hyperopia can occur in PACD. Despite a shallower ACD in angle closure myopes,the AL was not different between groups.
文摘Fourty-three cases (86 eyes) of primary chronic angle-closure glaucoma were randomly selected. An additional 44 cases (77 eyes) of primary acute angle-closure glaucoma and 30 normal subjects (34 eyes) were also randomly enrolled as control groups for comparison in the clinical study. Ultrasonic biometric measurements of the anterior chamber depth, lens thickness and axial length of the eyeball were performed. Using an potic microgauge attached to the slit-lamp, the entrance of anterior chamber angle was...
