transscleral cyclophotocoagulation

经巩膜睫状体光凝
  • 文章类型: Journal Article
    背景:尽管最近有很多进展,选择不受控制的眼内压(IOP)的手术治疗仍是一个挑战.
    目的:本研究比较了内镜下睫状体光凝(ECP)与其他外科手术的临床疗效和安全性,所有类型的青光眼。
    方法:该方法符合系统评价的首选报告项目和系统评价报告的荟萃分析指南。报道ECP和替代手术治疗难治性青光眼的研究,新生血管性青光眼,无晶状体青光眼,滤过手术失败的青光眼,先天性或幼年性青光眼,继发性青光眼如葡萄膜炎青光眼,外伤性青光眼,角膜移植术后继发性青光眼,等。包括在内。从降低IOP药物的数量来评估疗效,和IOP前后的平均变化是本综述评估的ECP和非ECP组的结局.术后并发症的评估显示了该手术的安全性评估。
    结果:总计,本研究共选择了11项相关研究,共5418只眼,其中ECP组763只眼,非ECP组4655只眼。这篇综述观察到ECP和非ECP手术均成功降低了术后眼压。
    结论:从这篇综述中可以推断出,所有类型的青光眼都可以有效治疗,ECP和ECP的成功率明显更高,与非ECP手术相比,ECP的术后并发症最低。这篇综述提供了最新的科学证据,以支持青光眼手术治疗的临床决策。
    BACKGROUND: Despite many recent developments, preference in the choice of surgical treatment of uncontrolled intraocular pressure (IOP) remains a challenge.
    OBJECTIVE: This study compares the clinical efficacy and safety of endoscopic cyclophotocoagulation (ECP) to alternative surgical procedures, for all types of glaucoma.
    METHODS: The methodology adheres to the preferred reporting items for systematic reviews and meta-analyses guidelines for systematic review reporting. Studies reporting ECP and alternative surgeries in treating refractory glaucoma, neovascular glaucoma, aphakic glaucoma, filtering surgical failure-induced glaucoma, congenital or juvenile glaucoma, and secondary glaucoma such as uveitis glaucoma, traumatic glaucoma, secondary glaucoma postcorneal transplantation, etc. were included. The efficacy was evaluated from the number of IOP-lowering drugs, and mean change in pre- and post-IOP were the outcomes assessed in ECP and non-ECP groups in this review. Evaluations of the postoperative complications revealed the safety assessment of the procedure.
    RESULTS: In total, 11 relevant studies were selected in this study with a total of 5418 eyes, including 763 eyes in the ECP group and 4655 in the non-ECP group. This review observed that both ECP and non-ECP procedures had been successful in reducing postoperative IOP.
    CONCLUSIONS: It can be deduced from this review, that all types of glaucoma can be treated efficiently with significantly higher success rates with ECP and ECP demonstrates lowest postoperative complications when compared to non ECP procedures. This review provides updated scientific evidence which caters to support clinical decisions for surgical treatment of glaucoma.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    由于眼内炎症导致角膜附带损害和继发性眼内压升高(IOP),病毒性角膜葡萄膜炎(VKU)可能会导致视觉衰弱。在这次回顾中,单中心,观察性研究,我们分析了VKU的临床特征和管理方案,简要回顾了青光眼的发病率及其治疗结果。我们回顾了2015年至2020年三甲医院的门诊记录,发现55例患者的53只眼被诊断为VKU。主要结果指标是临床体征的发生率,IOP升高和青光眼,和使用的治疗方式。64%是男性,平均发病年龄为45.4岁。80%的眼睛被临床诊断为单纯疱疹病毒(HSV),16%的带状疱疹病毒(HZV)和4%的巨细胞病毒(CMV)。最常见的眼部表现是角膜沉淀物(70.4%),角膜水肿(66.7%)。相关的IOP升高见于24眼(44%),而青光眼损害见于20%的眼睛。uveitic发作次数较少(少于两次)的人,与发生两次以上发作的患者(p<0.09)相比,发生青光眼的风险较小.几乎所有人都用局部类固醇和口服阿昔洛韦治疗。青光眼手术的需要,在我们的研究中,只有7.2%。大多数青光眼患者,与没有的相比,似乎有更多的IOP峰值和葡萄膜发作。CMV相关的眼睛患青光眼的风险更高,而且更难处理,需要更强烈的治疗策略。这项对南印度独家VKU队列的临床资料的回顾,试图了解疱疹和CMV组之间的表现差异及其从青光眼角度的含义,使这项研究与众不同。
    未经批准:SudhakarP,梅农M,CKM,etal.病毒性角膜炎中的青光眼:三级眼科医院的回顾性研究。JCurr青光眼Pract2022;16(1):65-70。
    Viral keratouveitis (VKU) could be visually debilitating owing to the intraocular inflammation causing collateral damage to the cornea and secondary elevation of intraocular pressure (IOP). In this retrospective, single-center, observational study, we analyze the clinical features and management options for VKU, with a brief review on incidence of glaucoma and its treatment outcomes. We reviewed the outpatient records at our tertiary hospital from 2015 to 2020 and found 53 eyes of 55 patients diagnosed as VKU. The main outcome measures were incidence of clinical signs, elevated IOP and glaucoma, and treatment modalities used. Sixty-four percent were males with a mean age of onset being 45.4 years. Eighty percent of the eyes were clinically diagnosed to have herpes simplex virus (HSV), 16% herpes zoster virus (HZV) and 4% cytomegalovirus (CMV). Ocular presentations most commonly noted were keratic precipitates (70.4%), corneal edema (66.7%). Associated elevation of IOP was seen in 24 eyes (44%), while glaucomatous damage was seen in 20% of the eyes. Those with fewer uveitic episodes (less than two), as opposed to those having more than two episodes (p < 0.09) posed a lesser risk of developing glaucoma. Almost all were treated with topical steroids and oral acyclovir. The need for glaucoma surgery, in our study, was only 7.2%. Majority of patients with glaucoma, as compared to those without, appeared to have a higher number of IOP spikes and uveitic episodes. CMV-associated eyes had higher risk of developing glaucoma and were more intractable, requiring more intense treatment strategies. This review of the clinical profile of an exclusive South Indian cohort of VKU with an attempt to understand the differences in presentation between the herpetic and CMV groups and its implication from a glaucoma perspective makes this study distinctive.
    UNASSIGNED: Sudhakar P, Menon M, CK M, et al. Glaucoma in Viral Keratouveitis: A Retrospective Review at a Tertiary Eye Hospital. J Curr Glaucoma Pract 2022;16(1):65-70.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    青光眼是由于眼内压(IOP)升高而引起的所有物种的疾病,超过眼内压与神经节细胞和轴突功能相容,常导致视神经变性和不可逆性失明。青光眼治疗与手术干预旨在减少水的产生,或者增加或改变水性流出物在过去的几十年里已经发展起来,但是仍然没有治愈方法。本文旨在提供兽医眼科学中青光眼手术治疗的简要综述。
    Glaucoma is a disorder of all species due to a rise of intraocular pressure (IOP) beyond which is compatible with ganglion cell and axon function, often resulting in optic nerve degeneration and irreversible blindness. Glaucoma treatment with surgical intervention aimed at either reducing aqueous production, or increasing or altering aqueous outflow has evolved over preceding decades, but there remains no cure. The present article is intended to provide a concise review of glaucoma surgical therapies in veterinary ophthalmology.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号