trabeculectomy with mitomycin C

  • 文章类型: Journal Article
    原发性先天性青光眼(PCG)在世界范围内发生,并具有广泛的眼部表现。它对眼科医生提出了治疗挑战。对于所有不配合办公室检查的儿童,建议在麻醉下进行适当的诊断评估。药物治疗只能起到辅助作用,手术干预仍然是主要的治疗方式。在高加索人群中,角切开术或小梁切开术等角度切口手术是首选手术。在某些地区,例如印度和中东,有或没有抗纤维化治疗的原发性联合小梁切开术-小梁切除术是首选,该疾病通常伴有严重的角膜水肿和巨角膜。在难治性病例中,具有抗纤维化治疗或青光眼引流装置的小梁切除术是兵工厂的可用选项。对于视觉潜能差的眼睛,应保留旋光手术。近视在PCG儿童中很常见,应提供适当的眼镜或隐形眼镜形式的光学屈光矫正。应建立弱视治疗,以确保早期发育的整体视觉发育。应向视力障碍儿童提供低视力康复服务。长期随访是强制性的,应就这一需求向PCG儿童的看护者提供咨询和教育。不管视觉结果如何,临床医生应强调在就诊期间对这些儿童进行教育的必要性.管理的总体目标应该是提高PCG儿童及其照顾者的整体生活质量。
    Primary congenital glaucoma (PCG) occurs worldwide and has a broad range of ocular manifestations. It poses a therapeutic challenge to the ophthalmologist. A proper diagnostic evaluation under anesthesia is advisable for all children who do not cooperate for an office examination. Medical therapy only serves as a supportive role, and surgical intervention remains the principal therapeutic modality. Angle incision surgery such as goniotomy or trabeculotomy ab externo is the preferred choice of surgery in the Caucasian population. Primary combined trabeculotomy-trabeculectomy with or without antifibrotic therapy is the preferred choice in certain regions such as India and the Middle East where the disease usually presents with severe forms of corneal edema along with megalocornea. In refractory cases, trabeculectomy with antifibrotic therapy or glaucoma drainage devices are available options in the armamentarium. Cycloablative procedures should be reserved for eyes with poor visual potential. Myopia is common among children with PCG, and appropriate optical refractive correction in the form of glasses or contact lenses should be provided. Amblyopia therapy should be instituted to ensure overall visual development in the early developmental years. Low-vision rehabilitation services should be provided to children with vision impairment. Long-term follow-up is mandatory and carers of children with PCG should be counseled and educated about this need. Regardless of the visual outcomes, clinicians should emphasize the need for education of these children during the clinic visit. The overall goal of the management should be to improve the overall quality of life of the children with PCG and their carers.
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  • 文章类型: Case Reports
    我们报告了口服多西环素治疗对丝裂霉素增强小梁切除术后早期气泡渗漏的辅助作用。两名青光眼患者,用丝裂霉素C进行小梁切除术,术后早期出现低眼压(IOP)。两名患者均有中度升高的气泡,Seidel的阳性测试。除常规术后管理外,每天两次口服多西环素100mg,为期1周。多西环素治疗后1周,伤口愈合,Seidel的测试结果为阴性.2例患者术后3个月维持眼压。
    We report the adjuvant role of oral doxycycline therapy for the management of early bleb leaks post mitomycin-augmented trabeculectomy. Two glaucoma patients, who underwent trabeculectomy with mitomycin C, presented with a low intraocular pressure (IOP) in the early postoperative period. Both patients had moderately elevated bleb with Seidel\'s positive test. Oral doxycycline 100 mg twice daily was given for 1 week in addition to routine postoperative management. Post doxycycline therapy at 1 week, healing of the wound was noted, with a negative Seidel\'s test. The IOP was maintained at 3 months postoperatively in both patients.
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  • 文章类型: Case Reports
    病例系列的目的是强调手术经历的挑战,如失败的干预,脉络膜积液,术后囊样黄斑水肿,并描述Radius-Maumenee综合征的治疗方案。作者报道了3例接受药物治疗的双侧Radius-Maumenee综合征,丝裂霉素C小梁切除术,植入XEN45,Ahmed青光眼阀,Baerveldt青光眼植入物,和睫状体光凝术。
    The aim of the case series is to highlight the surgical challenges experienced like failed intervention, choroidal effusion, a postoperative cystoid macular oedema, and describe treatment options for Radius-Maumenee syndrome. Authors reported on 3 bilateral cases of Radius-Maumenee syndrome which underwent medical treatment, trabeculectomy with Mitomycin C, implantation with XEN45, Ahmed glaucoma valve, Baerveldt glaucoma implant, and cyclophotocoagulation.
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  • 文章类型: Journal Article
    UNASSIGNED: To compare the safety, efficacy, and outcome measures of a single-site, mitomycin C (MMC)-augmented trabeculectomy combined with phacoemulsification (PT) versus manual small-incision cataract surgery (MSICS) with the posterior chamber intraocular lens (PCIOL) implantation as a primary surgery in the patients with primary glaucoma coexistent with cataract.
    UNASSIGNED: From April 2015 to August 2017, medical records of all the patients who underwent combined cataract surgery with PCIOL and MMC augmented trabeculectomy were reviewed. One hundred and thirty-seven eyes met the inclusion criteria. Ninety-seven eyes which underwent PT with MMC were compared with forty eyes that underwent MSICS combined with trabeculectomy (MSICST) MMC. Outcome measures were best corrected visual acuity (BCVA), intraocular pressure (IOP), and number of anti-glaucoma medications (AGM). Complications, if any, were noted in both the groups.
    UNASSIGNED: The mean follow-up period after surgery was 18.6 ± 7.7 months (range, 12-40 months). At the last follow-up visit, there was no statistically significant difference between the groups, in terms of mean logMAR BCVA (PT: 0.22 ± 0.31, MSICST: 0.21 ± 0.33, P = 0.8), mean IOP reduction (PT: 13.9 ± 2.98 mmHg, MSICST: 14.1 ± 4.12 mmHg, P = 0.8), and mean number of AGM (PT: 0.03 ± 0.8, MSICST: 0.025 ± 0.7, P = 0.8). Complications were few and transient. One eye in the PT group was considered as a failure and had to undergo needling, repeat trabeculectomy, and later, cyclodestructive procedure. None of the eyes in the MSICST group required an additional procedure for IOP reduction.
    UNASSIGNED: There was no difference in the mean IOP reduction, BCVA, and mean number of AGM between the two procedures, and both appeared to be safe and effective techniques as a primary surgery in the patients with coexistent cataract and glaucoma.
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