44 research outputs found
Long-term outcomes of antiproliferative agents in primary trabeculectomy
Purpose: To evaluate and compare long-term outcomes of trabeculectomies with subconjunctival injections of 5-fluorouracil (5-FU) after sugery or use of mitomycin C (MMC) during surgery. Methods: Retrospective study of 133 eyes who underwent primary trabeculectomy. Results: Intraocular pressure levels were not statistically significant at any of the postoperative visits when comparing the 5-fluorouracil and mitomycin C groups. In each group, analyzed separately, the intra-ocular pressure levels showed no statistically significant difference before or after surgery. The incidence of postoperative complications was not statistically significant as well, except for a greater incidence of the corneal epithelial defects, more frequent in the 5-fluorouracil group. In both groups, a greater incidence of development/progression of cataract was noted. Conclusion: Both mitomycin C and 5-fluorouracil promoted an important and stable decrease in intraocular pressure with similar complication rates.Objetivo: Avaliar comparativamente a longo prazo os resultados cirúrgicos de trabeculectomias nas quais foram utilizadas injeções subconjuntivais de 5-fluorouracil (5-FU) no pós-operatório ou aplicações de mitomicina C (MMC) peroperatória. Métodos: Estudo retrospectivo de 133 olhos submetidos a trabeculectomia primária. Resultados: A pressão ocular não apresentou valores estatisticamente significantes em nenhuma das visitas de pós-operatório quando comparados os grupos em que se utilizou a mitomicina C ou 5-fluorouracil. Em cada um dos grupos analisados separadamente, os nÃveis da pressão ocular não apresentaram diferenças estatisticamente significantes nos perÃodos pré e pós-operatório. A incidência de complicações pós-operatórias também não apresentou diferença estatisticamente significante à exceção de alterações epiteliais na córnea, mais freqüentes no grupo tratado com 5-fluorouracil. Nos dois grupos, destacou-se a elevada incidência de desenvolvimento/progressão de catarata. Conclusão: O uso de mitomicina C ou 5-fluorouracil promoveu redução importante e estável da pressão ocular, com Ãndices de complicações semelhantes.Universidade Federal de São Paulo (UNIFESP) Departamento de OftalmologiaUniversidade de Miami Bascom Palmer Eye InstituteUNIFESP, Depto. de OftalmologiaSciEL
Variable Curvature Slab Molecular Dynamics as a Method to Determine Surface Stress
A thin plate or slab, prepared so that opposite faces have different surface
stresses, will bend as a result of the stress difference. We have developed a
classical molecular dynamics (MD) formulation where (similar in spirit to
constant-pressure MD) the curvature of the slab enters as an additional
dynamical degree of freedom. The equations of motion of the atoms have been
modified according to a variable metric, and an additional equation of motion
for the curvature is introduced. We demonstrate the method to Au surfaces, both
clean and covered with Pb adsorbates, using many-body glue potentials.
Applications to stepped surfaces, deconstruction and other surface phenomena
are under study.Comment: 16 pages, 8 figures, REVTeX, submitted to Physical Review
Combined pars plana vitrectomy and Baerveldt glaucoma implant placement for refractory glaucoma
To evaluate outcomes of combined pars plana vitrectomy and Baerveldt glaucoma implant (PPV-BGI) placement for refractory glaucoma
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What Is It About Intraocular Pressure That Matters in Glaucoma Progression?
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Ab-interno Bleb Needling
The postoperative management in trabeculectomy plays a very important role in achieving long-term intraocular pressure lowering and corresponding decrease in risk of progressive glaucomatous optic neuropathy. We describe here a new approach we have been using for several years, ab-interno trans-corneal needling of the scleral wound and bleb, performed at the slit lamp. The procedure offers logistical, financial, and psychological advantages over standard trans-conjunctival bleb needling techniques. Preliminary, unpublished results suggest relatively high efficacy and safety compared to trans-conjunctival techniques
Needling Revision of Glaucoma Drainage Device Filtering Blebs
Purpose: Needling revision is an accepted method of management of poorly functioning trabeculectomy blebs. The authors present the outcome of the analogous needling revision of poorly functioning filtering blebs over glaucoma drainage device (GDD) reservoirs.
Methods: Review of 20 patients (21 eyes) who underwent needling to the bleb overlying the GDD reservoir, with or without adjunctive 5-fluorouracil injection.
Results: In the nine eyes (43%) that were considered successes (defined as intraocular pressure [IOP] less than or equal to 21 mmHg and decrease in IOP greater than or equal to 20% with no additional medication or glaucoma surgery), the mean IOP fell from 28.3 ± 6.4 mmHg to 13.9 ± 2.7 mmHg at last follow-up, after a mean of 1.7 needlings (range, 1–3 needlings) with mean follow-up of 14.6 months (range, 3–35 months). Needling success was associated with larger GDD surface area (mean, 267 ± 95 mm2 vs. 179 ± 79 mm2 in eyes needled unsuccessfully, P = 0.04) and use of Baerveldt implants (six of eight eyes needled successfully). Minor complications were few. Endophthalmitis developed in one patient (5% of all eyes) after needling.
Conclusions: Needling revision can be useful in the management of poorly functioning GDD blebs, although the risk for severe complications exists
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Needling Revision of Glaucoma Drainage Device Filtering Blebs
Purpose: Needling revision is an accepted method of management of poorly functioning trabeculectomy blebs. The authors present the outcome of the analogous needling revision of poorly functioning filtering blebs over glaucoma drainage device (GDD) reservoirs.
Methods: Review of 20 patients (21 eyes) who underwent needling to the bleb overlying the GDD reservoir, with or without adjunctive 5-fluorouracil injection.
Results: In the nine eyes (43%) that were considered successes (defined as intraocular pressure [IOP] less than or equal to 21 mmHg and decrease in IOP greater than or equal to 20% with no additional medication or glaucoma surgery), the mean IOP fell from 28.3 ± 6.4 mmHg to 13.9 ± 2.7 mmHg at last follow-up, after a mean of 1.7 needlings (range, 1–3 needlings) with mean follow-up of 14.6 months (range, 3–35 months). Needling success was associated with larger GDD surface area (mean, 267 ± 95 mm2 vs. 179 ± 79 mm2 in eyes needled unsuccessfully, P = 0.04) and use of Baerveldt implants (six of eight eyes needled successfully). Minor complications were few. Endophthalmitis developed in one patient (5% of all eyes) after needling.
Conclusions: Needling revision can be useful in the management of poorly functioning GDD blebs, although the risk for severe complications exists