6 research outputs found
Intracameral Tissue Plasminogen Activator Use in a Large Series of Eyes With Valved Glaucoma Drainage Implants
Silicone Oil Pupillary Block: An Exception to Combined Argon–Nd:YAG Laser Iridotomy Success in Angle-closure Glaucoma
Recommended from our members
Silicone oil pupillary block: an exception to combined argon-Nd:YAG laser iridotomy success in angle-closure glaucoma.
OBJECTIVES: To examine the rate of laser iridotomy failure at the University of Cincinnati Glaucoma Service, Cincinnati, Ohio, during the last 10 years and to evaluate the importance of silicone oil pupillary block glaucoma (SOPBG) as a causal factor. METHODS: We retrospectively reviewed the operative records of all 1711 eyes that underwent laser iridotomy for the treatment of pupillary block angle-closure glaucoma between January 1, 1996, and December 31, 2005. The occurrence, etiology, timing, and rate of laser iridotomy failure were assessed with SOPBG cases analyzed separately. RESULTS: Analyses using the chi(2) test demonstrated significantly higher laser iridotomy failure rates for 13 eyes with SOPBG compared with 1698 eyes with non-SOPBG for all 3 timing outcomes (immediate, 15.4% vs 0%; short term, 92.3% vs 2.5%; and long term, 38.5% vs 0.1%; all P < .0001). To achieve long-term patency, SOPBG iridotomy failures required, on average, 2.7 laser iridotomy procedures, 4.1 periocular steroid injections, and 0.7 intracameral tissue plasminogen activator injections. CONCLUSIONS: Eyes with SOPBG require extensive resources to prevent laser iridotomy failure. In managing SOPBG, ophthalmologists should anticipate the need for additional laser treatment and use adjunctive steroids and intracameral tissue plasminogen activator to enhance long-term patency and avert invasive surgical procedures
Recommended from our members
Silicone oil pupillary block: an exception to combined argon-Nd:YAG laser iridotomy success in angle-closure glaucoma.
OBJECTIVES: To examine the rate of laser iridotomy failure at the University of Cincinnati Glaucoma Service, Cincinnati, Ohio, during the last 10 years and to evaluate the importance of silicone oil pupillary block glaucoma (SOPBG) as a causal factor. METHODS: We retrospectively reviewed the operative records of all 1711 eyes that underwent laser iridotomy for the treatment of pupillary block angle-closure glaucoma between January 1, 1996, and December 31, 2005. The occurrence, etiology, timing, and rate of laser iridotomy failure were assessed with SOPBG cases analyzed separately. RESULTS: Analyses using the chi(2) test demonstrated significantly higher laser iridotomy failure rates for 13 eyes with SOPBG compared with 1698 eyes with non-SOPBG for all 3 timing outcomes (immediate, 15.4% vs 0%; short term, 92.3% vs 2.5%; and long term, 38.5% vs 0.1%; all P < .0001). To achieve long-term patency, SOPBG iridotomy failures required, on average, 2.7 laser iridotomy procedures, 4.1 periocular steroid injections, and 0.7 intracameral tissue plasminogen activator injections. CONCLUSIONS: Eyes with SOPBG require extensive resources to prevent laser iridotomy failure. In managing SOPBG, ophthalmologists should anticipate the need for additional laser treatment and use adjunctive steroids and intracameral tissue plasminogen activator to enhance long-term patency and avert invasive surgical procedures
Recommended from our members
Intracameral tissue plasminogen activator use in a large series of eyes with valved glaucoma drainage implants.
ObjectiveTo describe the efficacy and complications of intracameral tissue plasminogen activator (tPA) in a large series of glaucomatous eyes with valved glaucoma drainage implants (GDIs).MethodsA retrospective analysis of 620 Ahmed and Krupin aqueous shunts implanted between December 1992 and May 2001 identified 36 eyes treated with intracameral tPA for total or imminent tube obstruction by fibrin and/or blood. For a successful ocular outcome, tPA use must prevent the need for additional glaucoma surgery to replace or revise an occluded drainage implant.ResultsIntracameral tPA successfully cleared or prevented tube occlusion by fibrin/blood clots in 32 (88.9%) of 36 eyes. Multiple tPA injections were administered in 38.9% of eyes, and the mean number of injections required to achieve successful outcomes was 1.6. The mean +/- SD tPA dose per injection was 9.8 +/- 3.1 micro g, and the mean +/- SD total tPA dose required to achieve successful outcomes was 15.5 +/- 9.9 micro g. For injections to be successful in totally occluded tubes (n = 31), the mean +/- SD intraocular pressure change 24 hours after tPA administration was -21.2 +/- 15.6 mm Hg. Significant complications, including severe hyphema, profound hypotony, and anterior chamber flattening, occurred after 10.9% of tPA administrations.ConclusionIntracameral tPA clears and prevents obstruction of valved GDIs by fibrin and/or blood clots