AIM： To investigate the incidence rate and risk factors for grade Ⅲ flat anterior chamber（FAC） after glaucoma filtration surgery based on 5-year data.METHODS： Patients who underwent glaucoma filtration surgery in...AIM： To investigate the incidence rate and risk factors for grade Ⅲ flat anterior chamber（FAC） after glaucoma filtration surgery based on 5-year data.METHODS： Patients who underwent glaucoma filtration surgery in Daping hospital from January 2009 to December 2013 were enrolled in this retrospective study. The incidence of grade Ⅲ FAC following glaucoma filtration surgery was determined. Regression analysis was performed to investigate the influence of glaucoma type, surgical approach, age, and preoperative intraocular pressure（IOP） on the risk of postoperative FAC.RESULTS： A total of 2179 eyes receiving anti-glaucoma surgery were included. Ninety-one eyes suffered from postoperative FAC, with an overall incidence rate of 4.18%. Of 471 eyes with primary open angle glaucoma（POAG）, grade Ⅲ FAC occurred in only 3 eyes（0.64%）. Primary angleclosure glaucoma（PACG） was diagnosed in 1076 eyes, 39（3.62%） of which developed grade Ⅲ FAC, including 12 eyes（12/300, 4%） with acute PACG（aP ACG） and 27 eyes（27/776, 3.48%） with chronic PACG（c PACG）. Six of 259 eyes（2.32%） with secondary glaucoma, 28 of 186 eyes（15.05%） with neovasular glaucoma, 1 of 66 eyes（1.52%） with congenital glaucoma, and 14 of 115 eyes（12.17%） with remnant glaucoma suffered from grade Ⅲ FAC. Of 6 eyes with mixed glaucoma, none developed grade Ⅲ FAC after surgery. When stratified by surgical approach, 24 of 766 eyes（3.13%） undergoing trabeculectomy, 21 of 924 eyes（2.27%） treated by trabeculectomy plus mitomycin C（MMC）, 18 of 109 eyes（16.51%） undergoing Ahmed glaucoma valve implantation, 23 of 201 eyes（11.44%） managed by Ahmed implantation plus MMC, and 5 of 133 eyes（3.76%） treated by Ahmed implantation plus lens extraction or vitrectomy developed grade Ⅲ FAC. Logistic regression analysis revealed that factors including neovasular glaucoma, remnant glaucoma, glaucoma valve implantation, glaucoma valve implantation＋MMC, glaucoma valve implantation＋vitrectomy, age〉60 y, and IOP at admission 〉50 mm Hg were significantly associated with an increased risk for grade Ⅲ FAC.CONCLUSION： The overall incidence of grade Ⅲ FAC after glaucoma filtration surgery is 4.18%. Patients with neovasular glaucoma and remnant glaucoma are at a higher risk of developing FAC. Ahmed glaucoma valve implantation is associated with a higher risk for grade Ⅲ FAC compared with trabeculectomy. No significant correlation was observed between the use of MMC in glaucoma filtration surgery and the risk of postoperative FAC. Higher IOP at admission（〉50 mm Hg） and old age（〉60 y） are risk factors for grade Ⅲ FAC.展开更多
Filtration surgery still plays a mainstream role of treatment for glaucoma.Postoperative scarring is the main cause of surgical failure.This study evaluated the biocompatibility and anti-proliferative properties of pu...Filtration surgery still plays a mainstream role of treatment for glaucoma.Postoperative scarring is the main cause of surgical failure.This study evaluated the biocompatibility and anti-proliferative properties of pure magnesium with three different coatings,which are hydroxyapatite(HA),dicalcium phosphate dihydrate(DCPD)and DCPD+stearic acid(SA),in a primary culture of human tenon's capsule fibroblasts(HTCFs)and in rabbit Glaucoma Filtration Surgery.Titanium and glass were used as controls in vitro,and trabeculectomy was used as control in vivo.The results show the number and shape of HTCFs seeded on different coatings showed less quantity and poor cell morphology.Each type of coated magnesium demonstrated significantly decreased metabolic activity of HTCFs.DCPD+SA showed higher cytotoxicity than the other coatings.Significant inhibition of proliferation was observed with the DCPD+SA coating.The expression ofα-SMA was decreased in the cells when seeded on all of the coated magnesium disks.In vivo,no obvious adverse effects were observed after operation.No significant difference existed for any of the different samples regarding different ion concentrations in the aqueous humor.The inflammatory response in the titanium,DCPD and DCPD+SA treated eyes was more intense than in the trabeculectomy alone and HA groups.Western Blot analysis showed that collagen-1 andα-SMA expression was significantly lower in the titanium,HA,DCPD and DCPD+SA groups compared with the control.Different coatings on magnesium were able to affect the corrosive properties,which in turn,influenced the morphology and function of HTCFs.HA coated magnesium may be considered a very promising biodegradable material for the next generation of glaucoma drainage devices.展开更多
文摘AIM： To investigate the incidence rate and risk factors for grade Ⅲ flat anterior chamber（FAC） after glaucoma filtration surgery based on 5-year data.METHODS： Patients who underwent glaucoma filtration surgery in Daping hospital from January 2009 to December 2013 were enrolled in this retrospective study. The incidence of grade Ⅲ FAC following glaucoma filtration surgery was determined. Regression analysis was performed to investigate the influence of glaucoma type, surgical approach, age, and preoperative intraocular pressure（IOP） on the risk of postoperative FAC.RESULTS： A total of 2179 eyes receiving anti-glaucoma surgery were included. Ninety-one eyes suffered from postoperative FAC, with an overall incidence rate of 4.18%. Of 471 eyes with primary open angle glaucoma（POAG）, grade Ⅲ FAC occurred in only 3 eyes（0.64%）. Primary angleclosure glaucoma（PACG） was diagnosed in 1076 eyes, 39（3.62%） of which developed grade Ⅲ FAC, including 12 eyes（12/300, 4%） with acute PACG（aP ACG） and 27 eyes（27/776, 3.48%） with chronic PACG（c PACG）. Six of 259 eyes（2.32%） with secondary glaucoma, 28 of 186 eyes（15.05%） with neovasular glaucoma, 1 of 66 eyes（1.52%） with congenital glaucoma, and 14 of 115 eyes（12.17%） with remnant glaucoma suffered from grade Ⅲ FAC. Of 6 eyes with mixed glaucoma, none developed grade Ⅲ FAC after surgery. When stratified by surgical approach, 24 of 766 eyes（3.13%） undergoing trabeculectomy, 21 of 924 eyes（2.27%） treated by trabeculectomy plus mitomycin C（MMC）, 18 of 109 eyes（16.51%） undergoing Ahmed glaucoma valve implantation, 23 of 201 eyes（11.44%） managed by Ahmed implantation plus MMC, and 5 of 133 eyes（3.76%） treated by Ahmed implantation plus lens extraction or vitrectomy developed grade Ⅲ FAC. Logistic regression analysis revealed that factors including neovasular glaucoma, remnant glaucoma, glaucoma valve implantation, glaucoma valve implantation＋MMC, glaucoma valve implantation＋vitrectomy, age〉60 y, and IOP at admission 〉50 mm Hg were significantly associated with an increased risk for grade Ⅲ FAC.CONCLUSION： The overall incidence of grade Ⅲ FAC after glaucoma filtration surgery is 4.18%. Patients with neovasular glaucoma and remnant glaucoma are at a higher risk of developing FAC. Ahmed glaucoma valve implantation is associated with a higher risk for grade Ⅲ FAC compared with trabeculectomy. No significant correlation was observed between the use of MMC in glaucoma filtration surgery and the risk of postoperative FAC. Higher IOP at admission（〉50 mm Hg） and old age（〉60 y） are risk factors for grade Ⅲ FAC.
基金funded by Natural Science Foundation of China(Grant number 81470629)Natural Science Foundation of Chongqing(Grant number cstc2018jcyjAX0016)。
文摘Filtration surgery still plays a mainstream role of treatment for glaucoma.Postoperative scarring is the main cause of surgical failure.This study evaluated the biocompatibility and anti-proliferative properties of pure magnesium with three different coatings,which are hydroxyapatite(HA),dicalcium phosphate dihydrate(DCPD)and DCPD+stearic acid(SA),in a primary culture of human tenon's capsule fibroblasts(HTCFs)and in rabbit Glaucoma Filtration Surgery.Titanium and glass were used as controls in vitro,and trabeculectomy was used as control in vivo.The results show the number and shape of HTCFs seeded on different coatings showed less quantity and poor cell morphology.Each type of coated magnesium demonstrated significantly decreased metabolic activity of HTCFs.DCPD+SA showed higher cytotoxicity than the other coatings.Significant inhibition of proliferation was observed with the DCPD+SA coating.The expression ofα-SMA was decreased in the cells when seeded on all of the coated magnesium disks.In vivo,no obvious adverse effects were observed after operation.No significant difference existed for any of the different samples regarding different ion concentrations in the aqueous humor.The inflammatory response in the titanium,DCPD and DCPD+SA treated eyes was more intense than in the trabeculectomy alone and HA groups.Western Blot analysis showed that collagen-1 andα-SMA expression was significantly lower in the titanium,HA,DCPD and DCPD+SA groups compared with the control.Different coatings on magnesium were able to affect the corrosive properties,which in turn,influenced the morphology and function of HTCFs.HA coated magnesium may be considered a very promising biodegradable material for the next generation of glaucoma drainage devices.
