AIM:To report a one-year clinical outcomes of low-dose laser cycloplasty(LCP)among malignant glaucoma patients.METHODS:In this prospective,multicenter,noncomparative clinical study,participants with malignant glaucoma...AIM:To report a one-year clinical outcomes of low-dose laser cycloplasty(LCP)among malignant glaucoma patients.METHODS:In this prospective,multicenter,noncomparative clinical study,participants with malignant glaucoma were recruited and underwent LCP at eight ophthalmic centers in China.Patients were followed up at 1wk,1,3,6,and 12mo.Intraocular pressure(IOP),number of glaucoma medications,anterior chamber depth(ACD),and complications were recorded.Anatomical success was defined as the reformation of the anterior chamber based on slit-lamp biomicroscopy.Recurrence was defined by the presence of a shallow orflat anterior chamber after initial recovery from treatment.RESULTS:A total of 34 eyes received LCP.Mean IOP and medications decreased from 36.1±11.5 mm Hg with 3.3±1.5 glaucoma medications pre-treatment to 20.9±9.8 mm Hg(P<0.001)with 2.9±1.6 medications(P=0.046)at 1d,and 17.4±6.7 mm Hg(P<0.001)with 1.3±1.7 medications(P<0.001)at 12mo.The ACD increased from 1.1±0.8 mm at baseline to 1.7±1.0 mm and to 2.0±0.5 mm at 1d and 12mo,respectively.A total of 32(94.1%)eyes achieved initial anatomical success.During follow-up,2(5.9%)eyes failed and 8(23.5%)eyes relapsed,yielding a 12-month anatomical success rate of 64.3%.Complications including anterior synechia(8.82%),choroidal/ciliary detachment(5.88%)and hypopyon(2.94%)were observed within 1wk.CONCLUSION:LCP is simple,safe,and effective in reforming the anterior chamber in malignant glaucoma.展开更多
AIM：To assess the outcomes of various interventions for malignant glaucoma（MG）.·M ETHODS：A retrospective,comparative analysis of case series were performed on 38 eyes of 35 MG patients treated in Aier Eye Hos...AIM：To assess the outcomes of various interventions for malignant glaucoma（MG）.·M ETHODS：A retrospective,comparative analysis of case series were performed on 38 eyes of 35 MG patients treated in Aier Eye Hospital of Wuhan between Jan.2009and Dec.2012.Numerous treatments were administered including medical therapy,neodymium：yttriumaluminium-garnet（Nd：YAG）laser posterior capsulotomy and hyaloidotomy as well as 3 surgical options.The characteristic,treatment option and outcome of MG in every individual patient were reviewed and analyzed among all patients who were followed up for an average of 27.1±9.1mo.·RESULTS：Four eyes of 3 patients achieved complete resolution with medical therapy.Nd：YAG laser posterior capsulotomy and hyaloidotomy were performed on 2 eyes,both of which achieved resolution after initial intervention.Thirty-two eyes were given surgical treatments with anterior vitrectomy-reformation of anterior chamber in13 eyes,phacoemulsification-intraocular lens implantation in 10 eyes and phacoemulsification-intraocular lens implantation-anterior vitrectomy in 9 eyes.Resolution of MG was seen in almost all patients.The mean intraocular pressure decreased from 41.87±9.44 mm Hg at presentation to 15.84±3.73 mm Hg at the last visit.The mean anterior chamber depth improved from 0.28±0.27 mm to 2.28±0.19 mm.Twenty eyes with preoperative visual acuity better than counting figure/50 cm had various visual improvements.Complications occurred in 3 eyes of 3 patients including bleeding at the entry site of vitrectomy into vitreous cavity,corneal endothelial decompensation and allergic to atropine respectively.·CONCLUSION：MG occurs as a result of multiple mechanisms involved simultaneously or sequentially.Medical therapy is advocated as the initial treatment,laser therapy is beneficial in pseudophakic eyes,and different surgical regimen is recommended based on different pathogenesis of MG when non-response occurs to nonsurgical management.MG can be managed successfully by appropriate and timely interventions with good visual outcome.展开更多
AIM:To assess the effectiveness of core vitrectomyphacoemulsification-intraocular lens(IOL)implantationcapsulo-hyaloidotomy in treating phakic eye at least 1 mo after the onset of malignant glaucoma.METHODS:A retrospe...AIM:To assess the effectiveness of core vitrectomyphacoemulsification-intraocular lens(IOL)implantationcapsulo-hyaloidotomy in treating phakic eye at least 1 mo after the onset of malignant glaucoma.METHODS:A retrospective analysis were performed on malignant glaucoma patients treated in Zhongshan Ophthalmic Center between 2016 and 2018.Demographic and clinical data were described.The preoperative and postoperative visual acuity(VA),intraocular pressure(IOP),number of IOP-lowering medications used,and anterior chamber depth(ACD)of the case series were compared by Wilcoxon signed-rank test.RESULTS:Thirteen phakic eyes with long time intervals between onset and surgery were identified in this case series.Core vitrectomy-phacoemulsification-IOL implantation-capsulohyaloidotomy reduced the IOP(P=0.046)and the number of IOP-lowering medications used(P=0.004),deepened the ACD(P=0.005).Complete success was achieved in 38.5%of the eyes,and anatomical success was achieved in 100%of the eyes without any recurrence.The only postoperative complication observed is corneal endothelial decompensation.It occurred in two cases.CONCLUSION:Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy is safe and effective for treatment of long onset phakic malignant glaucoma.展开更多
BACKGROUND Malignant glaucoma,caused by aqueous misdirection,is a challenging postsurgical complication presented with normal/high intraocular pressure and shallowing of the central and peripheral anterior chambers.It...BACKGROUND Malignant glaucoma,caused by aqueous misdirection,is a challenging postsurgical complication presented with normal/high intraocular pressure and shallowing of the central and peripheral anterior chambers.Its incidence is about 0.6%-4.0%.It can be secondary to filtering surgeries,laser iridotomy,and cataract surgery.Short axial length and a history of angle closure glaucoma are its main risk factors.Here,we report a bilateral malignant glaucoma with bullous keratopathy in the patient’s left eye.CASE SUMMARY We present a case of bilateral malignant glaucoma.The cause of malignant glaucoma for each eye of this patient was different.Hence,the management strategy and selection of surgical methods were also different.However,the normal anterior chamber was ultimately maintained,and maximum visual function was preserved.Even though the left eye received multiple surgeries and corneal endothelial decompensation occurred,the formation of a retroendothelial fibrous membrane partially compensated for the function of the corneal endothelium.CONCLUSION The formation of a retroendothelial fibrous membrane partially compensated for the function of the corneal endothelium.展开更多
Dear Editor,We read with great interest the article by Wu et al[1]which comprehensively assessed the outcomes of various interventions in 38 eyes of 35 patients with malignant glaucoma（MG）secondary to antiglaucoma s...Dear Editor,We read with great interest the article by Wu et al[1]which comprehensively assessed the outcomes of various interventions in 38 eyes of 35 patients with malignant glaucoma（MG）secondary to antiglaucoma surgery whowere followed up for an average of 27.1mo.展开更多
Objective: to determine the specific therapeutic effect of Nd: YAG laser on malignant glaucoma patients after glaucoma filtering surgery, and to determine the correlation between the clinical characteristics of patien...Objective: to determine the specific therapeutic effect of Nd: YAG laser on malignant glaucoma patients after glaucoma filtering surgery, and to determine the correlation between the clinical characteristics of patients and the therapeutic effect of Nd: YAG laser. Methods: this study is a retrospective case series report study. Patients with malignant glaucoma after glaucoma filtering surgery treated by Nd: YAG laser in our hospital were collected retrospectively. The intraocular pressure, anterior chamber depth and uncorrected visual acuity of the patients at different time points before and after operation were compared. To clarify the clinical application effect of Nd: YAG laser in the treatment of malignant glaucoma after Qingguang filtration. Through Spearman correlation analysis of preoperative clinical characteristics of patients with intraocular pressure and anterior chamber depth at 3 months after operation, the correlation between preoperative clinical characteristics of patients and treatment effect was clarified. Results: the study included 35 eyes with malignant glaucoma after glaucoma filtering surgery from January 2015 to July 2021. The results of comparison between preoperative IOP and postoperative IOP at different time points showed that the IOP of the patients at 1 day, 3 days, 1 month and 3 months after operation was lower than that before operation, and the difference was statistically significant (p<0.05). The results of the comparison between preoperative anterior chamber depth and postoperative anterior chamber depth at different time points showed that the anterior chamber depth of the patients increased significantly at 3 days, 1 month and 3 months after operation, and the difference was statistically significant (p<0.05). The comparison of the patients' visual acuity at 3 months after operation and preoperative visual acuity showed that the proportion of patients with visual acuity > 0.8 at 3 months after operation was significantly higher than that before operation, and the proportion of patients with visual acuity < 0.05 was significantly lower than that before operation, and the difference was statistically significant (p<0.05). The results of correlation analysis showed that the age, gender, onset time, preoperative intraocular pressure and axial length of the patients had certain correlation with the intraocular pressure and anterior chamber depth at 3 months after operation (P<0.05). Conclusion: Nd: YAG laser technology has good clinical therapeutic effect on malignant glaucoma patients after glaucoma filtering surgery. The therapeutic effect of Nd: YAG laser technology has certain correlation with patients' age, gender, onset time, preoperative intraocular pressure and axial length.展开更多
基金Supported by the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)Development Projects of Zhejiang Province(No.2022C03112)Innovation Team Program of Wenzhou.
文摘AIM:To report a one-year clinical outcomes of low-dose laser cycloplasty(LCP)among malignant glaucoma patients.METHODS:In this prospective,multicenter,noncomparative clinical study,participants with malignant glaucoma were recruited and underwent LCP at eight ophthalmic centers in China.Patients were followed up at 1wk,1,3,6,and 12mo.Intraocular pressure(IOP),number of glaucoma medications,anterior chamber depth(ACD),and complications were recorded.Anatomical success was defined as the reformation of the anterior chamber based on slit-lamp biomicroscopy.Recurrence was defined by the presence of a shallow orflat anterior chamber after initial recovery from treatment.RESULTS:A total of 34 eyes received LCP.Mean IOP and medications decreased from 36.1±11.5 mm Hg with 3.3±1.5 glaucoma medications pre-treatment to 20.9±9.8 mm Hg(P<0.001)with 2.9±1.6 medications(P=0.046)at 1d,and 17.4±6.7 mm Hg(P<0.001)with 1.3±1.7 medications(P<0.001)at 12mo.The ACD increased from 1.1±0.8 mm at baseline to 1.7±1.0 mm and to 2.0±0.5 mm at 1d and 12mo,respectively.A total of 32(94.1%)eyes achieved initial anatomical success.During follow-up,2(5.9%)eyes failed and 8(23.5%)eyes relapsed,yielding a 12-month anatomical success rate of 64.3%.Complications including anterior synechia(8.82%),choroidal/ciliary detachment(5.88%)and hypopyon(2.94%)were observed within 1wk.CONCLUSION:LCP is simple,safe,and effective in reforming the anterior chamber in malignant glaucoma.
文摘AIM：To assess the outcomes of various interventions for malignant glaucoma（MG）.·M ETHODS：A retrospective,comparative analysis of case series were performed on 38 eyes of 35 MG patients treated in Aier Eye Hospital of Wuhan between Jan.2009and Dec.2012.Numerous treatments were administered including medical therapy,neodymium：yttriumaluminium-garnet（Nd：YAG）laser posterior capsulotomy and hyaloidotomy as well as 3 surgical options.The characteristic,treatment option and outcome of MG in every individual patient were reviewed and analyzed among all patients who were followed up for an average of 27.1±9.1mo.·RESULTS：Four eyes of 3 patients achieved complete resolution with medical therapy.Nd：YAG laser posterior capsulotomy and hyaloidotomy were performed on 2 eyes,both of which achieved resolution after initial intervention.Thirty-two eyes were given surgical treatments with anterior vitrectomy-reformation of anterior chamber in13 eyes,phacoemulsification-intraocular lens implantation in 10 eyes and phacoemulsification-intraocular lens implantation-anterior vitrectomy in 9 eyes.Resolution of MG was seen in almost all patients.The mean intraocular pressure decreased from 41.87±9.44 mm Hg at presentation to 15.84±3.73 mm Hg at the last visit.The mean anterior chamber depth improved from 0.28±0.27 mm to 2.28±0.19 mm.Twenty eyes with preoperative visual acuity better than counting figure/50 cm had various visual improvements.Complications occurred in 3 eyes of 3 patients including bleeding at the entry site of vitrectomy into vitreous cavity,corneal endothelial decompensation and allergic to atropine respectively.·CONCLUSION：MG occurs as a result of multiple mechanisms involved simultaneously or sequentially.Medical therapy is advocated as the initial treatment,laser therapy is beneficial in pseudophakic eyes,and different surgical regimen is recommended based on different pathogenesis of MG when non-response occurs to nonsurgical management.MG can be managed successfully by appropriate and timely interventions with good visual outcome.
基金Supported by the National Natural Science Foundation of China(No.81700812)。
文摘AIM:To assess the effectiveness of core vitrectomyphacoemulsification-intraocular lens(IOL)implantationcapsulo-hyaloidotomy in treating phakic eye at least 1 mo after the onset of malignant glaucoma.METHODS:A retrospective analysis were performed on malignant glaucoma patients treated in Zhongshan Ophthalmic Center between 2016 and 2018.Demographic and clinical data were described.The preoperative and postoperative visual acuity(VA),intraocular pressure(IOP),number of IOP-lowering medications used,and anterior chamber depth(ACD)of the case series were compared by Wilcoxon signed-rank test.RESULTS:Thirteen phakic eyes with long time intervals between onset and surgery were identified in this case series.Core vitrectomy-phacoemulsification-IOL implantation-capsulohyaloidotomy reduced the IOP(P=0.046)and the number of IOP-lowering medications used(P=0.004),deepened the ACD(P=0.005).Complete success was achieved in 38.5%of the eyes,and anatomical success was achieved in 100%of the eyes without any recurrence.The only postoperative complication observed is corneal endothelial decompensation.It occurred in two cases.CONCLUSION:Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy is safe and effective for treatment of long onset phakic malignant glaucoma.
基金Supported by The Central Guiding Local Science&Technology Projects,No.Z20221341047The Major Scientific and Technological Project of Sanmenxia 2022,No.2022001007。
文摘BACKGROUND Malignant glaucoma,caused by aqueous misdirection,is a challenging postsurgical complication presented with normal/high intraocular pressure and shallowing of the central and peripheral anterior chambers.Its incidence is about 0.6%-4.0%.It can be secondary to filtering surgeries,laser iridotomy,and cataract surgery.Short axial length and a history of angle closure glaucoma are its main risk factors.Here,we report a bilateral malignant glaucoma with bullous keratopathy in the patient’s left eye.CASE SUMMARY We present a case of bilateral malignant glaucoma.The cause of malignant glaucoma for each eye of this patient was different.Hence,the management strategy and selection of surgical methods were also different.However,the normal anterior chamber was ultimately maintained,and maximum visual function was preserved.Even though the left eye received multiple surgeries and corneal endothelial decompensation occurred,the formation of a retroendothelial fibrous membrane partially compensated for the function of the corneal endothelium.CONCLUSION The formation of a retroendothelial fibrous membrane partially compensated for the function of the corneal endothelium.
文摘Dear Editor,We read with great interest the article by Wu et al[1]which comprehensively assessed the outcomes of various interventions in 38 eyes of 35 patients with malignant glaucoma（MG）secondary to antiglaucoma surgery whowere followed up for an average of 27.1mo.
文摘Objective: to determine the specific therapeutic effect of Nd: YAG laser on malignant glaucoma patients after glaucoma filtering surgery, and to determine the correlation between the clinical characteristics of patients and the therapeutic effect of Nd: YAG laser. Methods: this study is a retrospective case series report study. Patients with malignant glaucoma after glaucoma filtering surgery treated by Nd: YAG laser in our hospital were collected retrospectively. The intraocular pressure, anterior chamber depth and uncorrected visual acuity of the patients at different time points before and after operation were compared. To clarify the clinical application effect of Nd: YAG laser in the treatment of malignant glaucoma after Qingguang filtration. Through Spearman correlation analysis of preoperative clinical characteristics of patients with intraocular pressure and anterior chamber depth at 3 months after operation, the correlation between preoperative clinical characteristics of patients and treatment effect was clarified. Results: the study included 35 eyes with malignant glaucoma after glaucoma filtering surgery from January 2015 to July 2021. The results of comparison between preoperative IOP and postoperative IOP at different time points showed that the IOP of the patients at 1 day, 3 days, 1 month and 3 months after operation was lower than that before operation, and the difference was statistically significant (p<0.05). The results of the comparison between preoperative anterior chamber depth and postoperative anterior chamber depth at different time points showed that the anterior chamber depth of the patients increased significantly at 3 days, 1 month and 3 months after operation, and the difference was statistically significant (p<0.05). The comparison of the patients' visual acuity at 3 months after operation and preoperative visual acuity showed that the proportion of patients with visual acuity > 0.8 at 3 months after operation was significantly higher than that before operation, and the proportion of patients with visual acuity < 0.05 was significantly lower than that before operation, and the difference was statistically significant (p<0.05). The results of correlation analysis showed that the age, gender, onset time, preoperative intraocular pressure and axial length of the patients had certain correlation with the intraocular pressure and anterior chamber depth at 3 months after operation (P<0.05). Conclusion: Nd: YAG laser technology has good clinical therapeutic effect on malignant glaucoma patients after glaucoma filtering surgery. The therapeutic effect of Nd: YAG laser technology has certain correlation with patients' age, gender, onset time, preoperative intraocular pressure and axial length.
