The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform

Atsushi Hayashi - One of the best experts on this subject based on the ideXlab platform.

  • Ex-Press^® versus Baerveldt implant surgery for primary open-angle Glaucoma and pseudo-exfoliation Glaucoma
    International Ophthalmology, 2021
    Co-Authors: Naoki Tojo, Atsushi Hayashi
    Abstract:

    Purpose To compare surgical outcomes between Ex-Press^® (EXP) and Baerveldt Glaucoma implant (BGI) surgeries for primary open-angle Glaucoma (POAG) and pseudo-exfoliation Glaucoma (PEXG) patients. Patients and methods This was a retrospective single-facility study. The inclusion criteria were that the patient's preoperative intraocular pressure (IOP) was > 21 mmHg and the post-surgery follow-up was > 1 year. We recruited 161 patients who had undergone a trabeculectomy with EXP (89 eyes) or BGI surgery (72 eyes). We compared these groups' Postoperative IOP values and Postoperative Glaucoma medications, the reduction rate of corneal endothelial cell density (ECD), surgical outcomes, complications, the hospital stay duration, and the number of visits within 3 months post-surgery. Results Both the EXP and BGI surgeries could significantly decrease the IOP. When the surgical success was defined Postoperative IOP ≤ 21 mmHg, the surgical outcome of BGI was significantly better than EXP ( p  = 0.0148). When the surgical success was defined Postoperative IOP ≤ 18, 15 , and 12 mmHg, the surgical outcomes between BGI and EXP surgeries were not significantly different ( p  = 0.0815, p  = 0.331, and p  = 0.910). The mean ECD reduction rate was significantly faster in the EXP group. The BGI patients had significantly shorter stays in the hospital and fewer visits within 3 months post-surgery ( p  

  • Ex-Press ® versus Baerveldt implant surgery for primary open-angle Glaucoma and pseudo-exfoliation Glaucoma
    International ophthalmology, 2021
    Co-Authors: Naoki Tojo, Atsushi Hayashi
    Abstract:

    PURPOSE To compare surgical outcomes between Ex-Press® (EXP) and Baerveldt Glaucoma implant (BGI) surgeries for primary open-angle Glaucoma (POAG) and pseudo-exfoliation Glaucoma (PEXG) patients. PATIENTS AND METHODS This was a retrospective single-facility study. The inclusion criteria were that the patient's preoperative intraocular pressure (IOP) was > 21 mmHg and the post-surgery follow-up was > 1 year. We recruited 161 patients who had undergone a trabeculectomy with EXP (89 eyes) or BGI surgery (72 eyes). We compared these groups' Postoperative IOP values and Postoperative Glaucoma medications, the reduction rate of corneal endothelial cell density (ECD), surgical outcomes, complications, the hospital stay duration, and the number of visits within 3 months post-surgery. RESULTS Both the EXP and BGI surgeries could significantly decrease the IOP. When the surgical success was defined Postoperative IOP ≤ 21 mmHg, the surgical outcome of BGI was significantly better than EXP (p = 0.0148). When the surgical success was defined Postoperative IOP ≤ 18, 15 , and 12 mmHg, the surgical outcomes between BGI and EXP surgeries were not significantly different (p = 0.0815, p = 0.331, and p = 0.910). The mean ECD reduction rate was significantly faster in the EXP group. The BGI patients had significantly shorter stays in the hospital and fewer visits within 3 months post-surgery (p 

A. Weller - One of the best experts on this subject based on the ideXlab platform.

  • Subluxatio lentis und Glaukom-Indikationen und Risiken Kataraktchirurgie
    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 2000
    Co-Authors: H. Häberle, D. T. Pham, A. Weller
    Abstract:

    Background: Iridodonesis is the clinical sign of lens subluxation.Acute Glaucoma caused by a ciliolenticular block may develop. YAG iridotomy or peripheral iridectomy are rarely effective in controlling intraocular pressure. The results of phacoemulsification and posterior lens implantation for subluxated lens and Glaucoma are reported. Patients and methods: Seven patients aged 69±9.5 years were followed up.All 10 eyes with subluxated lens and Glaucoma had phacoemulsification and posterior chamber lens implantation.Two different groups relating to axial length could be analyzed.Intraoperative findings and Postoperative Glaucoma situation are reported. Results: Six eyes had average axial length of 21.5±0.17 mm and previous acute Glaucoma. Five of these eyes had therapeutic YAG iridotomy and one, peripheral iridectomy. All eyes had dysregulated Glaucoma despite antiGlaucomatous medications. After cataract surgery five of six eyes had regular intraocular pressure without any medication. Four eyes had average axial length of 24.4±1.1 mm and chronic Glaucoma. After complicated phacoemulsification three of these eyes had regular intraocular pressure with antiGlaucomatous medication, one eye without. Conclusions: For short eyes with subluxated lens and preceding acute Glaucoma, cataract surgery with posterior chamber lens implantation is an effective therapeutic procedure for IOP regulation. For chronic Glaucoma with subluxated lens, conventional or surgical approach to Glaucoma remains dominant.

  • Subluxatio lentis und Glaukom-Indikationen und Risiken Kataraktchirurgie
    Der Ophthalmologe, 2000
    Co-Authors: H. Häberle, D. T. Pham, A. Weller
    Abstract:

    Background: Iridodonesis is the clinical sign of lens subluxation. Acute Glaucoma caused by a ciliolenticular block may develop. YAG iridotomy or peripheral iridectomy are rarely effective in controlling intraocular pressure. The results of phacoemulsification and posterior lens implantation for subluxated lens and Glaucoma are reported. Patients and methods: Seven patients aged 69±9.5 years were followed up. All 10 eyes with subluxated lens and Glaucoma had phacoemulsification and posterior chamber lens implantation. Two different groups relating to axial length could be analyzed. Intraoperative findings and Postoperative Glaucoma situation are reported. Results: Six eyes had average axial length of 21.5±0.17 mm and previous acute Glaucoma. Five of these eyes had therapeutic YAG iridotomy and one, peripheral iridectomy. All eyes had dysregulated Glaucoma despite antiGlaucomatous medications. After cataract surgery five of six eyes had regular intraocular pressure without any medication. Four eyes had average axial length of 24.4±1.1 mm and chronic Glaucoma. After complicated phacoemulsification three of these eyes had regular intraocular pressure with antiGlaucomatous medication, one eye without. Conclusions: For short eyes with subluxated lens and preceding acute Glaucoma, cataract surgery with posterior chamber lens implantation is an effective therapeutic procedure for IOP regulation. For chronic Glaucoma with subluxated lens, conventional or surgical approach to Glaucoma remains dominant. Hintergrund: Iridodonesis ist das klinische Symptom einer subluxierten Linse. Hierbei kann es zu einem akuten Glaukomanfall im Sinne eines ziliolentikulären Blockes kommen oder ein chronisches Glaukom bestehen. Eine YAG-Iridotomie oder basale Iridektomie führen selten zu einer Druckregulation. Wir berichten über die Ergebnisse nach Kataraktoperation bei Subluxatio lentis und Glaukom. Patienten und Methode: 10 Augen von 7 Patienten (68±9,5 Jahre) wurden nach Phakoemulsifikation und Hinterkammerlinsenimplantation untersucht. Es konnten bezüglich der Achsenlänge zwei Gruppen unterschieden werden. Die intraoperativen Besonderheiten und die Postoperative Drucksituation werden dargestellt. Ergebnisse: Bei 6 Augen handelte es sich um eine mittlere Bulbuslänge von 21,5±0,17 mm mit vorangegangenem akutem Glaukom, welches bei 5 Augen durch eine YAG-Iridotomie und einmal durch eine basale Iridektomie behandelt wurde. Trotz zusätzlicher antiglaukomatöser Therapie kam es zu keiner ausreichenden Druckregulation. Nach der Kataraktoperation war der Druck außer bei einem Auge ohne Therapie reguliert. Bei 4 Augen bestand ein chronisches Offenwinkelglaukom bei einer Bulbuslänge von 24,5±1,13 mm. Bei 3 Augen war nach komplizierter Kataraktoperation weiterhin lokal antiglaukomatöse Therapie erforderlich, einmal war der Druck ohne Therapie im Normbereich. In sämtlichen Fällen war die HKL postoperativ zentriert. Schlußfolgerung: Bei Subluxatio lentis und kurzgebautem Auge und vorangegangenem ziliolentikuärem Block stellt die Kataraktoperation mit HKL-Implantation eine sinnvolle Maßnahme zur dauerhaften Druckregulation dar. Bei chronischem Glaukom und subluxierter Linse bleibt nach der Kataraktoperation die medikamentöse oder operative Drucksenkung im Vordergrund.

Naoki Tojo - One of the best experts on this subject based on the ideXlab platform.

  • Ex-Press^® versus Baerveldt implant surgery for primary open-angle Glaucoma and pseudo-exfoliation Glaucoma
    International Ophthalmology, 2021
    Co-Authors: Naoki Tojo, Atsushi Hayashi
    Abstract:

    Purpose To compare surgical outcomes between Ex-Press^® (EXP) and Baerveldt Glaucoma implant (BGI) surgeries for primary open-angle Glaucoma (POAG) and pseudo-exfoliation Glaucoma (PEXG) patients. Patients and methods This was a retrospective single-facility study. The inclusion criteria were that the patient's preoperative intraocular pressure (IOP) was > 21 mmHg and the post-surgery follow-up was > 1 year. We recruited 161 patients who had undergone a trabeculectomy with EXP (89 eyes) or BGI surgery (72 eyes). We compared these groups' Postoperative IOP values and Postoperative Glaucoma medications, the reduction rate of corneal endothelial cell density (ECD), surgical outcomes, complications, the hospital stay duration, and the number of visits within 3 months post-surgery. Results Both the EXP and BGI surgeries could significantly decrease the IOP. When the surgical success was defined Postoperative IOP ≤ 21 mmHg, the surgical outcome of BGI was significantly better than EXP ( p  = 0.0148). When the surgical success was defined Postoperative IOP ≤ 18, 15 , and 12 mmHg, the surgical outcomes between BGI and EXP surgeries were not significantly different ( p  = 0.0815, p  = 0.331, and p  = 0.910). The mean ECD reduction rate was significantly faster in the EXP group. The BGI patients had significantly shorter stays in the hospital and fewer visits within 3 months post-surgery ( p  

  • Ex-Press ® versus Baerveldt implant surgery for primary open-angle Glaucoma and pseudo-exfoliation Glaucoma
    International ophthalmology, 2021
    Co-Authors: Naoki Tojo, Atsushi Hayashi
    Abstract:

    PURPOSE To compare surgical outcomes between Ex-Press® (EXP) and Baerveldt Glaucoma implant (BGI) surgeries for primary open-angle Glaucoma (POAG) and pseudo-exfoliation Glaucoma (PEXG) patients. PATIENTS AND METHODS This was a retrospective single-facility study. The inclusion criteria were that the patient's preoperative intraocular pressure (IOP) was > 21 mmHg and the post-surgery follow-up was > 1 year. We recruited 161 patients who had undergone a trabeculectomy with EXP (89 eyes) or BGI surgery (72 eyes). We compared these groups' Postoperative IOP values and Postoperative Glaucoma medications, the reduction rate of corneal endothelial cell density (ECD), surgical outcomes, complications, the hospital stay duration, and the number of visits within 3 months post-surgery. RESULTS Both the EXP and BGI surgeries could significantly decrease the IOP. When the surgical success was defined Postoperative IOP ≤ 21 mmHg, the surgical outcome of BGI was significantly better than EXP (p = 0.0148). When the surgical success was defined Postoperative IOP ≤ 18, 15 , and 12 mmHg, the surgical outcomes between BGI and EXP surgeries were not significantly different (p = 0.0815, p = 0.331, and p = 0.910). The mean ECD reduction rate was significantly faster in the EXP group. The BGI patients had significantly shorter stays in the hospital and fewer visits within 3 months post-surgery (p 

Gunilla Magnusson - One of the best experts on this subject based on the ideXlab platform.

  • The Swedish National Pediatric Cataract Register (PECARE): incidence and onset of Postoperative Glaucoma
    Acta ophthalmologica, 2020
    Co-Authors: Alf Nyström, Birgitte Haargaard, Annika Rosensvärd, Kristina Tornqvist, Gunilla Magnusson
    Abstract:

    Purpose: The aim was to report cumulative incidence and time of onset of Postoperative Glaucoma in a paediatric early cataract surgery cohort. Methods: Data were retrieved from the Pediatric Cataract Register (PECARE), a prospective register of Swedish cataract operations before 8 years of age. All eyes with surgery between January 2007 and December 2014 and a registered follow-up were included. Cataracts caused by uveitis, trauma or coexisting congenital Glaucoma were excluded. Glaucoma was defined as early onset if diagnosed within a year after surgery and late onset if diagnosed later. Results: The study included 288 eyes in 207 children (106 girls), 81 with bilateral and 126 with unilateral cataracts, with a mean follow-up of 3.31 ± 1.77 years. Of the 288, 168 (58.3%) had surgery before 3 months of age; most of these 92.3% (155/168) were defined as dense, 208 (72.2%) were below 1 year of age. Cumulative incidence of surgically treated Glaucoma among individuals was 23.7% (49/207). Median time to Glaucoma onset was 0.91 years (range: 0.05–4.97 years) for eyes. Early-onset Glaucoma was found in 98 % (63/64), and late onset in 2% (1/64). Conclusion: In this paediatric cataract cohort, a majority of eyes had surgery before 3 months of age (58.3%). Secondary Glaucoma-onset peaked within the first Postoperative year, with a cumulative incidence of 23.7%. Surgery performed after the first month of life, resulted in a lower Glaucoma rate. Long-term follow-up will reveal whether the low rate of late-onset Glaucoma with early surgery will last, and if so, the consequences. (Less)

  • Glaucoma following congenital cataract surgery: an 18-year longitudinal follow-up.
    Acta ophthalmologica Scandinavica, 2000
    Co-Authors: Gunilla Magnusson, Maths Abrahamsson, Johan Sjöstrand
    Abstract:

    . Purpose: To report the occurrence of Postoperative Glaucoma and to evaluate risk factors. Methods: Children born in four of the western counties of Sweden who were diagnosed with congenital cataracts formed a cohort (n=137). The following parameters were evaluated: age at cataract surgery; type of surgery; visual outcome; Postoperative IOP; optic disc abnormalities; date of onset of the complication; number of reoperations, including treatment for secondary cataract; presence of systemic anomalies; microphthalmus; and eye-related anomalies. Results: A diagnosis of Glaucoma was recorded for 12% of the eyes. The mean follow-up time was 9.6 years. There is a relationship between surgery before the age of 10 days and development of Glaucoma. Microphthalmus is an important risk factor as well. Conclusions: Despite modern surgical techniques the incidence of aphakic Glaucoma is 10% or higher. No time-dependent increase in the incidence of late-onset Glaucoma between the 1980s and the 1990s could be proven.

Jugnoo S Rahi - One of the best experts on this subject based on the ideXlab platform.

  • 5 year outcomes after primary intraocular lens implantation in children aged 2 years or younger with congenital or infantile cataract findings from the iolunder2 prospective inception cohort study
    The Lancet Child & Adolescent Health, 2018
    Co-Authors: Ameenat Lola Solebo, Phillippa M Cumberland, Jugnoo S Rahi
    Abstract:

    Summary Background International initiatives to prevent childhood blindness have highlighted the importance of early, effective intervention for congenital and infantile cataract. In the UK, intraocular lens implantation has been widely adopted by surgeons to treat these conditions. However, evidence about the benefits and risks of this technique in different age groups is limited. The IoLunder2 study assessed outcomes following primary intraocular lens implantation in children aged 2 years and younger with congenital or infantile cataract. Methods The IoLunder2 study was a prospective observational cohort study done at 31 sites in the UK and Ireland. Eligible children were aged 2 years or younger who had cataract surgery concurrently with intraocular lens implantation or conventional treatment (aphakic correction with contact lenses or glasses) after cataract surgery between Jan 1, 2009, and Dec 31, 2010. Children with significant ocular comorbidity precluding lens implantation, defined by the presence of complex persistent fetal vasculature, other ocular structural anomalies, severe microcornea (horizontal corneal diameter Findings A total of 256 eligible children were recruited; two had incomplete data and were excluded. 158 of the 254 included children (102 [65%] with bilateral cataract and 56 [35%] with unilateral cataract) had no significant ocular morbidity and were analysed for the key outcomes. Primary intraocular lens implantation was done in 88 (56%) of 158 children (50 children with bilateral cataract and 38 children with unilateral cataract). 70 (44%) of 158 children had conventional treatment (52 with bilateral cataract and 18 with unilateral cataract). Overall median visual acuity at 5 years was 0·34 logMAR (IQR 0·20–0·54) for children with bilateral cataract and 0·70 logMAR (IQR 0·3–1·3) in the operated eye for children with unilateral cataract. Primary intraocular lens implantation was not associated with better visual outcome than conventional treatment in children with bilateral cataract (adjusted coefficient −0·1, 95% CI −0·5 to 0·3, p=0·48) or unilateral cataract (adjusted coefficient −0·3, −0·6 to 0·2, p=0·36), or reduced incidence of Postoperative Glaucoma in children with bilateral cataract (adjusted odds ratio [OR] 0·5, 0·10 to 1·80, p=0·28), but was associated with a five times higher risk of reoperation for visual axis opacity requiring general anaesthesia in children with bilateral cataract (adjusted OR 5·94, 95% CI 2·14–16·47, p=0·001) and a 20 times higher risk in children with unilateral cataract (20·15, 3·01–134·00, p=0·001). Interpretation The findings of this cohort study indicate that intraocular lens implantation does not confer better vision or protection against Postoperative Glaucoma, and conversely increases the risk of requiring early reoperation in children younger than 2 years with bilateral or unilateral cataract. The routine use of intraocular lens implantation in this age group cannot be recommended. Funding National Institute for Health Research, Ulverscroft Foundation, and the Academy of Medical Sciences.

  • Risks and outcomes associated with primary intraocular lens implantation in children under 2 years of age: the IoLunder2 cohort study.
    The British journal of ophthalmology, 2015
    Co-Authors: Ameenat Lola Solebo, Phillippa M Cumberland, Isabelle Russell-eggitt, Jugnoo S Rahi
    Abstract:

    Background/aims To investigate outcomes following cataract surgery with and without primary intraocular lens (IoL) implantation in children under 2 years of age with congenital or infantile cataract. Method Prospective population based cohort study undertaken through the British Isles Congenital Cataract Interest Group, with systematic data collection on children undergoing surgery in UK and Ireland between January 2009 and December 2010. ORs for the association between IoL implantation and visual acuity, Postoperative Glaucoma and reoperation at 1 year after surgery were estimated using multivariable regression analysis to control for potential confounders. Results Of 221 children, 56/131 with bilateral and 48/ 90 with unilateral cataract underwent primary IoL implantation. IoL implantation was independently associated with better visual outcome in bilateral (OR 4.6, 95% CI 1.6 to 13.1, p=0.004) but not unilateral disease. IoL use increased the odds of reoperation requiring repeat general anaesthetic (bilateral OR 5.5, p

  • Risks and outcomes associated with primary intraocular lens implantation in children under 2 years old with congenital and infantile cataract: the UK and Ireland IoLunder2 cohort study
    The Lancet, 2014
    Co-Authors: Ameenat Lola Solebo, Phillippa M Cumberland, Isabelle Russell-eggitt, Jugnoo S Rahi
    Abstract:

    Abstract Background Public health initiatives to prevent childhood blindness have emphasised the importance of effective intervention for congenital cataract. Primary intraocular lens implantation, an important recent management innovation, has been rapidly adopted despite the absence of robust supporting evidence. The IoLunder2 study aimed to provide much needed insights into visual and adverse outcomes after surgery with and without primary intraocular lens implantation in children aged under 2 years. Methods Active surveillance case identification of cataract surgery and systematic data collection were undertaken through the British Congenital Cataract Interest Group (comprising 173 ophthalmologists who manage affected children in the UK and Ireland), which identified more children undergoing surgery for cataract than were reported to the National Health Service statutory databases. Multivariable regression analysis was used to estimate associations of intraocular lens use with visual outcome (assessed with standard hospital-specific but harmonised protocols) and incidence of adverse events at 1 year after surgery, with adjustment for all relevant confounding factors (eg, ocular comorbidity or age at surgery), which were agreed a priori on the basis of previous research or biological plausibility. All reported odds ratios (ORs) are fully adjusted. Findings Of 221 children, 56 of 131 with bilateral cataract and 48 of 90 with unilateral cataract had primary intraocular lens implantation. Implantation was independently associated with better visual outcome in bilateral (OR 5·4, 95% CI 1·09–26·4, p=0·04) but not unilateral disease, and with increased odds of reoperation (bilateral OR 5·5, 95% CI 2·3–13·2, p=0·002; unilateral 16·7, 4·1–68·9, p=0·009). Intraocular lens use did not reduce the odds of Postoperative Glaucoma, the key sight-threatening complication, after surgery in bilateral or unilateral cataract. Interpretation Use of intraocular lenses in young children, particularly in settings where follow-up is limited, should be critically reassessed. The absence of visual benefit and the lack of a previously postulated protective effect against Postoperative Glaucoma question the value of intraocular lens implantation in unilateral disease. The association between intraocular lens implantation and better early visual outcomes in bilateral disease needs to be balanced against the risk of reoperation and exposure to general anaesthetics during a key neurodevelopmental period. Funding Ulverscroft Vision Research Group, Great Ormond Street Hospital/UCL Institute of Child Health National Institute for Health Research Biomedical Research Centre, and Moorfields Eye Hospital NHS Foundation Trust/UCL Institute of Ophthalmology National Institute for Health Research Biomedical Research Centre.

  • Incidence of and Factors Associated with Glaucoma after Surgery for Congenital Cataract: Findings from the British Congenital Cataract Study
    Ophthalmology, 2007
    Co-Authors: Melanie Chak, Jugnoo S Rahi
    Abstract:

    Purpose To report the incidence of and factors associated with Postoperative open-angle Glaucoma in a nationally representative group of children undergoing surgery for congenital or infantile cataract. Design Noncomparative interventional cohort study. Participants All children in the United Kingdom who were newly diagnosed with congenital or infantile cataract in a 12-month period in 1995 and 1996 (the British Congenital/Infantile Cataract Study) were eligible for this study. One hundred sixty-five children with congenital or infantile cataract underwent cataract surgery. Methods All the children were traced through their managing ophthalmologists. Standardized outcome data were collected at least 6 years after diagnosis. For children undergoing cataract extraction, Cox regression analysis was performed to determine incidence of Postoperative open-angle Glaucoma and the effect of key factors considered, a priori, potentially to be associated with it (i.e., age at detection and surgery, type of cataract surgery, primary intraocular lens implantation, severe Postoperative uveitis, and microphthalmia). Main Outcome Measures Development of open-angle Glaucoma after cataract surgery. Results Postoperative Glaucoma developed in 27 of 275 eyes of 165 children who underwent cataract surgery. The overall annual incidence of Postoperative Glaucoma was 5.25 per 100 cataract operations. The median time to development of Postoperative Glaucoma was 1.34 years (range, 0.39 months–6.73 years). Younger age at detection of cataract was the only factor independently associated with the development of Glaucoma when all other factors of interest (which were all statistically associated with age at detection) were accounted for. A 10-fold increase in the age at detection (for example, 30 days compared with 3 days) was associated with a 64% decrease in the hazard ratio (95% confidence interval, 41%–79%; P Conclusions Median time to development of Postoperative open-angle Glaucoma in the present study was lower than that reported previously, emphasizing the need for vigilance from the early Postoperative period. Earlier detection of cataract was the only significant factor associated with the development of Glaucoma after surgery for congenital cataract.