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Hum Chung - One of the best experts on this subject based on the ideXlab platform.
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risk factors associated with sclerotomy leakage and postoperative hypotony after 23 gauge transconjunctival sutureless vitrectomy
Retina-the Journal of Retinal and Vitreous Diseases, 2009Co-Authors: Se Joon Woo, Kyu Hyung Park, Jeong Min Hwang, Jeong Hun Kim, Hum ChungAbstract:PURPOSE To investigate the incidence and risk factors of sclertomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy. METHODS This was a retrospective study including 322 eyes of 292 patients who underwent 23-gauge transconjunctival sutureless vitrectomy by a single surgeon with minimum follow-up period of 1 month. The incidence and risk factors of intraoperative suture placement for leaking sclerotomies and postoperative hypotony (vitreous base dissection (OR = 3.5). The incidences of postoperative hypotony were 11.3% at 2 hours, 6.5% at 5 hours, 3.8% at 1 day, and 0% at 1 week. Myopia and gas tamponade were associated with early postoperative hypotony. No complications developed related to sclerotomy leakage or postoperative hypotony. CONCLUSIONS The risk factors of intraoperative sclerotomy leakage requiring suture placement after 23-gauge transconjunctival sutureless vitrectomy are prior vitrectomy, a young age at operation, and vitreous base dissection. Caution should be exercised to ensure the detection of sclerotomy leakage and hypotony in cases with these risk factors.
Wolfgang Wetzel - One of the best experts on this subject based on the ideXlab platform.
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comparison of the efficacy of er yag laser Sclerostomy ab externo versus trabeculectomy in the treatment of patients with primary open angle glaucoma
Ophthalmologe, 1998Co-Authors: Detlev Spiegel, Wolfgang Wetzel, Reginald BirngruberAbstract:Purpose: This study was conducted to compare the efficacy of the Er-YAG laser Sclerostomy ab externo versus trabeculectomy in the treatment of primary open – angle glaucoma.
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Evaluation of laser Sclerostomy fistulas using ultrasound biomicroscopy
International Ophthalmology, 1997Co-Authors: Georg Haring, Stephan Behrendt, Wolfgang WetzelAbstract:Background. Laser Sclerostomy is a relatively new technique in glaucoma surgery. Clinical examination,particularly of the intrascleral part of laser Sclerostomy fistulas, is difficult. We performed ultrasound biomicroscopy (UBM) in order to determine,if it were possible to visualize fistulas. Moreover,it was the aim to investigate whether this imaging technique could provide additional information on fistula morphology. Patients and methods. Ten eyes of eight patients with chronic open angle glaucoma who had undergone erbium-YAG laser Sclerostomy ab externo were examined using a UBM-probe with a 20 MHz transducer providing spatial resolution of approximately 80 μm. Results. Radial scanning allowed visualization of the Sclerostomy fistula in nine of ten eyes. The different functional state of Sclerostomy fistulas correlated well to UBM findings. It was possible to image differences in the morphology of occluded and patent fistulas and to visualize the filtering pathway in functioning blebs. Conclusions. Ultrasound biomicroscopy allows imaging of laser Sclerostomy fistulas. UBM and clinical findings correlated well in the majority of the patients we examined. The technique supplements clinical examination and in some cases may provide additional information.
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progress in laser sclerotomy ab externo enlarging the Sclerostomy channel and local mitomycin administration
Ophthalmologe, 1995Co-Authors: Ursula Schmidterfurth, Wolfgang Wetzel, G Droge, Georg Haring, Stephan Behrendt, Reginald BirngruberAbstract:In a previous study we presented our first results after Sclerostomy using a pulsed erbium/holmium: YAG laser. At a fiber diameter of 300 microns a success rate of 20-30% was found after a 1-year follow-up. This study concentrates on the improvement of the parameters for filter survival. METHODS. The fiber diameter and thus the size of the fistula increased to 400 microns. Patients who had undergone fibrosis for a previous fistula were treated intraoperatively with topical mitomycin administration. RESULTS. After a follow-up of 6 months, filter function in the 300 microns group was maintained in 26% of the treated eyes (n = 23), while 400 microns fistulas were successful in 48% (n = 26). In the mitomycin-treated group (n = 6), Sclerostomy achieved an IOP regulation in four patients. Postoperative hypotony was more frequent, but did not exceed 2 weeks. CONCLUSION. An increase in fistula diameter improves the long-term results of laser Sclerostomy. Mitomycin is useful in maintaining filter function in patients with an unfavorable prognosis.
Christopher J Dickens - One of the best experts on this subject based on the ideXlab platform.
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subconjunctival thc yag holmium laser thermal Sclerostomy ab externo a one year report
Ophthalmology, 1993Co-Authors: Andrew G Iwach, Dunbar H Hoskins, Michael V Drake, Christopher J DickensAbstract:Background: Laser Sclerostomy can be performed in a less-invasive manner than standard filtering surgery. Longer wavelengths in the infrared range have water-absorptive characteristics that facilitate perforation of the sclera. The goal was to perform laser Sclerostomy ab externo to avoid intraocular instrumentation and minimize conjunctival trauma. Methods: A thulium, holmium, chromium-doped:YAG (THC:YAG) crystal laser was used to create thermal sclerostomies in 49 glaucomatous eyes of 46 patients. The laser is a long-pulsed (300-μsecond), compact, self-contained, solid-state laser operating in the near infrared (2.1 μm). Energy was delivered via a specially designed 22-gauge (712-μm) optic probe that emits energy at a right angle to the long axis of the fiber. Pulse energies of 80 to 120 mJ were used. Total energy levels to produce full-thickness sclerostomies ranged from 1.4 to 7.2 J. Subconjunctival 5-fluorouracil (5-FU) injections were administered in 46 eyes. Success was defined as an intraocular pressure (IOP) of less than or equal to 22 mmHg with or without medications. For eyes in which preoperative IOP was less than or equal to 22 mmHg, success was defined as a decrease in IOP of greater than or equal to 30%. Results: Estimated probability of success allowing for one retreatment was 0.75 at 6 months and 0.68 at 12 months. Mean IOP of successful cases was 13.3 mmHg at both 6 and 12 months. Twelve cases failed within the initial 6 months, and two additional cases failed by 12 months. Conclusion: THC:YAG ("holmium") laser thermal Sclerostomy is an alternative to other full-thickness filtration procedures. Further evaluation and understanding will define its ultimate role in glaucoma management.
Günter K. Krieglstein - One of the best experts on this subject based on the ideXlab platform.
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Prospective Study of Ab Externo Erbium: YAG Laser Sclerostomy in Humans
American journal of ophthalmology, 1997Co-Authors: Philipp C Jacobi, Thomas S. Dietlein, Günter K. KrieglsteinAbstract:Purpose To evaluate the efficacy of ab externo erbium:YAG (Er YAG) laser Sclerostomy in controlling intraocular pressure in eyes with uncontrolled glaucoma. Methods We performed ab externo laser Sclerostomy on eyes of 26 patients. Mean ± SD postoperative follow-up was 11.4 ± 0.9 months. Complete success was defined as intraocular pressure below 22 mm Hg with no adjunct medication; qualified success was defined as intraocular pressure below 22 mm Hg with medication. Results In all eyes, ab externo Er:YAG laser Sclerostomy achieved a functioning fistula with a prominent filtering bleb. Twelve eyes had had neodymium:YAG (Nd: YAG) laser iridotomy at the site of laser Sclerostomy 2 weeks before filtering surgery; 14 eyes had surgical iridectomy at the site of laser Sclerostomy. Mean preoperative intraocular pressure of 30.7 ± 7.3 mm Hg (range, 17.0 to 48.0 mm Hg) was significantly ( P Conclusions Ab externo Er:YAG laser Sclerostomy reliably created successful full-thickness fistulae with prominent filtering blebs in human glaucomatous eyes. However, a transient phase of ocular hypotony caused by aqueous overfiltration, followed by an ongoing rate of fistula patency failure, renders Er: YAG laser Sclerostomy, as performed in this study, unsuitable for long-term pressure control.
Andrew G Iwach - One of the best experts on this subject based on the ideXlab platform.
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thc yag laser Sclerostomy clinical trial
https: doi.org 10.1117 12.178556, 1994Co-Authors: Andrew G Iwach, H D Hoskins, David R HenningsAbstract:The THC:YAG laser was used to create 93 thermal sclerostomies ab externo in 81 glaucomatous eyes of 76 patients. This holmium laser is a long-pulsed, compact, self-contained, solid-state laser operating in the near infrared. A 1-mm conjunctival stab incision was made 5-15 mm from the Sclerostomy site to allow entry of a specially designed 22-gauge optic probe that delivers energy at a right angle to the long axis of the fiber. Pulse energies of 80 mJ to 120 mJ were used with a repetition rate of 5 pulses per second. Total energy levels to produce full-thickness sclerostomies ranged from 1.4 to 7.2 J. Seventy-eight eyes received the antimetabolite 5-fluorouracil. Success was defined as postoperative intraocular pressure 30% reduction in intraocular pressure if preoperative pressure was <22 mmHg. Estimated probability of success was 0.66 at 12 months and 0.57 at both 24 months and 30 months. Mean intraocular pressure of successful cases was 12.7 mmHg, 12.9 mmHg, and 13.0 mmHg at 12, 24, and 30 months, respectively. This is the 30-month report of an on-going clinical trial.© (1994) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
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subconjunctival thc yag holmium laser thermal Sclerostomy ab externo a one year report
Ophthalmology, 1993Co-Authors: Andrew G Iwach, Dunbar H Hoskins, Michael V Drake, Christopher J DickensAbstract:Background: Laser Sclerostomy can be performed in a less-invasive manner than standard filtering surgery. Longer wavelengths in the infrared range have water-absorptive characteristics that facilitate perforation of the sclera. The goal was to perform laser Sclerostomy ab externo to avoid intraocular instrumentation and minimize conjunctival trauma. Methods: A thulium, holmium, chromium-doped:YAG (THC:YAG) crystal laser was used to create thermal sclerostomies in 49 glaucomatous eyes of 46 patients. The laser is a long-pulsed (300-μsecond), compact, self-contained, solid-state laser operating in the near infrared (2.1 μm). Energy was delivered via a specially designed 22-gauge (712-μm) optic probe that emits energy at a right angle to the long axis of the fiber. Pulse energies of 80 to 120 mJ were used. Total energy levels to produce full-thickness sclerostomies ranged from 1.4 to 7.2 J. Subconjunctival 5-fluorouracil (5-FU) injections were administered in 46 eyes. Success was defined as an intraocular pressure (IOP) of less than or equal to 22 mmHg with or without medications. For eyes in which preoperative IOP was less than or equal to 22 mmHg, success was defined as a decrease in IOP of greater than or equal to 30%. Results: Estimated probability of success allowing for one retreatment was 0.75 at 6 months and 0.68 at 12 months. Mean IOP of successful cases was 13.3 mmHg at both 6 and 12 months. Twelve cases failed within the initial 6 months, and two additional cases failed by 12 months. Conclusion: THC:YAG ("holmium") laser thermal Sclerostomy is an alternative to other full-thickness filtration procedures. Further evaluation and understanding will define its ultimate role in glaucoma management.