The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Makoto Nagata - One of the best experts on this subject based on the ideXlab platform.
-
long term outcome of Trabeculotomy for the treatment of developmental glaucoma
Archives of Ophthalmology, 2004Co-Authors: Hanako Ikeda, Hidenobu Tanihara, Hitoshi Ishigooka, Tomoyuki Muto, Makoto NagataAbstract:OBJECTIVE: To elucidate long-term outcome of Trabeculotomy in primary and secondary developmental glaucoma. METHODS: One hundred forty-nine eyes of 89 patients with developmental glaucoma who underwent Trabeculotomy were retrospectively studied. Intraocular pressure (IOP), success probabilities, visual acuities, and visual field were determined during follow-up and at the final visit. RESULTS: The mean +/- SD IOP of 112 eyes with primary developmental glaucoma at the final visit with an mean +/- SD follow-up period of 9.5 +/- 7.1 years was 15.6 +/- 5.0 mm Hg. The average IOP for 37 eyes with secondary developmental glaucoma was 16.7 +/- 4.2 mm Hg. One hundred eyes (89.3%) with primary developmental glaucoma were defined as achieving success at the final visit. Complete and qualified successes were achieved in 71 eyes (63.4%) and 29 eyes (25.9%), respectively. Visual acuities were 20/40 or better in 78 (59.5%) of 131 eyes examined and were poorer than 20/200 in 32 eyes (24.4%). The causes of poor visual acuities were mainly progression of glaucoma, including delay of detection of onset or surgery and amblyopia. Eyes with glaucoma that existed before 2 months of age or eyes that needed several trabeculotomies were considered to have poor visual acuity. Visual fields were classified as normal or almost normal in 21 (44.7%) of 47 eyes. CONCLUSIONS: Trabeculotomy for developmental glaucoma is effective over a long time. There is a fairly good prognosis for visual function of eyes with developmental glaucoma with early detection of the onset, proper treatment, and proper management after Trabeculotomy.
-
Surgical effects of combined Trabeculotomy and sinusotomy compared to Trabeculotomy alone.
Acta Ophthalmologica Scandinavica, 2000Co-Authors: Takanori Mizoguchi, Makoto Nagata, Miyo Matsumura, Shin Ichirou Kuroda, Terauchi H, Hidenobu TaniharaAbstract:. Purpose: To elucidate long-term surgical results and problems of combined Trabeculotomy and sinusotomy in comparison with Trabeculotomy alone. Methods: The study included 91 glaucomatous eyes in 57 patients with primary open angle glaucoma, who underwent either combined Trabeculotomy and sinusotomy (40 eyes) or Trabeculotomy alone (51 eyes). The mean follow-up period (±standard deviation) was 46.1±10.4 months (range: 30 to 60 months). Results: At the final examination, in 37 (93%) of the 40 eyes after combined Trabeculotomy and sinusotomy and in 40 (78%) of the 51 eyes after Trabeculotomy alone, intraocular pressures were well controlled. The mean intraocular pressures at the end of the first postoperative year were 15.6±3.0 mmHg in the 40 eyes after the combined procedure, and 17.8±3.1 mmHg in the 51 eyes after Trabeculotomy alone (p=0.0001, unpaired t-test). Complications included Descemet's membrane detachment in 1 eye (3%) and 4 eyes (8%), and transient elevation of intraocular pressure to higher than 30 mmHg (IOP spike) in 6 eyes (15%) and 11 eyes (22%), respectively, after the combined procedure and Trabeculotomy alone. Conclusion: Combined Trabeculotomy and sinusotomy is a useful surgical modality for the treatment of primary open angle glaucoma to obtain lower intraocular pressure levels than those after Trabeculotomy alone.
-
Surgical effects of Trabeculotomy after long-term topical antiglaucoma medications
Japanese Journal of Ophthalmology, 1995Co-Authors: Takanori Mizoguchi, Miyo Matsumura, Terauchi H, Shinichiro Kuroda, Makoto NagataAbstract:: We retrospectively analyzed the effects of long-term topical antiglaucoma therapy on the results of Trabeculotomy. We studied 83 eyes with 76 primary open angle glaucoma and 7 eyes with capsular glaucoma, each of which had undergone Trabeculotomy alone and none of which had a history of laser trabeculoplasty or glaucoma surgery. The outcome of Trabeculotomy was assessed after a minimum follow-up of 12 months. Using a life-table method, there was no significant difference in the outcome of Trabeculotomy between groups divided by duration and type of preoperative topical therapy. There was not statistically significant difference in the intraocular pressure reduction between the groups of long or short duration of topical therapy. We concluded that the duration and type of topical antiglaucoma medications had no significant effect on the outcome of Trabeculotomy.
-
Long-term results of non-filtering surgery for the treatment of primary angle-closure glaucoma
Graefe's Archive for Clinical and Experimental Ophthalmology, 1995Co-Authors: Hidenobu Tanihara, Akira Negi, Masayuki Akimoto, Makoto NagataAbstract:• Background: We previously reported the effectiveness of goniosynechialysis and Trabeculotomy ab externo for adult-onset glaucoma. In this study, we performed non-filtering surgery on patients with primary angle-closure glaucoma and studied the long-term outcome of this treatment. • Methods: Included in this study were 35 eyes of 25 patients with primary angle-closure glaucoma, each of which had an intraocular pressure greater than 20 mmHg with maximal tolerated antiglaucoma medication, even after laser iridotomy or surgical iridectomy. Of these 35 eyes, 22 underwent Trabeculotomy and 13 underwent goniosynechialysis. All patients were followed up for at least 18 months. • Results: In 21 (95%) of 22 eyes after Trabeculotomy, and in 12 (92%) of 13 eyes after goniosynechialysis, intraocular pressures were well controlled at or below 21 mmHg at the final examination. However, in two of the 21 eyes in which Trabeculotomy was a success, and in four of the 12 eyes in which goniosynechialysis was successful, the procedure had to be repeated before adequate control of pressure was achieved. • Conclusion: Our results show that intraocular pressure in most cases of primary angle-closure glaucoma can be controlled by restructuring of the physiologic aqueous outflow route by means of goniosynechialysis or Trabeculotomy, and that filtering surgery is not necessary.
-
long term surgical results of combined Trabeculotomy ab externo and cataract extraction
Ophthalmic surgery, 1995Co-Authors: Hidenobu Tanihara, Akira Negi, Masayuki Akimoto, Makoto NagataAbstract:: Trabeculotomy ab externo has been demonstrated to be effective in controlling intraocular pressure (IOP) in adult patients with either primary open-angle glaucoma or pseudoexfoliation syndrome. We evaluated the surgical outcome of 60 eyes with either primary open-angle glaucoma or pseudoexfoliation syndrome that underwent combined Trabeculotomy ab externo and cataract extraction. All patients were at least 40 years old, and were followed for at least 1 year. At the final examination, IOP was well controlled (21 mm Hg or less) in 54 (90%) of the 60 eyes, with or without medication. Also, "overall success" (ie, stabilization of IOP, visual field, and optic nerve status) was achieved in 49 (81.7%). Complications included fibrin exudation (22%), transient IOP elevation (17%), early perforation of the probe into the anterior chamber (10%), and detachment of Descemet's membrane (5%). We recommend combined Trabeculotomy ab externo and cataract extraction in selected cases of glaucoma with coexisting cataract. For cases in which the target IOP level is in the low teens, or for patients who may not tolerate postoperative fluctuations in IOP, we do not recommend Trabeculotomy ab externo. Also, in eyes that have normal-tension glaucoma, or that have already sustained severe damage to the optic nerve, visual dysfunction caused by glaucomatous changes may progress even after successful combined Trabeculotomy ab externo and cataract extraction.
Ghada Gawdat - One of the best experts on this subject based on the ideXlab platform.
-
factors influencing the outcome of goniotomy and Trabeculotomy in primary congenital glaucoma
British Journal of Ophthalmology, 2019Co-Authors: Yasmine El Sayed, Amanne F Esmael, Nader Mettias, Zeinab El Sanabary, Ghada GawdatAbstract:Purpose To study the prognostic factors influencing intraocular pressure (IOP) reduction and success rates of paediatric goniotomy and Trabeculotomy. Patients Data from patients aged ≤12 years who underwent goniotomy or Trabeculotomy for primary congenital glaucoma from 2013 to 2016 were reviewed. The analysis included 452 eyes of which 120 eyes of patients with a median age (IQR) of 6 months (4.1–11 months) underwent goniotomy, and 332 eyes of patients with a median age of 5.2 months (2.3–9.3 months) underwent Trabeculotomy. Methods Multivariate linear regression analysis was used to predict the correlation of preoperative and operative risk factors to the per cent IOP reduction, while multivariate logistic regression was done to determine independent predictors of failure. Failure was defined as a final IOP >18 mm Hg while on medications or the need for another glaucoma procedure. Results In the goniotomy group, the median IOP reduction was 19.4% and was positively correlated to a high initial IOP (p≤0.001) while in the Trabeculotomy group, it was 36.8% and mostly influenced by preoperative IOP (p≤0.001), corneal clarity (p=0.04), gender (p=0.04) and consanguinity (p=0.03). The failure rate in the goniotomy group was 56% and was influenced by the preoperative cup-to-disc ratio, while in the Trabeculotomy group it was 30% and strongly correlated to positive consanguinity (p≤0.001), higher preoperative IOP (p=0.003), female gender (p=0.01) and younger age at surgery (p=0.03). Conclusion Several factors can predict the outcome of angle surgery and can help in deciding the appropriate surgical intervention in paediatric glaucoma. Trabeculotomy seems to be superior to goniotomy in primary congenital glaucoma.
-
Microcatheter-assisted Trabeculotomy Versus 2-site Trabeculotomy With the Rigid Probe Trabeculotome in Primary Congenital Glaucoma.
Journal of Glaucoma, 2018Co-Authors: Yasmine M. El Sayed, Ghada GawdatAbstract:PURPOSE: The purpose of this study was to compare the outcomes of microcatheter-assisted Trabeculotomy to circumferential Trabeculotomy using the rigid probe trabeculotome in primary congenital glaucoma. METHODS: This retrospective study was performed in an institutional setting. The medical records of primary congenital glaucoma patients who underwent circumferential Trabeculotomy (≥270 degrees incised) using Glaucolight-illuminated microcatheter or a rigid probe trabeculotome were reviewed. The primary outcomes were the percent reduction of intraocular pressure (IOP) and success rates. Complete success was defined as achieving an IOP
-
microcatheter assisted Trabeculotomy versus 2 site Trabeculotomy with the rigid probe trabeculotome in primary congenital glaucoma
Journal of Glaucoma, 2018Co-Authors: Yasmine El M Sayed, Ghada GawdatAbstract:PURPOSE: The purpose of this study was to compare the outcomes of microcatheter-assisted Trabeculotomy to circumferential Trabeculotomy using the rigid probe trabeculotome in primary congenital glaucoma. METHODS: This retrospective study was performed in an institutional setting. The medical records of primary congenital glaucoma patients who underwent circumferential Trabeculotomy (≥270 degrees incised) using Glaucolight-illuminated microcatheter or a rigid probe trabeculotome were reviewed. The primary outcomes were the percent reduction of intraocular pressure (IOP) and success rates. Complete success was defined as achieving an IOP<18 mm Hg without medications. Secondary outcomes were the postoperative IOP and glaucoma medications. RESULTS: The study included 92 eyes of 92 patients. Of these, 33 eyes of 33 patients aged 6.4±8.7 months underwent microcatheter-assisted Trabeculotomy creating a 336±34-degree incision, with 19 eyes (58%) having a complete 360-degree incision. The other 59 eyes of 59 patients aged 8.2±13.1 months underwent 2-site Trabeculotomy, using a rigid probe trabeculotome through a combined superonasal and inferotemporal approach, creating a 338±29-degree incision, with 33 eyes (56%) having a complete incision. After a follow-up of 21.2±8.9 months, there was a 42%±25% IOP reduction and a 73% rate of complete success in the microcatheter group, compared with 40%±22% IOP reduction and an 80% success rate in the rigid probe group (P=0.7 and 0.3, respectively). There was no significant difference in survival time in both groups (P=0.6). CONCLUSION: Circumferential Trabeculotomy using either the illuminated microcatheter or rigid probe trabeculotome yielded comparable results; however, the added cost of the microcatheter should be considered.
-
Two‐year results of microcatheter‐assisted Trabeculotomy in paediatric glaucoma: a randomized controlled study
Acta Ophthalmologica, 2017Co-Authors: Yasmine El Sayed, Ghada GawdatAbstract:Purpose To compare the outcomes of microcatheter-assisted circumferential Trabeculotomy to standard rigid probe Trabeculotomy in childhood glaucomas. Methods Eyes of children requiring Trabeculotomy for primary congenital or secondary paediatric glaucoma were randomized to undergo either Trabeculotomy using the Glaucolight illuminated microcatheter, or a rigid probe Trabeculotomy. Complete success was defined as an intraocular pressure (IOP) of
-
two year results of microcatheter assisted Trabeculotomy in paediatric glaucoma a randomized controlled study
Acta Ophthalmologica, 2017Co-Authors: Yasmine El Sayed, Ghada GawdatAbstract:Purpose To compare the outcomes of microcatheter-assisted circumferential Trabeculotomy to standard rigid probe Trabeculotomy in childhood glaucomas. Methods Eyes of children requiring Trabeculotomy for primary congenital or secondary paediatric glaucoma were randomized to undergo either Trabeculotomy using the Glaucolight illuminated microcatheter, or a rigid probe Trabeculotomy. Complete success was defined as an intraocular pressure (IOP) of <18 mmHg without medications. Results A total of 62 eyes of 62 patients were included. Of these 30 eyes of 30 patients aged 5.6 ± 4.8 months underwent microcatheter-assisted Trabeculotomy, with 15 eyes (50%) having a complete 360° cut, while 15 eyes (50%) had an incomplete cut ranging from 250 to 350 degrees. The rigid probe Trabeculotomy group included 32 eyes of 32 patients aged 4.4 ± 3.8 months. At the end of the 2-year follow-up period, the complete success and the failure rates were 67% and 15%, respectively, in the microcatheter-assisted group versus 47% and 50% in the rigid probe Trabeculotomy group (p = 0.006). There was a tendency towards lower IOP in the microcatheter group at 1, 3, 6, 12 and 24 months postoperatively, with the difference in IOP reaching statistical significance at 6 months (p = 0.004). The mean survival time was significantly longer for the microcatheter group (p = 0.01). Conclusion At 2 years postoperatively, microcatheter-assisted Trabeculotomy still yielded superior results in terms of IOP control and success rates in children with primary congenital glaucoma. The need for reoperation for glaucoma was significantly lower in the microcatheter group.
Hidenobu Tanihara - One of the best experts on this subject based on the ideXlab platform.
-
success rates of Trabeculotomy for steroid induced glaucoma a comparative multicenter retrospective cohort study
American Journal of Ophthalmology, 2011Co-Authors: Masaru Inatani, Keiichiro Iwao, Hidenobu TaniharaAbstract:Purpose To evaluate the surgical outcomes of Trabeculotomy for steroid-induced glaucoma. Design Multicenter, retrospective cohort study. Methods At 17 Japanese clinical centers, 121 steroid-induced glaucoma patients who underwent Trabeculotomy between 1997 and 2006 were reviewed. Surgical failure was defined by the need for additional glaucoma surgery, deterioration of visual acuity to no light perception, or intraocular pressure ≥21 mm Hg (criterion A) and ≥18 mm Hg (criterion B). Surgical outcomes were compared with those of 108 primary open-angle glaucoma (POAG) patients who underwent Trabeculotomy and 42 steroid-induced glaucoma patients who underwent trabeculectomy. Prognostic factors for failure were evaluated using the Cox proportional hazards model. Results The probabilities of success at 3 years for Trabeculotomy for steroid-induced glaucoma vs Trabeculotomy for POAG was 78.1% vs 55.8% for criterion A ( P = .0008) and 56.4% vs 30.6% for criterion B ( P P = .3636), but lower for criterion B (71.6%; P = .0352). Prognostic factors for failure of Trabeculotomy for steroid-induced glaucoma were previous vitrectomy (relative risk [RR] = 5.340; P = .0452 on criterion A, RR=3.898; P = .0360 for criterion B) and corticosteroid administration other than ocular instillation (RR = 2.752; P = .0352 for criterion B). Conclusions Trabeculotomy is effective for controlling intraocular pressure
-
long term outcome of Trabeculotomy for the treatment of developmental glaucoma
Archives of Ophthalmology, 2004Co-Authors: Hanako Ikeda, Hidenobu Tanihara, Hitoshi Ishigooka, Tomoyuki Muto, Makoto NagataAbstract:OBJECTIVE: To elucidate long-term outcome of Trabeculotomy in primary and secondary developmental glaucoma. METHODS: One hundred forty-nine eyes of 89 patients with developmental glaucoma who underwent Trabeculotomy were retrospectively studied. Intraocular pressure (IOP), success probabilities, visual acuities, and visual field were determined during follow-up and at the final visit. RESULTS: The mean +/- SD IOP of 112 eyes with primary developmental glaucoma at the final visit with an mean +/- SD follow-up period of 9.5 +/- 7.1 years was 15.6 +/- 5.0 mm Hg. The average IOP for 37 eyes with secondary developmental glaucoma was 16.7 +/- 4.2 mm Hg. One hundred eyes (89.3%) with primary developmental glaucoma were defined as achieving success at the final visit. Complete and qualified successes were achieved in 71 eyes (63.4%) and 29 eyes (25.9%), respectively. Visual acuities were 20/40 or better in 78 (59.5%) of 131 eyes examined and were poorer than 20/200 in 32 eyes (24.4%). The causes of poor visual acuities were mainly progression of glaucoma, including delay of detection of onset or surgery and amblyopia. Eyes with glaucoma that existed before 2 months of age or eyes that needed several trabeculotomies were considered to have poor visual acuity. Visual fields were classified as normal or almost normal in 21 (44.7%) of 47 eyes. CONCLUSIONS: Trabeculotomy for developmental glaucoma is effective over a long time. There is a fairly good prognosis for visual function of eyes with developmental glaucoma with early detection of the onset, proper treatment, and proper management after Trabeculotomy.
-
external Trabeculotomy for the treatment of steroid induced glaucoma
Journal of Glaucoma, 2000Co-Authors: Megumi Honjo, Hidenobu Tanihara, Masaru Inatani, Yoshihito HondaAbstract:PURPOSE: To investigate the effect of external Trabeculotomy on eyes with steroid-induced glaucoma. METHODS: We retrospectively analyzed the surgical results of 14 eyes of seven patients that underwent Trabeculotomy for the first surgical procedure. All patients had the history of receiving topical or systemic corticosteroids before the rise of intraocular pressure had been noted. RESULTS: After an average follow-up of 60.6 +/- 33.5 months, in all of the 14 eyes, intraocular pressure was well controlled below or equal to 21 mm Hg at the final examinations. CONCLUSIONS: Surgical results of external Trabeculotomy remain effective for a long time. It has been shown that the Trabeculotomy can be a useful and effective surgical treatment of patients with steroid-induced glaucoma.
-
Surgical effects of combined Trabeculotomy and sinusotomy compared to Trabeculotomy alone.
Acta Ophthalmologica Scandinavica, 2000Co-Authors: Takanori Mizoguchi, Makoto Nagata, Miyo Matsumura, Shin Ichirou Kuroda, Terauchi H, Hidenobu TaniharaAbstract:. Purpose: To elucidate long-term surgical results and problems of combined Trabeculotomy and sinusotomy in comparison with Trabeculotomy alone. Methods: The study included 91 glaucomatous eyes in 57 patients with primary open angle glaucoma, who underwent either combined Trabeculotomy and sinusotomy (40 eyes) or Trabeculotomy alone (51 eyes). The mean follow-up period (±standard deviation) was 46.1±10.4 months (range: 30 to 60 months). Results: At the final examination, in 37 (93%) of the 40 eyes after combined Trabeculotomy and sinusotomy and in 40 (78%) of the 51 eyes after Trabeculotomy alone, intraocular pressures were well controlled. The mean intraocular pressures at the end of the first postoperative year were 15.6±3.0 mmHg in the 40 eyes after the combined procedure, and 17.8±3.1 mmHg in the 51 eyes after Trabeculotomy alone (p=0.0001, unpaired t-test). Complications included Descemet's membrane detachment in 1 eye (3%) and 4 eyes (8%), and transient elevation of intraocular pressure to higher than 30 mmHg (IOP spike) in 6 eyes (15%) and 11 eyes (22%), respectively, after the combined procedure and Trabeculotomy alone. Conclusion: Combined Trabeculotomy and sinusotomy is a useful surgical modality for the treatment of primary open angle glaucoma to obtain lower intraocular pressure levels than those after Trabeculotomy alone.
-
Long-term results of non-filtering surgery for the treatment of primary angle-closure glaucoma
Graefe's Archive for Clinical and Experimental Ophthalmology, 1995Co-Authors: Hidenobu Tanihara, Akira Negi, Masayuki Akimoto, Makoto NagataAbstract:• Background: We previously reported the effectiveness of goniosynechialysis and Trabeculotomy ab externo for adult-onset glaucoma. In this study, we performed non-filtering surgery on patients with primary angle-closure glaucoma and studied the long-term outcome of this treatment. • Methods: Included in this study were 35 eyes of 25 patients with primary angle-closure glaucoma, each of which had an intraocular pressure greater than 20 mmHg with maximal tolerated antiglaucoma medication, even after laser iridotomy or surgical iridectomy. Of these 35 eyes, 22 underwent Trabeculotomy and 13 underwent goniosynechialysis. All patients were followed up for at least 18 months. • Results: In 21 (95%) of 22 eyes after Trabeculotomy, and in 12 (92%) of 13 eyes after goniosynechialysis, intraocular pressures were well controlled at or below 21 mmHg at the final examination. However, in two of the 21 eyes in which Trabeculotomy was a success, and in four of the 12 eyes in which goniosynechialysis was successful, the procedure had to be repeated before adequate control of pressure was achieved. • Conclusion: Our results show that intraocular pressure in most cases of primary angle-closure glaucoma can be controlled by restructuring of the physiologic aqueous outflow route by means of goniosynechialysis or Trabeculotomy, and that filtering surgery is not necessary.
Masayuki Akimoto - One of the best experts on this subject based on the ideXlab platform.
-
Long-term results of non-filtering surgery for the treatment of primary angle-closure glaucoma
Graefe's Archive for Clinical and Experimental Ophthalmology, 1995Co-Authors: Hidenobu Tanihara, Akira Negi, Masayuki Akimoto, Makoto NagataAbstract:• Background: We previously reported the effectiveness of goniosynechialysis and Trabeculotomy ab externo for adult-onset glaucoma. In this study, we performed non-filtering surgery on patients with primary angle-closure glaucoma and studied the long-term outcome of this treatment. • Methods: Included in this study were 35 eyes of 25 patients with primary angle-closure glaucoma, each of which had an intraocular pressure greater than 20 mmHg with maximal tolerated antiglaucoma medication, even after laser iridotomy or surgical iridectomy. Of these 35 eyes, 22 underwent Trabeculotomy and 13 underwent goniosynechialysis. All patients were followed up for at least 18 months. • Results: In 21 (95%) of 22 eyes after Trabeculotomy, and in 12 (92%) of 13 eyes after goniosynechialysis, intraocular pressures were well controlled at or below 21 mmHg at the final examination. However, in two of the 21 eyes in which Trabeculotomy was a success, and in four of the 12 eyes in which goniosynechialysis was successful, the procedure had to be repeated before adequate control of pressure was achieved. • Conclusion: Our results show that intraocular pressure in most cases of primary angle-closure glaucoma can be controlled by restructuring of the physiologic aqueous outflow route by means of goniosynechialysis or Trabeculotomy, and that filtering surgery is not necessary.
-
long term surgical results of combined Trabeculotomy ab externo and cataract extraction
Ophthalmic surgery, 1995Co-Authors: Hidenobu Tanihara, Akira Negi, Masayuki Akimoto, Makoto NagataAbstract:: Trabeculotomy ab externo has been demonstrated to be effective in controlling intraocular pressure (IOP) in adult patients with either primary open-angle glaucoma or pseudoexfoliation syndrome. We evaluated the surgical outcome of 60 eyes with either primary open-angle glaucoma or pseudoexfoliation syndrome that underwent combined Trabeculotomy ab externo and cataract extraction. All patients were at least 40 years old, and were followed for at least 1 year. At the final examination, IOP was well controlled (21 mm Hg or less) in 54 (90%) of the 60 eyes, with or without medication. Also, "overall success" (ie, stabilization of IOP, visual field, and optic nerve status) was achieved in 49 (81.7%). Complications included fibrin exudation (22%), transient IOP elevation (17%), early perforation of the probe into the anterior chamber (10%), and detachment of Descemet's membrane (5%). We recommend combined Trabeculotomy ab externo and cataract extraction in selected cases of glaucoma with coexisting cataract. For cases in which the target IOP level is in the low teens, or for patients who may not tolerate postoperative fluctuations in IOP, we do not recommend Trabeculotomy ab externo. Also, in eyes that have normal-tension glaucoma, or that have already sustained severe damage to the optic nerve, visual dysfunction caused by glaucomatous changes may progress even after successful combined Trabeculotomy ab externo and cataract extraction.
-
surgical results of Trabeculotomy ab externo for developmental glaucoma
Archives of Ophthalmology, 1994Co-Authors: Masayuki Akimoto, Akira Negi, Hidenobu Tanihara, Makoto NagataAbstract:OBJECTIVE: To elucidate long-term surgical outcome of Trabeculotomy ab externo in the treatment of developmental glaucoma. PATIENTS: Included in this retrospective study are 116 eyes of 71 patients with developmental glaucoma. We classified patients into three groups based on their age: congenital (33 eyes), existing before age 2 months; infantile (31 eyes), occurring from ages 2 months to 2 years; and juvenile (52 eyes), age 2 years or older. RESULTS: A life-table analysis showed that the total success probabilities at 5 and 10 years with one or more Trabeculotomy ab externo operations were, respectively, 92.5% +/- 2.7% and 76.5% +/- 6.2%. The success probability of patients with congenital glaucoma (60.3% +/- 15.9%) was significantly lower than it was for those with infantile (96.3% +/- 3.6%) or juvenile (76.4% +/- 7.5%) glaucoma (P < .01 for both). CONCLUSIONS: Surgical results of Trabeculotomy ab externo remain effective for a long time. Congenital glaucoma has the worst prognosis, and infantile glaucoma has a better prognosis than does juvenile glaucoma.
-
surgical effects of Trabeculotomy ab externo on adult eyes with primary open angle glaucoma and pseudoexfoliation syndrome
Archives of Ophthalmology, 1993Co-Authors: Hidenobu Tanihara, Akira Negi, Masayuki Akimoto, Hiroshi Terauchi, Akihisa Okudaira, Jun Kozaki, Atsushi Takeuchi, Makoto NagataAbstract:Objectives: Retrospective and prospective studies examined the surgical effects in lowering intraocular pressure levels of Trabeculotomy ab externo in adult eyes with either primary open angle glaucoma or pseudoexfoliation syndrome. We report the results of primary Trabeculotomy as an intervention for glaucoma. Patients: Included in the retrospective study were 357 eyes of 227 patients with primary open angle glaucoma and 82 eyes of 65 patients with pseudoexfoliation syndrome, each of which underwent Trabeculotomy ab externo alone and none of which had a history of laser or surgical treatment for ocular disease. Included in the prospective study were 33 eyes of 22 patients with primary open angle glaucoma and 17 eyes of 15 patients (older than 40 years) with pseudoexfoliation syndrome. Results: A life-table analysis for the retrospective study showed that the final success probability (mean±SE) at 5 years after surgery was 73.5%±6.3% in eyes with pseudoexfoliation syndrome, which is significantly better than 58.0%±3.1% in eyes with primary open angle glaucoma (P Conclusion: The surgical results of Trabeculotomy ab externo remain effective in controlling intraocular pressure levels for a long time in selected patients. It thus appears that Trabeculotomy ab externo can be considered as an alternative choice of surgical treatment in some cases of glaucoma.
Akira Negi - One of the best experts on this subject based on the ideXlab platform.
-
Long-term results of non-filtering surgery for the treatment of primary angle-closure glaucoma
Graefe's Archive for Clinical and Experimental Ophthalmology, 1995Co-Authors: Hidenobu Tanihara, Akira Negi, Masayuki Akimoto, Makoto NagataAbstract:• Background: We previously reported the effectiveness of goniosynechialysis and Trabeculotomy ab externo for adult-onset glaucoma. In this study, we performed non-filtering surgery on patients with primary angle-closure glaucoma and studied the long-term outcome of this treatment. • Methods: Included in this study were 35 eyes of 25 patients with primary angle-closure glaucoma, each of which had an intraocular pressure greater than 20 mmHg with maximal tolerated antiglaucoma medication, even after laser iridotomy or surgical iridectomy. Of these 35 eyes, 22 underwent Trabeculotomy and 13 underwent goniosynechialysis. All patients were followed up for at least 18 months. • Results: In 21 (95%) of 22 eyes after Trabeculotomy, and in 12 (92%) of 13 eyes after goniosynechialysis, intraocular pressures were well controlled at or below 21 mmHg at the final examination. However, in two of the 21 eyes in which Trabeculotomy was a success, and in four of the 12 eyes in which goniosynechialysis was successful, the procedure had to be repeated before adequate control of pressure was achieved. • Conclusion: Our results show that intraocular pressure in most cases of primary angle-closure glaucoma can be controlled by restructuring of the physiologic aqueous outflow route by means of goniosynechialysis or Trabeculotomy, and that filtering surgery is not necessary.
-
long term surgical results of combined Trabeculotomy ab externo and cataract extraction
Ophthalmic surgery, 1995Co-Authors: Hidenobu Tanihara, Akira Negi, Masayuki Akimoto, Makoto NagataAbstract:: Trabeculotomy ab externo has been demonstrated to be effective in controlling intraocular pressure (IOP) in adult patients with either primary open-angle glaucoma or pseudoexfoliation syndrome. We evaluated the surgical outcome of 60 eyes with either primary open-angle glaucoma or pseudoexfoliation syndrome that underwent combined Trabeculotomy ab externo and cataract extraction. All patients were at least 40 years old, and were followed for at least 1 year. At the final examination, IOP was well controlled (21 mm Hg or less) in 54 (90%) of the 60 eyes, with or without medication. Also, "overall success" (ie, stabilization of IOP, visual field, and optic nerve status) was achieved in 49 (81.7%). Complications included fibrin exudation (22%), transient IOP elevation (17%), early perforation of the probe into the anterior chamber (10%), and detachment of Descemet's membrane (5%). We recommend combined Trabeculotomy ab externo and cataract extraction in selected cases of glaucoma with coexisting cataract. For cases in which the target IOP level is in the low teens, or for patients who may not tolerate postoperative fluctuations in IOP, we do not recommend Trabeculotomy ab externo. Also, in eyes that have normal-tension glaucoma, or that have already sustained severe damage to the optic nerve, visual dysfunction caused by glaucomatous changes may progress even after successful combined Trabeculotomy ab externo and cataract extraction.
-
surgical results of Trabeculotomy ab externo for developmental glaucoma
Archives of Ophthalmology, 1994Co-Authors: Masayuki Akimoto, Akira Negi, Hidenobu Tanihara, Makoto NagataAbstract:OBJECTIVE: To elucidate long-term surgical outcome of Trabeculotomy ab externo in the treatment of developmental glaucoma. PATIENTS: Included in this retrospective study are 116 eyes of 71 patients with developmental glaucoma. We classified patients into three groups based on their age: congenital (33 eyes), existing before age 2 months; infantile (31 eyes), occurring from ages 2 months to 2 years; and juvenile (52 eyes), age 2 years or older. RESULTS: A life-table analysis showed that the total success probabilities at 5 and 10 years with one or more Trabeculotomy ab externo operations were, respectively, 92.5% +/- 2.7% and 76.5% +/- 6.2%. The success probability of patients with congenital glaucoma (60.3% +/- 15.9%) was significantly lower than it was for those with infantile (96.3% +/- 3.6%) or juvenile (76.4% +/- 7.5%) glaucoma (P < .01 for both). CONCLUSIONS: Surgical results of Trabeculotomy ab externo remain effective for a long time. Congenital glaucoma has the worst prognosis, and infantile glaucoma has a better prognosis than does juvenile glaucoma.
-
surgical effects of Trabeculotomy ab externo on adult eyes with primary open angle glaucoma and pseudoexfoliation syndrome
Archives of Ophthalmology, 1993Co-Authors: Hidenobu Tanihara, Akira Negi, Masayuki Akimoto, Hiroshi Terauchi, Akihisa Okudaira, Jun Kozaki, Atsushi Takeuchi, Makoto NagataAbstract:Objectives: Retrospective and prospective studies examined the surgical effects in lowering intraocular pressure levels of Trabeculotomy ab externo in adult eyes with either primary open angle glaucoma or pseudoexfoliation syndrome. We report the results of primary Trabeculotomy as an intervention for glaucoma. Patients: Included in the retrospective study were 357 eyes of 227 patients with primary open angle glaucoma and 82 eyes of 65 patients with pseudoexfoliation syndrome, each of which underwent Trabeculotomy ab externo alone and none of which had a history of laser or surgical treatment for ocular disease. Included in the prospective study were 33 eyes of 22 patients with primary open angle glaucoma and 17 eyes of 15 patients (older than 40 years) with pseudoexfoliation syndrome. Results: A life-table analysis for the retrospective study showed that the final success probability (mean±SE) at 5 years after surgery was 73.5%±6.3% in eyes with pseudoexfoliation syndrome, which is significantly better than 58.0%±3.1% in eyes with primary open angle glaucoma (P Conclusion: The surgical results of Trabeculotomy ab externo remain effective in controlling intraocular pressure levels for a long time in selected patients. It thus appears that Trabeculotomy ab externo can be considered as an alternative choice of surgical treatment in some cases of glaucoma.
