scholarly journals Effectiveness of trabeculectomy with mitomycin C for glaucomatous eyes with low intraocular pressure on treatment eye drops

2019 ◽  
Vol 98 (1) ◽  
Author(s):  
Yuki Yuasa ◽  
Yosuke Sugimoto ◽  
Kazuyuki Hirooka ◽  
Shinji Ohkubo ◽  
Tomomi Higashide ◽  
...  
2020 ◽  
Vol 17 (1) ◽  
pp. 128-131
Author(s):  
Keith Ong ◽  
Leonard Ong

Purpose: Subconjunctival fibrosis is one of the main causes of failure of glaucoma filtration surgery. It can result in absence of a filtration bleb, a small scarred bleb, or a cystic bleb. 5-Fluorouracil (5-FU), mitomycin C (MMC), and topical steroids have been used to suppress subconjunctival fibrosis. Method: A study was done analyzing the number of postoperative subconjunctival 5-FU injections for trabeculectomy on pseudophakic eyes prior to and following the change to a BAK-free regimen. The cohort consisted of 16 consecutive cases undergoing primary trabeculectomy without intraoperative MMC or 5-FU. The trabeculectomy surgery included a groove sclerectomy procedure. Group A were 8 eyes of patients who had the author’s standard Chlorsig, Maxidex, and Prednefrin Forte eye drops tds. Group B were 8 eyes who had Chlorsig-dexamethasone and Optive-dexamethasone tds eye drops postoperatively. Results: Group B (BAK-free) patients required fewer postoperative 5-FU subconjunctival injections (average: 2.9, range: 1-5 injections) compared to Group A (BAK) patients (average: 7.3, range: 4-18 injections). This difference was statistically significant (P = 0.02, unpaired t-test). All patients had functioning blebs and did not require glaucoma medications to maintain target intraocular pressure. The Group B (BAK-free) patients had more diffuse blebs than the Group A (BAK) patients. Conclusion: The results demonstrated that when BAK was eliminated from postoperative eye drops in trabeculectomy, the number of postoperative 5-FU injections was reduced.


2018 ◽  
Vol 6 ◽  
pp. 205031211878226
Author(s):  
Marcelo Ayala

Aim: To evaluate the results of a long-term follow-up after two different types of surgical techniques: trabeculectomy with or without mitomycin-C. Materials and methods: This study is a retrospective chart review of patients operated on with a primary trabeculectomy at the Eye Department of the Skaraborg Hospital, Skövde, Sweden. Complete success was defined as intraocular pressure ⩽18 mmHg (criterion 1) or intraocular pressure reduction ⩾30% (criterion 2) without eye drops postoperatively. Qualified success was defined using the same criteria (1 and 2), but patients were treated or untreated with eye-drops. Results: A total of 167 patients were included in this retrospective study, 83 patients in the no-mitomycin-C group and 84 patients in the mitomycin-C-treated group. No significant difference was found in intraocular pressure reduction between the mitomycin-C and no-mitomycin-C group (t-test; p = 0.19). Complete success using criterion 1 was 66.2% in no-mitomycin-C and 62.8% in mitomycin-C (p = 0.88); success using criterion 2 was 76.6% in the no-mitomycin-C and 64.2% in the mitomycin-C group (p = 0.21). Qualified success using criterion 1 was 71.4% in the no-mitomycin-C and 74.4% in the mitomycin-C group (p = 0.84); success using criterion 2 was 80.0% in the no-mitomycin-C and 84.4% in the mitomycin-C group. All included patients were born in Sweden. Conclusion: Mitomycin-C seems to add no benefits to intraocular pressure reduction after primary trabeculectomies in a Swedish population.


Author(s):  
Magdalena Gumińska ◽  
Roman Goś ◽  
Janusz Śmigielski ◽  
Michał Szymon Nowak

Purpose: The evaluation of the efficacy of topical hypotensive treatment and/or systemic corticosteroids therapy in patients with elevated intraocular pressure and Graves’ orbitopathy (GO). Methods: 172 eyes in 86 individuals with duration of GO ≥ 3 months, intraocular pressure in either eye ≥ 25.0 mmHg and GO ranked ≥ 3 at least in one eye in modified CAS form, were included. The study subjects were divided into three treatment subgroups: subgroup I was administered latanoprost QD; subgroup II was administered a combined preparation of brimonidine and timolol BID; subgroup III was the control group, not receiving any topical hypotensive treatment. All the study participants received systemic treatment – intravenous corticosteroid therapy at the same dose, according to the EUGOGO guideline Results: On the final visit, the mean IOP value was significantly lower in all treatment subgroups comparing to the initial values. In both subgroups receiving topical treatment the IOP reduction was higher than in the control group receiving systemic corticosteroids only. However, the latanoprost eye drops decreased intraocular pressure more effectively than drops containing brimonidine and timolol. Conclusion: Topical ocular hypotensive treatment is effective in reducing intraocular pressure in GO and decreases intraocular pressure more effectively than systemic corticosteroid therapy alone.


Author(s):  
Panos Theodosiadis ◽  
Anastasios Konstas ◽  
Ioannis Halkiadakis ◽  
Vasiliki Dimera ◽  
Dimitrios Koufakis ◽  
...  

Background: The aim of this study was to test the non-inferiority of preservative-free (PF) latanoprost 50 μg/mL multi-dose ophthalmic solution versus the marketed benzalkonium chloride (BAK)-preserved latanoprost 50 μg/mL ophthalmic solution in patients with open-angle glaucoma and patients with ocular hypertension. Methods: This was a prospective, national, randomized, multi-center, observer-blind, parallel-group controlled clinical trial. Patients were randomized to receive either PF or BAK-preserved latanoprost once daily for 12 weeks. The primary endpoint was the change in intraocular pressure (IOP) at 8:00 AM in the affected eye between the end of the treatment (week 12) and the baseline (week 0). Secondary measurements were taken at weeks 2 and 6, with IOP being recorded at 8:00 AM, 12:00 PM, and 4:00 PM. Results: A total of 158 patients were included in the per protocol (PP) population (77 in the PF latanoprost treatment arm and 81 patients in the BAK-preserved latanoprost treatment arm). PF latanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP at 8:00 AM in the study eye from the baseline (week 0) to the end of the treatment (week 12). The point estimate of the between-treatment difference was 0.1 mmHg (95% confidence interval: -0.646, 0.847). Mean between-group differences in IOP reduction from the baseline to each of the secondary measurements were also similar between the two treatment arms. The two treatments were well tolerated and had comparable adverse event profiles. Conclusions: PF latanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP in patients with open-angle glaucoma or ocular hypertension. Both treatments were well tolerated.


2019 ◽  
Author(s):  
Hiroyuki Yazu ◽  
Dai Miyazaki ◽  
Hiroshi Fujishima

Abstract BACKGROUND: To examine the efficacy of 0.1% tacrolimus eye drops in the treatment of noninfectious, non-necrotizing anterior scleritis. METHODS: This prospective, single-arm study included nine patients (4 males and 5 females; mean age = 59.4 years, standard deviation = 10.5) with anterior scleritis. All patients were first treated with steroids for 1 month and then switched to tacrolimus eye drops alone. We defined baseline as the initiation of steroid or tacrolimus eye drops. Hyperemia and pain were scored before each treatment, at 1 and 2 weeks, and at 1 month after initiation of each treatment by using 5 grades (0 = none; 1+ = mild; 2+ = moderate; 3+ = severe; 4+ = extremely severe). Intraocular pressure (IOP) was also measured from baseline to 6 months after initiating tacrolimus eye drops. Safety was assessed based on the severity and the incidence of adverse events. RESULTS: The scores of hyperemia and pain had significantly decreased from baseline by 1 week after initiating tacrolimus eye drops (both P < 0.05). No significant reduction was observed with steroid treatment throughout the 1-month period in terms of both scores. Tacrolimus eye drops elicited statistically significant differences in mean IOP over the course of treatment (P = 0.02). No additional medications were required to provide relief in any of the patients receiving tacrolimus treatment. No patient had infectious adverse events after initiation of tacrolimus treatment. CONCLUSIONS: Topical tacrolimus may effectively and immediately reduce clinical signs and symptoms of noninfectious, non-necrotizing anterior scleritis. TRIAL REGISTRATION: This trial was prospectively registered on 16/10/2015 under the number (UMIN000034460).


Sign in / Sign up

Export Citation Format

Share Document