Background： Early surgical intervention is required for the primary congenital glaucoma （PCG）. There are currently few reports on the surgical outcomes in infants with PCG. This study aimed to evaluate the efficacy...Background： Early surgical intervention is required for the primary congenital glaucoma （PCG）. There are currently few reports on the surgical outcomes in infants with PCG. This study aimed to evaluate the efficacy and safety oftrabeculotomy and the postoperative visual outcomes in Chinese newborns with PCG within 4 weeks of birth. Methods： A total of 21 eyes of 12 patients with PCG who underwent primary trabeculotomy within 4 weeks of birth were retrospectively studied. Preoperative and postoperative intraocular pressure （lOP）, corneal clarity and diameter, axial length and optic disc cupping, visual acuity and postoperative refractive error, success rates, and complications were evaluated. Kaplan-Meier survival analysis was applied to evaluate the success rates. Results： The mean follow-up time was 46.9 ~ 34.4 months （range： 12-122 months）. The postoperative lOP was significantly lower than the preoperative lOP at all of the follow-up visits （P 〈 0.001 ）. The complete success rates for all eyes at 1,2, 3, and 5 years postoperatively were 90.5%, 85.7%, 85.7%, and 85.7%, respectively. The lOPs of the three patients who needed antiglaucomatous medications postoperatively were also well controlled. At the last visit, the cornea became clear, and the cup-to-disc ratio decreased significantly （P = 0.01） although the horizontal corneal diameter did not change significantly （P = 0.11 ）. Visual acuities were able to be recorded in eight eyes at the last visit, among which six eyes had a best-corrected visual acuity of 20/40 or better. There were no severe intraoperative or postoperative complications. Conclusions： Trabeculotomy proves to be a safe and effective treatment in reducing lOP in this group of Chinese newborns with PCG. The outcomes of vision function were satisfactory in most of the patients.展开更多
Background The extent of our knowledge of the epidemiology of pediatric glaucoma in China is limited. To better characterize the epidemiology of pediatric glaucoma in eastern China, we report the clinical profile, eti...Background The extent of our knowledge of the epidemiology of pediatric glaucoma in China is limited. To better characterize the epidemiology of pediatric glaucoma in eastern China, we report the clinical profile, etiologies, and treatment modalities in patients 〈18 years of age in Shanghai Eye, Ear, Nose and Throat Hospital. Methods The medical records of patients presenting glaucoma between January 2003 and December 2010 were retrospectively reviewed. The demographic characteristics, the proportion of different glaucoma subtypes and surgical precedures were collected and analyzed. Results A total of 1 142 eyes of 734 pediatric patients （500 males） were included. Congenital glaucoma was the leading subtype, accounting for 47.55% of all patients. The ratio of boys to girls was 2.5：1. Patients with congenital glaucoma affecting both eyes accounted for 72.5% of all patients examined. Patients with primary juvenile glaucoma were the second most common group （n=125, 17.03%）. Traumatic glaucoma was the third most common subtype （n=81, 11.03%）. The type of surgery was related to the subtype of glaucoma. Conclusions Congenital glaucoma, primary juvenile glaucoma, and traumatic glaucoma are the most prevalent subtypes in pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital. The characteristics of congenital glaucoma in China are similar to those in Western countries.展开更多
AIM： To evaluate the long-term outcome of viscocanalostomy combined with trabeculotomy and mitomycin C in the treatment of primary congenital glaucoma. METHODS： This is a retrospective study. Forty-two eyes of 26 p...AIM： To evaluate the long-term outcome of viscocanalostomy combined with trabeculotomy and mitomycin C in the treatment of primary congenital glaucoma. METHODS： This is a retrospective study. Forty-two eyes of 26 patients with primary congenital glaucoma were enrolled, Intraocular pressure （lOP）, corneal diameter （mm） and cup/disc （C/D） were measured before and after the surgery respectively. Follow-up period was 30mo. RESULTS： The mean preoperative lOP was 30.6：1：7.35 mm Hg. Of the 42 eyes, 2 eyes were required conversion to trabeculectomy for the absence of Schlemm＇s canal. Of remained 40 eyes, 38 eyes （95%） achieved successful lOP control. The average postoperative lOP was 11.69±4.18 mm Hg at 12mo. The mean reduction was 18.91 mm Hg （P〈0.00Ol）. Eighteen （75%） eyes presented a reduction in corneal diameter, and 25 （62.5%） eyes presented a C/D ratio reversal after the surgery. There was no serious complication in any patients over the follow-up period. CONCLUSION： Viscocanalostomy combined with trabeculotomy and mitomycin C is useful in the management of primary congenital glaucoma,展开更多
Purpose: To identify the clinical features of the syndrome Frank-Kamenetsky and determine the criteria of early formation of glaucoma. Materials and Methods: We observed 52 patients. Follow up period was from 5 to 22 ...Purpose: To identify the clinical features of the syndrome Frank-Kamenetsky and determine the criteria of early formation of glaucoma. Materials and Methods: We observed 52 patients. Follow up period was from 5 to 22 years. The first group (juvenile) consisted of males who had the first signs of glaucoma diagnosed before the age of 12 (n = 22). The average age of the group was 10.1 ± 2.4 years. The control group included healthy males (n = 30) in the same age range (average age 7.2 ± 1.6 years). The second group (adults) consisted of patients who had the first signs of glaucoma diagnosed after the age of 18 and elder. The average age of the group was 32.44 ± 6.28 years. The control group had males (n = 30) in the same age range (average age 26.59 ± 4.12 years). The inclusion criterion was: the presence of congenital bilateral mesodermal iris leaf hypoplasia, tra-becular dysgenesis signs, the presence of blood relatives on the maternal line (grandfather, uncle) male with similar changes iridociliary zone and glaucoma. Criteria of glaucoma formation were: increased IOP more than 21 mmHg with accompanying it expansion of the cup/disc ratio, reducing the thickness of the nerve fiber layer (RNFL) according to OCT. Results: It was found that Frank-Kamenetsky Syndrome had an X-linked with sex, recessive inheritance and was characterized by bilateral congenital irisdysgenesis and goniodysgenesis with the accession glaucoma. Predictors of glaucoma formation in early childhood are a combination of: 1) congenital subtotal atrophy of iris mesodermal layer (from 0 to 30 mkm) with signs of progressive dystrophy;2) nonprogressive congenital megalocornea (cornea diameter 12 - 14 mm);3) iridotrabecular dysgenesis of II-III degree;4) hyperopic refraction in axial myopia.展开更多
In traditional trabeculotomy,a radial incision is performed at the corneoscleral transition zone to locate the Schlemm＇s canal.However,in some conditions,finding the Schlemm＇s canal is difficult because of the enlar...In traditional trabeculotomy,a radial incision is performed at the corneoscleral transition zone to locate the Schlemm＇s canal.However,in some conditions,finding the Schlemm＇s canal is difficult because of the enlargement of the comea,developmental anomalies of the angle,etc.In our study,we performed a modified trabeculotomy,to locate the Schlemm＇s canal easily and accurately and evaluated the outcomes.展开更多
文摘Background： Early surgical intervention is required for the primary congenital glaucoma （PCG）. There are currently few reports on the surgical outcomes in infants with PCG. This study aimed to evaluate the efficacy and safety oftrabeculotomy and the postoperative visual outcomes in Chinese newborns with PCG within 4 weeks of birth. Methods： A total of 21 eyes of 12 patients with PCG who underwent primary trabeculotomy within 4 weeks of birth were retrospectively studied. Preoperative and postoperative intraocular pressure （lOP）, corneal clarity and diameter, axial length and optic disc cupping, visual acuity and postoperative refractive error, success rates, and complications were evaluated. Kaplan-Meier survival analysis was applied to evaluate the success rates. Results： The mean follow-up time was 46.9 ~ 34.4 months （range： 12-122 months）. The postoperative lOP was significantly lower than the preoperative lOP at all of the follow-up visits （P 〈 0.001 ）. The complete success rates for all eyes at 1,2, 3, and 5 years postoperatively were 90.5%, 85.7%, 85.7%, and 85.7%, respectively. The lOPs of the three patients who needed antiglaucomatous medications postoperatively were also well controlled. At the last visit, the cornea became clear, and the cup-to-disc ratio decreased significantly （P = 0.01） although the horizontal corneal diameter did not change significantly （P = 0.11 ）. Visual acuities were able to be recorded in eight eyes at the last visit, among which six eyes had a best-corrected visual acuity of 20/40 or better. There were no severe intraoperative or postoperative complications. Conclusions： Trabeculotomy proves to be a safe and effective treatment in reducing lOP in this group of Chinese newborns with PCG. The outcomes of vision function were satisfactory in most of the patients.
基金This work was supported by grants from the National Natural Science Foundation （No. NSFC81100667） and the Science and Technology Commission of Shanghai （No. 114119a7300）.Acknowledgments： We thank Prof. Chen Dongfeng and Yang Lanbo in Massachusetts Eye and Ear, Harvard Medical School, Boston, USA, for their great help to edit the English in the paper.
文摘Background The extent of our knowledge of the epidemiology of pediatric glaucoma in China is limited. To better characterize the epidemiology of pediatric glaucoma in eastern China, we report the clinical profile, etiologies, and treatment modalities in patients 〈18 years of age in Shanghai Eye, Ear, Nose and Throat Hospital. Methods The medical records of patients presenting glaucoma between January 2003 and December 2010 were retrospectively reviewed. The demographic characteristics, the proportion of different glaucoma subtypes and surgical precedures were collected and analyzed. Results A total of 1 142 eyes of 734 pediatric patients （500 males） were included. Congenital glaucoma was the leading subtype, accounting for 47.55% of all patients. The ratio of boys to girls was 2.5：1. Patients with congenital glaucoma affecting both eyes accounted for 72.5% of all patients examined. Patients with primary juvenile glaucoma were the second most common group （n=125, 17.03%）. Traumatic glaucoma was the third most common subtype （n=81, 11.03%）. The type of surgery was related to the subtype of glaucoma. Conclusions Congenital glaucoma, primary juvenile glaucoma, and traumatic glaucoma are the most prevalent subtypes in pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital. The characteristics of congenital glaucoma in China are similar to those in Western countries.
文摘AIM： To evaluate the long-term outcome of viscocanalostomy combined with trabeculotomy and mitomycin C in the treatment of primary congenital glaucoma. METHODS： This is a retrospective study. Forty-two eyes of 26 patients with primary congenital glaucoma were enrolled, Intraocular pressure （lOP）, corneal diameter （mm） and cup/disc （C/D） were measured before and after the surgery respectively. Follow-up period was 30mo. RESULTS： The mean preoperative lOP was 30.6：1：7.35 mm Hg. Of the 42 eyes, 2 eyes were required conversion to trabeculectomy for the absence of Schlemm＇s canal. Of remained 40 eyes, 38 eyes （95%） achieved successful lOP control. The average postoperative lOP was 11.69±4.18 mm Hg at 12mo. The mean reduction was 18.91 mm Hg （P〈0.00Ol）. Eighteen （75%） eyes presented a reduction in corneal diameter, and 25 （62.5%） eyes presented a C/D ratio reversal after the surgery. There was no serious complication in any patients over the follow-up period. CONCLUSION： Viscocanalostomy combined with trabeculotomy and mitomycin C is useful in the management of primary congenital glaucoma,
文摘Purpose: To identify the clinical features of the syndrome Frank-Kamenetsky and determine the criteria of early formation of glaucoma. Materials and Methods: We observed 52 patients. Follow up period was from 5 to 22 years. The first group (juvenile) consisted of males who had the first signs of glaucoma diagnosed before the age of 12 (n = 22). The average age of the group was 10.1 ± 2.4 years. The control group included healthy males (n = 30) in the same age range (average age 7.2 ± 1.6 years). The second group (adults) consisted of patients who had the first signs of glaucoma diagnosed after the age of 18 and elder. The average age of the group was 32.44 ± 6.28 years. The control group had males (n = 30) in the same age range (average age 26.59 ± 4.12 years). The inclusion criterion was: the presence of congenital bilateral mesodermal iris leaf hypoplasia, tra-becular dysgenesis signs, the presence of blood relatives on the maternal line (grandfather, uncle) male with similar changes iridociliary zone and glaucoma. Criteria of glaucoma formation were: increased IOP more than 21 mmHg with accompanying it expansion of the cup/disc ratio, reducing the thickness of the nerve fiber layer (RNFL) according to OCT. Results: It was found that Frank-Kamenetsky Syndrome had an X-linked with sex, recessive inheritance and was characterized by bilateral congenital irisdysgenesis and goniodysgenesis with the accession glaucoma. Predictors of glaucoma formation in early childhood are a combination of: 1) congenital subtotal atrophy of iris mesodermal layer (from 0 to 30 mkm) with signs of progressive dystrophy;2) nonprogressive congenital megalocornea (cornea diameter 12 - 14 mm);3) iridotrabecular dysgenesis of II-III degree;4) hyperopic refraction in axial myopia.
文摘In traditional trabeculotomy,a radial incision is performed at the corneoscleral transition zone to locate the Schlemm＇s canal.However,in some conditions,finding the Schlemm＇s canal is difficult because of the enlargement of the comea,developmental anomalies of the angle,etc.In our study,we performed a modified trabeculotomy,to locate the Schlemm＇s canal easily and accurately and evaluated the outcomes.
