Objective: To assess the accuracy of classification of narrow anterior chamber (AC) angles using quantitative imaging by optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM). Design: Observational com...Objective: To assess the accuracy of classification of narrow anterior chamber (AC) angles using quantitative imaging by optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM). Design: Observational comparative study. Methods: A high-speed (4000 axial scans/s) anterior segment OCT prototype was developed using a 1.3- μ m light source. Seventeen normal subjects (17 eyes) and 7 subjects (14 eyes)-with narrow angle glaucoma were enrolled. All subjects underwentg onioscopy, OCT, and UBM. Quantitative AC angle parameters (angle opening distance, angle recess area, and the trabecular-iris space area [a new parameter we have defined])-were measured from OCT and UBM images using proprietary processing software. Main Outcome Measures: Specificity and sensitivity in identifying narrow angles with image-derived AC angle parameters. Results: Eight of 31 eyes were classified as having narrow angles (Shaffer grade ≤ 1 in all quadrants). The AC angle parameters measured by both OCT and UBM had similar mean values, reproducibility, and sensitivity specificity profiles. Both OCT and UBM showed excellent performance in identifying eyes with narrow angles. Areas under the receiver operating characteristic curves for these parameters were all in the range of 0.96 to 0.98. Conclusions: Optical coherence tomography was similar to UBM in quantitative AC angle measurement and detection of narrow angles. In addition, it was easier to use and did not require contact with the eye. Optical coherence tomography is a promising method for screening individuals at risk for narrow angle glaucoma.展开更多
Purpose:To investigate the safety and efficacy of combined trabeculectomy for primary acute angle closure glaucoma with persistent ocular hypertension.Methods:A total of 36 patients.(40 eyes).with primary acute angle ...Purpose:To investigate the safety and efficacy of combined trabeculectomy for primary acute angle closure glaucoma with persistent ocular hypertension.Methods:A total of 36 patients.(40 eyes).with primary acute angle closure glaucoma,who were treated with combined trabeculectomy in the Ophthalmology Unit of our hospital,were selected.Before the procedure,patients were assigned to ocular hypertension group(≥ 40 mm Hg) or control group(< 40 mm Hg) based on intraocular pressure.These two groups were followed up for one year,and compared for post-operative visual acuity,intraocular pressure,filtering bleb,anterior chamber depth,and the occurrence of complications.Results:At 1 week,6 months,and 12 months after the procedure,intraocular pressure was controlled in both the ocular hypertension group and the control group,without significant differences between the two groups(P>0.05).At 1 week,6 months,and 12 months after the procedure,all of the patients,in both groups,had improved in terms of visual acuity,with a significant difference before and after the procedure for the ocular hypertension group(P<0.05).After follow-up at 12 months,the two groups presented no statistically significant differences in anterior chamber depth,filtering bleb survival,or the incidence of post-operative complications(P>0.05 for all).Conclusion:It is feasible,safe,and effective to perform combined trabeculectomy on patients with primary acute angle closure glaucoma complicated by persistent ocular hypertension.展开更多
Purpose: To investigate the efficacy of a soft bandage contact lens in the management of early bleb leak following trabeculectomy.Methods: Between October 2011 and April 2013, 11 patients with early bleb leak followin...Purpose: To investigate the efficacy of a soft bandage contact lens in the management of early bleb leak following trabeculectomy.Methods: Between October 2011 and April 2013, 11 patients with early bleb leak following fornix-based trabeculectomy were instructed to wear a soft bandage contact lens 14 mm in diameter continuously for 1-2 weeks. The daily visual acuity,intraocular pressure(IOP), anterior chamber situation, and healing condition were measured at 1, 3, and 7 d, after con tact lens removal,.and 3 months after trabeculectomy..The conditions of blebs,.sensation of wearing contact lens,.and adverse events were recorded.Results:.Bleb leaks were observed at 2-8 d after surgery,(4.09±1.10 d on average). The daily Log MAR visual acuity did not significantly differ before and after contact lens wear(P>0.05). The IOP was significantly raised after at 1, 3, and7 d after lens wear.(all P <0.05).The IOP at 3 months after lens wear did not significantly differ from that measured at lens removal(t=1.191, P=0.089). At 1 d after lens wear, 6cases had deeper anterior chambers..All patients presented with a significantly deepened anterior chamber at 3 d after lens wear,.and were restored to the preoperative conditions..The bleb leakage was successfully treated at 7 d after lens removal in 10 patients, while 1 patient had to wear the contact lens for another 7 d for full healing of the bleb leak. No ocular infection was noted throughout the management.Conclusion: A soft bandage contact lens of 14 mm diameter is a safe and efficacious therapy for an early bleb leak following fornix-based trabeculectomy.展开更多
Purpose: To evaluate quantitatively, by means of ultrasound biomicroscopy (UBM), changes in the anterior segment con-figuration, including the ciliary processes, induced by cataract surgery in eyes with primary angle ...Purpose: To evaluate quantitatively, by means of ultrasound biomicroscopy (UBM), changes in the anterior segment con-figuration, including the ciliary processes, induced by cataract surgery in eyes with primary angle closure. Design: Retrospective interventional case series. Participants: Thirty-one eyes of 31 patients with primary angle closure or primary angle-closure glaucoma were treated with cataract surgery. Before cataract surgery, 10 eyes had been treated with laser peripheral iridotomy, and 1 with laser peripheral iridoplasty. Methods: Configuration of the anterior chamber was examined by means of UBM before and at 3 months after cataract surgery. Main Outcome Measures: Using UBM, anterior chamber depth (ACD), angle opening distance at points 500 μ m from the scleral spur (AOD500), and trabecular-ciliary process distance (TCPD) were measured. Results: Not only ACD and AOD500, but also TCPD, increased significantly after cataract surgery, compared with measurements obtained before surgery (P < 0.001). Postoperative AOD500 was correlated significantly with postoperative TCPD (r=0.72, P < 0.001) and with the amount of change of TCPD caused by cataract surgery (▲ TCPD)(r=0.52, P < 0.01). Conclusions: Cataract surgery attenuated anterior positioning of the ciliary processes in eyes with primary angle closure,concomitant with significant widening of the angle. Cataract surgery resulted in not only complete dissolution of lens volume and pupillary block, but also attenuation of the anterior positioning of the ciliary processes, all of which contributed to postoperative widening of the anglein eyes with primary angle closure.展开更多
文摘Objective: To assess the accuracy of classification of narrow anterior chamber (AC) angles using quantitative imaging by optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM). Design: Observational comparative study. Methods: A high-speed (4000 axial scans/s) anterior segment OCT prototype was developed using a 1.3- μ m light source. Seventeen normal subjects (17 eyes) and 7 subjects (14 eyes)-with narrow angle glaucoma were enrolled. All subjects underwentg onioscopy, OCT, and UBM. Quantitative AC angle parameters (angle opening distance, angle recess area, and the trabecular-iris space area [a new parameter we have defined])-were measured from OCT and UBM images using proprietary processing software. Main Outcome Measures: Specificity and sensitivity in identifying narrow angles with image-derived AC angle parameters. Results: Eight of 31 eyes were classified as having narrow angles (Shaffer grade ≤ 1 in all quadrants). The AC angle parameters measured by both OCT and UBM had similar mean values, reproducibility, and sensitivity specificity profiles. Both OCT and UBM showed excellent performance in identifying eyes with narrow angles. Areas under the receiver operating characteristic curves for these parameters were all in the range of 0.96 to 0.98. Conclusions: Optical coherence tomography was similar to UBM in quantitative AC angle measurement and detection of narrow angles. In addition, it was easier to use and did not require contact with the eye. Optical coherence tomography is a promising method for screening individuals at risk for narrow angle glaucoma.
文摘Purpose:To investigate the safety and efficacy of combined trabeculectomy for primary acute angle closure glaucoma with persistent ocular hypertension.Methods:A total of 36 patients.(40 eyes).with primary acute angle closure glaucoma,who were treated with combined trabeculectomy in the Ophthalmology Unit of our hospital,were selected.Before the procedure,patients were assigned to ocular hypertension group(≥ 40 mm Hg) or control group(< 40 mm Hg) based on intraocular pressure.These two groups were followed up for one year,and compared for post-operative visual acuity,intraocular pressure,filtering bleb,anterior chamber depth,and the occurrence of complications.Results:At 1 week,6 months,and 12 months after the procedure,intraocular pressure was controlled in both the ocular hypertension group and the control group,without significant differences between the two groups(P>0.05).At 1 week,6 months,and 12 months after the procedure,all of the patients,in both groups,had improved in terms of visual acuity,with a significant difference before and after the procedure for the ocular hypertension group(P<0.05).After follow-up at 12 months,the two groups presented no statistically significant differences in anterior chamber depth,filtering bleb survival,or the incidence of post-operative complications(P>0.05 for all).Conclusion:It is feasible,safe,and effective to perform combined trabeculectomy on patients with primary acute angle closure glaucoma complicated by persistent ocular hypertension.
基金supported by Fund for Medical Sciences of Guangdong Province(Grant:B2012264)
文摘Purpose: To investigate the efficacy of a soft bandage contact lens in the management of early bleb leak following trabeculectomy.Methods: Between October 2011 and April 2013, 11 patients with early bleb leak following fornix-based trabeculectomy were instructed to wear a soft bandage contact lens 14 mm in diameter continuously for 1-2 weeks. The daily visual acuity,intraocular pressure(IOP), anterior chamber situation, and healing condition were measured at 1, 3, and 7 d, after con tact lens removal,.and 3 months after trabeculectomy..The conditions of blebs,.sensation of wearing contact lens,.and adverse events were recorded.Results:.Bleb leaks were observed at 2-8 d after surgery,(4.09±1.10 d on average). The daily Log MAR visual acuity did not significantly differ before and after contact lens wear(P>0.05). The IOP was significantly raised after at 1, 3, and7 d after lens wear.(all P <0.05).The IOP at 3 months after lens wear did not significantly differ from that measured at lens removal(t=1.191, P=0.089). At 1 d after lens wear, 6cases had deeper anterior chambers..All patients presented with a significantly deepened anterior chamber at 3 d after lens wear,.and were restored to the preoperative conditions..The bleb leakage was successfully treated at 7 d after lens removal in 10 patients, while 1 patient had to wear the contact lens for another 7 d for full healing of the bleb leak. No ocular infection was noted throughout the management.Conclusion: A soft bandage contact lens of 14 mm diameter is a safe and efficacious therapy for an early bleb leak following fornix-based trabeculectomy.
文摘Purpose: To evaluate quantitatively, by means of ultrasound biomicroscopy (UBM), changes in the anterior segment con-figuration, including the ciliary processes, induced by cataract surgery in eyes with primary angle closure. Design: Retrospective interventional case series. Participants: Thirty-one eyes of 31 patients with primary angle closure or primary angle-closure glaucoma were treated with cataract surgery. Before cataract surgery, 10 eyes had been treated with laser peripheral iridotomy, and 1 with laser peripheral iridoplasty. Methods: Configuration of the anterior chamber was examined by means of UBM before and at 3 months after cataract surgery. Main Outcome Measures: Using UBM, anterior chamber depth (ACD), angle opening distance at points 500 μ m from the scleral spur (AOD500), and trabecular-ciliary process distance (TCPD) were measured. Results: Not only ACD and AOD500, but also TCPD, increased significantly after cataract surgery, compared with measurements obtained before surgery (P < 0.001). Postoperative AOD500 was correlated significantly with postoperative TCPD (r=0.72, P < 0.001) and with the amount of change of TCPD caused by cataract surgery (▲ TCPD)(r=0.52, P < 0.01). Conclusions: Cataract surgery attenuated anterior positioning of the ciliary processes in eyes with primary angle closure,concomitant with significant widening of the angle. Cataract surgery resulted in not only complete dissolution of lens volume and pupillary block, but also attenuation of the anterior positioning of the ciliary processes, all of which contributed to postoperative widening of the anglein eyes with primary angle closure.
