| Autor: |
Dan, Jacob A., Honavar, Santosh G., Belyea, David A., Mandal, Anil K., Garudadri, Chandrasekhar, Levy, Brian, Ramakrishnan, Rengappa, Krishnadas, Ramasamy, Lieberman, Marc F., Stamper, Robert L., Yaron, Arieh |
| Předmět: |
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| Zdroj: |
Archives of Ophthalmology; May2002, Vol. 120 Issue 5, p548, 6p |
| Abstrakt: |
Objective: To evaluate the feasibility and safety of enzymatic sclerostomy as a new modality to lower intraocular pressure in patients with open-angle glaucoma. Methods: This single-center, prospective, noncomparative, interventional case series included 15 blind symptomatic eyes of 15 patients with primary open-angle glaucoma. Enzymatic sclerostomy was performed with the patient under topical or peribulbar anesthesia. A specially designed polymethylmethacrylate enzyme applicator filled with a mean ± SD of 123 ± 13 µg of collagenase was introduced through a 5-mm peritomy, and affixed to the limbus by means of cyanoacrylate tissue glue. After 22 to 24 hours, the applicators were removed and the patients were followed up for 1 year. Intraocular pressure changes from baseline and complications related to the procedure were the main outcome measures. Results: Controlled thinning of the treated sclera associated with aqueous percolation and shallow filtration bleb was seen in all eyes in the immediate postoperative period. The mean ± SD intraocular pressure decreased from 43.5 ± 9.8 mm Hg (while the patients were receiving a mean ± SD of 1.75 ± 0.75 antiglaucoma medications) preoperatively to 24.8 ± 10.6 mm Hg (a 43.0% decrease from baseline with no antiglaucoma medication) on the first postoperative day and to 34.8 ± 10.5 mm Hg (a 20.0% decrease from baseline with no antiglaucoma medication) at the end of 1 year. Ophthalmic adverse effects were limited to the treated area and included immediate postoperative transient conjunctival reaction ranging from mild chemosis to conjunctival maceration. Immediate full-thickness perforation developed in 1 eye; the patient was treated and excluded from data analysis. Two eyes developed symptoms related to increase in intraocular pressure after 9 months; the patients were treated and excluded from further data analysis. No systemic complications were noted. Conclusions: Enzymatic... [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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