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Secondary Open-Angle Glaucomas
Published in Neil T. Choplin, Carlo E. Traverso, Atlas of Glaucoma, 2014
Jonathan Myers, L. Jay Katz, Anand Mantravadi
Laser trabeculoplasty has been shown to be very effective. Lower laser powers are sufficient as the trabecular meshwork pigment absorbs the energy well. However, long-term results show more than half of patients losing treatment effect within 5 years. Conventional filtering surgery yields good results in pigmentary glaucoma. Results are similar to those obtained in patients with primary open-angle glaucoma. Antimetabolites should be used cautiously as these young, myopic patients are more prone to hypotony maculopathy.
Silicone Tube Miniature Drainage Device Implanted under Scleral Flap for the Surgical Treatment of Glaucoma
Published in Current Eye Research, 2020
Aiwu Fang, Li Nie, Peijuan Wang, Jingwei Zheng, Yau Kei Chan, Qi Zhang, Yuanbo Liang, Jia Qu
Intraoperative complications were rare. The most common postoperative event was shallow anterior chamber in the early stage (12.1%). In one of them, viscoelastic injection in the anterior chamber was performed in the first week, whereas three cases resolved spontaneously. Three eyes (9.1%) experienced choroidal effusions. Of these eyes, none required surgical drainage of choroidal effusions. There was no case of hypotony at any time after implantation. Transient IOP increases occurred in three eyes (9.1%). Two eyes (IOP > 30 mmHg) were treated by pressing the posterior lip of the paracentesis with a 26G needle at the slit lamp to allow egress of aqueous and any residual viscoelastic during the first day postoperatively, and resulted in an IOP decrease to normal range. The other case was not treated, as the IOP was only 23 mmHg. In three eyes (9.1%), the tip of the silicone tube miniature drainage device touched the iris. One resolved spontaneously and the other two were left in place because the tip did not indent deeply into the iris and the patient had no complaints of pain or discomfort. The first one was due to a shallow anterior chamber, and the other two were due to improper orientation of the needle during the pre-perforation step. No pigment shedding and persistent anterior uveitis were observed. Most of the complications were clinically mild and transient, and resolved spontaneously. No cases of hypotony maculopathy, suprachoroidal hemorrhage, conjunctival erosion, infection or undue inflammation were observed.
Choroidal detachments: what do optometrists need to know?
Published in Clinical and Experimental Optometry, 2019
Martin Q Diep, Michele C Madigan
Choroidal detachments may be observed clinically through ophthalmoscopy. Individuals with small, peripheral serous detachments may be completely asymptomatic, or display a small myopic shift, and angle closure from anterior displacement of the ciliary body, lens, and iris.2012 Typically, there may be up to four smooth lobes of fluid accumulation which characteristically extend up to the vortex veins, as the vortex veins are firmly attached to the choroid and sclera. Hypotony maculopathy may also be present, with subretinal fluid, macula striae and retinal vessel distortion. However, a retrospective case‐controlled study of 228 eyes did report the presence of choroidal detachment to be associated with a reduced risk of developing hypotony maculopathy.2003 In severe cases of appositional retina, it is impossible to view the posterior chamber. Developments in wide field retinal imaging techniques now allow enhanced and easier documentation of more peripheral choroidal detachments2009 (Figure 1).
22q11.2 microduplication syndrome and juvenile glaucoma
Published in Ophthalmic Genetics, 2018
Federico Di Matteo, Paolo Bettin, Giulia Ferrari, Marina Fiori, Carlo Ciampi, Emanuela Manfredini, Alessandro Rabiolo, Francesco Bandello
According to the collaborative bleb-related infection incidence and treatment study (22), limbus-based conjunctival flap, lower preoperative IOP, and choroidal detachment within 6 months of the surgery were risk factors for persistent hypotony. In our case series, none out of three risk factors was present and, nevertheless, we had a 100% of incidence of persistent hypotony following trabeculectomy. Late-onset hypotony maculopathy after trabeculectomy has been reported in a case of high myopia with juvenile open-angle glaucoma (23). In that case, progressive scleral thinning, reduced scleral rigidity, and scleral morphologic changes related to progressive myopia were advocated as possible causative factors.