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  • 1
    Electronic Resource
    Electronic Resource
    Conditions for balance between lower normal pressure control and hypotony in mitomycin trabeculectomy (1998)
    Springer
    Graefe's archive for clinical and experimental ophthalmology 236 (1998), S. 420-425 
    Details
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  · Background: Striving for low to ultra-low postoperative intraocular pressure (IOP) through filtering surgery usually increases the incidence of prolonged hypotony. Early postoperative prognostic indicators for IOP control to lower normal level and prolonged hypotony in trabeculectomy with mitomycin C were examined to determine conditions required to obtain an optimum balance between them. · Methods: Records of initial trabeculectomy with mitomycin C (0.4 mg/ml, 3 min) in 59 consecutively operated Japanese patients with primary open-angle glaucoma who had used multiple medications before operation were retrospectively analyzed. IOP control to lower normal level was defined as having failed if IOP could not be maintained below 15 mm Hg without medication. Prolonged hypotony was defined as postoperative IOP below 5 mm Hg for more than 2 months, excluding the first month. The Cox proportional harzards model was applied to identify early postoperative factors contributing to the two surgical outcomes. · Results: Among the factors studied, only the mean IOP on postoperative days 9–14 was significantly correlated with the surgical outcome. A receiver operating characteristic plot suggested that mean IOP of 8 mm Hg in this period would give an optimum balance between the two. · Conclusion: IOP of 8 mm Hg 9–14 days after surgery may be advisable in patients with preoperative multiple medications in whom IOP control to lower normal level is attempted with mitomycin C trabeculectomy. Knowledge of this may helpful in deciding when laser lysis of sutures is indicated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004170050100
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  • 2
    Electronic Resource
    Electronic Resource
    Use of Fieldmaster automated perimeter for the detection of early visual field changes in glaucoma (1982)
    Springer
    International ophthalmology 4 (1982), S. 151-156 
    Details
    ISSN: 1573-2630
    Keywords: automated perimeter ; glaucoma ; visual field defect ; Goldmann perimeter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The efficacy of automated suprathreshold perimetry with Fieldmaster automated perimeter (model 101 PR and 200) was evaluated in the screening for very early glaucomatous visual field defects which failed to be detected with kinetic perimetry using a Goldmann perimeter. Evaluation of 117 eyes with elevated intraocular pressure revealed a small, relative defect in the central field in 14 eyes which was confirmed by static perimetry with a Tübinger perimeter. Although Fieldmaster model 200 is equipped with more target positions than model 101 PR, detectability of early defects was almost identical between two models. Automated suprathreshold perimetry with either model of Fieldmaster perimeter is useful in detecting the early changes which may be missed by kinetic perimetry with a Goldmann perimeter. Based on the difference in the false positive rate (45.6% with model 200 vs 26.7% with model 101 PR) the screening with 101 PR seems to be more rewarding.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00161905
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Effect of postoperative subconjunctival 5-fluorourcil injections on the surgical outcome of trabeculectomy in the Japanese (1989)
    Springer
    Graefe's archive for clinical and experimental ophthalmology 227 (1989), S. 569-574 
    Details
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A controlled study was carried out to evaluate the effect of postoperative subconjunctival 5-fluorouracil (5-FU) injections on the surgical outcomes of trabeculectomy in the Japanese (a total of 196 eyes in 157 patients). The eyes that had undergone trabeculectomy with postoperative 5-FU (5-FU group) included 36 eyes with primary open-angle glaucoma (POAG) and 17 with secondary glaucoma (SG) undergoing their first or second trabeculectomy. There were also 34 eyes with refractory glaucoma. The eyes that had had trabeculectomy without postoperative 5-FU (control group) included 46 POAG and 31 SG eyes undergoing their first or second trabeculectomy and 24 refractory glaucoma eyes. The surgical techniques and postoperative care were virtually identical between the two groups, except that the control group did not receive 5-FU. The results were analyzed by means of a life table method and a postoperative intraocular pressure (IOP) level equal to or less than 20 mmHg was adopted as the criterion for successful IOP control. In the 5-FU group, the success probability (%) at the 3-year follow-up was 93.9 ± 4.2 (SE) for POAG eyes, 93.8 ± 6.1 for SG eyes, and 86.7 ± 5.6 for refractory glaucoma eyes. In the control group, it was 55.0 ± 7.9, 37.2 ± 13.5, and 16.1 ± 7.4, respectively. The difference in success probability between the 5-FU and control groups was highly significant (P 〈 0.001 or 0.01). In the POAG and SG eyes, the mean postoperative IOP was significantly lower in the 5-FU group than in the control group. Except for the fact that the corneal epithelial defect and conjuntival wound leak were encountered significantly more frequently in the 5-FU group, there was no significant difference in the incidences of postoperative complications between the 5-FU and control groups. Postoperative subconjunctival 5-FU increased the success probability of the trabeculectomy operation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02169454
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  • 4
    Electronic Resource
    Electronic Resource
    A comparative study of optic nerve head in low- and high-tension glaucomas (1992)
    Springer
    Graefe's archive for clinical and experimental ophthalmology 230 (1992), S. 446-450 
    Details
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The disc and rim areas in 15 eyes from 15 selected low-tension glaucoma (LTG) patients were compared with those in 15 eyes from 15 selected high-tension glaucoma (HTG) patients. In all patients, visual field defects (VFD) were at an early stage (mean deviation 〉 − 5 dB, program 30-2 of Humphrey Visual Field Analyzer, STATPAC) and were confined to either the upper or lower hemifield. There were no significant differences in the degree of VFD between LTG and HTG, and the peak intraocular pressure averaged 18.9 and 29.2 mmHg for LTG and HTG eyes, respectively. The disc and rim areas were determined from stereoscopic disc photographs using the method of Littmann. The half rim area corresponding to the upper or lower hemifield without VFD was significantly smaller for LTG than HTG (LTG 0.26 ± 0.08 mm2, HTG 0.31 ± 0.08 mm2, mean ± SID, n= 15, P 〈 0.005). The rim area corresponding to the upper or lower hemifield with VFD was also significantly smaller for LTG than HTG (LTG 0.19 ± 0.08 mm2 HTG 0.24 ± 0.08 mm2, P 〈 0.01). On the other hand, there was no significant difference in the disc area between LTG and HTG (LTG 1.96 ± 0.57 mm2, HTG 2.03 ± 0.45 mm2, P 〉 0.4). It was suggested that the differences in rim area were already present prior to the manifestation of the VFD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00175931
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Risk factors for the progression of treated primary open-angle glaucoma: a multivariate life-table analysis (1999)
    Springer
    Graefe's archive for clinical and experimental ophthalmology 237 (1999), S. 463-467 
    Details
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  · Background: Several factors have been reported as risk factors for the progression of primary open-angle glaucoma (POAG) but previous reports were not necessarily in agreement. We applied a multivariate life-table analysis to a large number of longitudinal data to determine the extent of the influence of various factors simultaneously. · Methods: Two hundred fifteen eyes of 215 POAG patients were included. The follow-up period ranged from 24 to 134 months (average 82.7 months). The visual field stage was determined separately in upper and lower hemifields according to the classification of Aulhorn (modified by Greve). The progression was defined as an irreversible increase of the stage in at least one hemifield. The follow-up data were analyzed with the Cox proportional hazard model. · Results: Mean intraocular pressure (IOP) in the follow-up period and the initial visual field stage significantly affected POAG progression (P〈0.05). The risk of POAG progression was calculated to double as the mean IOP increased by 4 mmHg. Eyes with the initial visual field of stage 0–1 and moderately advanced stages had a greater risk of progression than other stages. · Conclusion: To prevent the progression of POAG, the IOP should be kept as low as possible, particularly at the early and moderately advanced stages.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004170050262
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