Abstract:
PURPOSE:To establish the safety and efficacy of simultaneous bilateral primary combined trabeculotomy-trabeculectomy for developmental glaucoma. METHODS:We studied 109 consecutive patients who underwent planned simultaneous bilateral primary combined trabeculotomy-trabeculectomy for developmental glaucoma by a single surgeon from January 1990 through December 1999. The main outcome measures were postoperative intraocular pressure (IOP), corneal clarity and diameter, visual acuity, bleb characteristics, time of surgical failure and complications. Postoperative complications including endophthalmitis and anaesthetic morbidity and mortality were also analysed. RESULTS:The series consisted of 218 primary combined trabeculotomy-trabeculectomy surgeries during 109 anaesthesias. The mean follow-up period was 16.33 +/- 16.22 months. The IOP reduced from 26.4 +/- 5.9 mmHg to 13.5 +/- 4.5 mmHg, with a mean percentage reduction of 46.2 +/- 23.7 (P < 0.0001). The success (IOP < 16 mmHg) probabilities were 90.9%, 88.0% and 69.3% at first, second and third year respectively (Kaplan-Meier analysis). The success probability of 69.3% obtained at third year was maintained till 6 years of follow-up. One hundred and sixty six (76.1%) eyes had significant corneal oedema. Postoperatively, the cornea cleared in 93 (57.8%) eyes. Clinically, well functioning blebs were present in 114 of 171 eyes (66.6%). Postoperatively, 18 (8.3%) eyes developed shallow anterior chamber and 6 (33.3%) of them required surgical reformation. There was no incidence of endophthalmitis or any other sight-threatening complication. Of the anesthetic complications, apnea occurred in 17 (15.6%) patients and all were successfully resuscitated. The most serious post-anaesthetic complication was cardio-pulmonary arrest that occurred 5 hours postoperatively following aspiration during feeding in one child; this child could not be resuscitated. Two children had delayed recovery (2 and 4 hours respectively). The child who had delayed recovery by 2 hours survived and has completed 3 years of follow-up while the other child expired 48 hours later. CONCLUSION:Simultaneous bilateral primary combined trabeculotomy-trabeculectomy is safe and effective for developmental glaucoma. It obviates the need for long second anaesthesia with its attendant risks. It offers several other benefits to the patients and families.
journal_name
Indian J Ophthalmoljournal_title
Indian journal of ophthalmologyauthors
Mandal AK,Bhatia PG,Gothwal VK,Reddy VM,Sriramulu P,Prasad MS,John RK,Nutheti R,Shamanna BRkeywords:
subject
Has Abstractpub_date
2002-03-01 00:00:00pages
13-9issue
1eissn
0301-4738issn
1998-3689journal_volume
50pub_type
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:
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abstract::The surgical procedure, observations, results, complications and advantages of anterior segment reconstruction and membranectomy procedure through the parsplana route are discussed in this paper. ...
journal_title:Indian journal of ophthalmology
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
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journal_title:Indian journal of ophthalmology
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journal_title:Indian journal of ophthalmology
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doi:10.4103/0301-4738.121135
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:10.4103/0301-4738.21614
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journal_title:Indian journal of ophthalmology
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doi:10.4103/0301-4738.83611
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:10.4103/0301-4738.73691
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章,评审
doi:
更新日期:1995-06-01 00:00:00
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:10.4103/0301-4738.181740
更新日期:2016-03-01 00:00:00
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:10.4103/0301-4738.73684
更新日期:2011-01-01 00:00:00
abstract::Argon laser suture lysis using the Ritch lens provides a safe and effective means for correction of post--ECCE suture--induced astigmatism. ...
journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:
更新日期:2002-06-01 00:00:00
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:10.4103/0301-4738.156938
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章,评审
doi:10.4103/0301-4738.116060
更新日期:2013-08-01 00:00:00
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章,评审
doi:10.4103/0301-4738.73700
更新日期:2011-01-01 00:00:00
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journal_title:Indian journal of ophthalmology
pub_type:
doi:10.4103/ijo.IJO_1603_20
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:10.4103/0301-4738.18903
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:10.4103/0301-4738.77047
更新日期:2011-03-01 00:00:00
abstract:: ...
journal_title:Indian journal of ophthalmology
pub_type: 评论,信件
doi:10.4103/ijo.IJO_1415_18
更新日期:2018-11-01 00:00:00
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:10.4103/ijo.IJO_588_19
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
doi:10.4103/ijo.IJO_2858_20
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journal_title:Indian journal of ophthalmology
pub_type: 杂志文章
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