Ophthalmic viscoelastic device injection for the treatment of flat anterior chamber after trabeculectomy

A case series study

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: Flat anterior chamber (FAC) in association with overfiltration is a complication after trabeculectomy. The aim of the current study was to investigate the efficacy of injection of an ophthalmic viscoelastic device (OVD) to treat FAC after trabeculectomy in a retrospective consecutive case series study. Materials and methods: Twenty-five consecutive patients who underwent injection of OVD for the treatment of FAC after trabeculectomy were analyzed. The primary outcome variable was the qualified success of trabeculectomy, which was defined at three different levels by the achievement of one of three IOP-related criteria with or without glaucoma medication. Kaplan-Meier plots were generated to estimate survival functions for trabeculectomy with OVD injection. Results: Twenty-one patients (21/25 = 84.0%) recovered from FAC by one OVD injection. The postoperative intraocular pressure (IOP) measured at 12 months, 24 months, 36 months, 48 months, and 60 months was 14.7 ± 3.6 mmHg, 15.6 ± 7.0 mmHg, 14.2 ± 2.8 mmHg, 14.2 ± 3.8 mmHg, and 14.6 ± 2.7 mmHg, respectively. All postoperative IOP measurements were significantly lower than the preoperative IOP (P < 0.001). The probabilities of qualified success for 5 years after trabeculectomy with OVD injection were as follows: 24.4% (IOP ≦ 21 mmHg and ≧20% reduction of preoperative IOP), 16.5% (IOP ≦ 16 mmHg and ≧20% reduction) and 6.3% (IOP ≦ 12 mmHg and ≧30% reduction). One patient, who had undergone deep lamellar keratoplasty, experienced a complication associated with the injection of the viscoelastic material, Descemet's membrane detachment. Conclusion: Injection of OVD may be effective for the treatment of FAC; however, the longterm success rate was relatively low.

Original languageEnglish
Pages (from-to)1781-1785
Number of pages5
JournalClinical Ophthalmology
Volume7
DOIs
Publication statusPublished - 2013 Sep 5

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Trabeculectomy
Anterior Chamber
Intraocular Pressure
Equipment and Supplies
Injections
Therapeutics
Descemet Membrane
Corneal Transplantation
Glaucoma
Survival

Keywords

  • Flat anterior chamber
  • Glaucoma
  • Ophthalmic viscoelastic device injection
  • Trabeculectomy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

@article{9635c87b2f954c7598e18c2403c1f1ea,
title = "Ophthalmic viscoelastic device injection for the treatment of flat anterior chamber after trabeculectomy: A case series study",
abstract = "Purpose: Flat anterior chamber (FAC) in association with overfiltration is a complication after trabeculectomy. The aim of the current study was to investigate the efficacy of injection of an ophthalmic viscoelastic device (OVD) to treat FAC after trabeculectomy in a retrospective consecutive case series study. Materials and methods: Twenty-five consecutive patients who underwent injection of OVD for the treatment of FAC after trabeculectomy were analyzed. The primary outcome variable was the qualified success of trabeculectomy, which was defined at three different levels by the achievement of one of three IOP-related criteria with or without glaucoma medication. Kaplan-Meier plots were generated to estimate survival functions for trabeculectomy with OVD injection. Results: Twenty-one patients (21/25 = 84.0{\%}) recovered from FAC by one OVD injection. The postoperative intraocular pressure (IOP) measured at 12 months, 24 months, 36 months, 48 months, and 60 months was 14.7 ± 3.6 mmHg, 15.6 ± 7.0 mmHg, 14.2 ± 2.8 mmHg, 14.2 ± 3.8 mmHg, and 14.6 ± 2.7 mmHg, respectively. All postoperative IOP measurements were significantly lower than the preoperative IOP (P < 0.001). The probabilities of qualified success for 5 years after trabeculectomy with OVD injection were as follows: 24.4{\%} (IOP ≦ 21 mmHg and ≧20{\%} reduction of preoperative IOP), 16.5{\%} (IOP ≦ 16 mmHg and ≧20{\%} reduction) and 6.3{\%} (IOP ≦ 12 mmHg and ≧30{\%} reduction). One patient, who had undergone deep lamellar keratoplasty, experienced a complication associated with the injection of the viscoelastic material, Descemet's membrane detachment. Conclusion: Injection of OVD may be effective for the treatment of FAC; however, the longterm success rate was relatively low.",
keywords = "Flat anterior chamber, Glaucoma, Ophthalmic viscoelastic device injection, Trabeculectomy",
author = "Shingo Hosoda and Kenya Yuki and Takeshi Ono and Kazuo Tsubota",
year = "2013",
month = "9",
day = "5",
doi = "10.2147/OPTH.S51165",
language = "English",
volume = "7",
pages = "1781--1785",
journal = "Clinical Ophthalmology",
issn = "1177-5467",
publisher = "Dove Medical Press Ltd.",

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TY - JOUR

T1 - Ophthalmic viscoelastic device injection for the treatment of flat anterior chamber after trabeculectomy

T2 - A case series study

AU - Hosoda, Shingo

AU - Yuki, Kenya

AU - Ono, Takeshi

AU - Tsubota, Kazuo

PY - 2013/9/5

Y1 - 2013/9/5

N2 - Purpose: Flat anterior chamber (FAC) in association with overfiltration is a complication after trabeculectomy. The aim of the current study was to investigate the efficacy of injection of an ophthalmic viscoelastic device (OVD) to treat FAC after trabeculectomy in a retrospective consecutive case series study. Materials and methods: Twenty-five consecutive patients who underwent injection of OVD for the treatment of FAC after trabeculectomy were analyzed. The primary outcome variable was the qualified success of trabeculectomy, which was defined at three different levels by the achievement of one of three IOP-related criteria with or without glaucoma medication. Kaplan-Meier plots were generated to estimate survival functions for trabeculectomy with OVD injection. Results: Twenty-one patients (21/25 = 84.0%) recovered from FAC by one OVD injection. The postoperative intraocular pressure (IOP) measured at 12 months, 24 months, 36 months, 48 months, and 60 months was 14.7 ± 3.6 mmHg, 15.6 ± 7.0 mmHg, 14.2 ± 2.8 mmHg, 14.2 ± 3.8 mmHg, and 14.6 ± 2.7 mmHg, respectively. All postoperative IOP measurements were significantly lower than the preoperative IOP (P < 0.001). The probabilities of qualified success for 5 years after trabeculectomy with OVD injection were as follows: 24.4% (IOP ≦ 21 mmHg and ≧20% reduction of preoperative IOP), 16.5% (IOP ≦ 16 mmHg and ≧20% reduction) and 6.3% (IOP ≦ 12 mmHg and ≧30% reduction). One patient, who had undergone deep lamellar keratoplasty, experienced a complication associated with the injection of the viscoelastic material, Descemet's membrane detachment. Conclusion: Injection of OVD may be effective for the treatment of FAC; however, the longterm success rate was relatively low.

AB - Purpose: Flat anterior chamber (FAC) in association with overfiltration is a complication after trabeculectomy. The aim of the current study was to investigate the efficacy of injection of an ophthalmic viscoelastic device (OVD) to treat FAC after trabeculectomy in a retrospective consecutive case series study. Materials and methods: Twenty-five consecutive patients who underwent injection of OVD for the treatment of FAC after trabeculectomy were analyzed. The primary outcome variable was the qualified success of trabeculectomy, which was defined at three different levels by the achievement of one of three IOP-related criteria with or without glaucoma medication. Kaplan-Meier plots were generated to estimate survival functions for trabeculectomy with OVD injection. Results: Twenty-one patients (21/25 = 84.0%) recovered from FAC by one OVD injection. The postoperative intraocular pressure (IOP) measured at 12 months, 24 months, 36 months, 48 months, and 60 months was 14.7 ± 3.6 mmHg, 15.6 ± 7.0 mmHg, 14.2 ± 2.8 mmHg, 14.2 ± 3.8 mmHg, and 14.6 ± 2.7 mmHg, respectively. All postoperative IOP measurements were significantly lower than the preoperative IOP (P < 0.001). The probabilities of qualified success for 5 years after trabeculectomy with OVD injection were as follows: 24.4% (IOP ≦ 21 mmHg and ≧20% reduction of preoperative IOP), 16.5% (IOP ≦ 16 mmHg and ≧20% reduction) and 6.3% (IOP ≦ 12 mmHg and ≧30% reduction). One patient, who had undergone deep lamellar keratoplasty, experienced a complication associated with the injection of the viscoelastic material, Descemet's membrane detachment. Conclusion: Injection of OVD may be effective for the treatment of FAC; however, the longterm success rate was relatively low.

KW - Flat anterior chamber

KW - Glaucoma

KW - Ophthalmic viscoelastic device injection

KW - Trabeculectomy

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