Holmium YAG laser sclerostomy ab externo for refractory glaucoma.
Identifieur interne : 006592 ( Main/Merge ); précédent : 006591; suivant : 006593Holmium YAG laser sclerostomy ab externo for refractory glaucoma.
Auteurs : E. Onda [Japon] ; H. Ando ; S. Jikihara ; Y. KitazawaSource :
- International ophthalmology [ 0165-5701 ]
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Antibiotiques antinéoplasiques (administration et posologie), Antimétabolites (administration et posologie), Chambre antérieure du bulbe oculaire (), Chambre antérieure du bulbe oculaire (anatomopathologie), Femelle, Fluorouracil (administration et posologie), Glaucome (), Glaucome (traitement médicamenteux), Humains, Mitomycine (administration et posologie), Mâle, Pression intraoculaire, Résultat thérapeutique, Sclérostomie (), Sclérostomie (effets indésirables), Sujet âgé, Études de suivi.
- MESH :
- administration et posologie : Antibiotiques antinéoplasiques, Antimétabolites, Fluorouracil, Mitomycine.
- anatomopathologie : Chambre antérieure du bulbe oculaire.
- effets indésirables : Sclérostomie.
- traitement médicamenteux : Glaucome.
- Adolescent, Adulte, Adulte d'âge moyen, Chambre antérieure du bulbe oculaire, Femelle, Glaucome, Humains, Mâle, Pression intraoculaire, Résultat thérapeutique, Sclérostomie, Sujet âgé, Études de suivi.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Anterior Chamber (pathology), Anterior Chamber (surgery), Antibiotics, Antineoplastic (administration & dosage), Antimetabolites (administration & dosage), Female, Fluorouracil (administration & dosage), Follow-Up Studies, Glaucoma (drug therapy), Glaucoma (surgery), Humans, Intraocular Pressure, Male, Middle Aged, Mitomycin (administration & dosage), Sclerostomy (adverse effects), Sclerostomy (methods), Treatment Outcome.
- MESH :
- chemical , administration & dosage : Antibiotics, Antineoplastic, Antimetabolites, Fluorouracil, Mitomycin.
- adverse effects : Sclerostomy.
- drug therapy : Glaucoma.
- methods : Sclerostomy.
- pathology : Anterior Chamber.
- surgery : Anterior Chamber, Glaucoma.
- Adolescent, Adult, Aged, Female, Follow-Up Studies, Humans, Intraocular Pressure, Male, Middle Aged, Treatment Outcome.
Abstract
Ab externo thermal sclerostomy was performed with the holmium YAG (thulium, holmium, chromium-doped YAG crystal) laser in 21 eyes of 20 patients with refractory glaucoma. We used either the 5-fluorouracil (5-FU) or mitomycin C (MMC) antimetabolites in all cases. The rate of intraocular pressure (IOP) control defined as IOP < 21 mmHg regardless of whether antiglaucoma medication was applied postoperatively) was estimated by the life-table methods of Kaplan-Meier. The postoperative IOP control rate was 47.1% in the MMC-treated group at 57 months, and 14.3% in the 5-FU-treated group at 52 months. There were statistically significant differences in success rates between the MMC- and 5-FU-treated groups. We observed no clinically significant complications except excess filtration associated with a shallow anterior chamber in one case. This procedure is thought to have several advantages over more conventional filtration surgery; the operation time is shorter, and there is no need for intraocular manipulation, which means conjunctival trauma is minimal. However, the IOP control rate was substantially lower than that achieved via conventional trabeculectomy. Our results suggest that the selection of patients and the use of MMC is an important factor in maintaining successful filtration.
PubMed: 9237131
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pubmed:9237131Le document en format XML
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<term>Adult</term>
<term>Aged</term>
<term>Anterior Chamber (pathology)</term>
<term>Anterior Chamber (surgery)</term>
<term>Antibiotics, Antineoplastic (administration & dosage)</term>
<term>Antimetabolites (administration & dosage)</term>
<term>Female</term>
<term>Fluorouracil (administration & dosage)</term>
<term>Follow-Up Studies</term>
<term>Glaucoma (drug therapy)</term>
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<term>Sclerostomy (methods)</term>
<term>Treatment Outcome</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Antibiotiques antinéoplasiques (administration et posologie)</term>
<term>Antimétabolites (administration et posologie)</term>
<term>Chambre antérieure du bulbe oculaire ()</term>
<term>Chambre antérieure du bulbe oculaire (anatomopathologie)</term>
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<term>Fluorouracil (administration et posologie)</term>
<term>Glaucome ()</term>
<term>Glaucome (traitement médicamenteux)</term>
<term>Humains</term>
<term>Mitomycine (administration et posologie)</term>
<term>Mâle</term>
<term>Pression intraoculaire</term>
<term>Résultat thérapeutique</term>
<term>Sclérostomie ()</term>
<term>Sclérostomie (effets indésirables)</term>
<term>Sujet âgé</term>
<term>Études de suivi</term>
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<term>Mitomycin</term>
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<term>Mitomycine</term>
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<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Chambre antérieure du bulbe oculaire</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Glaucoma</term>
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<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Anterior Chamber</term>
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<term>Glaucoma</term>
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<term>Aged</term>
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<term>Follow-Up Studies</term>
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<term>Chambre antérieure du bulbe oculaire</term>
<term>Femelle</term>
<term>Glaucome</term>
<term>Humains</term>
<term>Mâle</term>
<term>Pression intraoculaire</term>
<term>Résultat thérapeutique</term>
<term>Sclérostomie</term>
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<front><div type="abstract" xml:lang="en">Ab externo thermal sclerostomy was performed with the holmium YAG (thulium, holmium, chromium-doped YAG crystal) laser in 21 eyes of 20 patients with refractory glaucoma. We used either the 5-fluorouracil (5-FU) or mitomycin C (MMC) antimetabolites in all cases. The rate of intraocular pressure (IOP) control defined as IOP < 21 mmHg regardless of whether antiglaucoma medication was applied postoperatively) was estimated by the life-table methods of Kaplan-Meier. The postoperative IOP control rate was 47.1% in the MMC-treated group at 57 months, and 14.3% in the 5-FU-treated group at 52 months. There were statistically significant differences in success rates between the MMC- and 5-FU-treated groups. We observed no clinically significant complications except excess filtration associated with a shallow anterior chamber in one case. This procedure is thought to have several advantages over more conventional filtration surgery; the operation time is shorter, and there is no need for intraocular manipulation, which means conjunctival trauma is minimal. However, the IOP control rate was substantially lower than that achieved via conventional trabeculectomy. Our results suggest that the selection of patients and the use of MMC is an important factor in maintaining successful filtration.</div>
</front>
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