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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2004, Number 2

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Rev Mex Oftalmol 2004; 78 (2)

Evaluación clínica y ecográfica del desprendimiento coroideo de inicio temprano post-trabeculectomía

Paczka JA, Sánchez-Castellanos VE, De-los-Ríos D, Topete-Jiménez J, Gil-Carrasco F

Language: Spanish
References: 23
Page: 71-76
PDF size: 241.91 Kb.


ABSTRACT

Purpose: To evaluate the peri-operative, clinical and echographic differences in eyes that developed early choroidal detachment (CD) compared with those that did not had such complication after trabeculectomy.
Methods: A cohort of 53 patients affected by uncontrolled glaucoma who underwent primary trabeculectomy was prospectively evaluated. A- and B-scan ultrasonography and a clinical examination were carried out 24 hours before and after surgery. Pre- and post-operative IOP, proportion of IOP reduction, blood pressure, type and number of glaucoma medicines, and surgeon’s level of experience were collected variables.
Results: From 53 operated eyes, the presence of CD was detected by echographic and/or clinical examination in 15 eyes (28.3%). Mean pre-operative IOP in eyes that developed CD (26.0 ± 8.0 mmHg) was significantly higher (P = 0.011) than in eyes not affected by this condition (21.2 ± 5.3 mmHg). One day after surgery, there was no significant difference (P = 0.390) in the post-operative IOP (5.0 ± 4.6 mmHg vs. 6.0 ± 5.6 mmHg). A proportion of eyes with a net reduction equal or greater than 15 mmHg was significantly higher in the CD group (P = 0.017).
Conclusions: Our data supports the fact that early-onset CD after trabeculectomy appears to be more frequent in cases with higher pre-operative IOP and greater proportions of IOP reduction but not necessarily with lower post-operative IOP.


REFERENCES

  1. Katz LJ. Ciliochoroidal detachment. Ophthalmic Surg 1987; 2: 175.

  2. Bellows A. Complications of filtering surgery. En: Principles and Practice of Ophthalmology. Albert DM, Jakobiec FA (Eds.) WB Saunders, Philadelphia 1999: pp 1646-1655.

  3. Pederson JE. Hypotony. En: Duane’s Clinical Ophthalmology. Tasman W, Jaeger EA (eds.). Lippincott-Raven Publishers, Philadelphia 1995: pp 1-9.

  4. Liebmann JM, Ritch R. Complications of glaucoma filtering surgery. En: The Glaucomas. Ritch R, Shields MB, Krupin T (Eds). Mosby, St. Louis, 1996: pp 1703-1736.

  5. Brubaker RF, Pederson JE. Ciliochoroidal detachment. Surv Ophthalmol 1983; 27:281-289.

  6. Stewart WC, Shields MB. Management of anterior chamber depth after trabeculectomy. Am J Ophthalmol 1988; 106:41-44.

  7. Stewart WC, Crinkley CM. Influence of serous choroidal detachments on the results of trabeculectomy surgery. Acta Ophthalmologica Scand 1994; 72:309-314.

  8. Burney EN, Quigley MA, Robin AL. Hypotony and choroidal detachment as late complications of trabeculectomy. Am J Ophthalmol 1987; 103:685-670.

  9. Kim YY, Jung HR. The effect of flat anterior chamber on the success of trabeculectomy. Acta Ophthalmologica Scand 1995; 73:268-272.

  10. Migdal C, Hitchings R. Morbidity following prolonged postoperative hypotony after trabeculectomy. Ophthalmic Surg 1988; 19:865-857.

  11. Blok MDW, Greve EL, Dunnebier EA, Kijlstra A. Scleral flap sutures and the development of shallow or flat anterior chamber after trabeculectomy. Ophthalmic Surg 1993; 24:309-313.

  12. Costa VP, Correa MM, Kara-Jose N. Needling versus medical treatment in encapsulated blebs. A randomized, prospective study. Ophthalmology 1997; 104:1215-1220.

  13. Gillies WE, Brooks AM. Restoring the function of the failed bleb. Aust N Z J Ophthalmol 1991; 19:49-51.

  14. Pederson JE, Smith SG. Surgical management of encapsulated filtering blebs. Ophthalmology 1985; 92:955-958.

  15. Raina UK, Tuli D. Trabeculectomy with releasable sutures: a prospective, randomized pilot study. Arch Ophthalmol 1998; 116:1288-1293.

  16. Gray TB. Removable sutures in glaucoma surgery. Aust N Z J Ophthalmol 1994; 22:211-213.

  17. Hsu CT, Yarng SS. A modified removable suture in trabeculectomy. Ophthalmic Surg 1993; 24:579-584.

  18. Kapetansky FM. Laser suture lysis after trabeculectomy. J Glaucoma 2003; 12:316-320.

  19. Wieland M, Spaeth GL. Use of digital compression following glaucoma surgery. Ophthalmic Surg 1988; 19:350-352.

  20. Sugimoto K, Ito K, Esaki K y cols. Supraciliochoroidal fluid at an early stage after trabeculectomy. Jpn J Ophthalmol 2002; 46:548-552.

  21. Lama PJ, Fechtner RD. Antifibrotics and wound healing in glaucoma surgery. Surv Ophthalmol 2003; 48:314-346.

  22. WuDunn D, Cantor LB, Palanca-Capistrano AM y cols. A prospective randomized trial comparing intraoperative 5-fluorouracil vs. mitomycin C in primary trabeculectomy. Am J Ophthalmol 2002; 134:521-528.

  23. Suzuki R, Dickens CJ, Iwach AG y cols. Long-term follow-up of initially successful trabeculectomy with 5-fluorouracil injections. Ophthalmology 2002; 109:1921-1924.




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