advertisement

---

1 General aspects (0)   1.1 Epidemiology (11)   1.2 Population genetics (0)   1.3 Pathogenesis (4)   1.4 Quality of life (12)   1.5 Glaucomas as cause of blindness (5)   1.6 Prevention and screening (9) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (4)   2.2 Cornea (18)   2.3 Sclera (4)   2.4 Anterior chamber angle (4)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (7)     2.5.2 Schlemms canal (1)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (1)     2.6.1 Production (0)     2.6.2 Outflow (2)       2.6.2.1 Trabecular meshwork (1)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (1)   2.7 Episcleral veins and venous pressure (1)   2.8 Iris (2)   2.9 Ciliary body (1)   2.10 Lens (0)   2.11 Vitreous body (1)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (1)   2.13 Retina and retinal nerve fibre layer (16)   2.14 Optic disc (8)   2.15 Optic nerve (1)   2.16 Chiasma and retrochiasmal central nervous system (9)   2.17 Stem cells (1)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (2)   3.2 Electron microscopy (4)   3.3 Immunohistochemistry (5)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (33)   3.5 Molecular biology incl. SiRNA (16)   3.6 Cellular biology (22)   3.7 Biochemistry (5)   3.8 Pharmacology (5)   3.9 Pathophysiology (10)   3.10 Immunobiology (2)   3.11 Pharmacogenetics (0)   3.12 Proteomics (1)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (0)     3.13.3 RGC Imaging (0)     3.13.4 Other (0)   3.20 Other (0) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (1)   5.1 Rodent (24)   5.2 Primates (7)   5.3 Other (21) 6 Clinical examination methods (0)   6.1 Intraocular pressure measurement; factors affecting IOP (0)     6.1.1 Devices, techniques (9)     6.1.2 Fluctuation, circadian rhythms (6)     6.1.3 Factors affecting IOP (13)   6.2 Tonography, aqueous flow measurement (see also 2.6) (1)   6.3 Biomicroscopy (slitlamp) (0)     6.3.1 Anterior segment (0)     6.3.2 Posterior segment (0)   6.4 Gonioscopy (2)   6.5 Ophthalmoscopy (0)   6.6 Visual field examination and other visual function tests (0)     6.6.1 Conventional manual (5)     6.6.2 Automated (12)     6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (10)   6.7 Electro-ophthalmodiagnosis (7)   6.8 Photography (0)     6.8.1 Anterior segment (6)     6.8.2 Posterior segment (7)   6.9 Computerized image analysis (0)     6.9.1 Laser scanning (0)       6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (20)       6.9.1.2 Confocal Scanning Laser Polarimetry (12)     6.9.2 Optical coherence tomography (0)       6.9.2.1 Anterior (6)       6.9.2.2 Posterior (29)     6.9.5 Other (0)   6.10 Fluorescein (ICG) angiography (0)     6.10.1 Anterior segment (1)     6.10.2 Posterior segment (0)   6.11 Bloodflow measurements (23)   6.12 Ultrasonography and ultrasound biomicroscopy (7)   6.13 Provocative tests (2)   6.19 Telemedicine (0)   6.20 Progression (4)   6.30 Other (8) 8 Refractive errors in relation to glaucoma (0)   8.1 Myopia (1)   8.2 Hypermetropia (0)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (1)   8.5 Other (0) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (1)     9.1.1 Congenital glaucoma, Buphthalmos (4)     9.1.2 Juvenile glaucoma (7)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (3)     9.1.4 Other (0)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (3)     9.2.2 Other risk factors for glaucoma (1)     9.2.3 Open angle glaucoma with elevated IOP (2)     9.2.4 Normal pressure glaucoma (17)   9.3 Primary angle closure glaucomas (0)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (12)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (3)     9.3.3 Plateau iris syndrome (0)     9.3.4 Primary angle closure suspect (2)     9.3.5 Primary angle closure (0)     9.3.10 Other (0)   9.4 Glaucomas associated with other ocular and systemic disorders (0)     9.4.1 Steroid-induced glaucoma (8)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (1)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (0)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (1)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (3)       9.4.3.5 Other (3)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (10)       9.4.4.2 Glaucomas associated with cataracts (0)       9.4.4.3 Glaucomas associated with lens dislocation (2)       9.4.4.5 Other (2)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (16)       9.4.5.5 Other (7)     9.4.6 Glaucomas associated with inflammation, uveitis (4)     9.4.7 Glaucomas associated with ocular trauma (5)     9.4.8 Glaucomas associated with intraocular tumors (0)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (0)       9.4.10 Glaucomas associated with hemorrhage (2)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (1)       9.4.11.2 Glaucomas in aphakia and pseudophakia (4)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (6)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (7)     9.4.15 Glaucoma in relation to systemic disease (26)     9.4.20 Other (1) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (2) 11 Medical treatment (0)   11.1 General management, indication (4)   11.2 Cholinergic drugs (0)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (1)     11.3.4 Betablocker (13)     11.3.5 Other (0)   11.4 Prostaglandins (40)   11.5 Carbonic anhydrase inhibitors (0)     11.5.1 Systemic (2)     11.5.2 Topical (7)   11.6 Osmotic treatment (0)   11.7 Treatment of bloodflow (0)   11.8 Neuroprotection (30)   11.9 Gene therapy (3)   11.13 Combination therapy (0)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (2)     11.13.3 Betablocker and brimonidine (2)     11.13.4 Betablocker and prostaglandin (7)     11.13.5 Other (0)   11.14 Investigational drugs; pharmacological experiments (37)   11.15 Other drugs in relation to glaucoma (19)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (10)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (7)   11.20 Other (0) 12 Surgical treatment (0)   12.1 General management, indication (1)   12.2 Laser iridotomy (5)   12.3 Laser iridoplasty (0)   12.4 Laser trabeculoplasty and other laser treatment of the angle (8)   12.7 Surgical iridectomy (0)   12.8 Filtering surgery (0)     12.8.1 Without tube implant (18)     12.8.2 With tube implant or other drainage devices (23)     12.8.3 Non-perforating (5)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (14)     12.8.11 Complications, endophthalmitis (9)   12.9 Trabeculotomy, goniotomy (1)   12.10 Cyclodestruction (5)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (7)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (15)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (3)   12.20 Other (9) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (1)     13.2.2 Visual field (0)       13.2.2.1 Progression (2)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (7) 15 Miscellaneous (8)

---

Abstract #25605 Published in IGR 12-1

Nd: YAG laser goniopuncture after deep sclerectomy: Outcomes

Anand N; Pilling R
Acta Ophthalmologica 2010; 88: 110-115

---

Purpose: This study aimed to investigate the safety and efficacy of Nd: YAG laser goniopuncture (LGP) in lowering intraocular pressure (IOP) after deep sclerectomy (DS). Methods: We reviewed the outcomes in 258 eyes of 258 consecutive patients who underwent DS or combined phacoemulsification and DS between August 2001 and December 2003. Mitomycin C was used during surgery in 192 eyes (74.4%). Results: Mean follow-up was 40 (plus or minus) 11 months after DS and 31 (plus or minus) 12 months after LGP. Laser goniopuncture was performed in 173 eyes (67.0%). The mean interval between LGP and DS was 10.3 (plus or minus) 8.7 months. The probability of LGP being performed was 63.1% (95% confidence interval [CI] 57.3-69.4) at 36 months after surgery. At 2 years after LGP, the probability of maintaining IOP < 15 mmHg with a 20% decrease from the pre-laser IOP and no further glaucoma procedure or medication was 49.7% (95% CI 41.9-57.1). Iris covering the trabeculo-Descemet's membrane was the only factor significantly associated with the failure of LGP (hazard ratio 3.0, p < 0.001). Complications observed after LGP included peripheral anterior synechiae in 23 (13.2%), hypotony in seven (4.0%), late acute IOP rise in three (1.7%), delayed bleb leak in one and blebitis in two eyes. Argon laser iridoplasty was performed in 45 (26.0%) and needle revision in 41 (23.7%) eyes. Conclusions: ND: YAG laser goniopuncture is an effective procedure to further lower IOP after DS. An IOP of < 15 mmHg is achieved and maintained for (greater-than or equal to) 2 years in about 50% of cases after a single LGP procedure. There are potentially serious complications associated with the procedure. Regular gonioscopy is recommended following LGP to detect any occlusion of the goniopuncture by the iris.

N. Anand. Department of Ophthalmology, Huddersfield Royal Infirmary Lindley, Huddersfield HD3 3EA West Yorkshire, United Kingdom. anand1604@gmail.com

---

Classification:

12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)

---

• ← Previous
• Next →

---