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1 General aspects (0)   1.1 Epidemiology (2)   1.2 Population genetics (1)   1.3 Pathogenesis (3)   1.4 Quality of life (2)   1.5 Glaucomas as cause of blindness (3)   1.6 Prevention and screening (5) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (0)   2.2 Cornea (19)   2.3 Sclera (0)   2.4 Anterior chamber angle (1)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (12)     2.5.2 Schlemms canal (1)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (2)     2.6.1 Production (0)     2.6.2 Outflow (1)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (0)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (0)   2.9 Ciliary body (0)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (1)   2.13 Retina and retinal nerve fibre layer (8)   2.14 Optic disc (10)   2.15 Optic nerve (2)   2.16 Chiasma and retrochiasmal central nervous system (0)   2.17 Stem cells (0)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (1)   3.2 Electron microscopy (3)   3.3 Immunohistochemistry (5)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (10)     3.4.2 Gene studies (6)   3.5 Molecular biology incl. 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tube implant (8)     12.8.2 With tube implant or other drainage devices (11)     12.8.3 Non-perforating (4)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (11)     12.8.11 Complications, endophthalmitis (9)   12.9 Trabeculotomy, goniotomy (1)   12.10 Cyclodestruction (4)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (9)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (1)   12.15 Capsulotomy (0)   12.16 Vitrectomy (1)   12.17 Anesthesia (1)   12.20 Other (2) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (0)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (6) 15 Miscellaneous (6)

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Abstract #13679 Published in IGR 8-2

Long-term results of early trabeculectomy with mitomycin-C and subsequent posterior segment intervention in the treatment of neovascular glaucoma with hazy ocular media

Euswas A; Warrasak S
Journal of the Medical Association of Thailand 2005; 88: 1582-1590

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OBJECTIVES: To assess the long-term efficacy and safety of early trabeculectomy with mitomycin-C (TMMC) and subsequent posterior segment intervention in the treatment of neovascular glaucoma (NVG) with hazy ocular media. MATERIAL AND METHOD: Twenty-three eyes of 21 patients who had NVG with hazy ocular media that precluded posterior segment and had persistent IOP of 30 mmHg or more despitefully antiglaucoma medications for 48 hours, underwent a modified TMMC (twice application of subconjunctival and subscleral MMC 0.2 mg/ml for 3 and 2 minutes, small internal block excision, laser suturelysis at two weeks) and subsequent posterior segment intervention with or without phacoemulsification. RESULTS: Preoperative IOP ranged from 30-80 mmHg, (mean 38.87 ± 9.52). Follow-up period ranged from 12-47 months (mean 29 ± 11.03). At final follow-up, qualified success (an IOP of ≤ 21 mmHg with or without medication) and complete success (an IOP of ≤ 15 mmHg without medication) was achieved in 21 (91.3%) of 23 eyes and in 12 (52.7%) of 23 eyes, respectively. The median successful period of maintaining qualified success was 13 months. Final visual acuity of 20/400 or better was preserved in 12 of 23 eyes (52.7%). None had hypotony maculopathy, leaking blebs or endophthalmitis. CONCLUSION: Early TMMC and subsequent posterior segment intervention, offerred a safe and prolonged satisfactory result of IOP control in NVG patients with hazy ocular media.

Dr. A. Euswas, Glaucoma Service, Department of Ophthalmology, Ramathibodi Hospital Faculty, Mahidol University, Bangkok, Thailand. ataya@loxinfo.co.th

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Classification:

9.4.5.1 Neovascular glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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