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1 General aspects (0)   1.1 Epidemiology (7)   1.2 Population genetics (1)   1.3 Pathogenesis (3)   1.4 Quality of life (5)   1.5 Glaucomas as cause of blindness (1)   1.6 Prevention and screening (1) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (2)   2.2 Cornea (7)   2.3 Sclera (0)   2.4 Anterior chamber angle (0)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (7)     2.5.2 Schlemms canal (0)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (1)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (2)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (2)   2.9 Ciliary body (0)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (2)   2.13 Retina and retinal nerve fibre layer (16)   2.14 Optic disc (7)   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 (0)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (7)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (16)     3.4.2 Gene studies (3)   3.5 Molecular biology incl. 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    9.4.1 Steroid-induced glaucoma (8)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (2)       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 (0)       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 (0)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (9)       9.4.4.2 Glaucomas associated with cataracts (0)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (0)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (1)       9.4.5.5 Other (0)     9.4.6 Glaucomas associated with inflammation, uveitis (2)     9.4.7 Glaucomas associated with ocular trauma (0)     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 (0)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (0)       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 (0)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (0)     9.4.15 Glaucoma in relation to systemic disease (6)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (4) 11 Medical treatment (1)   11.1 General management, indication (8)   11.2 Cholinergic drugs (1)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (6)     11.3.4 Betablocker (10)     11.3.5 Other (0)   11.4 Prostaglandins (21)   11.5 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tube implant (12)     12.8.2 With tube implant or other drainage devices (6)     12.8.3 Non-perforating (8)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (9)     12.8.11 Complications, endophthalmitis (6)   12.9 Trabeculotomy, goniotomy (2)   12.10 Cyclodestruction (1)   12.11 Cyclodialysis (1)   12.12 Cataract extraction (2)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (3)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (3)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (3)   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 (5) 15 Miscellaneous (8)

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Abstract #14310 Published in IGR 8-3

Trabeculectomy with scleral tunnel treating refractory glaucoma

Pan R-G; Chen X-M; Li M; Liu D-J
Ophthalmology in China 2006; 15: 105-107

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OBJECTIVE: To investigate the clinical effect of trabeculectomy with scleral tunnel in the treatment of refractory glaucoma. DESIGN: Prospective, randomized and comparative clinical study. PARTICIPANTS: Eighty-seven patients (98 eyes) with refractory glaucoma. METHODS: The patients were randomly assigned to receiving trabeculectomy with or without scleral tunnel. The tunnel group (50 eyes) underwent trabeculectomy with an additional deep scleral tunnel of 5.0 mm x 1.5 mm beneath the superficial scleral flap. The control group (48 eyes) underwent conventional trabeculectomy. The average follow-up period was 6 to 12 months postoperatively. MAIN OUTCOME MEASURES: Visual acuity, intraocular pressures (IOP), filtering blebs, operative and postoperative complications. RESULTS: (1) No significant differences in visual acuity were found between two groups. (2) The postoperative IOPs were significantly lower than the preoperative IOPs in both groups, while the IOPs on the 7th day after the surgery between the two groups were not different significantly. The average postoperative IOP at the 6th month in the tunnel group was 14.34 ± 3.95 mmHg and 19.57 ± 7.76 mmHg in the control group, which were different significantly (P < 0.05). The successful rates were 88.00% and 64.58% in two groups respectively. (3) The percentage of functional filtering blebs in the tunnel group was 82.0%, significantly higher than that of 60.4% in the control group (P < 0.05). (4) The incidence rate of shallow anterior chamber in the tunnel group was higher than that in the control group, but all the cases had recovered by the end of 1 week after proper treatment. There were no relative complications. CONCLUSION: The trabeculectomy with scleral tunnel has the advantages of preventing postoperative scar formation and achieving better control of postoperative IOP over the conventional trabeculectomy in treating refractory glaucoma.

Dr. X.-M. Chen, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China

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Classification:

12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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