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Wentworth McClanahan posted an update a month ago
trated similar knowledge of glaucoma compared with those attending face-to-face clinics but gaps in knowledge were identified in both groups. Patient education should be incorporated into the design of all glaucoma services.We report a case of tube obstruction of a non valved glaucoma drainage device (Aurolab Aqueous Drainage Implant; AADI) with a dislocated Soemmering’s ring leading to a postoperative intraocular pressure (IOP) spike after an initial IOP reduction. A 24 year old male with bilateral aphakia, bilateral secondary glaucoma developed corneal decompensation in the left eye. The IOP in the left eye was 22▒mmHg with three IOP topical lowering medications (timolol 0.5%, brimonidine 0.2% and latanoprost 0.005%). To control the IOP prior to performing a penetrating keratoplasty, AADI was implanted. A good bleb and an IOP of 10▒mmHG was noted at 6.5 weeks postoperatively. The following day the patient developed an acute rise in IOP (42▒mmHg) due to tube obstruction of the AADI by a Soemmering’s ring. The IOP spike was initially controlled with oral acetazolamide and topical IOP lowering medications (fixed combination of timolol 0.5% and brimonidine 0.2%). Six days later, pars plana vitrectomy, Soemmering’s ring removal, penetrating keratoplasty, and tube trimming was performed. Following this, the patient had good IOP control, and a clear corneal graft at 1 year follow up. In aphakic eyes undergoing non valved glaucoma drainage device implantation, a complete pars plana vitrectomy combined with any lens remnant removal may be considered. Selleck Romidepsin It helps to avoid tube obstruction due to these lens remnants which can migrate anteriorly along with the aqueous currents.
This paper reports a retrospective consecutive case series investigating the efficacy of Mitomycin C-augmented trabeculectomy in the treatment of primary and secondary pediatric glaucoma in a mixed etiology, multiethnic cohort of patients.
To evaluate the long-term efficacy and safety of Mitomycin C-augmented trabeculectomy in a mixed, tertiary-referral, pediatric glaucoma cohort.
Retrospective consecutive review of all children (37 eyes) undergoing Mitomycin C-augmented trabeculectomy by a single surgeon between 2008 and 2016. Seventeen eyes (45.9%) had primary congenital glaucoma, and 20 eyes (54.1%) had secondary glaucoma. The median age at surgery was 11 months (range, 2 to 146). The mean follow-up was 69.2±4.7 months (range, 3.5 to 107.9).
Overall, trabeculectomy was successful in 80.6% of eyes at 12 months, 60.5% at 3 years, and 57.5% at 5 years. 45.9% cases (17 eyes) required further laser or surgery for uncontrolled intraocular pressure (IOP) and were therefore deemed as failures. The time to y in a significant proportion of children.
This study provides valuable evidence that Mitomycin C-augmented trabeculectomy is safe and effective as a treatment of primary or secondary pediatric glaucoma, with particularly encouraging results in cases of secondary glaucoma. Trabeculectomy offers the potential for delaying or avoiding glaucoma drainage device surgery in a significant proportion of children.
To report a case of bilateral acute angle-closure glaucoma associated with hyponatremia in the setting of chlorthalidone use and SARS-CoV-2 infection, and to demonstrate the challenges of managing this patient given her infectious status.
This was a case report.
A 65-year-old woman taking chlorthalidone for hypertension presented to the emergency room with headache, pain, and blurry vision in both eyes and was found to be in bilateral acute angle closure. On laboratory investigation, she was severely hyponatremic and also tested positive for SARS-CoV-2. B-scan ultrasound demonstrated an apparent supraciliary effusion in the right eye. Following stabilization of her intraocular pressures with medical management, she ultimately underwent cataract extraction with iridectomies and goniosynechiolysis in both eyes.
We report a rare case of bilateral acute angle-closure glaucoma associated with hyponatremia. Chlorthalidone use and perhaps SARS-CoV-2 infection may have contributed to this electrolyte abnormality and unique clinical presentation. In addition, we discuss the challenges of managing this complex patient with active SARS-CoV-2 infection during the pandemic.
We report a rare case of bilateral acute angle-closure glaucoma associated with hyponatremia. Chlorthalidone use and perhaps SARS-CoV-2 infection may have contributed to this electrolyte abnormality and unique clinical presentation. In addition, we discuss the challenges of managing this complex patient with active SARS-CoV-2 infection during the pandemic.
Postoperative suprachoroidal hemorrhage is an infrequent but devastating complication after non-valved aqueous drainage implant surgery and demonstrated a bimodal distribution. The final outcomes of either conservative management or surgical drainage of the hemorrhage remained poor.
To report the incidence and outcomes of eyes developing postoperative suprachoroidal hemorrhage (PSCH) after undergoing Aurolab Aqueous Drainage Implant (AADI) surgery for adult and pediatric refractory glaucomas.
In this retrospective series, case files of all patients who underwent AADI between May 2012 and December 2019 were retrieved from an electronic database. A PSCH was defined as the presence of hemorrhagic choroidal detachment, confirmed by ultrasound B scan, occurring in a closed system in the postoperative period.
Of the 986 eyes that underwent AADI during the study period, 7 (0.7%), developed PSCH (95% CI=0.3-1.6%). There were no differences in the preoperative parameters between those with and without PSCH. Ofnly about half these eyes.
A frozen neck is a scarred neck with severe fibrosis with a loss of tissue planes secondary to prior irradiation with or without surgery. The purpose of this study was to evaluate the outcomes of cervicofacial reconstruction in patients with soft tissue defects and bone flap and reconstruction plate exposure with the upper trapezius myocutaneous flap. Fifteen oncologic patients with prior surgery and radiotherapy developed soft tissue dehiscence with bone and osteosynthesis material exposure. All patients had either a frozen neck or a vessel-depleted neck. The soft tissue defects were reconstructed, the osteosynthesis material was removed and the bone flap exposure was covered in all patients. One patient developed a seroma and 1 patient reported wound dehiscence. In terms of esthetic results, 6 patients referred a good esthetic result, whereas 8 patients referred a fair result and 1 patient a poor result. Two patients with prior radical neck dissection reported a poor functional result in the ipsilateral shoulder, previously to secondary reconstruction.