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Preoperative Values (preoperative + value)
Selected AbstractsIncidentally discovered pheochromocytoma in long-term hemodialysis patientsINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2002MASAAKI MORIOKA Abstract Two cases of pheochromocytoma incidentally discovered in long-term hemodialysis patients are reported. Case 1 was a 47-year-old-man who had been receiving hemodialysis for 18 years. Case 2 was a 33-year-old woman who had been receiving hemodialysis for 12 years. Both cases were normotensive, and no specific symptoms suggesting pheochromocytoma were seen. Plasma norepinephrine (NE) levels were not elevated in both cases; however, the level of epinephrine (E) was double the normal range in Case 2. After surgery, plasma E level returned to the normal range in Case 2; however, the level of NE remained almost the same as the preoperative value in both cases. Plasma catecolamine levels in long-term hemodialysis patients with pheochromocytoma are reviewed in the present report, and the efficacy of imaging methods in the diagnosis of pheochromocytoma are discussed. [source] Twenty-Four Hours Postoperative Results After Orthotopic Cardiac Transplantation in SwineJOURNAL OF CARDIAC SURGERY, Issue 4 2007Matthias Siepe M.D. However, there is no functional data available for a longer time period after transplantation. We have established a pig model to investigate myocardial function 24 hours after orthotopic transplantation.Materials and Methods: Orthotopic cardiac transplantations (HTx) in pigs were performed with a postoperative observation period of 24 hours (n = 6). To analyze myocardial function after transplantation, hemodynamical parameters (Swan-Ganz- and impedance-catheter data) as well as tissue and blood samples were obtained. Regional myocardial blood flow (RMBF) was assessed using fluorescent microspheres. Results: The impedance-catheter parameters demonstrated a preserved contractility in both ventricles 24 hours post-transplantation. In contrast, cardiac output 24 hours after HTx was diminished by 50% as compared to the preoperative value. Conversely, pulmonary vascular resistance increased significantly. The RMBF was increased in both ventricles. Metabolic and histological analyses indicate myocardial recovery 24 hours after HTx with no irreversible damage. Conclusions: For the first time, we were able to establish a porcine model to investigate myocardial function 24 hours after heart transplantation. While the contractility of the transplanted hearts was well-preserved, impaired cardiac output was going along with an increase in pulmonary vascular resistance. Using this clinical relevant model, improvements of human cardiac transplantation and post-transplant contractile dysfunction, especially, could be investigated. [source] Aprotinin and renal dysfunction after pediatric cardiac surgeryPEDIATRIC ANESTHESIA, Issue 2 2008ANDREA SZÉKELY MD PhD Summary Background:, Aprotinin is a potent antifibrinolytic drug, which reduces postoperative bleeding and transfusion requirements. Recently, two observational studies reported increased incidence of renal dysfunction after aprotinin use in adults. Therefore, the aim of the study was to investigate the safety of aprotinin use in pediatric cardiac surgery patients. Methods:, Data were prospectively and consecutively collected from 657 pediatric patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The database was assessed with regard to a possible relationship between aprotinin administration and dialysis and between aprotinin and postoperative renal dysfunction [defined as 25% decrease in the creatinine clearance (Ccr) compared with the preoperative value] by propensity-score adjustment and multivariable methods. Results:, The incidence of dialysis (9.6% vs 4.1%; P = 0.005) and renal dysfunction (26.3% vs 16.1%; P = 0.019) was higher in patients who received aprotinin; however, propensity adjusted risk ratios were not significant [odds ratio (OR) of dialysis: 1.22; 95% confidence interval (CI) 0.46,3.22; OR of renal dysfunction 1.26; 95% CI: 0.66,1.92]. Aprotinin significantly reduced blood loss in the first postoperative 24 h. The main contributors of renal dysfunction were CPB duration, cumulative inotropic support, age, preoperative Ccr, amount of transfusion and pulmonary hypertension. Conclusions:, Despite the higher incidences of renal dysfunction and failure in the aprotinin group, an independent role of the drug in the development of renal dysfunction or dialysis could not be demonstrated in pediatric cardiac patients undergoing CPB. [source] The effect of multilevel upper airway surgery on continuous positive airway pressure therapy in obstructive sleep apnea/hypopnea syndrome,,THE LARYNGOSCOPE, Issue 1 2009FACS, Michael Friedman MD Abstract Objective: To investigate the effect of multilevel upper airway surgery (USA) on subsequent continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Study Design: Fifty-two patients who underwent multilevel UAS with persistent symptoms of OSAHS represent the cohort for this study. All patients had undergone manual CPAP titrations both pre- and postoperatively. Patients were used as their own controls and were compared pre- and postoperatively with regard to body mass index, full night polysomnography (PSG), optimal CPAP pressure settings, presence of rapid eye-movement (REM) sleep, identification of mouth leakage, and CPAP compliance. Results: Postoperative values for apnea index (AI), apnea hypopnea index (AHI), and minimum oxygen saturation (min SaO2) were all significantly decreased from their preoperative levels. Compliance with CPAP therapy significantly increased from a mean 0.02 ± 0.14 hours per night prior to surgery to a 3.2 ± 2.6 hours per night following surgery (P < .001). In addition, the optimal CPAP pressure setting decreased significantly for a preoperative value of 10.6 ± 2.1 cm H2O to 9.8 ± 2.1 cm H2O following surgery. Fifty of the 52 patients (96.2%) studied were able to maintain optimal pressure settings without mouth leak, postoperatively. Conclusions: In this study, most patients who had persistent symptoms of OSAHS after multilevel UAS did not have significant mouth leak that would preclude CPAP therapy. In this cohort of patients, CPAP pressure setting as well as compliance was significantly improved postoperatively. Laryngoscope, 119:193,196, 2009 [source] Pattern of carcinoembryonic antigen drop after laparoscopic radiofrequency ablation of liver metastasis from colorectal carcinomaCANCER, Issue 1 2006Mohammed Ghanamah M.D. Abstract BACKGROUND Laparoscopic radiofrequency ablation (RFA) is being increasingly used for local control of hepatic metastasis from colorectal carcinoma (CRC). After surgical resection of colorectal liver metastasis, carcinoembryonic antigen (CEA) values fall within 2 weeks, making this a useful parameter to follow shortly after surgery. Little is known, however, about the expected pattern of the CEA drop after RFA. METHODS From September 1998 to October 2002, RFA to CRC liver metastasis was performed on 144 patients. A subset of 17 patients were studied who had no evidence of extrahepatic disease preoperatively, had all detectable tumor ablated intraoperatively, and who on long-term follow-up (up to 15 months) had no evidence of recurrent disease. Serum CEA was determined preoperatively, on the first postoperative day, at 1 week, and every 3 months afterwards. A computed tomography (CT) scan of the abdomen and pelvis was obtained every 3 months postoperatively. RESULTS Ten (58.8%) patients showed an increase in CEA on postoperative Day 1, averaging 38.3% compared with the preoperative value. CEA then fell to 50% of the preoperative value, on average, on Day 7 postoperatively and only reached its nadir at 3 months. CONCLUSIONS Unlike resection patients, those undergoing ablation show an initial rise in CEA, probably due to release from the ablated tissue. Although heating of RFA would be expected to destroy CEA, the initial rise and slow drop postoperatively argue for a release of immunoreactive CEA from the ablated zone. This slow decline in CEA indicates that several months should pass before assessing the extent of potential residual disease. Cancer 2006. © 2006 American Cancer Society. [source] Evaluation of the visibility and the course of the mandibular incisive canal and the lingual foramen using cone-beam computed tomographyCLINICAL ORAL IMPLANTS RESEARCH, Issue 7 2010Nikos Makris Abstract Objectives: To assess the visibility and the course of the incisive canal and the visibility and the location of the lingual foramen using cone-beam computed tomography (CBCT). Methods: In total, 100 CBCT examinations of patients for preoperative planning were used for this study. The examinations were taken using the NewTom 3G CBCT unit, applying a standardized exposure protocol. Image reconstruction from the raw data was performed using the NewTom software. Three experts were asked to assess the visibility of the incisive canal using a four-point rating scale. The position of the incisive canal was recorded in relation to the lower, buccal and lingual border of the mandible using the application provided by the CBCT software. Results: The incisive canal was definitely visible in 83.5% of the scans and the mean endpoint was approximately 15 mm anterior to the mental foramen. The mean distance from the lower border of the mandible was 11.5 mm and its course was closer to the buccal border of the mandible in 87% of the scans. The lingual foramen was definitely visible in 81% of the scans. Conclusions: The high detection rate of the incisive canal and the lingual foramen in the anterior region of the mandible using CBCT indicates the potentional high preoperative value of CBCT scan for surgical procedures in the anterior mandible. To cite this article: Makris N, Stamatakis H, Syriopoulos K, Tsiklakis K, van der Stelt PF. Evaluation of the visibility and the course of the mandibular incisive canal and the lingual foramen using cone-beam computed tomography. Clin. Oral Impl. Res. 21, 2010; 766,771. doi: 10.1111/j.1600-0501.2009.01903.x [source] Early Hemodynamic Results of the Shelhigh SuperStentless Aortic BioprosthesesJOURNAL OF CARDIAC SURGERY, Issue 5 2007Paolo Cattaneo M.D. The aim of the study was to evaluate the early hemodynamic performance of the Shelhigh SuperStentless aortic valve (AV). Methods: Between July 2003 and June 2005, 35 patients (18 females; age 70.8 ± 11.7 years, range: 22-85) underwent AV replacement with the Shelhigh SuperStentless bioprostheses. Most recurrent etiology was senile degeneration in 25 (71%) patients and 24 (69%) were in New York Heart Association (NYHA) functional class III or IV. Concomitant coronary artery bypass grafting was performed in nine patients (25.7%) and mitral valve surgery in two patients (5.7%). Doppler echocardiography was performed before surgery, at six-month and one-year follow-up. Results: There were no hospital deaths and no valve-related perioperative complications. During one-year follow-up, no endocarditis or thromboembolic events were registered, no cases of structural dysfunction or valve thrombosis were noted. Mean and peak transvalvular gradients significantly decrease after AV replacement, with an evident reduction to approximately 50% of the preoperative values at six months. A 20% reduction was also observed for left ventricular mass (LVM) index at six months, with a further regression at one year. Correspondingly, significant increases in effective orifice area (EOA) and indexed EOA were determined after surgery (0.87 ± 0.14 versus 1.84 ± 0.29 cm2 and 0.54 ± 0.19 versus 1.05 ± 0.20 cm2/m2, respectively). Valve prosthesis-patient mismatch was moderate in five patients and severe in one case. Conclusions: Shelhigh SuperStentless AV provided good and encouraging hemodynamic results. Long-term follow-up is necessary to evaluate late hemodynamic performance and durability of this stentless bioprosthesis. [source] Comparison between intubation and the laryngeal mask airway in moderately obese adultsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2009M. ZOREMBA Background: Obesity is a well-established risk factor for perioperative pulmonary complications. Anaesthetic drugs and the effect of obesity on respiratory mechanics are responsible for these pathophysiological changes, but tracheal intubation with muscle relaxation may also contribute. This study evaluates the influence of airway management, i.e. intubation vs. laryngeal mask airway (LMA), on postoperative lung volumes and arterial oxygen saturation in the early postoperative period. Methods: We prospectively studied 134 moderately obese patients (BMI 30) undergoing minor peripheral surgery. They were randomly assigned to orotracheal intubation or LMA during general anaesthesia with mechanical ventilation. Premedication, general anaesthesia and respiratory settings were standardized. While breathing air, we measured arterial oxygen saturation by pulse oximetry. Inspiratory and expiratory lung function was measured preoperatively (baseline) and at 10 min, 0.5, 2 and 24 h after extubation, with the patient supine, in a 30° head-up position. The two groups were compared using repeated-measure analysis of variance (ANOVA) and t -test analysis. Statistical significance was considered to be P<0.05. Results: Postoperative pulmonary mechanical function was significantly reduced in both groups compared with preoperative values. However, within the first 24 h, lung function tests and oxygen saturation were significantly better in the LMA group (P<0.001; ANOVA). Conclusions: In moderately obese patients undergoing minor surgery, use of the LMA may be preferable to orotracheal intubation with respect to postoperative saturation and lung function. [source] New Method to Prevent Bladder Dysfunction after Radical Hysterectomy for Uterine Cervical CancerJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2000Dr. Yoshinori Kuwabara Abstract Objective: The purpose was to improve the surgical procedures to prevent bladder dysfunction after radical hysterectomy. Methods: Twelve patients with stage Ib cervical cancer underwent intraoperative electrical stimulation to identify the vesical branches of the pelvic nerves. Autonomic nerve localization in the vesicouterine ligament was examined in 10 patients immunohistochemically. According to the results of the above studies a new method to preserve the vesical branches was developed. Grades of postoperative bladder dysfunction were compared between new (n = 19) and conventional methods (n = 18). Results: Electrical stimulation on the outer surface of the posterior sheath of the vesicouterine ligament caused the increase of intravesical pressure. S-100 protein localized also on this area. Postoperative compliance of the detrusor in cases with the new method demonstrated less decrement from preoperative values than in cases with the conventional method. The new method required significantly fewer days to achieve residual urine volumes less than 50 ml after surgery. Conclusions: The new method significantly reduces bladder dysfunction after radical hysterectomy. [source] Increased Cortisol Response to Surgery in Patients With Alcohol Problems Who Developed Postoperative ConfusionALCOHOLISM, Issue 8 2004Akira Kudoh Background: Patients with alcohol problems often develop postoperative confusion and have impaired cortisol, ACTH, and norepinephrine. However, the relationship between neuroendocrine responses to surgical stress and postoperative confusion remains unclear in patients with alcohol problems. Methods: Plasma cortisol, ACTH, and norepinephrine concentrations during and after surgery in 30 patients with alcohol problems and 30 control patients who underwent lower abdominal surgery were measured before the induction of anesthesia, 15 and 60 min after skin incision, 60 min after the end of surgery, the next day, and the second day after the operation. Results: Plasma cortisol concentrations (21.2 ± 4.7 ,g·dl,1) of patients with alcohol problems before anesthesia were significantly higher than 15.6 ± 4.8 ,g·dl,1 of control patients. Plasma cortisol and ACTH responses to surgery in patients with alcohol problems were not significantly increased compared with preoperative values. The incidence of postoperative confusion was significantly higher in patients with alcohol problems than that of control patients (33% vs. 3%). Plasma cortisol concentrations (29.7 ± 7.0, 31.2 ± 6.6, 30.3 ± 8.0, and 28.4 ± 6.2 ,g·dl,1) 15 and 60 min after the skin incision, 60 min after the end of surgery, and the next day after operation in postoperatively confused patients with alcohol problems were significantly higher than those of nonconfused patients with alcohol problems (23.0 ± 5.8, 22.7 ± 4.1, 22.4 ± 7.2, and 21.9 ± 5.5 ,g·dl,1). Conclusion: The cortisol response to surgical stress increases in patients with alcohol problems who develop postoperative confusion, although cortisol response to surgical stress decreases in patients with alcohol problems without postoperative confusion. [source] The effects of exposure to environmental tobacco smoke on pulmonary function in children undergoing anesthesia for minor surgeryPEDIATRIC ANESTHESIA, Issue 5 2006JAMES M. O'ROURKE FFARCSI Summary Background:, The objectives of this study were to assess whether children exposed to environmental tobacco smoke (ETS) present for surgery with poorer pulmonary function, and experience a more pronounced deterioration in pulmonary function following anesthesia and surgery, than non-ETS-exposed children. Methods:, Fifty-four children aged 5,15 years with a history of ETS exposure from one or both parents and 54 children with no such ETS history were included in the study. All participants were presenting for ambulatory surgery and were judged to conform to American Society of Anesthesiology class I or II. Spirometry was performed preoperatively, postoperatively in the recovery ward when the child met criteria for discharge (Aldrete score 8), and before discharge from the day ward. Results:, The ETS-exposed group had a significantly lower mean preoperative peak expiratory flow rate (PEFR) (9.5 points lower percent predicted, 95% confidence interval ,18.1 to ,1.0, P = 0.03). Although not statistically significant, they also had lower percent predicted baseline mean values of the other spirometric variables that were measured (forced expiratory volume in 1 s ,4.5%, P = 0.07; forced vital capacity ,4.1%, P = 0.10; forced expiratory flow between 25% and 75%,3.6%, P = 0.44). Pulmonary function tests (PFTs) performed in recovery were between 8% and 14% worse than preoperative values, but the results were similar in the two groups of children. PFTs performed before hospital discharge demonstrated an near-complete recovery to baseline values. Again the pattern was similar in exposed and nonexposed children. Conclusions:, Environmental tobacco smoke exposure is associated with lower preoperative PEFR values, but does not impact on recovery from anesthesia for healthy children undergoing ambulatory anesthesia. [source] A 10-year follow-up after transurethral resection of the prostate, contact laser prostatectomy and electrovaporization in men with benign prostatic hyperplasia; long-term results of a randomized controlled trialBJU INTERNATIONAL, Issue 6 2010Robert J. Hoekstra Study Type , Therapy (RCT) Level of Evidence 1b OBJECTIVE To compare long-term results of transurethral resection of the prostate (TURP), contact laser prostatectomy (CLP) and electrovaporization of the prostate (EVAP) in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). PATIENTS AND METHODS Between 1996 and 2001, a prospective, randomized controlled trial was conducted in 150 men with LUTS suggestive of BPH, who had a prostate volume of 20,65 mL and a Schäfer's obstruction grade of ,2. Outcome variables were the International Prostate Symptom Score (IPSS), Quality of Life (QoL) question, Symptom Problem Index (SPI), BPH Impact Index (BII), maximum urinary flow rate (Qmax), prostate volume, prostate specific antigen (PSA) level, morbidity and mortality. In 2008 we carried out a long-term follow-up in these patients. Long-term values were compared with preoperative values for each treatment group (Wilcoxon signed-rank test), differences among groups were analysed (Kruskal,Wallis test) and actuarial failure-rates of the interventions were determined (Kaplan-Meier analysis). RESULTS Although we could account for 91% of the initial participants in 2008, 66 (44%) patients (29 TURP, 20 CLP and 17 EVAP) were available for follow-up measurements after a mean (range) of 10.1(6.9,12.7) years Among the three treatment groups, there were no significant differences in IPSS, QoL, SPI, BII, Qmax, PSA level and prostate volume. The IPSS, QoL, SPI and BII were still improved (P < 0.05) from values before treatment for all treatments. Only in the TURP group were the long-term results of Qmax still improved (P < 0.05). The mortality rate was comparable among the treatments. The 10-year actuarial failure rates (95% confidence interval) were 0.11 (0.03,0.20), 0.22 (0.10,0.35) and 0.23 (0.11,0.35) for TURP, CLP and EVAP, respectively. CONCLUSIONS After a mean follow-up of 10.1 years, there were similar and durable improvements in IPSS, QoL, SPI and BII for patients with LUTS suggestive of BPH after TURP, CLP and EVAP. Between the treatment groups there were no statistically significant differences in Qmax, PSA levels and prostate volume at any time during the follow-up. However, only patients treated with TURP showed minimal durable improvements in Qmax. There was no statistically significant difference in success rate and mortality rate among the three treatments. [source] Sacral nerve stimulation for neurogenic faecal incontinenceBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2007B. Holzer Background: Sacral nerve stimulation (SNS) has emerged as a promising technique for the treatment of faecal incontinence. This study assessed the outcome of SNS in a cohort of patients with incontinence of neurological aetiology. Methods: Thirty-six patients were included in a trial of SNS. Twenty-nine subsequently had a permanent implant. Evaluation consisted of a continence diary, anal manometry, saline retention testing and quality of life assessment. Results: After a median follow-up of 35 (range 3,71) months, 28 patients showed a marked improvement in or complete recovery of continence. Incontinence to solid or liquid stool decreased from a median of 7 (range 4,15) to 2 (range 0,5) episodes in 21 days (P = 0·002). Saline retention time increased from a median of 2 (range 0,5) to 7 (range 2,15) min (P = 0·002). Maximum resting and squeeze anal canal pressures increased compared with preoperative values. Quality of life on all scales among patients who received a permanent implant increased at 12 and 24 months after operation. Conclusion: SNS is of value in selected patients with neurogenic faecal incontinence. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Oesophageal resection for high-grade dysplasia in Barrett's oesophagusBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2000Dr G. Zaninotto Background The aims of this study were to evaluate the prevalence of invasive cancer in patients with high-grade dysplasia in Barrett's oesophagus and to verify whether a second endoscopy with multiple biopsies could improve the accuracy of preoperative diagnosis. In addition, the mortality, morbidity and survival rates in patients with high-grade dysplasia having oesophageal resection were recorded. Methods Fifteen patients were observed from 1982 to 1998; the first seven patients were offered primary oesophageal resection after diagnosis. The other eight patients underwent a second endoscopy with a median of 12 biopsies examined. All later underwent oesophageal resection. Results Invasive adenocarcinoma was found in five patients, with a minimal difference between the first and second periods (two of seven versus three of eight). There were no perioperative deaths. Early morbidity was observed in eight patients and late morbidity in four. The actuarial survival rate was 79 per cent at 5 years. The Karnofsky status was unchanged from preoperative values in 13 of 15 patients after a median follow-up of 46 months. Conclusion These patients with high-grade dysplasia had a 33 per cent probability of harbouring invasive oesophageal carcinoma but even a second endoscopy failed to identify patients with invasive tumour. Oesophagectomy was performed with no deaths and remains a rational treatment in patients fit for surgery. © 2000 British Journal of Surgery Society Ltd [source] Efficacy of dye disappearance test and tear meniscus height in diagnosis and postoperative assessment of nasolacrimal duct obstructionACTA OPHTHALMOLOGICA, Issue 3 2010Joon Ho Roh Abstract. Objective:, To evaluate the efficacy of the fluorescein dye disappearance test (FDDT) and measurement of tear meniscus height (TMH) in the diagnosis and postoperative assessment of nasolacrimal duct obstruction (NLDO). Methods:, The study group included 42 eyes of 42 patients who had a diagnosis of primary acquired nasolacrimal duct obstruction (PANDO) or functional nasolacrimal duct obstruction (FNDO) and underwent endoscopic transnasal dacryocystorhinostomy. The control group included 38 eyes of 38 people without tearing. The values of the FDDT, TMH and tearing symptom score (TSS), which was evaluated in five levels based on patients' history taking, were measured before surgery, and 1 day, 2 weeks, 1, 3 and 6 months after surgery. The values of the FDDT, TMH and TSS in the study group were compared with those of the control group. Results:, The preoperative values of the FDDT, TMH and TSS were 0.7 ± 0.4, 0.22 ± 0.08 mm and 1.6, respectively, in the control group and 3.0 ± 0.8, 0.53 ± 0.15 mm and 4.4, respectively, in the study group. These differences were statistically significant. Also, at each follow-up, the postoperative values of the FDDT and TMH decreased significantly compared to their preoperative values in the study group. The postoperative TSS decreased significantly compared to the preoperative values at each follow-up except at postoperative 1-day follow-up. There were no significant differences in the preoperative values of the FDDT, TMH and TSS between the types of NLDO. The TSS had positive correlations with the FDDT and TMH before and after surgery. Conclusion:, These results suggest that the FDDT and TMH measurement might be effective in the diagnosis and postoperative assessment of NLDO. [source] The effect of deep sclerectomy on intraocular pressure of normal-tension glaucoma patients: 1-year resultsACTA OPHTHALMOLOGICA, Issue 1 2010Sakari Suominen Abstract. Purpose:, To study the intraocular pressure (IOP)-reducing effect of deep sclerectomy on normal-tension glaucoma (NTG) patients. Methods:, We retrospectively analysed 21 eyes of 18 consecutive NTG patients who had undergone deep sclerectomy with mitomycin-C and a collagen implant. Results:, Median (range) preoperative IOP was 15.1 mmHg (9.3,20.8) and median follow-up time 13 months (12,18). At the 1-year follow-up visit, median IOP was significantly (P < 0.001) reduced to 10.5 mmHg (4,15) with median IOP reduction from preoperative values of 37% (12,78). Laser goniopuncture was performed in 10 eyes (48%) 1,16 months postoperatively. After 13 months' follow-up, a complete success at 20%, 25% and 30% IOP reduction levels was achieved in 67%, 62% and 52% of eyes, respectively. Few complications were encountered, but these included reduced visual acuity, problems with conjunctiva, microperforation, hyphaema, Dellen formation and encapsulated bleb. We encountered no complications related to postoperative hypotony. Conclusion:, Deep sclerectomy with a collagen implant and mitomycin-C was a safe and effective method for reducing IOP in NTG patients during 1-year follow-up. [source] Baerveldt glaucoma implants in the management of refractory glaucoma after vitreous surgeryACTA OPHTHALMOLOGICA, Issue 1 2010Elisabeth Van Aken Abstract. Purpose:, To examine the effectiveness and safety of Baerveldt glaucoma implants in eyes with refractory glaucoma following vitrectomy. Methods:, We performed a retrospective study of a non-comparative case series of 30 eyes of 30 patients who had undergone the implantation of a Baerveldt glaucoma device. All eyes (30/30) had a minimum follow-up of 6 months, and 16/30 (53%) had a follow-up of 24 months. Surgical success was defined as intraocular pressure (IOP) < 22 mmHg on the last two follow-up visits with or without glaucoma medication and a decrease in IOP of at least 20% compared to preoperative values with or without glaucoma medication. Results:, The mean IOP before implantation of a Baerveldt glaucoma device was 30 mmHg [± 11.4 mmHg standard deviation (SD)] with maximally tolerated medical therapy. Six months after implantation of the Baerveldt glaucoma device, the mean IOP was 17.3 mmHg (± 6.7 mmHg SD) and the mean number of glaucoma medications had gone down from 3.0 (± 0.4 SD) to 0.3 (± 0.3 SD). Successful outcomes were found in 24 eyes (80%). Small complications occurred in six eyes (20%): transient postoperative hypotony (17%) and tube retraction (3%). Larger complications occurred in another six eyes (20%): corneal decompensation requiring keratoplasty (7%), suprachoroidal haemorrhage (3%) and persistently high IOP (10%). Conclusion:, Baerveldt glaucoma devices are a valid treatment option in eyes with refractory glaucoma after vitreous surgery, although failure occurred in 20% of our patients. Transient complications occurred in 20% and severe complications in another 20%. [source] | ||||||||||||||||||||||