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ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2021

Outcomes of adjusted trabeculotomy in cases with juvenile glaucoma.

Ahmad K Khalil

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Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 citing paper in PubMed.

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5 · Who and what money

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1 author.

Ahmad K KhalilResearch Institute of Ophthalmology, 2 Al-Ahram St., Giza, Egypt. drkhalil@eyecairo.net.ORCID https://orcid.org/0000-0002-7583-3918

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No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate surgical and visual outcomes of modified adjusted trabeculotomy in juvenile glaucoma (JG) cases.

methodsA retrospective case series; medical records of 43 patients (69 eyes) JG cases operated by adjusted trabeculotomy between 2011 and 2018. Those who completed a minimum of 1 year of regular follow-up, and up to 5 years were included in the study. Intraocular pressure (IOP), number of medications, cup/disc ratio (CDR), and visual acuity (VA) at baseline, postoperative 1, 3, 5 years were evaluated. Success required IOP ≤ 18 mmHg and a minimum of 20% reduction, without medications (full), or with medications (qualified).

resultsNumbers of patients (eyes) who completed 1, 3, and 5 follow-up years were as follows: 26 (43), 15 (27), and 11 (19). Median (range) age at surgery was 21.5 (8-43) years. Mean (range) IOP was significantly (P < .001) reduced from 23.4 ± 8.8 (11.0-46.0) mmHg to 11.5 ± 3.5 (7.0-28.0), 10.9 ± 3.6 (6.0-24.0), and 11.4 ± 3.0 (7.0-17.0) mmHg at 1, 3, and 5 years, with reduction of medication scores. At years 1, 3, and 5, complete success rates were 89.5%, 86.8%, and 89.5%, and qualified success rates were 97.4%, 94.7%, and 97.4%. Median (range) LogMAR VA significantly (P < .001) improved from 0.3 (0-2.8) to 0.17 (0-2.8) and 0.17 (0-2.8) at 1 and 5 years. Median (range) CDR was significantly (P < .001) reduced from 0.85 (0.3-1.0) to 0.85 (0.1-1.0), 0.7 (0.05-1.0), and 0.7 (0.05-0.9) at 1, 3, and 5 years.

conclusionsAdjusted trabeculotomy could effect remarkable IOP lowering for up to 5 years postoperatively in JG eyes, and seems to be an effective, low-risk surgical modality for treating such eyes. It can be associated with cupping reversibility, and visual improvement on the long-term. Good surgical technique and postoperative care are imperative to achieve a successful outcome.

Indexed as

GlaucomaTrabeculectomyFollow-Up StudiesHumansIntraocular PressureRetrospective StudiesTreatment OutcomeGlaucomaJuvenileSurgeryTrabeculotomy

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