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- Belitsky, Yuri, et al.
(författare)
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Evaluation of selective laser trabeculoplasty as an intraocular pressure lowering option.
- 2019
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Ingår i: Acta ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 97:7, s. 707-713
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Tidskriftsartikel (refereegranskat)abstract
- Selective laser trabeculoplasty (SLT) is one of the many treatment options for lowering intraocular pressure (IOP) in patients with glaucoma. This study aimed to evaluate the effect of SLT.Data were collected from medical records of 289 patients who underwent SLT treatment (180° of trabecular meshwork) during 2014 and 2015 at the Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden. Baseline characteristics and information from a follow-up within 100 days were also recorded. The study analysed different subtypes of glaucoma with regard to SLT, with a particular focus on exfoliative glaucoma, a common subtype in Sweden. Successful treatment was defined as an IOP lowering effect of >20% with no further changes in treatment. The impact of surgeon's experience on treatment outcome was also analysed.Both patients with exfoliative glaucoma and those with primary open-angle glaucoma showed a reduction in mean IOP; no significant difference was found between these two subtypes before treatment or at the first follow-up. The success rate at follow-up (within 100 days) was 52%. There was a significant difference in outcome between surgeons with different levels of experience, but this difference could likely be explained by differences in treatment strategies and total energy used.For many patients with glaucoma, SLT was an effective treatment option for lowering IOP. It was also effective for several glaucoma subtypes. However, not all patients had a significant reduction in IOP after treatment with SLT, and some may require additional treatment.
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- Busch, T., et al.
(författare)
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Four-Year Outcome of XEN 45 Gel Stent Implantation in a Swedish Population
- 2023
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Ingår i: Clinical Ophthalmology. - 1177-5483. ; 17, s. 1897-1910
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To report the long-time success rate of XEN 45 gel stent implantation in a Scandinavian population.Patients and Methods: This was a retrospective single-center analysis of all patients undergoing XEN 45 stent surgery between December 2015 and May 2017. The main outcome was success rate according to several definitions of success. Subgroup analysis was performed. Secondary outcomes were change in intraocular pressure (IOP) and number of IOP-lowering agents. Need for secondary glaucoma surgery, needling rate and complications were recorded.Results: A total of 103 eyes could be evaluated after four years. Mean age was 70.6 years. Primary open-angle glaucoma (POAG) accounted for 46.6% and exfoliative glaucoma (PEXG) for 39.8%. Mean IOP dropped from 24.0 to 15.9 mmHg (p<0.001) and IOP-lowering agents from 3.5 to 1.5 (p<0.001). The success rate with individual target pressures after four years was 43.7%. Secondary glaucoma surgery was performed in 45 (43.7%) of cases. Combined cases (n=12) were not statistically different to stand-alone procedures (p=0.28). No difference between PEXG and POAG could be detected (p=0.44). During the learning curve, stent misplacement was common and resulted in worse outcome for less experienced surgeons. Conclusion: The overall success rate of XEN 45 gel stent surgery in the present cohort is relatively low in a long-time follow-up under the given circumstances if all initial patients are included to follow-up. The influence of the surgeon's learning curve is obvious, and improvement in success can be expected when used by experienced and high-volume surgeons. No significant differences were found in PEXG compared to POAG or in XEN surgery combined with cataract surgery compared to stand-alone.
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- Busch, T., et al.
(författare)
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Learning Curve and One-Year Outcome of XEN 45 Gel Stent Implantation in a Swedish Population
- 2020
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Ingår i: Clinical Ophthalmology. - 1177-5483. ; 14, s. 3719-3733
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Evaluation of 1-year-outcome of XEN 45 gel stent surgery in a Swedish cohort with regard to clinical success, complications, and learning curve. Patients and Methods: This was a retrospective study of glaucoma patients undergoing glaucoma XEN-stent surgery alone or combined with phacoemulsification between December 2015 and May 2017. Intraocular pressure (IOP), number of medical agents, and adverse events were assessed. Clinical success rate was defined as achieving individual target pressure with/without medication. Results: A total of 113 eyes were included in the final statistics. Mean age was 70.8 +/- 11.8 years. Primary open angle glaucoma (POAG) accounted for 46.9% and exfoliative glaucoma (PEXG) for 40.7%. Mean preoperative TOP was 23.8 +/- 6.2 mmHg and mean number of agents 3.4. After 1 year, mean IOP was reduced to 16.1 +/- 4.7 mmHg and medication to 1.34 substances on average. Failure rate at 1-year follow-up was 34% with no significant difference between POAG and PEXG. There was a trend of higher success rate for combined cases (P=0.116). Stents with malpositioned or curved appearance had significantly worse outcome. The failure rate of the most productive surgeon dropped from 33% to 10% from the first implantations. Temporary hypotony (19.5%) and choroidal detachment (9.7%) were the most common complications. Blockage of the inner stent lumen was common (8.8%), with a high proportion of failure. Conclusion: XEN-stent surgery is a surgical option in uncontrolled glaucoma in both POAG and PEXG. A XEN-stent can reduce both IOP and the number of antiglaucoma medications needed. The learning curve is significant and stent positioning is crucial for optimal results. Combined XEN-cataract surgery is not inferior to stand-alone procedures. The long-time effectiveness is still to be proven.
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- Havstam Johansson, Lena, 1963, et al.
(författare)
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Vision-related quality of life and visual function in a 70-year-old Swedish population
- 2020
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 98:5, s. 521-529
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To investigate vision-related quality of life (VRQoL), visual function and predictors of poor vision in a population of 70-year-olds. Methods Self-reported ocular morbidity and responses to the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) in a cross-sectional population study (N = 1203) in Gothenburg, Sweden, were compared with results from ophthalmic examination (N = 560). Results The most common self-reported ophthalmic morbidities were cataract (23.4%), age-related macular degeneration (AMD; 4.7%), glaucoma (4.3%) and diabetic retinopathy (1.4%). Cataract was more prevalent in women (p = 0.001). The composite score from NEI VFQ-25 for the entire cohort was 91.4 (standard deviation: 27.5). When comparing composite score for different eye diseases, persons with cataract or AMD exhibited lower scores (p = 0.029 and 0.018, respectively). Best-corrected visual acuity (BCVA) was normal (>= 0.5 decimal) in 98.9%; two individuals had low vision (<0.3). Men exhibited better BCVA (median: -0.08 logMAR) than women (-0.06; p = 0.005). Visual field defects were observed in 16.3% and uncorrected refractive errors in 61.5%. Poor vision was reported by 7.4% of participants with presenting visual acuity (PVA) >= 0.5 (decimal), while 66.7% with PVA PVA <0.5, 55.6% obtained a BCVA of >= 1.0 with the right correction. Low contrast sensitivity was a significant predictor of experiencing poor vision (p = 0.008), while PVA and visual field defects were not. Conclusions Low contrast sensitivity is a predictor of experiencing poor vision. There is a discrepancy between subjective/objective visual function and a high prevalence of uncorrected refractive errors. Women have more cataract, and men demonstrate slightly better visual acuity.
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- Pålsson, Sara, et al.
(författare)
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Phacoemulsification with primary implantation of an intraocular lens in patients with uveitis
- 2017
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Ingår i: Clinical Ophthalmology. - : Informa UK Limited. - 1177-5483. ; 11, s. 1549-1555
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the outcome of cataract surgery in adult patients with uveitis. Materials and methods: In this retrospective cohort study, medical charts of patients with uveitis and matched control patients without uveitis who underwent cataract surgery at the Eye Clinic, Sahlgrenska University Hospital, Molndal, between January 2005 and December 2009 were analyzed. Results: The study included 58 eyes with and 283 eyes without uveitis. The most common etiologies were idiopathic anterior uveitis and Fuchs' heterochromic uveitis. Postoperative visual acuity at 4 weeks was >= 0.5 decimal (0.3 logMAR) in 48 eyes with uveitis (87.3%) compared to 180 non-uveitic eyes (86.1%). Four eyes with uveitis (7.1%) and one eye without uveitis (0.5%) developed postoperative intraocular hypertension/glaucoma. Posterior capsule opacification developed in 11 eyes (19.0%) with and 28 eyes (12.4%) without uveitis. Conclusion: With appropriate perioperative anti-inflammatory regimen and surveillance, modern cataract surgery using phacoemulsification and primary intraocular lens implantation can be performed in patients with uveitis without greater risk of complications, yielding similar visual outcome as in patients without uveitis.
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- Riedl, Philip, et al.
(författare)
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Myopic shift and lens turbidity following hyperbaric oxygen therapy : a prospective, longitudinal, observational cohort study
- 2019
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Ingår i: Acta Ophthalmologica. - : John Wiley & Sons. - 1755-375X .- 1755-3768. ; 97:6, s. 596-602
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To examine visual acuity, refraction and ocular status before, during and after hyperbaric oxygen therapy (HBOT).METHODS: Twenty-nine patients underwent 40 standard protocol HBOT treatments. In all subjects, refraction and best corrected visual acuity were measured at baseline and after ten, 20, 30 and 40 treatments, and at a 12-week follow-up. A subgroup (n = 19) were given additional examinations at baseline, after 40 treatments and at follow-up including measuring central corneal thickness (CCT), corneal curvature, anterior chamber depth, lens thickness, axial length, fundus morphology, blood pressure and intraocular pressure (IOP). Lens colour and opalescence were graded using the Lens Opacities Classification System III (LOCS III).RESULTS: Myopic shifts [≥0.5 dioptre (D) spherical equivalent (SE)] occurred in 45 (77.6%) eyes. Median refractive changes of -0.75 D SE (right eye; p < 0.001) and -0.66 D SE (left eye; p < 0.001) were observed between pretreatment and treatment end (Wilcoxon signed rank test). Refraction returned to baseline at follow-up, except for a small persisting change towards myopia, median -0.25 D SE (left eye; p = 0.01). Using the LOCS III, median increases in lens nuclear colour, of 0.6 (right eye; p < 0.001) and 0.7 (left eye; p < 0.001), and opalescence of 0.7 (both eyes; p = 0.01) were found at the last examination. Small reductions were noted in CCT of -6.00 μm (right eye; p = 0.03) and -4.00 μm (left eye; p = 0.03), and IOP of -1.50 mmHg (left eye; p = 0.01).CONCLUSIONS: The transient myopic shift may have been due to lenticular refractive index changes. Reduced lens transparency is a potential consequence of HBOT.
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