Displaying all 9 publications

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  1. Sharif FM, Selvarajah S
    Med J Malaysia, 1997 Mar;52(1):17-25.
    PMID: 10968049
    A clinical audit was conducted for a 4-year period at the Universiti Kebangsaan Malaysia (UKM) Ophthalmology Department in which 61 eyes of adult patients with primary glaucoma underwent trabeculectomies without antimetabolites. At a 2-year follow-up duration, successful trabeculectomies as defined by intraocular pressure below 20 mm Hg without additional glaucoma medication were 62% for primary open-angle glaucoma, 48% for primary acute angle-closure glaucoma and 43% for chronic angle-closure glaucoma. 50.8% of eyes were without complications while 49.2% had complications. Shallow anterior chamber (22.9%) and hyphaema (19.7%) were the two commonest complications.
    Matched MeSH terms: Glaucoma/surgery*
  2. Lee RM, Samsudin A, Bouremel Y, Brocchini S, Khaw PT
    Invest Ophthalmol Vis Sci, 2015 Dec;56(13):8026.
    PMID: 26720450 DOI: 10.1167/iovs.15-18495
    Matched MeSH terms: Glaucoma/surgery*
  3. Lockie P
    Aust N Z J Ophthalmol, 1987 Aug;15(3):207-9.
    PMID: 3675913
    Ciliary-block glaucoma occurred in one eye of a 65-year-old-male, following a combined trabeculectomy and extracapsular lens extraction for long-standing angle-closure glaucoma. After pupillary block was excluded as a cause, a posterior capsulotomy resolved the condition. This procedure was repeated successfully when a flat anterior chamber recurred on spontaneous closure of the initial capsulotomy. The ciliary block appeared to be caused by the residual zonule and lens capsule.
    Matched MeSH terms: Glaucoma/surgery*
  4. Samsudin A, Eames I, Brocchini S, Khaw PT
    J Glaucoma, 2016 Jan;25(1):e39-45.
    PMID: 25719236 DOI: 10.1097/IJG.0000000000000243
    PURPOSE: ExPress devices are available as P50 and P200 models, the numbers related to their luminal diameters in μm. We compared their Poiseuille's Law-based theoretical resistance values with experimental values and correlated these with their luminal dimensions derived from electron microscopy.

    METHODS: Scanning electron microscopy was performed on P50 and P200 devices. Bench-top flow studies were performed to find the resistances of the devices. Devices were also incorporated into a perfused, ex vivo porcine sclera model to test and compare their control of pressure, with and without overlying scleral flaps, and with trabeculectomies.

    RESULTS: The luminal dimensions of the P200 device were 206.4±3.3 and 204.5±0.9 μm at the subconjunctival space and anterior chamber ends, respectively. Those of the P50 device were 205.0±5.8 and 206.9±3.7 μm, respectively. There were no significant differences between the P200 and P50 devices (all P>0.05). The resistances of the P200 and P50 devices were 0.010±0.001 and 0.054±0.002 mm Hg/μL/min, respectively (P<0.05). Equilibrium pressures with overlying scleral flaps were 17.81±3.30 mm Hg for the P50, 17.31±4.24 mm Hg for the P200, and 16.28±6.67 mm Hg for trabeculectomies (P=0.850).

    CONCLUSIONS: The luminal diameters of both devices are externally similar. The effective luminal diameter of the P50 is much larger than 50 μm. Both devices have low resistance values, making them unlikely to prevent hypotony on their own. They lead to similar equilibrium pressures as the trabeculectomy procedure when inserted under the scleral flap.

    Matched MeSH terms: Glaucoma/surgery
  5. Samsudin A, Eames I, Brocchini S, Khaw PT
    J Glaucoma, 2016 07;25(7):e704-12.
    PMID: 26561421 DOI: 10.1097/IJG.0000000000000360
    PURPOSE: Intraocular pressure and aqueous humor flow direction determined by the scleral flap immediately after trabeculectomy are critical determinants of the surgical outcome. We used a large-scale model to objectively measure the influence of flap thickness and shape, and suture number and position on pressure difference across the flap and flow of fluid underneath it.

    METHODS: The model exploits the principle of dynamic and geometric similarity, so while dimensions were up to 30× greater than actual, the flow had similar properties. Scleral flaps were represented by transparent 0.8- and 1.6-mm-thick silicone sheets on an acrylic plate. Dyed 98% glycerin, representing the aqueous humor was pumped between the sheet and plate, and the equilibrium pressure measured with a pressure transducer. Image analysis based on the principle of dye dilution was performed using MATLAB software.

    RESULTS: The pressure drop across the flap was larger with thinner flaps, due to reduced rigidity and resistance. Doubling the surface area of flaps and reducing the number of sutures from 5 to 3 or 2 also resulted in larger pressure drops. Flow direction was affected mainly by suture number and position, it was less toward the sutures and more toward the nearest free edge of the flap. Posterior flow of aqueous humor was promoted by placing sutures along the sides while leaving the posterior edge free.

    CONCLUSION: We demonstrate a new physical model which shows how changes in scleral flap thickness and shape, and suture number and position affect pressure and flow in a trabeculectomy.

    Matched MeSH terms: Glaucoma/surgery*
  6. Jaais F
    Med J Malaysia, 2004 Aug;59(3):378-83.
    PMID: 15727384
    This study reviewed the trabeculectomies (TEs) carried out in University Malaya Medical Center between 1994 to 1998. One hundred and nine of 132 eyes operated were in the primary glaucoma group of which 63 (47.7%) were of the open angle type and 46 (34.8%) were of the angle closure type. Twenty-three eyes belong to the secondary glaucoma group. Sixty-five eyes had plain or non-augmented trabeculectomy (TE) while 20 were augmented with mitomycin C (MMC) and 11 with 5 flourouracil (5FU). In 31 eyes the plain TEs were combined with extracapsular cataract extraction (ECCE) and 4 with phacoemusification. One case had combined ECCE and augmented trabeculectomy with mitomycin-C. The patients were followed up at 1 month, 6 months, 1 year and 2 years. Ninety-four of 132 (71.2%) eyes had successful surgery with intraocular pressure (IOP) of less than 21 mmHg (tonometric success) at the end of 2 years. Four of these patients needed topical medication for the IOP control. More failures were seen in patients with cystic blebs than those with diffuse blebs. Complications include hypotony, shallow anterior chamber, cataracts and hyphaema. The majority of cases (53%) had no complications.
    Matched MeSH terms: Glaucoma/surgery*
  7. Wong EY, Chew PT, Chee CK, Wong JS
    Am J Ophthalmol, 1997 Dec;124(6):797-804.
    PMID: 9402826
    PURPOSE: To evaluate the effectiveness and safety of diode laser contact transscleral cyclophotocoagulation in Asian patients with refractory glaucoma by lower energy settings with an innovative probe featuring a glass ball tip that focused the laser beam onto the ciliary body.

    METHODS: This prospective clinical study included consecutive Asian patients with dark irides and confirmed for glaucoma. Only one eye of each patient was treated. Diode laser contact transscleral cyclophotocoagulation treatment was performed with the center of the probe placed 1.5 mm behind the limbus. About 30 pulses of 810-mm laser radiation (power, 1.8 to 2.0 W; duration, 0.3 to 0.5 second) were applied around the eye. Patients were examined at fixed postoperative intervals. Intraocular pressure levels and postoperative complications were recorded. The relation between patient and disease characteristics, total laser energy delivered, and intraocular pressure effects were analyzed.

    RESULTS: Thirty-three patients were studied, with a mean follow-up period of 9.4 months. An average 56% of patients showed a 30% or greater drop in intraocular pressure. About 38% of patients achieved sustained intraocular pressure lowering to below 22 mm Hg at 18 months. Complications were few and included transient hypotony and iritis.

    CONCLUSIONS: In Asian patients with refractory glaucoma or painful glaucomatous eyes with poor visual acuity (defined for this study as worse than 20/200), low-energy-setting diode laser contact transscleral cyclophotocoagulation by means of the glass ball probe is relatively effective and safe.

    Matched MeSH terms: Glaucoma/surgery*
  8. Hooi ST, Hooi SH
    Med J Malaysia, 2003 Oct;58(4):565-78.
    PMID: 15190633
    A retrospective study was conducted at the Hospital Sultanah Aminah Johor Bahru to determine the outcome of trabeculectomy surgeries over a period of 4 years. One hundred and two eyes were followed up to a maximum of 63 months (mean 34.2 months). The 2-year survival rates for plain trabeculectomies, 5-Fluorouracil augmented trabeculectomies and Mitomycin-C augmented trabeculectomies were 52.9%, 27.3% and 60.5% respectively. The commonest complications noted were cataract formation (25%) and hyphaema (11%). Mitomycin-C induced complications were rarely seen. At last follow-up, 54% of eyes had intraocular pressures below 21 mmHg without medication, while 34% of eyes had intraocular pressures below 21 mmHg with medication. Vitreous at the trabeculectomy site was a statistically significant predictor of operative failure.
    Matched MeSH terms: Glaucoma/surgery*
  9. Din NM, Talat L, Isa H, Tomkins-Netzer O, Barton K, Lightman S
    Graefes Arch Clin Exp Ophthalmol, 2016 Dec;254(12):2439-2448.
    PMID: 27495303
    PURPOSE: To determine whether the second eyes (SE) of patients with bilateral uveitic glaucoma undergoing filtration surgery have more glaucomatous progression in terms of visual acuity, visual field (VF) and optic nerve changes compared to the first eyes (FE).

    METHODS: This retrospective study analysed data of 60 eyes from 30 patients with bilateral uveitic glaucoma who had undergone glaucoma surgery in both eyes on separate occasions. Humphrey VF progression was assessed using the Progressor software.

    RESULTS: The pre-operative IOP between the FE (43.1 ± 7.7 mmHg) and SE (40 ± 8.7 mmHg) was not statistically significant (p = 0.15). IOP reduction was greater in the FE (64 %) than SE (59.7 %) post-operatively, but the mean IOP at the final visit in the FE (12.3 ± 3.9 mmHg) and SE (14.5 ± 7 mmHg) was not statistically different (p = 0.2). There was no significant change in mean logMAR readings pre and post-operatively (0.45 ± 0.6 vs 0.37 ± 0.6, p = 0.4) or between the FE and SE. The number of SE with CDR > 0.7 increased by 23 % compared to the FE. From 23 available VFs, five SE (21.7 %) progressed at a median of five locations (range 1-11 points) with a mean local slope reduction of 1.74 ± 0.45 dB/year (range -2.39 to -1.26), whereas only one FE progressed. However, there was no significant difference between mean global rate of progression between the FE (-0.9 ± 1.6 dB/year) and SE (-0.76 ± 2.1 dB/year, p = 0.17) in the Humphrey VF.

    CONCLUSION: In eyes with bilateral uveitic glaucoma requiring glaucoma surgery, the SEs had more progressed points on VF and glaucomatous disc progression compared to FEs at the final visit.

    Matched MeSH terms: Glaucoma/surgery*
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