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      Combined Approach to Phacoemulsification and Trabeculectomy Results in Less Ideal Refractive Outcomes Compared With the Sequential Approach :

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          Abstract

          To compare the refractive outcomes of combined versus sequential trabeculectomy and then phacoemulsification.

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          Most cited references 14

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          Population-based glaucoma prevalence studies in Asians.

          Glaucoma-related population-based studies from Japan, Mongolia, India, Singapore, Thailand, China, Bangladesh, Myanmar, Sri Lanka, and South Korea show a higher glaucoma prevalence in Asian patients, including a higher incidence of primary angle-closure glaucoma, than in white patients, although primary open-angle glaucoma (POAG) is still the most commonly reported. Among POAG, normal tension glaucoma predominates over high tension glaucoma, a distinctive finding. Risk factors for glaucoma in population-based studies in both Asian and white patients are similar, except that myopia is a greater risk factor in Asian patients. Diagnostic criteria differ among studies, some using the International Society of Geographic and Epidemiologic Ophthalmology (ISGEO) classification and others not. The devices used to observe the optic disk and test the visual field are also not uniform across studies. Moreover, the ages of patients, and whether rural or urban, were different. To allow reliable comparison of the results of epidemiologic studies, efforts to standardize the diagnostic criteria, devices, and the age range of the study population are required. Copyright © 2014 Elsevier Inc. All rights reserved.
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            Axial length decrease accompanying successful glaucoma filtration surgery.

             L Cashwell,  C De Bari (1999)
            To evaluate change in axial length measurement after successful glaucoma filtering surgery. Retrospective consecutive case series. Sixty-two patients with phakia who underwent primary trabeculectomy. The A-scan biometry of ocular axial length before and after trabeculectomy. Changes in ocular axial length measurement after successful trabeculectomy were analyzed. The mean decrease in axial length measurement was 0.423 mm (range, -2.8 to +0.5 mm). Regression analysis yielded a statistically significant association between decrease in axial length measurement and age (P = 0.0001) and post-trabeculectomy intraocular pressure decrease greater than 30 mmHg (P = 0.01). Analysis of variance revealed a significant association between decrease in axial length measurement and use of antimetabolite (P = 0.005). Pseudophakic axial length measurements increased an average of 0.275 mm compared to the axial length after trabeculectomy and before cataract surgery. Axial length measurement decreased in 32 of 62 eyes after successful initial trabeculectomy. A decrease in axial length measurement may have an influence on intraocular lens calculations. Therefore, the authors recommend that an axial length measurement be obtained on phakic eyes before an initial trabeculectomy to reduce the risk of an inaccurate intraocular lens power calculation based on post-trabeculectomy axial length measurements.
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              Short-term effect of mitomycin-C augmented trabeculectomy on axial length and corneal astigmatism.

              To evaluate the short-term effect of trabeculectomy with adjunctive mitomycin-C (MMC) on corneal astigmatism and axial length. Asan Medical Center, University of Ulsan, Department of Ophthalmology, Seoul, Korea. Eighteen consecutive eyes of 16 patients having trabeculectomy with adjunctive MMC were prospectively analyzed. Intraocular pressure (IOP) and axial length were evaluated preoperatively and 1, 3, 6, and 12 months postoperatively. Postoperative changes in corneal astigmatism were evaluated using vector analysis. The overall mean induced astigmatism showed with-the-rule change up to 3 months postoperatively followed by an against-the-rule shift. The mean axial length was significantly less postoperatively and changed throughout the 12 month follow-up. There was a positive correlation between postoperative axial length and IOP. Eyes with higher preoperative IOP had a greater decrease in axial length after trabeculectomy with MMC. The induced corneal astigmatism after trabeculectomy with MMC was long lasting, although less than that in previous studies. The change in axial length after surgery was significant, especially in eyes with a high preoperative IOP. The decrease in axial length persisted throughout the follow-up.
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                Author and article information

                Journal
                Journal of Glaucoma
                Journal of Glaucoma
                Ovid Technologies (Wolters Kluwer Health)
                1057-0829
                2016
                October 2016
                : 25
                : 10
                : e873-e878
                Article
                10.1097/IJG.0000000000000489
                27483417
                © 2016

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