+1 Recommend
0 collections
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Comparison of surgically induced astigmatism following different glaucoma operations

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          To compare surgically induced astigmatism (SIA) among glaucomatous eyes treated with trabeculectomy (LEC), EX-PRESS ® shunt (EXP), ab externo trabeculotomy (exLOT), or microhook ab interno trabeculotomy (μLOT).

          Subjects and methods

          Eighty right eyes of 80 subjects who underwent LEC (n=20), EXP (n=20), exLOT (n=20), or μLOT (n=20) were included. The dataset including the best-corrected visual acuity (BCVA), intraocular pressure (IOP), and keratometry recordings preoperatively and 3 months postoperatively was collected by chart review. The means of the vector magnitude, vector meridian, and arithmetic magnitude of the preoperative and postoperative astigmatism and SIA were calculated. The correlations among the SIA magnitude, postoperative BCVA, and IOP were assessed.


          The mean astigmatic arithmetic magnitudes did not differ significantly ( P=0.0732) preoperatively among the four groups, but the magnitude was significantly ( P=0.0002) greater in the LEC group than the other groups postoperatively. The mean SIA vectors were calculated to be 1.01 D at 56°, 0.62 D at 74°, 0.23 D at 112°, and 0.12 D at 97° for the LEC, EXP, exLOT, and μLOT groups, respectively. The mean SIA arithmetic magnitudes were significantly ( P<0.0001) greater in the LEC group than the other groups. Three months postoperatively, the SIA magnitude was correlated positively with the logarithm of the minimum angle of resolution (logMAR) BCVA ( r=0.3538) and negatively with the IOP ( r=−0.3265); the logMAR BCVA was correlated negatively with the IOP ( r=−0.3105).


          EXP, exLOT, and μLOT induce less corneal astigmatism than LEC in the early postoperative period.

          Related collections

          Most cited references 26

          • Record: found
          • Abstract: found
          • Article: not found

          Clinical results with the Trabectome for treatment of open-angle glaucoma.

          To describe clinical results from a pilot study of a novel glaucoma surgical device. Prospective interventional case series. Thirty-seven adult Hispanic and Caucasian patients (17 male, 20 female) with uncontrolled open-angle glaucoma (OAG) in one or both eyes with or without previous surgery or laser treatment were recruited from a clinical practice in Tijuana, Mexico. Surgery was performed with the Trabectome (NeoMedix Corp., San Juan Capistrano, CA) in one eye of each patient. Goldmann applanation intraocular pressures and Snellen visual acuities were measured before and after surgery. Intraoperative and postoperative adverse events were tabulated, and numbers of preoperative and postoperative adjunctive medications were compared before and after surgery. Preoperative pressures after 1 week of medication washout averaged 28.2+/-4.4 mmHg (n = 37). Only 3 patients were not using topical medications preoperatively. Follow-up ranged between 3 months (n = 37) and 13 months (n = 11). Mean postoperative IOPs were 18.4+/-10.9 mmHg (n = 37) at 1 day, 17.5+/-5.9 mmHg (n = 37) at 1 week, 17.4+/-3.5 mmHg (n = 25) at 6 months, and 16.3+/-2.0 mmHg (n = 15) at 12 months. Visions returned to within 2 lines of preoperative levels and remained stable in all patients beyond 3 weeks postoperatively except one, not sutured at surgery, who had a late hyphema probably associated with corneal wound gaping after accidental blunt trauma. The number of adjunctive medications decreased from 1.2+/-0.6 among preoperative patients on medications (n = 34) to 0.4+/-0.6 among all patients at 6 months (n = 25). Blood reflux occurred in all eyes on instrument withdrawal after angle surgery and was present at day 1 in 22 eyes (59%) with clearing by slit-lamp examination at a mean of 6.4+/-4.1 days postoperatively. The Trabectome seems to offer a safe and effective method of lowering IOP in OAG.
            • Record: found
            • Abstract: found
            • Article: not found

            A new method of analyzing vectors for changes in astigmatism.

             N Alpins (1993)
            This method of astigmatism analysis recognizes the need to define an astigmatism goal, thus allowing the surgeon to obtain precise, separate measures of the magnitude and the angle of surgical error. From this, the surgeon can evaluate what surgery may be required to achieve the initial preoperative goal. An index that measures surgical success is adjusted for the level of preoperative astigmatism. The resulting data allow statistical comparison of multiple surgeries and techniques. This method also assists in resolving the case when spectacle and corneal astigmatism do not coincide.
              • Record: found
              • Abstract: found
              • Article: not found

              Randomized, prospective, comparative trial of EX-PRESS glaucoma filtration device versus trabeculectomy (XVT study).

              To compare the clinical outcomes of the EX-PRESS glaucoma filtration device placed under a partial-thickness scleral flap with trabeculectomy. Randomized, prospective, multicenter trial. A total of 120 eyes in 120 subjects were analyzed, including 59 eyes treated with EX-PRESS and 61 eyes treated with trabeculectomy. Both the EX-PRESS and the trabeculectomy groups were treated intraoperatively with mitomycin C and followed postoperatively for 2 years. Surgical success was defined as 5 mm Hg ≤ intraocular pressure ≤ 18 mm Hg, with or without medications, without further glaucoma surgery. Mean intraocular pressure was significantly reduced compared with baseline in both groups (P < 0.001). Average intraocular pressure and number of medications were similar in both groups during follow-up, with mean intraocular pressure at 2 years after surgery of 14.7 ± 4.6 mm Hg and 14.6 ± 7.1 mm Hg in the EX-PRESS and trabeculectomy groups, respectively (P = 0.927). At 2 years after surgery, the success rate was 83% and 79% in the EX-PRESS and trabeculectomy groups, respectively (P = 0.563). Although visual acuity (logMAR) was significantly decreased on day 1 in both groups, the vision was not significantly different compared with baseline at 1 month after EX-PRESS implant (P = 0.285) and 3 months after trabeculectomy (P = 0.255). The variance of early postoperative intraocular pressure values was similar between groups on the first postoperative day but higher after trabeculectomy compared with EX-PRESS implant on day 7 (P = 0.003). The total number of postoperative complications was higher after trabeculectomy than after EX-PRESS implantation (P = 0.013). Mean intraocular pressures, medication use, and surgical success were similar at 2 years after treatment with the EX-PRESS device and trabeculectomy. Vision recovery between groups was also similar throughout the study, although return to baseline vision was more rapid in the EX-PRESS group. Intraocular pressure variation was lower during the early postoperative period, and postoperative complications were less common after EX-PRESS implantation compared with trabeculectomy. Copyright © 2014 Elsevier Inc. All rights reserved.

                Author and article information

                Clin Ophthalmol
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                28 November 2017
                : 11
                : 2113-2120
                Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan
                Author notes
                Correspondence: Masaki Tanito, Division of Ophthalmology, Matsue Red Cross Hospital, 200 Horo-machi, Matsue, Shimane, 690-8506, Japan, Tel +81 852 24 2111, Fax +81 852 31 9783, Email tanito-oph@ 123456umin.ac.jp
                © 2017 Tanito et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Original Research


                Comment on this article