Response to Letter to the Editor: Outcome of Bleb Revision With Autologous Conjunctival Graft Alone or Combined With Donor Scleral Graft for Late-onset Bleb Leakage With Hypotony After Standard Trabeculectomy With Mitomycin C.

Outcome of Bleb Revision With Autologous Conjunctival Graft Alone or Combined With Donor Scleral Graft for Late-onset Bleb Leakage With Hypotony After Standard Trabeculectomy With Mitomycin C

Prcis Treatment of leakage with ocular hypotony after trabeculectomy with mitomycin C (MMC) can be safely achieved through conjunctival patch alone or combined with donor scleral graft in cases of melted underlying sclera. Purpose To report outcomes of 2 surgical approaches for treating ocular hypotony in eyes with blebs with late-onset leakage after standard trabeculectomy with MMC. Methods Thirty consecutive cases with bleb leakage and hypotony underwent bleb revision surgery between 2009 and 2014 by the same surgeon (J.W.) at the Department of Ophthalmology of the Mainz University Medical Center, Germany. In 18 patients, an autologous conjunctival patch graft was applied. In 12 patients,…

Trabeculotomy in congenital glaucoma.

Background: Congenital glaucoma is a potentially blinding disease that requires surgical therapy. This paper describes the outcome of trabeculotomy in primary congenital glaucoma. Methods: Thirty-nine eyes of 22 children with congenital glaucoma who underwent trabeculotomy with or without a simultaneous trabeculectomy between 1992 and 1997 were retrospectively analyzed. Results: Mean follow-up was 24.7±17.9 months. A mean of 1.3 operations per eye were performed. The mean IOP at the end of follow-up (n=39) was 17.7±6.0 mmHg; in 8 eyes (20.5%) the IOP was >21 mmHg, in 31 eyes (79.5%) it was ≤21 mmHg. The mean difference between pretreatment IOP and IOP at the end of follow-up (n=39) was –10.…

Anaesthetic protocol for paediatric glaucoma examinations: the prospective EyeBIS Study protocol

IntroductionNeonates and young infants with diagnosed or highly suspected glaucoma require an examination under anaesthesia to achieve accurate intraocular pressure (IOP) measurements, since crying or squinting of the eyes may increase IOP and lead to falsely high values. IOP considerably depends on perioperative variables such as haemodynamic factors, anaesthetics, depth of anaesthesia and airway management. The aim of this paper is to report the design and baseline characteristics of EyeBIS, which is a study to develop a standardised anaesthetic protocol for the measurement of IOP under anaesthesia in childhood glaucoma, by investigating the link between the magnitude of IOP and depth of …

XEN-augmented Baerveldt Implantation for Refractory Childhood Glaucoma: A Retrospective Case Series

Background Tube implants can lead to long-term decompensation of the cornea after decades, in particular in complicated childhood glaucoma, because of a variety of causes including contact between the tube tip and the corneal endothelium. The augmentation of a XEN implant with a Baerveldt (250) tube implant, introduced 2016 by Mermoud et al for refractory glaucoma in adult patients, may reduce this risk in children. In our retrospective study, we report on the XEN-augmented Baerveldt (250) tube implant in children. Patients and methods Ten consecutive patients with refractory childhood glaucoma who underwent XEN-augmented Baerveldt implantation by a single surgeon (F.G.) between January 201…

Epiphora Secondary to Blockage of the Lacrimal System: The Role of Endonasal Dacryocystorhinostomy

Stenosis of the lacrimal system may occur secondary to tumor, infection, trauma, and congenital etiologies. Attempts to remedy this problem often include irrigation and probing. However, if these fail, external or internal dacryocystorhinostomy (DCR) with or without stenting may be performed. The purpose of this article is to detail our experience with a microscopic endonasal approach to DCR utilized in 23 patients. This is a modification of an older accepted procedure which utilizes the modern techniques of endonasal sinus surgery. This approach has allowed for immediate restoration of drainage in 22 of 23 cases. In one case, the procedure was repeated because of restenosis at the level o…