Comparison of bleb morphologies between phacoemulsification combined with Ex-PRESS mini shunt implantation, phacotrabeculectomy and trabeculectomy alone: a two-year retrospective in vivo confocal microscopy study
Abstract Background To compare the bleb morphologies of phacoemulsification combined with Ex-PRESS implantation (Phaco-ExPRESS), phaco trabeculectomy (Phaco-Trab), and trabeculectomy (Trab) in postoperative two years. Methods Patients with primary open-angle glaucoma (POAG) with or without cataracts...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-024-03364-2 |
| _version_ | 1797266835551289344 |
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| author | Yuqiao Zhang Chunxin Lai Suwen Zhao Ling Li Xiaoyang Luo Yanlei Chen Yongyi Niu Yongjie Qin Hongyang Zhang |
| author_facet | Yuqiao Zhang Chunxin Lai Suwen Zhao Ling Li Xiaoyang Luo Yanlei Chen Yongyi Niu Yongjie Qin Hongyang Zhang |
| author_sort | Yuqiao Zhang |
| collection | DOAJ |
| description | Abstract Background To compare the bleb morphologies of phacoemulsification combined with Ex-PRESS implantation (Phaco-ExPRESS), phaco trabeculectomy (Phaco-Trab), and trabeculectomy (Trab) in postoperative two years. Methods Patients with primary open-angle glaucoma (POAG) with or without cataracts were included in this study. All patients underwent surgeries of either Phaco-ExPRESS, Phaco-Trab, or Trab. The morphologic structures of the filtering bleb, including microcysts area, hyperreflective dot density, and stromal connective tissue under in vivo confocal microscope (IVCM), were compared between the three groups. The data were collected preoperatively and postoperatively at 2 weeks, 1 month, 3 months, 6 months, 12 months, 18 months, and 24 months. Results Eighty-nine eyes from 89 patients were enrolled, including 32 in the Phaco-ExPRESS group, 25 in the Phaco-Trab group, and 32 in the Trab group. In a 24-month follow-up, bleb morphologies in Phaco-ExPRESS were similar to the Trab group. The area of epithelial microcysts was significantly increased in Phaco-ExPRESS and Trab groups while significantly decreased in Phaco-Trab. At postoperative 24 months, the complete success rate was 65.1% in Phaco-ExPRESS, 32.0% in Phaco-Trab, and 59.4% in the Trab group (P = 0.03). The phaco-Trab group had more postoperative anti-glaucoma medications than the other two groups (P < 0.05). Conclusions Phaco-ExPRESS group and Trab group had similar blebs morphologies in IVCM, with larger microcyst area, looser connective tissue, and less inflammation than Phaco-Trab, indicating that the function of blebs in the Phaco-ExPRESS and Trab group, was more potent than that of Phaco-Trab. All these surgical methods provided adequate IOP control, but Phaco-Trab required more anti-glaucoma medications. |
| first_indexed | 2024-04-25T01:07:00Z |
| format | Article |
| id | doaj.art-573d13401f0940bcac3b4bbbe5555c19 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-04-25T01:07:00Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
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| series | BMC Ophthalmology |
| spelling | doaj.art-573d13401f0940bcac3b4bbbe5555c192024-03-10T12:08:34ZengBMCBMC Ophthalmology1471-24152024-03-0124111110.1186/s12886-024-03364-2Comparison of bleb morphologies between phacoemulsification combined with Ex-PRESS mini shunt implantation, phacotrabeculectomy and trabeculectomy alone: a two-year retrospective in vivo confocal microscopy studyYuqiao Zhang0Chunxin Lai1Suwen Zhao2Ling Li3Xiaoyang Luo4Yanlei Chen5Yongyi Niu6Yongjie Qin7Hongyang Zhang8Department of Ophthalmology and Visual Sciences, The Chinese University of Hong KongDepartment of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s HospitalDepartment of Ophthalmology, Nanfang Hospital, Southern Medical UniversityDepartment of Ophthalmology, Nanfang Hospital, Southern Medical UniversityDepartment of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s HospitalDepartment of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s HospitalDepartment of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s HospitalDepartment of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s HospitalDepartment of Ophthalmology, Nanfang Hospital, Southern Medical UniversityAbstract Background To compare the bleb morphologies of phacoemulsification combined with Ex-PRESS implantation (Phaco-ExPRESS), phaco trabeculectomy (Phaco-Trab), and trabeculectomy (Trab) in postoperative two years. Methods Patients with primary open-angle glaucoma (POAG) with or without cataracts were included in this study. All patients underwent surgeries of either Phaco-ExPRESS, Phaco-Trab, or Trab. The morphologic structures of the filtering bleb, including microcysts area, hyperreflective dot density, and stromal connective tissue under in vivo confocal microscope (IVCM), were compared between the three groups. The data were collected preoperatively and postoperatively at 2 weeks, 1 month, 3 months, 6 months, 12 months, 18 months, and 24 months. Results Eighty-nine eyes from 89 patients were enrolled, including 32 in the Phaco-ExPRESS group, 25 in the Phaco-Trab group, and 32 in the Trab group. In a 24-month follow-up, bleb morphologies in Phaco-ExPRESS were similar to the Trab group. The area of epithelial microcysts was significantly increased in Phaco-ExPRESS and Trab groups while significantly decreased in Phaco-Trab. At postoperative 24 months, the complete success rate was 65.1% in Phaco-ExPRESS, 32.0% in Phaco-Trab, and 59.4% in the Trab group (P = 0.03). The phaco-Trab group had more postoperative anti-glaucoma medications than the other two groups (P < 0.05). Conclusions Phaco-ExPRESS group and Trab group had similar blebs morphologies in IVCM, with larger microcyst area, looser connective tissue, and less inflammation than Phaco-Trab, indicating that the function of blebs in the Phaco-ExPRESS and Trab group, was more potent than that of Phaco-Trab. All these surgical methods provided adequate IOP control, but Phaco-Trab required more anti-glaucoma medications.https://doi.org/10.1186/s12886-024-03364-2Primary open angle glaucomaGlaucoma drainage implantPhacoemulsificationTrabeculectomyIn vivo confocal microscopy |
| spellingShingle | Yuqiao Zhang Chunxin Lai Suwen Zhao Ling Li Xiaoyang Luo Yanlei Chen Yongyi Niu Yongjie Qin Hongyang Zhang Comparison of bleb morphologies between phacoemulsification combined with Ex-PRESS mini shunt implantation, phacotrabeculectomy and trabeculectomy alone: a two-year retrospective in vivo confocal microscopy study BMC Ophthalmology Primary open angle glaucoma Glaucoma drainage implant Phacoemulsification Trabeculectomy In vivo confocal microscopy |
| title | Comparison of bleb morphologies between phacoemulsification combined with Ex-PRESS mini shunt implantation, phacotrabeculectomy and trabeculectomy alone: a two-year retrospective in vivo confocal microscopy study |
| title_full | Comparison of bleb morphologies between phacoemulsification combined with Ex-PRESS mini shunt implantation, phacotrabeculectomy and trabeculectomy alone: a two-year retrospective in vivo confocal microscopy study |
| title_fullStr | Comparison of bleb morphologies between phacoemulsification combined with Ex-PRESS mini shunt implantation, phacotrabeculectomy and trabeculectomy alone: a two-year retrospective in vivo confocal microscopy study |
| title_full_unstemmed | Comparison of bleb morphologies between phacoemulsification combined with Ex-PRESS mini shunt implantation, phacotrabeculectomy and trabeculectomy alone: a two-year retrospective in vivo confocal microscopy study |
| title_short | Comparison of bleb morphologies between phacoemulsification combined with Ex-PRESS mini shunt implantation, phacotrabeculectomy and trabeculectomy alone: a two-year retrospective in vivo confocal microscopy study |
| title_sort | comparison of bleb morphologies between phacoemulsification combined with ex press mini shunt implantation phacotrabeculectomy and trabeculectomy alone a two year retrospective in vivo confocal microscopy study |
| topic | Primary open angle glaucoma Glaucoma drainage implant Phacoemulsification Trabeculectomy In vivo confocal microscopy |
| url | https://doi.org/10.1186/s12886-024-03364-2 |
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