Anterior chamber flare in primary open-angle glaucoma and exfoliation glaucoma after trabeculotomy
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LETTER TO THE EDITOR
Anterior chamber flare in primary open-angle glaucoma and exfoliation glaucoma after trabeculotomy Masaki Tanito 1
&
Katsunori Hara 1 & Yasuyuki Takai 1
Received: 25 August 2020 / Revised: 25 August 2020 / Accepted: 1 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Dear Editor, Trabeculotomy (LOT) reduces intraocular pressure (IOP) by eliminating aqueous flow resistance by cleavage of the trabecular meshwork and inner walls of Schlemm’s canal at the point of outflow resistance of the aqueous humor. Measurement of anterior chamber flare (ACF) is the established method for estimating postoperative inflammation [1]; however, few studies have estimated postoperative inflammation by ACF after LOT. The Ethics Committee of Shimane University Hospital approved the current study. Based on the regulations issued by the Japanese Government, the study protocol did not require each patient to provide written informed consent; instead, the protocol was posted in the outpatient clinic to notify the patients of the study. The study complied with the tenets of the Declaration of Helsinki. We searched the department database for eyes that underwent ab externo LOT by one surgeon (MT) to manage glaucoma between January 2008 and June 2010. The inclusion criteria were consecutive cases with primary open-angle glaucoma (POAG) or exfoliation glaucoma (EXG); measurement of IOP by Goldmann applanation tonometry preoperatively and 1, 3, and 6 months postoperatively; and measurement of the ACF by the FM-600 laser flare meter (Kowa, Nagoya, Japan) preoperatively and more than 2 times within 6 months postoperatively. If both eyes of a patient were eligible, the eye that underwent surgery first Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00417-020-04962-8) contains supplementary material, which is available to authorized users. * Masaki Tanito [email protected] 1
Department of Ophthalmology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan
was included. The surgical procedure was described previously [2]. At the end of surgery, 1.65 mg of dexamethasone sodium phosphate was injected subconjunctivally, and 1.5% levofloxacin and 0.1% betamethasone were applied topically four times daily for 3 to 4 weeks postoperatively in all cases. A topical non-steroidal anti-inflammatory drug was used in cases treated with combined LOT and cataract surgery. No severe surgical complications such as vitreous loss, suprachoroidal hemorrhage, and endophthalmitis were noted. Ultimately, 96 eyes of 96 subjects (mean age, 75.7 years; 51 [53%] men; 32 POAG and 64 EXG) were included. The demographic data of the subjects are shown in Table 1. All statistical analyses were performed using the JMP Pro version 14.2 statistical software (SAS Institute, Inc., Cary, NC, USA). By mixed-effects regression model, the IOP and number of medications decreased significantly for up to 6 months postoperatively in all patients and in the POAG a
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