Publications by authors named "Keith Barton"
Objective: To investigate the outcomes of aqueous shunt exposure repair and to identify risk factors for recurrent exposure after surgical repair.
Methods: This is a retrospective interventional case series of consecutive patients who underwent repair of an exposed aqueous shunt. Demographic and clinical data were extracted from the patients' records and survival analysis was employed to determine the probability of survival of the repair without further exposure.
Prcis: The combination of surgical peripheral iridectomy, goniosynechialysis, and goniotomy is a safe and effective surgical approach for advanced primary angle closure glaucoma without cataract.
Purpose: To evaluate the efficacy and safety of surgical peripheral iridectomy (SPI), goniosynechialysis (GSL), and goniotomy (GT) in advanced primary angle closure glaucoma (PACG) eyes without cataract.
Patients And Methods: A prospective multicenter observational study was performed for patients who underwent combined SPI, GSL, and GT for advanced PACG without cataract.
Article Synopsis
- The study examines the effectiveness of a combined eye surgery (phacoemulsification, goniosynechialysis, and goniotomy) for treating primary angle closure glaucoma in patients with cataracts, noting that success is not influenced by the severity of peripheral anterior synechiae.
- It involved 304 eyes from 283 patients over around 12.5 months, showing a significant reduction in intraocular pressure (IOP) post-surgery across all severity groups, with no notable differences in success rates.
- Although more severe peripheral anterior synechiae (270°≤PAS<360°) experienced increased instances of complications like hyphema, the overall results indicated that the combined procedure is effective regardless of PAS extent
Background: Narrative medicine demonstrated positive impact on empathy in medicine and nursing students. However, this pedagogical approach had not been evaluated in pharmacy education. This study sought to apply and evaluate the narrative medicine approach in extending empathy in Asian undergraduate pharmacy students.
View Article and Find Full Text PDFPhacogoniotomy versus phacotrabeculectomy for advanced primary angle-closure glaucoma with cataract: A randomized non-inferiority trial.
Asia Pac J Ophthalmol (Phila)
February 2024
Purpose: To investigate the effectiveness and safety of phacogoniotomy versus phacotrabeculectomy (PVP) among patients with advanced primary angle-closure glaucoma (PACG) and cataracts.
Design: Multicenter, randomized controlled, non-inferiority trial.
Methods: A total of 124 patients (124 eyes) with advanced PACG and cataracts were enrolled, with 65 in the phacogoniotomy group and 59 in the phacotrabeculectomy group.
Purpose: To determine whether primary trabeculectomy or medical treatment produces better outcomes in terms of quality of life (QoL), clinical effectiveness, and safety in patients with advanced glaucoma.
Design: Multicenter randomized controlled trial.
Participants: Between June 3, 2014, and May 31, 2017, 453 adults with newly diagnosed advanced open-angle glaucoma in at least 1 eye (Hodapp classification) were recruited from 27 secondary care glaucoma departments in the United Kingdom.
Article Synopsis
- A 70-year-old man with severe glaucoma had previous surgeries including selective laser trabeculoplasty and minimally invasive glaucoma surgery while also being intolerant to multiple medications.* -
- After consultation with a neuro-ophthalmologist, a trabeculectomy was performed on the left eye, which stabilized its intraocular pressure (IOP) for nearly two years, while the right eye continued to deteriorate.* -
- Visual acuity measurements showed significant impairment in the left eye (20/250) compared to the right eye (20/25), with the right eye's IOP at 20 mm Hg and ongoing treatment with medications.*
Prcis: Goniotomy (GT) 120 degrees with or without phacoemulsification was sufficient to lower the intraocular pressure (IOP) and reduce hyphema for primary open angle glaucoma.
Purpose: To compare the surgical outcomes and safety profiles of 120 degrees and 360 degrees GT with or without phacoemulsification cataract extraction and intraocular lens implantation (PEI) for primary open angle glaucoma.
Patients And Methods: This multicenter retrospective study consisted of 139 eyes and was divided into 4 groups: (1) 120 degrees GT, (2) 360 degrees GT, (3) PEI + 120 degrees GT, and (4) PEI + 360 degrees GT.
Objective: To describe the methodology of the Comparing the Effectiveness of Phacoemulsification + Endoscopic Cyclophotocoagulation Laser and Phacoemulsification Alone for the Treatment of Primary Open Angle Glaucoma in Patients with Cataract (CONCEPT) study, a randomized controlled trial.
Design: Double-masked, randomized controlled trial.
Subjects, Participants, And/or Controls: Participants will be recruited from 5 United Kingdom-based centers.
Objectives: To determine 36-month efficacy and safety outcomes of the PRESERFLO Microshunt implant in the treatment of refractory uveitic glaucoma.
Methods: Consecutive patients with uncontrolled uveitic glaucoma despite maximum medical treatment received PRESERFLO Microshunt implant with mitomycin C (MMC) in a tertiary referral glaucoma practice. Efficacy and safety outcomes data were collected at month 6, 12, 24, and 36, postoperatively.
Hypotony is a well-recognised, sight-threatening complication of uveitis. It can also be the final common endpoint for a multitude of disease entities. Multiple mechanisms underlie hypotony, and meticulous clinical history alongside ocular phenotyping is necessary for choosing the best intervention and therapeutic management.
View Article and Find Full Text PDFBackground/objectives: To explore the attitudes of UK glaucoma specialists regarding the current and future practice of trabeculectomy and the novel PRESERFLO™ MicroShunt (PF-MS) device, and intentions to adopt the PF-MS into routine glaucoma surgical practice.
Methods: Online survey of UK and Éire Glaucoma Society members.
Results: 43 glaucoma consultants completed the survey.
Background/objectives: PRESERFLO MicroShunt implantation is a relatively new and increasingly popular treatment for recalcitrant glaucoma. Though relatively uncommon, persistent or severe postoperative hypotony may occur and its treatment presents a significant challenge.
Subjects/methods: Interventional case series of the first 7 consecutive patients who underwent the insertion of a rip-cord suture to treat severe or persistent postoperative hypotony.
Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial: Six-Year Results of Primary Selective Laser Trabeculoplasty versus Eye Drops for the Treatment of Glaucoma and Ocular Hypertension.
Ophthalmology
February 2023
Purpose: The Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial has shown selective laser trabeculoplasty (SLT) to be clinically and cost-effective as a primary treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT) at 3 years. This article reports health-related quality of life (HRQoL) and clinical effectiveness of initial treatment with SLT compared with intraocular pressure (IOP)-lowering eye drops after 6 years of treatment.
Design: Prospective, multicenter randomized controlled trial.
Synopsis: Advanced glaucoma is associated with sight loss. This within-trial economic evaluation compares medical and surgical management strategies. At 2 years, medication appears more cost-effective though longitudinal outcomes are an important subject in future research.
View Article and Find Full Text PDFPurpose: To report 5-year treatment outcomes in the Primary Tube Versus Trabeculectomy (PTVT) Study.
Design: Multicenter randomized clinical trial.
Participants: A total of 242 eyes of 242 patients with medically uncontrolled glaucoma and no previous incisional ocular surgery, including 125 patients in the tube group and 117 patients in the trabeculectomy group.
Purpose: To describe postoperative complications encountered in the Primary Tube Versus Trabeculectomy (PTVT) Study during 5 years of follow-up.
Design: Multicenter randomized clinical trial.
Participants: A total of 242 eyes of 242 patients with medically uncontrolled glaucoma and no previous incisional ocular surgery, including 125 patients in the tube group and 117 patients in the trabeculectomy group.
Introduction: The implantation of the PRESERFLO™ MicroShunt (PMS) device has been shown to significantly lower increased intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG). However, guidelines on best practice for patient selection and pre-/peri-/postoperative care management are lacking. The aim of this modified Delphi panel was to achieve expert consensus on the role of the PMS to treat patients with glaucoma in Europe.
View Article and Find Full Text PDFPurpose: To describe methods that can be used to quantify and compare harm caused by surgical interventions in ophthalmology trials.
Design: Perspective study.
Methods: A published landmark glaucoma trial was used as an exemplar.
Article Synopsis
- - The study examined the incidence of glaucoma progression and deterioration of visual fields in a cohort of urban Ghanaians, finding a high progression rate of 9.7% annually with significant visual field mean deviation changes.
- - Out of 110 subjects, 81% showed signs of progression, with significant differences in the rates of deterioration depending on whether it was classified by structural changes (optic disc) or functional changes (visual field).
- - Key factors contributing to the likelihood and rate of progression included older age and higher baseline intraocular pressure, indicating that these factors may help identify individuals at greater risk for worsening glaucoma.