Oral acetazolamide for intraocular pressure lowering: balancing efficacy and safety in ophthalmic practice

2021 ◽  
Author(s):  
Shawn Gulati ◽  
Ahmad A. Aref
Keyword(s):  
Intraocular Pressure ◽  
Efficacy And Safety ◽  
Pressure Lowering

scholarly journals Prevention of intraocular pressure elevation after argon laser trabeculoplasty in primary open angle glaucoma

2011 ◽  
Vol 139 (1-2) ◽  
pp. 12-17
Author(s):  
Marija Bozic ◽  
Paraskeva Hentova-Sencanic ◽  
Djordje Kontic ◽  
Vujica Markovic ◽  
Ivan Marjanovic
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Argon Laser ◽  
Similar Efficacy ◽  
Efficacy And Safety ◽  
Argon Laser Trabeculoplasty ◽  
Pressure Elevation ◽  
Laser Trabeculoplasty ◽  
Intraocular Pressure Elevation ◽  
Pressure Lowering

Introduction. Argon laser trabeculoplasty (ALT) is an intraocular pressure lowering method that is overall safe and powerful, but often complicated by transient postoperative intraocular pressure rises. In prevention of this complication, we frequently use two potent alpha-adrenergic agonists - brimonidine and apraclonidine. Objective. The aim of this study was to compare brimonidine 0.2% and apraclonidine 0.5% efficacy and safety in prevention of intraocular pressure elevation after ALT. Methods. This was a prospective, randomized, double-masked and comparative study. This study included 27 POAG patients, 15 received 0.2% brimonidine, and 12 received 0.5% apraclonidine before laser surgery (22 eyes in both groups). Intraocular pressure readings were taken 1, 2, 3, 24 hours and 7 days after ALT. Student?s t-test was used to analyze data between two groups, and ?2 test to compare data within groups. Value p less than 0.05 was considered statistically significant. Results. We found statistically significantly lower IOP in eyes that received 0.2% brimonidine at readings taken 1 hour after ALT (p=0.001). There were no statistically significant differences in other IOP readings between two groups. Conclusion. A single preoperative drop of brimonidine 0.2% had similar efficacy and safety as apraclonidine 0.5% in preventing transient IOP elevations after ALT.

Long-term efficacy and safety of bimatoprost for intraocular pressure lowering in glaucoma and ocular hypertension: year 4

2008 ◽  
Vol 92 (10) ◽  
pp. 1387-1392 ◽  
Author(s):  
R D Williams ◽  
J S Cohen ◽  
R L Gross ◽  
C-c Liu ◽  
E Safyan ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Ocular Hypertension ◽  
Efficacy And Safety ◽  
Term Efficacy ◽  
Pressure Lowering

Efficacy and safety of the ab interno gelatin stent in severe pseudoexfoliation glaucoma compared to non-pseudoexfoliation glaucoma at 6 months

2019 ◽  
Vol 30 (5) ◽  
pp. 1028-1033 ◽  
Author(s):  
Nimrod Dar ◽  
Tal Sharon ◽  
Idan Hecht ◽  
Maya Kalev-Landoy ◽  
Zvia Burgansky-Eliash
Keyword(s):  
Intraocular Pressure ◽  
Patient Characteristics ◽  
Similar Efficacy ◽  
Efficacy And Safety ◽  
Pseudoexfoliation Glaucoma ◽  
Pressure Lowering ◽  
Surgery Rates ◽  
Glaucoma Group ◽  
Ab Interno

Purpose: To compare the efficacy and safety of the XEN45 Gel Stent surgery between patients with and without severe pseudoexfoliation glaucoma. Methods: In this retrospective, single-center, comparative chart review, records of 24 eyes of 23 patients with pseudoexfoliation glaucoma and 24 eyes of 23 patients with non-pseudoexfoliation glaucoma with severe glaucoma, defined as uncontrolled intraocular pressure on maximally tolerated medical therapy, were reviewed. All patients were treated with XEN45 Gel Stent surgery, in either a standalone procedure (84.8%) or combined with phacoemulsification (15.2%). Mean intraocular pressure, mean number of intraocular pressure-lowering medications, change in best-corrected visual acuity and needling or rescue surgery rates were assessed. Success was defined as at least 20% decrease in baseline intraocular pressure among treatment-free patients. Results: Patient characteristics were similar between the groups. At 6 months, intraocular pressure in the pseudoexfoliation glaucoma group decreased by 32% (24.3 ± 9 mmHg–14.8 ± 7 mmHg, p < 0.001), with comparable decrease in intraocular pressure in the non-pseudoexfoliation glaucoma group (22.6 ± 7 mmHg–16.7 ± 6 mmHg, p = 0.011). Similar rates of patients required topical anti-glaucoma therapy (29% vs 22%, p = 0.559), needling (54% vs 37%, p = 0.247), and rescue trabeculectomy (13% in both, p = 1.00) at the last follow-up. However, intraocular pressure decreased more in the pseudoexfoliation glaucoma group among treatment-free patients (–10.1 ± 8.0 mmHg vs −4.1 ± 8.1 mmHg, p = 0.043), and final intraocular pressure was lower in the pseudoexfoliation glaucoma group (12.2 ± 3.5 mmHg vs 15.8 ± 5.7 mmHg, p = 0.044). Conclusions: The XEN45 Gel Stent implant demonstrated similar efficacy and safety among severe pseudoexfoliation glaucoma and non-pseudoexfoliation glaucoma patients. Greater magnitude of decreased intraocular pressure occurred among treatment-free pseudoexfoliation glaucoma patients.

Efficacy and safety data for the Ab interno XEN45 gel stent implant at 3 Years: A retrospective analysis

2021 ◽  
pp. 112067212110143
Author(s):  
Itay E Gabbay ◽  
Mordechai Goldberg ◽  
Felicity Allen ◽  
Zhiheng Lin ◽  
Christine Morley ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Failure Rate ◽  
Open Angle Glaucoma ◽  
Safety Data ◽  
Angle Closure ◽  
Efficacy And Safety ◽  
Antihypertensive Medications ◽  
Uk National Health Service ◽  
The Uk ◽  
Comparative Audit

Purpose: To report efficacy and safety measures of the XEN45 gel stent at 36 months in the UK National Health Service setting. Methods: Retrospective non-comparative audit of the records of patients who underwent XEN45 implantation between June 2015 and May 2017 was performed. Main outcome measures were intraocular pressure and number of antihypertensive medications used. Failure was defined as need for further surgery or stent removal. Success was defined as a 20% decrease in intraocular pressure without the need for additional glaucoma medications or a reduction in antihypertensive medications without an increase in baseline intraocular pressure. Needling rates and preoperative factors effect were assessed. Results: The cohort included 205 patients (205 eyes) with primary open angle glaucoma (84.4%), angle closure glaucoma (7.8%), or refractory glaucoma (7.8%), 62.9% had a stand-alone procedure and 37.1%, a combined phaco-XEN45 procedure. Mean intraocular pressure was 22.6 ± 7.0 mmHg at baseline compared to 14.7 ± 3.8 mmHg at 24 months and 14.0 ± 2.9 mmHg at 36 months ( p < 0.001 for both). Mean number of medications used was 2.6 ± 1.1 at baseline compared to 0.5 ± 0.9 and 0.6 ± 1.0, at 24- and 36-months, respectively ( p < 0.001 for both). The failure rate at 36 months was 25%. Needling was required in 36.6%. Evaluation of background factors yielded an increased failure rate in non-Caucasians compared to Caucasians (74% vs 21%, p < 0.001). Conclusion: XEN45 implantation is effective and safe at 36 months’ follow-up. Patients should be advised regarding the risk of failure and possible need for bleb revisions. Careful patient selection may be required.

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