Advanced open angle glaucoma with controlled intraocular pressure and cataract: one-year predictive model of glaucoma progression after surgical treatment.

2012 ◽  
Vol 90 ◽  
pp. 0-0
Author(s):  
A LIASKA ◽  
D PAPAKONSTANTINOU ◽  
P THEODOSIADIS ◽  
K CHATZISTEPHANOU
Keyword(s):  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Predictive Model ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Glaucoma Progression ◽  
One Year

scholarly journals CO2-lézerrel végzett mélysclerectomiával szerzett tapasztalatok

2017 ◽  
Vol 158 (18) ◽  
pp. 701-705 ◽  
Author(s):  
Zoltán Sohajda ◽  
Ildikó Káldi ◽  
Magdolna Kiss ◽  
Andrea Facskó
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Open Angle Glaucoma ◽  
Medication Use ◽  
Open Angle

Abstract: Introduction: CO2 laser- assisted sclerectomy surgery (CLASS) can be used for the surgical treatment of open-angle glaucoma. Aim: To introduce our results with CLASS. Method: We performed 21 CLASS operations using OT-134-IOPtiMate (IOPtima Ltd, Ramat-Gan, Israel). Patients were examined on the 1st day, and in the 1st, 3rd, 6th, 9th and 12th months postoperatively. We evaluated intraocular pressure (IOP), antiglaucomatous medication-use, visual acuity, complications. Results: Mean age was 65.6 yrs. Complete success (no hypotensive medication required to target IOP) was achieved in 61.1% (18 patients) at 6 months, whereas in 50% (10 patients) at 12 months. Qualified success (hypotensive medication required to target IOP) was achieved in 72.2% and in 70%, preoperative mean IOP was 29.2 ± 9.4 Hgmm, which falled to 17.7 ± 4.9 Hgmm and 17.3 ± 4.3 Hgmm, respectively. Antiglaucomatous medication use falled significantly from 2.90 ± 0.83 to 2.05 ± 1.46. Apart from 1 macroperforation, no serious complication occurred. Conclusions: With CLASS it is possible to effectively lower intraocular pressure in open-angle glaucoma. Orv Hetil. 2017; 158(18): 701–705.

Study of the effectiveness of osteopathic correction in the complex treatment of patients with operated primary open-angle glaucoma

2021 ◽  
pp. 66-76
Author(s):  
O. V. Zubkov ◽  
E. A. Smirnova ◽  
V. V. Kramar ◽  
O. I. Kurbatov
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Pain Syndrome ◽  
Open Angle ◽  
Complex Treatment ◽  
Fiber Layer ◽  
Complex Therapy

Introduction. Glaucoma is a chronic eye disease characterized by a constant or periodic increase in intraocular pressure, a decrease of visual fields and visual acuity, and by a special form of optic nerve atrophy with excavation in the disc area. The reflection of this slowly fl owing atrophy is a disturbance in the visual field and a complete irreversible loss of visual function. The prevalence of the disease increases with increasing age. The main methods of treatment are medical and surgical. Non-penetrating operations are recognized as the safest methods of surgical treatment of glaucoma. The most common complications of such operations include: detachment of the choroid, small anterior chamber syndrome, hyphema, cicatricial changes in the filtration cushion. Based on the analysis of literature data, it can be assumed that the inclusion of osteopathic correction in the complex therapy of patients with operated glaucoma can increase the effectiveness of therapy.The aim of the research was to study the clinical efficacy of osteopathic correction in the complex treatment of patients operated on primary open-angle glaucoma.Materials and methods. The study involved 20 patients (20 eyes) aged 70 to 75 years with developed and advanced stages of primary open-angle glaucoma, who underwent surgical treatment. The main (10 people) and control (10 people) groups were formed by simple randomization. Participants in the main group received standard medical therapy and osteopathic correction, while participants in the control group received only medical therapy. Changes in the following clinical parameters were evaluated: visual acuity, visual fi eld, intraocular pressure, thickness of the retinal nerve fiber layer, and severity of pain syndrome. Indicators were recorded at the beginning of the study (2 weeks after surgery) and at the end of the study (2–3 months after surgery).Results. Patients receiving osteopathic correction as part of the complex therapy after surgery of primary openangle glaucoma are characterized by a statistically significant (p<0,05) decrease in the severity of pain syndrome, an increase in the magnitude of the visual field and of the thickness of the retinal nerve fiber layer.Conclusion. The obtained results suggest the effectiveness of the inclusion of osteopathic correction in the complex treatment of patients with operated on primary open-angle glaucoma. It is recommended to continue the study with a larger sample size.

scholarly journals Hypotensive effect of selective laser trabeculoplasty in patients with medically uncontrolled primary open-angle glaucoma

2014 ◽  
Vol 142 (9-10) ◽  
pp. 524-528 ◽  
Author(s):  
Marko Kontic ◽  
Dragana Ristic ◽  
Miroslav Vukosavljevic
Keyword(s):  
Surgical Treatment ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Congenital Glaucoma ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Initial Value ◽  
Laser Trabeculoplasty ◽  
The Mean ◽  
One Year

Introduction. Glaucoma is a chronic, progressive disease of the optic nerve which if left untreated can lead to blindness at end stages. A decrease of intraocular pressure (IOP) has proven to slow down the progression of the disease. IOP decrease can be achieved by medical, laser and surgical treatment. Objective. The aim of this study was to evaluate the response of patients with medically uncontrolled primary open angle glaucoma to selective laser trabeculoplasty (SLT). Methods. The study involved baseline characteristics recorded for each of 35 patients (48 eyes) in whom, despite being under full medication we could not achieve a satisfactory IOP. Patients, who had pressure above 25 mmHg under the maximal medication therapy, were not included into the study and were referred for surgical treatment. IOP was measured on admission, 1 hour, 7 days, 1, 3, 6 and 12 months after SLT. We considered satisfactory surgical result if IOP was decreased more than 20% of the initial value. Also, we investigated the influence of baseline IOP on SLT outcome after 12 months. Patient inclusion criteria were inability to reach target IOP with maximal medical therapy. Exclusion criteria were congenital glaucoma, any type of angle closure glaucoma, advanced-stage glaucoma, eyes with previous laser or surgical glaucoma applications and patients with baseline IOP >25 while fully medicated. Patients who could not be followed for at least 12 months were also excluded. Results. The mean age of our patients was 73?12 years. The mean baseline IOP was 20.48 mmHg (SD=1.91), and the mean change in IOP from baseline of the treated eye after one year was 4.47 mmHg (SD=2.12). In eyes with a higher baseline IOP the reduction of pressure at the end of the study was significantly higher. Satisfactory effect of IOP reduction after one year was achieved in 64.58% of eyes. The IOP reduction did not show to be dependent as regarding age and gender. Conclusion. SLT effectively lowers IOP in patients with primary open-angle glaucoma, and the intervention is not followed by significant complications. Our results confirm that the IOP reduction is more significant if the initial value is higher. Our first reliable results of IOP reduction were confirmed one month after the procedure so that the procedure should not be repeated before one month has elapsed. The study is limited by a small number of eyes, which is insufficient to make a complete case analysis.

scholarly journals Comparison of Prostaglandin Analogue and Selective Laser Trabeculoplasty Capability to Maintain Intraocular Pressure Fluctuation on Primary Open Angle Glaucoma

2017 ◽  
Vol 3 (1) ◽  
pp. 13
Author(s):  
Sara Listyani Koentjoro ◽  
Maharani Cahyono ◽  
Fifin Luthfia Rahmi
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Prostaglandin Analogue ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Glaucoma Progression ◽  
Laser Trabeculoplasty ◽  
Before And After ◽  
Result Analysis

Background: Glaucoma patients often come with intraocular pressure (IOP) that reach target pressure, but still have glaucoma progression due to IOP fluctuation. Water drinking test (WDT) can be used as a method to predict IOP fluctuation.Purpose: To compare prostaglandin analogue (PGA) and selective laser trabeculoplasty (SLT) capability to maintain IOP fluctuation on primary open angle glaucoma (POAG).Method: This clinical experimental research was conducted at Dr. Kariadi Hospital. Subjects were POAG patients selected with consecutive sampling. Intraocular pressure was measured before and after WDT. After WDT, IOP was measured every 15 minutes until 1 hour. Peak IOP and IOP fluctuation data were collected then analyzed with t-test.Results: Forty two eyes from 30 POAG patients were analyzed. Twenty six eyes in PGA group and 16 eyes in SLT group. Most of the subjects were male with mild glaucoma degree. WDT increased IOP significantly on both groups. Mean IOP pre WDT was 14.58 ± 2.580 mmHg and 16.94 ± 2.645 mmHg in PGA and SLT groups. Mean peak IOP post WDT was 22.73 ± 4.114 mmHg and 25.75 ± 5.859 mmHg in PGA and SLT groups. Mean IOP fluctuation was 8.15 ± 4.202 mmHg and 8.81 ± 5.344 mmHg in PGA and SLT groups. Peak IOP and IOP fluctuation result analysis on both groups were not significantly different.Conclusion: Prostaglandin analogue and SLT had equal capability to maintain IOP fluctuation but still higher than normal fluctuation (>6 mmHg) that affects glaucoma progression.

scholarly journals Prognosing intraocular pressure compensation in primary open-angle glaucoma patients at medical and surgical treatment

2015 ◽  
Vol 8 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Ol'ga Vladimirovna Soljannikova ◽  
Ekaterina Viktorovna Berdnikova ◽  
Valerij Fedorovich Ekgardt ◽  
Victorya Nikolaevna Dmitrienko
Keyword(s):  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Medical Treatment ◽  
Program Development ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Examination Methods ◽  
Pressure Compensation ◽  
Poag Patient

Objective. Criteria specification and prognosis establishment of intraocular pressure compensation in primary open-angle glaucoma (POAG) patients at medical and surgical treatment based on integrated clinical and instrumental examination. Methods. 128 POAG subjects (234 eyes) receiving medical treatment were included in the study, surgery was performed in 42 patients (52 eyes). Results. The use of multiple clinical parameters into the statistical analysis leads to an increase in the probability of IOP compensation and correct prognosis (up to 84.0-98.4 % of cases) in medical treatment, and does not alter the prognosis accuracy at surgical treatment. In analysis of lower variables number, correct prognosis of IOP compensation at medical treatment can be established in 75.4-75.7 % of cases, and at surgical treatment - in 100 % of cases. The results of present study are the basis for a computer program development that could allow a practicing ophthalmologist to determine the prognosis of IOP compensation in a POAG-patient.

scholarly journals Intraocular Pressure Control after Trabeculectomy with Adjunctive Use of Mitomycin-C versus Bevacizumab: A Hospital Based Study

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
P S Mahar ◽  
Sobia Tabassum ◽  
Mujahid Inam ◽  
Muhammad Faaz Malik ◽  
Tauseef Mahmood
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Pressure Control ◽  
T Test ◽  
P Value ◽  
Open Angle ◽  
One Year

Purpose:  To compare the control of intra ocular pressure (IOP) after trabeculectomy with adjunctive use of Mitomycin–C (MMC) versus Bevacizumab. Study Design:  Quasi experimental study. Place and Duration of Study:  Al-Ibrahim Eye Hospital, Isra Postgraduate Institute of Ophthalmology, Karachi, from August 2017 to August 2019. Methods:  One hundred and six patients of either gender, fulfilling the inclusion criteria were planned for trabeculectomy with adjunctive use of Mitomycin-C (MMC) or Bevacizumab. Each group consisted of 53 patients (53 Eyes). The patients diagnosed with Primary Open Angle Glaucoma (POAG) with IOP ? 21 mm Hg and not controlled with topical anti-glaucoma medication were selected. Data were analyzed by using SPSS Version 22.0. Independent sample t test was used to check significance between two drugs. Paired sample t test was used to check significance of pre and post-operative IOP. Results:  Mean age of patients was 56.67±7.34 years. Mean preoperative IOP was 31.51 ± 9.66 mm Hg in MMC group and 29.21 ± 7.69 mm Hg in Bevacizumab group. At first postoperative day, mean IOP after use of MMC was 14.75 ± 9.46 mm Hg and for Bevacizumab was 15.07 ± 6.47 mm Hg (p-value 0.001). Similarly, at one year follow-up, mean IOP for MMC group was 11.26 ± 2.31 mm Hg and for Bevacizumab was 11.73 ± 2.12 mm Hg(p-value 0.001). Conclusion:  There was significant reduction in IOP in both MMC and Bevacizumab groups. However, the difference between the two groups was not statistically significant at mean follow-up of one year. Key Words:  Primary Open Angle Glaucoma, Mitomycin–C, Intraocular Pressure, Bevacizumab, Trabeculectomy.

scholarly journals Laser Trabeculoplasty and Decay Effects in Glaucoma Patients

1984 ◽  
Vol 77 (2) ◽  
pp. 97-101 ◽  
Author(s):  
Austin I Fink ◽  
Alan J Jordan
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Diabetic Patients ◽  
Average Pressure ◽  
Open Angle ◽  
Hypertensive Patients ◽  
Narrow Angle ◽  
Laser Trabeculoplasty ◽  
Pressure Reversal ◽  
One Year

Forty patients (47 eyes) with open-angle glaucoma who had been treated by laser trabeculoplasty to help reduce intraocular pressure were reviewed. The majority of patients had been followed for at least one year. Eighty-nine percent responded satisfactorily, with an average pressure decrease of 5 mmHg. There was no evidence of decay (pressure reversal) after one year. Seventy-six percent of patients who had been on carbonic anhydrase inhibitor medication were able to discontinue this therapy after laser treatment. Blacks, aphakic and diabetic patients responded satisfactorily, but hypertensive patients and those with narrow-angle glaucoma less so. Re-lasering was successful in only one of 6 patients.

Clinical efficacy of osteopathic correction in the complex treatment of patients with unoperated open-angle glaucoma

2020 ◽  
pp. 97-105
Author(s):  
E. N. Simakova ◽  
O. V. Stenkova
Keyword(s):  
Intraocular Pressure ◽  
Drug Therapy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Randomized Study ◽  
Main Group ◽  
Control Group ◽  
Open Angle ◽  
Complex Treatment ◽  
Hypotensive Drug

Introduction. Glaucoma is one of the most significant eye diseases. It is often diagnosed, not always amenable to therapy, and can lead to a complete loss of visual functions. In recent years, the method of osteopathic correction has become widespread as one of the effective methods of treatment and rehabilitation of patients with pathologies of various body systems. In the pathogenesis of glaucoma, it is customary to distinguish a dystrophic concept, which considers primary open-angle glaucoma as a result of dystrophic changes in the connective tissue, as well as in the endothelial lining of the trabeculae and Schlemm′s canal, especially destructive changes in mitochondria and the alteration of their functional activity. A vascular concept is also distinguished. According to this concept, the central link in the pathogenesis of glaucoma is circulatory disorder in the ciliary vessels, ocular artery, and major vessels of the head and neck, it can be assumed that osteopathic correction in the treatment of patients with open-angle glaucoma will be pathogenetically substantiated and will have a positive effect on intraocular pressure and trophicity of the optic nerve. The goal of research — to study the influence of in osteopathic correction on the nature of unoperated glaucoma (stage IIA) and to substantiate the possibility of using osteopathic correction in the complex treatment of patients with this pathology.Materials and methods. A prospective controlled randomized study was conducted at 52 city polyclinics, branch 3, Moscow, from January 2018 to January 2019. 40 patients (70 eyes) aged 50 to 75 years with primary open-angle glaucoma IIA stage were examined. At this stage of the disease, patients most often seek medical care and the issue of conservative management is primarily considered. All patients were divided into two groups of 20 people: the main group and the control group. The treatment in the main group included hypotensive drug therapy and osteopathic correction. Patients of the control group received only drug therapy. All patients underwent ophthalmic (visometry, tonometry, perimetry) and osteopathic examination twice: before the treatment and after 3 months.Results. For patients with primary open-angle IIA non-operated glaucoma, regional (most often regions of the head, neck, dura mater) and local (abdominal diaphragm, iliac bones, hip and knee joints) somatic dysfunctions were the most typical. In the main group a statistically significant decrease in the frequency and severity of dysfunctions at all levels was stated. Also, in patients receiving osteopathic correction, a significant decrease in the level of intraocular pressure and perimetric indices was noted. In patients of the control group, no reliable changes in these indicators were obtained.Conclusion. The results obtained indicate that osteopathic correction is clinically effective in the complex treatment of patients with primary open-angle II A glaucoma.

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