scholarly journals Intraocular Pressure, Axial Length, and Refractive Changes after Phacoemulsification and Trabeculectomy for Open-Angle Glaucoma

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Alina Popa-Cherecheanu ◽  
Raluca Claudia Iancu ◽  
Leopold Schmetterer ◽  
Ruxandra Pirvulescu ◽  
Valeria Coviltir
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Time Span ◽  
Open Angle ◽  
Refractive Outcome ◽  
Group A ◽  
Hyperopic Shift ◽  
Group B ◽  
Axial Eye Length

Purpose. To compare changes in intraocular pressure (IOP), axial eye length (AEL), and refractive outcome in primary open-angle glaucoma patients undergoing cataract surgery and trabeculectomy in dependence of the sequence of surgeries. Materials and Methods. We retrospectively analysed 48 eyes. The changes in refraction, intraocular pressure, and axial eye length were analysed after surgery. In group A (21 subjects), phacoemulsification was performed before trabeculectomy, and in group B (27 subjects), trabeculectomy was performed before phacoemulsification with a minimum time span between interventions of 6 months. Results. The reduction in IOP and the decrease in AEL after trabeculectomy were significant after 6 and 12 months postsurgery (p<0.001 each). The decrease in AEL was 0.42 ± 0.11% at 6 months after surgery and 0.40 ± 0.13% after 12 months from surgery; this decrease in AEL was comparable between the groups. The refractive outcome was significantly different between the groups (group A: 0.35 ± 0.75 dpt, group B: −0.05 ± 0.36 dpt, p=0.018); in group A, trabeculectomy caused a hyperopic shift of 0.34 ± 0.44 dpt (p=0.002) at 12 months postsurgery. Conclusion. IOP reduction after trabeculectomy causes AEL shortening. The effect on refractive outcome depends on the sequence of surgeries. Better refractive outcome is achieved if phacoemulsification is performed after trabeculectomy.

scholarly journals Results of Rectangular and Triangular Shaped Scleral Flaps in Trabeculectomy in Terms of Control of Intra Ocular Pressure (IOP) and Complications

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Qirat Qurban ◽  
Zeeshan Kamil ◽  
Khalid Mahmood
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Anterior Chamber Depth ◽  
Open Angle ◽  
Scleral Flap ◽  
Intra Ocular Pressure ◽  
Group A ◽  
Ocular Pressure ◽  
Group B

Purpose: To compare between the results of rectangular and triangular shaped scleral flaps in trabeculectomy for primary open angle glaucoma. Study design: Quasi experimental study Place and Duration of Study: Khalid eye clinic, Karachi, from July 2018 to June 2019. Methods: This study included 24 patients of either gender and age from 40 to 65 years. Patients with a diagnosis of primary open angle glaucoma refractory to medical treatment were included by convenient sampling technique. They were divided into two groups. Group A underwent trabeculectomy with rectangular shaped scleral flap whereas Group B underwent trabeculectomy with triangular shaped scleral flap. The main outcome measures were intraocular pressure reduction, anterior chamber depth and post-operative complications. All patients were followed up for a period of two months. Results: Mean age was 52.1± 6.72 years. Mean pre-operative intraocular pressure in group A was 24.4±2.13 mmHg and 23.5±1.64 mmHg in group B. Mean post-operative IOP was 11.6±1.51 mmHg in group A and 13.4±1.67 mmHg in group B with p-value of 0.11. Pre-operative anterior chamber depth (ACD) was grade 4 both groups. It remained same in all patients of group A but two patients of group B changed to grade 3 ACD. Two patients of group B developed hypotony on the first post-operative day. They did not require revision suturing and were managed conservatively. Conclusion: Both types of scleral flap are effective in reducing IOP but rectangular scleral flap reduced IOP more as compared to triangular scleral flap but the difference was not statistically significant. Keywords: Trabeculectomy, Intra ocular pressure, Open angle glaucoma.

scholarly journals To Compare the Effect on IOP Following Primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma

2021 ◽  
pp. 475-480
Author(s):  
Zakaullah Gopang ◽  
Shabeer Ahmed Bhutto ◽  
Naeem Akhtar Katpar ◽  
Arslan hassan Rajper ◽  
Vijay Nagdev
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Test Group ◽  
Control Group ◽  
Open Angle ◽  
Primary Procedure ◽  
Group A ◽  
Group B ◽  
Medical University

Objective: To determine the effect on intraocular pressure following primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma. Study Design: This is a prospective and experimental Study. Setting: Study carried out at Ophthalmology Department, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 01-03-2020 to 31-08-2020 (06 Months). Materials and Methods: The patients with primary open angle glaucoma were selected from glaucoma clinic after taking careful history and clinical examination. Patients selected for trabeculectomy into two groups. Group A includes 43 patients while Group B also includes 43 patients. Among Group A patients adjunctive MMC 0.2mg/ml for a period of 3 minutes was used during trabeculectomy as a primary procedure (Test Group) while Group B patients were operated without MMC 0.2% (Control Group). Follow-up period of 06 months was observed in both groups. The span of study was from 01-03-2020 to 31-08-2020. Results: The total of 86 Eyes of 86 patients of POAG were included in this study. Group A patients were operated for trabeculectomy with MMC while group B patients were operated for trabeculectomy without MMC. The mean IOP before surgery of Group-A was 25.39±2.42 mmHg while in Group-B it was 26.23±4.23mmHg. At day 1 of surgery in Group-A patients IOP was 13.20±3.05 mmHg while in Group-B patients IOP, was 14.09±4.04 mmHg. After 3 months in Group-A, IOP was 13.04±3.81 mmHg in Group-B IOP was 14.01±4.18 mmHg. Out of 43 patients in Group-A, 41(95.3%) were succeeded while in Group-B, 39(90.7%)were succeeded. Significant result was found for IOP reduction after 6 months of surgeryin group-A IOP was 13.48 + 2.86 mmHg while in group-B, IOP was 15.09 ±2.64 (P=0.754). Conclusion: Trabeculectomy with MMC as a primary procedure seems to be more effective than trabeculectomy without MMC.

scholarly journals Selective laser trabeculoplasty in primary open-angle glaucoma: Primary versus secondary treatment outcomes

2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Emil Goosen ◽  
Linda Visser ◽  
Ben Sartorius
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Retrospective Chart Review ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Treatment Naïve ◽  
Prior Surgery ◽  
Group A ◽  
Group B

Objective: To compare the outcomes of selective laser trabeculoplasty (SLT) on treatmentnaive, primary open-angle glaucoma (POAG) patients with those of SLT on patients previously treated medically and/or surgically. Secondary objectives: To establish whether age, race or gender influenced SLT outcomes.Design: A retrospective chart review of patients who received SLT therapy for POAG between June 2011 and January 2015.Subjects: Group A: Treatment-naive patients (n = 15). Group B: Prior medical therapy and/or prior surgery (n = 69).Methods: Group A: Patients were treated with SLT therapy as first line, with medical treatment added as needed. Group B: Patients were treated with SLT therapy as additional therapy to medication and/or surgery. All patients were followed up for at least 1 year.Main outcome measures: A reduction in intraocular pressure (IOP) of at least 20% from baseline was considered significant.Results: The following percentage reduction in IOP was found in the different groups: Group A 50.7%, Group B 32.0%, Africans 52.2%, Indians 29.8% and Caucasians 28.87%.Conclusion: In our study patients, SLT achieved significant reductions in IOPs in treatmentnaive as well as previously surgically and medically treated eyes with POAG. Statistically significant higher reductions in IOP at 1 year after SLT was seen in treatment-naive eyes, patients older than 70 years when compared with younger patients, female patients (54%) when compared with male patients (30%) and in patients of African (52%) descent compared with Caucasians (30%).

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.

scholarly journals Intraocular Pressure-Lowering Potential of Subthreshold Selective Laser Trabeculoplasty in Patients with Primary Open-Angle Glaucoma

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Hong Yang Zhang ◽  
Yong Jie Qin ◽  
Yang Fan Yang ◽  
Jian Gang Xu ◽  
Min Bin Yu
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Initial Energy ◽  
The Other ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Pressure Lowering ◽  
Laser Flare

Purpose.To compare the efficacy of subthreshold and conventional selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in the patients with primary open-angle glaucoma (POAG).Methods.Fifty-two eyes from fifty-two POAG patients were randomized into two groups, one group treated with subthreshold SLT using two-thirds of the conventional energy and the other one treated with the conventional energy. IOP was measured with the Goldmann tonometer and the anterior chamber inflammation was determined using laser flare meter.Results.The initial energy dosage used in subthreshold SLT group was significantly lower than the amount of the energy used in conventional SLT group (0.4±0.1 mJ versus0.6±0.1 mJ,P=0.030). The total energy dosage was also significantly lower in subthreshold SLT group compared to the other group (37.6±3.3 mJ versus51.8±5.7 mJ,P=0.036). However, the level of inflammation in aqueous humor, amount of reduction in IOP, and the success rate in controlling IOP was the same in both groups.Conclusion.The efficacy of subthreshold SLT group in reducing IOP in POAG patients is comparable to the efficacy of conventional SLT group.

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