scholarly journals Comparison of the Effectiveness of Antiglaucomatous Surgeries with Various Glautex Drainage Models

2019 ◽  
Vol 16 (1S) ◽  
pp. 91-95 ◽  
Author(s):  
I. I. Khusnitdinov ◽  
A. E. Babushkin

Purpose: comparative study of trabeculectomy results with various models of domestic “Glautex” drainage in the surgical treatment of primary open angle glaucoma (POAG). Patients and methods. The results of surgical treatment of 98 (105 eyes) patients with POAG aged 50–83 years who underwent trabeculectomy with various Glautex drainage models were analyzed. There were 43 men (43.9 %) and 55 (56.1 %) women. The second (II) stage of POAG was diagnosed in 49 eyes (46.7 %), the third (III) stage in 56 (53.3 %). All patients were divided into 3 groups. The first (main) group consisted of 34 (37 eyes) patients who underwent trabeculectomy in combination with the implantation of Glautex DDA drainage model. The second (main) group included 29 (30 eyes) patients with trabeculectomy and implantation of the SDA model of this drainage. The third group was the control group and consisted of 35 (38 eyes) patients with the classical method of surgery without using any drainage. Results. There was a significant 71.7 % decrease in IOP compared with baseline data in the 1st patients group after antiglaucomatous surgery, 72 and 74 % decrease was in the 2nd and 3rd groups respectively (p < 0.05). An increase in IOP was noted predominantly in the control and in the second study group within 1 month of follow-up. Normalization of ophthalmotonous pressure was achieved by using needling in 13.3 % (4/30) patients in the second group, in 7.9 % (6/38) cases in the control group. The absolute hypotensive effect in the 1st group was noted in 75.7 % of cases; the relative hypotensive effect was in 8.1 %; total failure was in 16.2 %. In the 2nd group the absolute hypotensive effect of the surgery was in 73.3 % of 30 cases, the relative was in 6.7 %, total failure was in 20 %. In the control group (38 eyes), absolute success was in 63.1 %, the relative hypotensive effect was in 13.2 %, and the total failure was in 23.7 %. Conclusion. Trabeculectomy with Glautex drainage and with various models in case of primary open-angle glaucoma provided a sufficiently high relative hypotensive effect in 82 % of cases in a year after the surgery. The achieved surgery outcomes with this drainage in the studied periods did not depend on applied model: DDA or SDA (83.8 and 80 % respectively), but was higher than the classical trabeculectomy (76.3 %). However, in case of the SDA model, needling was required in 13.3 % of cases in the early postoperative period. 

Author(s):  
B.G. Dzhashi ◽  
◽  
T.N. Zhdanova ◽  
S.V. Balalin ◽  
A.R. Vinogradov ◽  
...  

Purpose. Analysis of the effectiveness of surgical treatment of patients with primary open-angle glaucoma associated with cataract the first stage realization of cataract phacoemulsification with IOL implantation (PHACO), and the second stage - microinvasive nonpenetrating deep sclerectomy (MNPDS). Material and methods. The results of 234 cases of performing PHACO and MNPDS at various stages have been analyzed. The main group included patients who underwent PHACO, followed by MNPDS – 39 persons, 40 eyes. The group was divided into a subgroup based on the date of the second intervention. 1 subgroup – patients who underwent MNPDS 1 month after PHACO (11 cases); 2 subgroup – 3 months after PHACO (29 cases). The control group included patients who underwent MNPDS followed by PHACO – 180 persons, 195 eyes. Also, subgroups of patients were identified for whom PHACO + IOL was performed in the second stage after 1 month – 1 subgroup (99 cases) and after 3 months – 2 subgroup (96 cases). Results. Patients of the main group showed a significant decrease in intraocular pressure after each stage of treatment. in the control group, intraocular pressure decreased after the first stage of treatment, but increased 6 months after surgery. Conclusions. According to the study, in primary open-angle glaucoma associated with cataract, the most persistent hypotensive effect is observed when the first stage of cataract phacoemulsification is performed, and the second stage is antiglaucoma surgical intervention. Key words: glaucoma, cataract, cataract phacoemulsification, microinvasive nonpenetrating deep sclerectomy.


Author(s):  
E. N. Simakova ◽  
O. V. Stenkova

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.


The Eye ◽  
2019 ◽  
Vol 125 (2019-1) ◽  
pp. 6-12
Author(s):  
Irina Gndoyan ◽  
Natalya Kuznetsova ◽  
Alexander Derevyanchenko

Purpose: To determine the role that progressive spectacle lenses play in intraocular pressure compensation and stabilization of the glaucomatous process in patients with primary open-angle glaucoma (POAG) combined with presbyopia and refractive errors. Material and methods. 29 patients (53 eyes) aged 43 to 67 years with I-II stage POAG and a certain type of refractive error were enrolled into study. All patients had intraocular pressure (IOP) compensated to the target level on medication. Patients of the main group (17 people, 32 eyes) used universal progressive spectacle lenses with optimized surface. The patients of the control group (12 people, 21 eyes) used separate monofocal glasses for near and distance vision as a method of ametropia correction. Visual acuity test, refractometry, pneumotonometry, tonography, automated static perimetry were applied for monitoring the patients. The measurements were taken before spectacle correction and a year after its prescription. Results. A decrease of IOP (p=0.01) and an increase of the aqueous humor outflow coefficient (p<0.01) were determined after one year use of the recommended type of vision correction in the main group, whereas in the control group there was an increased level of IOP (p<0.05) and a reduced aqueous humor outflow coefficient (p<0.2). Conclusion. The use of progressive spectacle lenses as a method of permanent vision correction reliably reduces IOP and improves the aqueous humor outflow in patients with early-stage POAG. The absence of negative visual field dynamics indicates the stabilization of the glaucomatous process.


2020 ◽  
Vol 17 (1) ◽  
pp. 49-55
Author(s):  
D. V. Lapochkin ◽  
V. I. Lapochkin ◽  
A. V. Lapochkin

Purpose: to evaluate the immediate and long-term hypotensive efficacy, the number of complications, and the clinical benefits of a draining autovalve limbosclerectomy (DALS) performed using a kit of disposable instruments in patients with POAG of various stages in comparison with trabeculectomy (TE).Patients and Methods. The study is based on the analysis of the clinical and functional condition of 127 eyes of 127 patients with primary open-angle glaucoma (stage I POAG was detected in 2 eyes, stage II in 30 eyes, stage III in 88 eyes and stage IV in 7 eyes). Patients were divided into groups: the main group—76 people who underwent DALS using a set of disposable instruments, and the control group—51 people who underwent TE. The average age of patients is 68.9 ± 10.3 years. Before and within 24 months after surgery, all patients underwent standard diagnostic examinations. The initial level of IOP against the background of the maximum antihypertensive mode varied from 24 to 50 mm. Hg. According to gonioscopy, the angle of the anterior chamber was open in all cases (III–IV degree). Patient exclusion criteria: history of laser or surgical treatment of glaucoma, cataract treatment.Results. After 24 months of follow-up after DALS, the level of IOP in patients with stage I–II of POAG was 14.19 ± 1.83 mm Hg and with III–IV stage of POAG 14.95 ± 2.15 mm Hg, compensation was achieved in 88.2 % of patients without the use of antihypertensive drops. After TE, compensation was received in 72.6 % of patients, the IOP level was 16.9 ± 2.21 and 17.78 ± 2.31 mm Hg. respectively (p < 0.01). After DALS surgery, a decrease in the number of complications was revealed in comparison with TE: a decrease in сiliochoroidal detachment by 9.1 %, hyphema by 2.5 %, ophthalmic hypertension in the early p/o period by 3.2 %, cystic changes in the filtering bleb by 7.1 %.Conclusion. The standardized DALS operation using a disposable tool kit is a new highly effective and safe method for the surgical treatment of glaucoma. DALS may be the operation of choice in the treatment of POAG of all stages.


2021 ◽  
Vol 13 (2) ◽  
pp. 62-68
Author(s):  
Nisha Manandhar ◽  
Chandni Pradhan ◽  
Purushottam Joshi ◽  
Prabha Subedi ◽  
Pranav Shrestha

Introduction: Glaucoma is one of the major causes of irreversible blindness. In Nepal, the most common type of Glaucoma seen is Primary Open Angle Glaucoma. There are many risk factors associated with Primary Open Angle Glaucoma. The main objective of the study was to compare ocular biometric parameters in patients diagnosed with Primary Open Angle Glaucoma and age matched controls. Material and methods: This is a hospital based cross sectional study done at Mechi Eye Hospital. The study included 137 cases of Primary Open Angle Glaucoma and 75 normal individuals as control.  Axial length (AL), anterior chamber depth (ACD), Keratometry ‘K’ value and Central Corneal Thickness (CCT) were measured. Mann – Whitney U test was used for statistical analysis. Results: Mean age in Primary Open Angle Glaucoma group was (55.25 ± 10.16 years) and in the control group was (60.96 ± 10.91 years). Axial length  in the Primary Open Angle Glaucoma group (23.16 ±1.19 mm) was deeper as compared to the control group (22.69 ±0.89 mm), the difference was statistically significant (p<0.001). Anterior chamber depth (ACD) was statistically deeper in the Primary Open Angle Glaucoma group (3.05 ±0.51 mm) as compared to the control group (2.86 ±0.46 mm), (p<0.01). Central corneal thickness (CCT) was thinner in the Primary Open Angle Glaucoma group (519.5 ±36.25 um) as compared to the control group (525.40 ±37.77 um) but the difference was not found to be statistically significant (p<0.19). K value in Primary Open Angle Glaucoma (7.54 ±0.41mm) was higher than age-matched controls (7.58 ± 0.33mm) but the difference was not statistically significant (p<0.79). Conclusion: Patients with Primary Open Angle Glaucoma had longer Axial length (AL) and deeper Anterior chamber depth (ACD) as compared to normal individuals.


Author(s):  
Raji Mohammad Mehdi

Background: Primary Open-Angle Glaucoma (POAG) the most common form of glaucoma is a neurodegenerative disease, which is the third most common cause of blindness worldwide. It is estimated that 60 million people in the world are affected by this disease and 8.4 million are bilaterally blind. Among the various factors that have been implicated in the pathophysiology of this disease is infection with Helicobacter pylori (HP), a Gram-negative bacterium that is commonly found in stomach and present in approximately one-half of the world’s population. Establishment of such a causal correlation will probably have important practical applications as the eradication of H. pylori might lead to developments in the treatment of glaucoma. Objectives: To investigate the association between Primary Open-Angle Glaucoma (POAG) and Helicobacter Pylori infection and to observe fluctuations in intra ocular pressure after Helicobacter Pylori infection eradication. Design: Duration based, prospective observational study. Participants: 50 patients with documented Primary Open-Angle Glaucoma (POAG) as case group and 50 non-glaucoma participants as control group. Methods: Upper gastrointestinal endoscopy was performed to evaluate macroscopic abnormalities, and gastric mucosal biopsy specimens were obtained for the presence of H. pylori infection tested by Rapid Urease Test (RUT). All subjects underwent detailed ocular examinations including visual acuity, slit-lamp examination, fundoscopy, intra-ocular pressure recording, gonioscopy, GHT to assess visual fields and OCT of optic nerve head. Results: In 90% of POAG patients of case group and in 68% of non-glaucoma participants of control group Helicobacter pylori infection was detected by RUT (P-Value=0.007). Conclusion: H. pylori infection is more frequent in glaucoma patients, perhaps more so in those of Indian ethnicity. It may play a role as a secondary aggravating factor or even may be the primary cause. The establishment of such a causal relationship will probably have important practical applications as the eradication of H. pylori might lead to developments in the treatment of glaucoma.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Yi Ma ◽  
Jianping Han ◽  
Shengjie Li ◽  
Aiping Zhang ◽  
Wenjun Cao ◽  
...  

Purpose. To evaluate platelet parameters in primary open-angle glaucoma (POAG) patients and to explore the association between platelet parameters and POAG severity. Methods. A total of 402 consecutive POAG patients and 408 healthy control subjects from the Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Fudan University, were consecutively recruited between January 2016 and October 2018. Detailed ophthalmological and systematic examinations were performed. Blood samples for platelet parameters, including platelet count (PLT), platelet distribution width (PDW), plateletcrit (PCT), mean platelet volume (MPV), and platelet large cell ratio (P-LCR), were analyzed using an automated hematology analyzer in the department of clinical laboratory science of the hospital. The POAG subgroups were classified according to age (<50, ≥50), gender, and visual field mean deviation (MD): mild (MD ≤ 6 dB), moderate (6 dB < MD ≤ 12 dB), and severe (MD > 12 dB). Results. In POAG patients, PLT counts (207.08 ± 54.70 ∗ 109/L) were significantly lower p=0.001 than those of the control group (220.46 ± 55.85 ∗ 109/L). In the POAG group, PDW (13.76 ± 3.16 fL) and MPV (10.46 ± 1.32 fL) values were significantly higher (all p<0.001) than those of the control group (PDW 11.82 ± 2.44 fL, MPV 10.13 ± 1.10 fL). PDW and MPV values were highest in the severe POAG group (PDW 14.49 ± 2.99 fL; MPV 10.74 ± 1.39 fL), followed by the moderate group (PDW 12.50 ± 3.14 fL; MPV 10.02 ± 1.08 fL) and then the mild group (PDW 11.82 ± 2.44 fL; MPV 9.92 ± 0.76 fL), with statistically significant differences observed between mild-severe POAG and moderate-severe POAG groups by LSD post hoc test. Multiple linear regression analyses showed a significant association between PDW and MD (β = 0.430, p<0.001) and MPV and MD (β = 0.363, p=0.001). Logistic regression analyses revealed that PDW (OR = 1.297, 95% CI = 1.011–1.663) was associated with the severity of POAG. Conclusions. PDW and MPV values were significantly elevated in POAG patients, and PDW was positively associated with disease severity, which suggested the possibility that platelet activation be involved in pathomechanisms of POAG.


Author(s):  
J. Caprioli ◽  
K. Nouri-Mahdavi ◽  
L. Brigatti ◽  
M. Weitzman

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