scholarly journals Ahmed valve implantation results in children with uveitic glaucoma

2021 ◽  
Vol 14 (1) ◽  
pp. 30-34
Author(s):  
L. A. Katargina ◽  
E. V. Denisova ◽  
I. N. A. Bahaaeddin ◽  
M. A. Khrabrova
Keyword(s):  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Anterior Chamber Angle ◽  
Safe Method ◽  
Ahmed Valve ◽  
Valve Implantation ◽  
Chamber Angle

The purpose is to evaluate the effectiveness and safety of Ahmed valve implantation in children with refractory postuveitic glaucoma (PUG).Material and methods. Ahmed valve was implanted to 10 children aged 7 to 17 years (10 eyes) with open-angle or mixed PUG uncompensated even by a maximum antihypertensive mode. Previously, all patients had undergone an average of 2.1 ± 0.9 surgeries aimed at normalizing the intraocular pressure (IOP) (predominantly, sinus trabeculectomy). 6 eyes were pseudophakic, 2 phakic, 2 aphakic. Ahmed valves were implanted according to the generally accepted technique. At the time of surgery IOP was 30.50 ± 4.35 mm Hg on average. The follow-up postsurgical period ranged from 3.9 to 23.6 months (averagely, 14.1 ± 6.5).Results. A stable hypotensive effect of the intervention was achieved in 90 % of cases, of which 3 patients had no hypotensives while 6 patients received hypotensive drugs even though their quantity was significantly smaller than before surgery (1.7 ± 1.49, p=0.028). At the end of the follow-up the average IOP was 18.1 ± 5.34 mm Hg, (significantly lower than before surgery, p = 0.008). During surgery, 1 patient experienced bleeding from the vessels of the anterior chamber angle after paracentesis, which was stopped by tamponade with sterile air. In other cases, the surgery as well as the immediate and distant postoperative period showed no complications.Conclusion. Ahmed valve implantation is an effective and safe method of the surgical treatment of refractory PUG in children and can be recommended in cases when previous antiglaucomatous operations proved ineffective, including patients with pseudophakia and aphakia.

Optimization of surgical treatment of secondary closed-angle glaucoma in patients with organic block of the anterior chamber angle

2021 ◽  
pp. 66-70
Author(s):  
I. M. Nasyrova ◽  
◽  
A.V. Ovchinnikova ◽  
Keyword(s):  
Surgical Treatment ◽  
Anterior Chamber ◽  
Saline Solution ◽  
Hypotensive Effect ◽  
Processing Technique ◽  
Anterior Chamber Angle ◽  
Closed Angle ◽  
Chamber Angle

Purpose. Optimization of surgical treatment of secondary closed-angle glaucoma in patients with organic block of the anterior chamber angle. Material and methods. The analysis of the results of 6 AGO using autologous scleral drains treated with MMC is presented in children with an organic block of the anterior chamber angle without the phenomena of neovascularization is privided. Five children had uveal glaucoma; one child had an essential mesodermal iris dystrophy with secondary glaucoma. In all cases before the formation of autologous scleral drains, intraoperative applications of MMC were performed, followed by a plentiful washing of the operating field with normal saline solution. The duration of follow-up was from 1.5 to 7 years. Results. The operations proceeded without complications. There was a long choroidal edema on one eye in the early postoperative, stopped with the help of conservative treatment for 10 days. In the long term, on one eye in the period of exacerbation of uveitis, dislocation of autodrainages arose, which was facilitated by the appearance of exudative effusion in the anterior chamber. Later on this eye the failure of the AGO developed. On the other eyes, the intraocular pressure remained compensated, and the functions were stable. Conclusion. Treatment of drainages from the autosclera with MMC before implanting them into the anterior chamber of the eye, in patients with organic block of the anterior chamber angle, is effective against the hypotensive effect of the operation and is safe for intraocular structures while observing the processing technique. Key words: secondary closed-angle glaucoma, anterior chamber, autologous

scholarly journals Complex use of energetic surgery in treatment of patients with primary open-angle glaucoma and cataract on the background of pseudoexfoliative syndrome

2021 ◽  
Vol 14 (3) ◽  
pp. 25-34
Author(s):  
Benta G. Dzhashi ◽  
Sergei V. Balalin
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Visual Functions ◽  
Incipient Stage ◽  
Laser Trabeculoplasty

BACKGROUND: Glaucoma remains one of the current problems of modern ophthalmology. The combination of glaucoma and cataract is observed in 1738.6% of cases, and glaucoma with pseudoexfoliative syndrome in 2050% of primary open-angle glaucoma cases. AIM: The aim of this work is to develop an effective and safe technology of complex energetic surgical treatment of the incipient primary open-angle glaucoma stage and cataract on the background of pseudoexfoliation syndrome on the basis of modified laser, hydrodynamic and ultrasound methods use. MATERIALS AND METHODS: 187 patients (187 eyes) with the incipient stage of primary open-angle glaucoma, cataract and pseudoexfoliation syndrome were examined. In the main group (111 eyes), selective laser trabeculoplasty followed by femtosecond laser-assisted cataract surgery with hydrodynamic trabeculocleaning was performed. Patients in the control group (76 eyes), after selective laser trabeculoplasty, underwent phacoemulsification according to the standard technique. RESULTS: The developed technology allowed to reach the hypotensive effect in 35.2% (t=23.0; р 0.001) of baseline intraocular pressure values, of individual intraocular pressure level without adding IOP-lowering medications in 27% of cases, stabilization of visual functions and morphometric indices of the optic disc during 2 years of follow-up in 97.3% of cases unlike the selective laser trabeculoplasty with subsequent phacoemulsification (21.2, 5.3 and 81.6% respectively). The patients of the main group had significantly lower energy expenditure during the stage of phacoemulsification, a lower percentage of postoperative inflammatory reaction was noted, and a persistent hypotensive effect with stabilization of visual functions was achieved based on the results of a two-year follow-up. CONCLUSIONS: Femtosecond laser-assisted phacoemulsification, performed as part of complex treatment in patients with cataract and incipient stage of primary open-angle glaucoma, is a sparing method that minimizes surgical trauma and achieves a persistent hypotensive effect, reduces intraocular pressure to an individual level and stabilizes visual functions in 97.3% of cases.

scholarly journals Evaluation of the Anterior Chamber Angle by Anterior Segment Optical Coherence Tomography After Implantable Phakic Contact Lens Implantation in Myopic Eyes.

2021 ◽  
Author(s):  
Mohamed Salah El-Din Mahmoud ◽  
Asmaa Anwar Mohamed ◽  
Hosny Ahmed Zein
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Prospective Observational Study ◽  
Anterior Segment ◽  
Anterior Chamber Angle ◽  
Safe Method ◽  
Lens Implantation ◽  
Lens Vault ◽  
Chamber Angle

Abstract Purpose: To evaluate the changes in the angle of the AC and lens vault after IPCL implantation by AS-OCT in myopic patients.Methods: A prospective observational study involving 30 myopic eyes which were implanted with IPCL with AS-OCT was used for evaluation of the anterior chamber angle parameters as anterior chamber angle (ACA), angle opening distance (AOD) and, trabecular iris space area (TISA) and lens vault at 1,3 and 6 months postoperatively.Results: There were high significant changes between the preoperative values of ACA, AOD and, TISA and first follow-up after 1 month postoperatively with no significant changes between second and third follow-up after 3 and 6 months postoperatively. Regarding the vault, there were stable vault values with no significant changes after 6 months follow-up.Conclusion: IPCL is a safe method of correction of myopia with stable AC angle narrowing which was monitored by the safe noncontact tool, AS-OCT.

scholarly journals Ahmed valve implantation results in neovascular glaucoma patients: Evaluation of short-term and remote

2015 ◽  
Vol 8 (3) ◽  
pp. 20-23
Author(s):  
Olga Gennadievna Pavlova ◽  
Vadim Petrovich Nikolaenko
Keyword(s):  
Intraocular Pressure ◽  
Pain Syndrome ◽  
Neovascular Glaucoma ◽  
Anterior Chamber Angle ◽  
Short Term ◽  
Lowering Therapy ◽  
Ahmed Valve ◽  
Valve Implantation ◽  
Implantation Method ◽  
Main Complication

Objective: to evaluate Ahmed valve implantation results in neovascular glaucoma patients. Methods: standard implantation method was used in 87 patients aged 57-86 years. Check-up examinations were performed in 1 week, 1, 3, 6, 9, 12 and 36 months after surgery. Results: during short-term post-op period (one month after surgery), intraocular pressure normalized in 48 patients. During remote post-op period (6-36 months after surgery), intraocular pressure normalization was achieved in 69 patients (79.2 %), among them in 62 patients (71.2 %) - against the background of IOP-lowering treatment. The main complication was a hemorrhage from anterior chamber angle and iris new vessels that was found in 37 patients (42.5 %), in a quarter of cases it required hyphema washout. In three patients, sustained hypotony developed, in one case it brought to globe sub-atrophy. In two of observed patients, enucleation was performed because of pain syndrome rebound. Conclusions: In 79.2 % neovascular glaucoma patients, the valve implantation led to IOP normalization, while in 71.2 % of cases it required a return to IOP-lowering therapy.

scholarly journals Transpalpebral Electrical Stimulation as a Novel Therapeutic Approach to Decrease Intraocular Pressure for Open-Angle Glaucoma: A Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Félix Gil-Carrasco ◽  
Daniel Ochoa-Contreras ◽  
Marco A. Torres ◽  
Jorge Santiago-Amaya ◽  
Fidel W. Pérez-Tovar ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Intraocular Pressure ◽  
Pilot Study ◽  
Open Angle Glaucoma ◽  
Constant Current ◽  
Open Angle ◽  
Naive Group ◽  
Treatment Naïve ◽  
The Mean

Purpose. To determine the effect on intraocular pressure of transpalpebral specific exogenous voltages in a cohort of open-angle glaucoma patients. Methods. This is a prospective, comparative, and experimental pilot study. The electrical stimuli applied consisted of 10 Hz, biphasic, nonrectangular current pulses (100 μA) delivered from an isolated constant current stimulator. At intake, baseline IOP measurements were obtained from each eye. The measurement was repeated before and after microstimulation until the end of the treatment. Results. Seventy-eight eyes of 46 patients diagnosed with POAG were studied: 58 eyes with maximum tolerated medical treatment and 20 eyes without treatment (naïve). The mean baseline IOP on the treated POAG group was 19.25 mmHg ± 4.71. Baseline IOP on the naïve group was 20.38 mmHg ± 3.28. At the four-month follow-up visit, the mean IOP value on the treatment group was 14.41 mmHg ± 2.06 (P<0.0001). The obtained mean IOP measurement on the treatment-naïve group was 15.29 mmHg ± 2.28 (P<0.0001). Conclusions. The hypotensive response obtained using transpalpebral electrical stimulation on POAG patients, both on treatment-naïve patients and on patients receiving maximum tolerable treatment, was statistically significant when comparing basal IOP measurements to those obtained at the four-month follow-up visit.

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.

The effectiveness of descemethogoniopuncture depending on the timing of its implementation after microinvasive non-penetrating deep sclerectomy in patients with glaucoma

2021 ◽  
pp. 79-82
Author(s):  
E.L. Sorokin ◽  
◽  
N.V. Postupaeva ◽  
◽  
Keyword(s):  
Intraocular Pressure ◽  
Antihypertensive Effect ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Hypotensive Effect ◽  
Ultrasound Biomicroscopy ◽  
Deep Sclerectomy ◽  
Group 2 ◽  
Group 1

Purpose. Evaluation of the efficacy of descemethogoniopuncture (DGP) at various times after microinvasive non-penetrating deep sclerectomy (MNPDS) in patients with glaucoma. Material and methods. The analysis of the results of DGP in 64 eyes of patients with primary open-angle glaucoma after previously performed MNPDS. According to the timing of DGP after MNPDS, the patients were divided into 3 groups. In the 1st group BPH was performed after 1–2 months (22 eyes), the 2nd group – after 3–4 months (21 eyes), the 3rd group after 5–6 months (21 eyes). The follow-up period was 1 year. Results. The level of intraocular pressure before DGP averaged 15.1±0.6 mm Hg in group 1, 17.5±0.9 mm Hg in group 2, and group – 18.6±0.7 mm Hg. After DGP, 13.1±0.4 mm Hg, 14.6±0.7 mm Hg, 16.1±0.5 mm Hg respectively. According to ultrasound biomicroscopy, the highest and extended intrascleral cavities and tunnels, as well as a thin loose trabeculodescemet membrane (TDM), were observed in the eyes of the 1st group. With an increase in the time after MNPDS, there was a compaction of TDM, a decrease in the height and length of the intrascleral cavity and tunnels. 12 months after DGP, the most pronounced antihypertensive effect without antihypertensive therapy occurred in group 1 – 55% of cases compared with groups 2 and 3 (33% and 14% respectively). Conclusion. The greatest efficiency was shown by performing DGP within 1–2 months after MNPDS, which is associated with the minimum development of proliferative processes in the intrascleral outflow tract in the early stages after this operation. Key words: descemethogoniopuncture, microinvasive non-penetrating deep sclerectomy, intraocular pressure, hypotensive effect, glaucoma.

Outcomes of micropulse transscleral cyclophotocoagulation in primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma

2020 ◽  
pp. 112067212091423 ◽  
Author(s):  
Oya Tekeli ◽  
Helin Ceren Köse
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Secondary Glaucoma ◽  
Open Angle ◽  
Pseudoexfoliation Glaucoma ◽  
Transscleral Cyclophotocoagulation ◽  
The Mean ◽  
Glaucoma Group

Purpose: The aim of this study is to compare the outcomes of micropulse transscleral cyclophotocoagulation between primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. Methods: Outcomes of 96 consecutive patients with refractory, end-stage glaucoma treated with micropulse transscleral cyclophotocoagulation were retrospectively reviewed. Follow-up examinations were performed on a regular basis until 12 months postoperatively. Surgical successes were defined as maintaining intraocular pressure ⩽18 mmHg and ⩾20% reduction in intraocular pressure (criteria A), ⩽15 mmHg intraocular pressure and ⩾25% reduction in intraocular pressure (criteria B), and ⩽12 mmHg intraocular pressure and ⩾30% reduction in intraocular pressure from baseline (criteria C). Results: Ninety-six eyes of 96 patients (50 (52%) females, 46 (48%) males) were included. Among all eyes, 32 were primary open-angle glaucoma, 30 were pseudoexfoliation glaucoma, and 34 were other types of secondary glaucoma. The mean age was 59.37 ± 11.45 (range: 20–91) years. The mean follow-up period was 14.2 ± 3.9 (range: 12–16) months. At 12 months, the success rates of primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma group were 68.75%, 66.6%, and 64.7% (p = 0.185) for criteria A; 56.25%, 53.3%, and 50% (p = 0.153) for criteria B; and 43.75%, 43.3%, and 38.2% (p = 0.146) for criteria C. Four patients (12.5%) in primary open-angle glaucoma group, 5 patients (16.6%) in pseudoexfoliation glaucoma group, and 14 (41.2%) patients in other secondary glaucoma group required reoperation during the follow-up (p < 0.05). Conclusion: Micropulse transscleral cyclophotocoagulation is an equally effective method of lowering intraocular pressure in patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. The rate of reoperation was higher in refractory secondary glaucoma patients.

scholarly journals Transscleral Fixation of Black Diaphragm Intraocular Lens in Complete Aniridia and Aphakia Due to Posttraumatic Eye Rupture: A Pilot Study

2019 ◽  
Vol 8 (1) ◽  
pp. 46
Author(s):  
Tomasz Chorągiewicz ◽  
Katarzyna Nowomiejska ◽  
Dariusz Haszcz ◽  
Dominika Nowakowska ◽  
Teresio Avitabile ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Anterior Segment ◽  
Case Series ◽  
Functional Restoration ◽  
Long Term Outcomes ◽  
Ahmed Valve ◽  
Post Traumatic ◽  
Valve Implantation

Introduction: To assess long-term outcomes of implantation of black diaphragm intraocular lens (BD IOL) in post-traumatic aniridia and aphakia due to eye rupture. Methods: This is a retrospective consecutive case series of 14 eyes with post-traumatic complete aniridia and aphakia treated with scleral fixation BD IOL. Measurements included ophthalmological comorbidities, best corrected visual acuity (BCVA), complications, and postoperative interventions. The average postoperative follow-up period was 36 months. Results: BCVA improved in 6 cases, was stable in 6 cases and worsened in 2 cases. The lens was well centered in 13 cases. Glaucoma was diagnosed in six cases developed, and three of them required Ahmed valve implantation. One lens developed opacity. The cornea was decompensated in 6 cases, while two of them required penetrating keratoplasty. Conclusion: Implantation of BD IOL in eyes with severely traumatized eyes enables reconstruction of the anterior segment and some functional restoration, although many complications may arise during the longitudinal follow-up.

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