New characteristics of intraocular pressure level in primary open-angle glaucoma patients before and after surgery on the background of round-the-clock monitoring with the use of modern technology (pilot study)

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.

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Effects of Preoperative Intraocular Pressure Level on Surgical Results of Microhook Ab Interno Trabeculotomy

Journal of Clinical Medicine ◽

10.3390/jcm10153327 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3327

Author(s):

Masaki Tanito ◽

Kazunobu Sugihara ◽

Aika Tsutsui ◽

Katsunori Hara ◽

Kaoru Manabe ◽

...

Keyword(s):

Intraocular Pressure ◽

Success Rate ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Pressure Level ◽

Surgical Results ◽

Open Angle ◽

Success Rates ◽

Factors Associated ◽

Ab Interno

To assess the roles of preoperative intraocular pressure (IOP) level on the IOP reducing efficacy of microhook ab interno trabeculotomy (µLOT), 126 consecutive open-angle glaucomatous eyes (90 primary open angle glaucoma, 36 exfoliation glaucoma) of 126 Japanese subjects (60 men, 66 women; mean age ± standard deviation, 70.5 ± 11.4 years) who underwent µLOT alone (25 eyes, 20%) or combined µLOT and cataract surgery (101 eyes, 80%) were retrospectively included, and subdivided into four groups based on the quartile of preoperative IOP: Q1, ≤15 mmHg; Q2, 15–18 mmHg, Q3, 18–21 mmHg, and Q4, >21 mmHg. Preoperative and 12 months postoperative IOPs and numbers of antiglaucoma medications were compared among IOP groups. Factors associated with postoperative IOP were assessed using multivariate analysis, and the success of IOP control was assessed with various definitions. Postoperatively, IOP was significantly higher in Q3 (p < 0.0146) and Q4 (p = 0.0320) groups than Q1 group, while the number of medications was not significantly different among four IOP groups (p = 0.1966). Older age was associated with lower postoperative IOP, and higher preoperative IOP was associated with higher postoperative IOP, while sex, glaucoma type, surgical procedure, lens status, extent of trabeculotomy incision, and preoperative number of medications were not associated with postoperative IOP. The success rates for IOP ≤ 18 and ≤15 mmHg were higher in lower preoperative IOP groups (i.e., Q1 and Q2) than higher preoperative IOP groups (Q3 and Q4), while the success rate for ≥20% IOP reduction was higher in higher preoperative IOP groups than in lower preoperative IOP groups; the success rate for ≥0% IOP reduction was equivalent among groups. By reviewing the previous studies in ab interno trabeculotomy/goniotomy procedures, positive correlation between preoperative and postoperative IOPs was preserved throughout the studies and surgical procedures. After the µLOT, larger %IOP reduction was achieved in higher preoperative IOP groups than in lower preoperative IOP groups, while postoperative IOP was still lower than in lower preoperative IOP groups.

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

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-3-4-97-105 ◽

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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