Hospitalization characteristics of patients with glaucoma in Central and West Serbia

Introduction/Objective. Glaucoma is a chronic disease that impairs the optic nerve irreversibly and can lead to serious loss of vision and blindness. As the most frequent out of all, primary open-angle glaucoma has a worldwide incidence of 2.4 million. The objective of this article is to examine the characteristics of glaucoma hospitalization patterns in Central and West Serbia in the 2006?2017 period. Methods. This study was a retrospective analysis of glaucoma hospitalizations in the Kragujevac Clinical Center from 2006 to 2017 (n = 1,751). All hospitalizations were divided according to discharge diagnoses into the following three subgroups: primary open-angle glaucoma, the primary closure glaucoma, and secondary glaucoma and other glaucoma types. Results. The average hospitalization rate for glaucoma is 5/10,000 inhabitants. The lowest rate was recorded in 2013 (1.8/10,000) and the highest in 2015 (9.3/10,000). The rehospitalization rate ranged from 0.5/10,000 in 2013 to 6.9/10,000 in 2015, with an average of 2.4 patients per 10,000. The most common glaucoma was secondary glaucoma and other glaucoma types (44.6%), followed by primary open-angle glaucoma (37.9%) and primary closure glaucoma (17.5%). The average hospitalization length was 6.5 ? 4.9 days and it decreased from the average 9.7 ? 6.5 (2006) to 5.5 ? 3.7 days (2013) (p < 0.01) in all glaucoma types. Conclusion. There was a significant reduction of the hospitalization length in all glaucoma types in Central and West Serbia. The hospitalization rates varied with a significant increase since 2013, which is the consequence of the increase in rehospitalization rates.

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Surgical resection of the sclera is a non-penetrating operation for the treatment of patients with primary open-angle and secondary glaucoma

GlaucomaNews ◽

10.25276/2227-8281-1-62-65 ◽

2020 ◽

pp. 62-65

Author(s):

А.Y. Kazantseva ◽

◽

O.A. Rumyantseva ◽

Keyword(s):

Surgical Resection ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Secondary Glaucoma ◽

Ophthalmological Examination ◽

Open Angle ◽

Visual Functions ◽

Dynamic Observation ◽

Uveoscleral Outflow ◽

Outflow Pathway

Purpose. To evaluate the effectiveness of surgical resection of the sclera in patients with primary open-angle and secondary glaucoma. Materials and methods. The study included 84 patients with POAG and SG stages III-IV and decompensated IOP level (not higher than 32 mm Hg). In order to normalize the increased ophthalmotonus, a non - penetrating operation was performed-surgical resection of the sclera (SRS). The patients underwent complex ophthalmological examination and dynamic observation. Result. In the studied groups of patients after surgical treatment there was a decrease in elevated IOP levels by 33.42%, an improvement in the coefficient of ease of outflow and a weakening of the hypotensive regime. Stabilization of visual functions was observed in all patients. Summary. The proposed new SRS technique provides a smooth decrease in IOP, preservation of visual functions and is not accompanied by intra-and postoperative complications. Key words: primary open-angle glaucoma, surgical resection of sclera, secondary glaucoma, uveoscleral outflow pathway (USPO), intraocular pressure, EO coefficient .

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Glaucoma at a tertiary referral eye hospital in Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v3i2.5263 ◽

1970 ◽

Vol 3 (2) ◽

pp. 123-127

Author(s):

I Paudyal ◽

SS Thapa ◽

G Paudyal ◽

R Gurung ◽

S Ruit

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Applanation Tonometry ◽

Acute Angle ◽

Secondary Glaucoma ◽

Angle Closure Glaucoma ◽

Field Analysis ◽

Angle Closure ◽

Open Angle ◽

Tertiary Referral

Background: Glaucoma is an important cause of blindness. Objective: To report the distribution of various types of glaucoma among patients presenting to a tertiary eye hospital in Nepal. Materials and methods: All new patients visiting the hospital between March 2007 and February 2008 underwent a comprehensive eye examination. Whenever glaucoma was suspected, patients were referred to fellowship-trained glaucoma specialists. Patients received a comprehensive glaucoma workup including applanation tonometry, stereoscopic examination of the optic nerve head performed by the glaucoma specialists, and a Humphrey visual field analysis (SITA 24 - 2). Results: 447 patients were newly diagnosed with glaucoma. 171 (38.2 %) patients had primary open-angle glaucoma (POAG), while 143 (32 %) had primary angle-closure glaucoma (PACG). The average age of presentation of patients with POAG was 65.78 ± 9.1 years, while the average age for PACG patients was 54.6 ±12.8 years. 30 (21 %) patients with PACG had acute angle-closure on presentation, while 113 (79 %) had chronic angle closure glaucoma. 107 (75 %) of these patients with PACG had visual acuity of less than 3/60 (20/ 400) in the worse eye at presentation. The most common form of secondary glaucoma was lens-induced (5.3 %), followed by neovascular (3.2 %) and uveitic glaucoma (3.2 %). Conclusion: The most common glaucoma seen in a tertiary referral eye hospital of Nepal is primary open-angle glaucoma. Among the angle-closure glaucoma, chronic angle-closure is the most common. Lens-induced glaucoma is still the commonest cause of secondary glaucoma. Keywords: glaucoma, open-angle, angle-closure, lens-induced DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5263 Nepal J Ophthalmol 2011; 3(2): 123-127

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

European Journal of Ophthalmology ◽

10.1177/1120672120914231 ◽

2020 ◽

pp. 112067212091423 ◽

Cited By ~ 1

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.

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Surgical resection of the sclera is a non-penetrating operation for the treatment of patients with primary open-angle and secondary glaucoma

GlaucomaNews ◽

10.25276/2227-8281-1-59-61 ◽

2020 ◽

pp. 59-61

Author(s):

А.Y. Kazantseva ◽

◽

O.A. Rumyantseva ◽

Keyword(s):

Surgical Resection ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Secondary Glaucoma ◽

Ophthalmological Examination ◽

Open Angle ◽

Visual Functions ◽

Dynamic Observation ◽

Uveoscleral Outflow ◽

Outflow Pathway

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Modern view of using gonioassociated trabeculotomy

Fyodorov journal of ophthalmic surgery ◽

10.25276/0235-4160-2021-3-77-82 ◽

2021 ◽

pp. 77-82

Author(s):

R.R. Fayzrakhmanov ◽

◽

M.E. Kalinin ◽

M.M. Shishkin ◽

O.A. Pavlovskiy ◽

...

Keyword(s):

Minimally Invasive ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Glaucoma Surgery ◽

Review Literature ◽

Secondary Glaucoma ◽

Maximum Effect ◽

Open Angle ◽

Minimally Invasive Glaucoma Surgery ◽

Minimal Trauma

Purpose. Provide data on the use of gonioscopy-assisted transluminal trabeculotomy (GATT), reflecting its effectiveness and safety when using this technique in various patient models. Material and methods. To perform the review, literature sources which were searched through the PubMed and Scopus databases up to and including 2021, using the keywords "gonioassociated trabeculotomy", "minimally invasive glaucoma surgery", "primary open-angle glaucoma", "glaucoma", "secondary glaucoma". A total of 19 articles related to the topic of the review were selected. The beginning of publications on this topic dates back to 2013. Results. GATT can be used at various stages of glaucoma, but at the same time, the maximum effect of lowering intraocular pressure (IOP) is achieved in patients with an early or middle stage of glaucoma. There are also good results of using the GATT technique after vitreoretinal surgery, with the development of secondary glaucoma or ophthalmic hypertension. One of the advantages of GATT is that all manipulations are performed in the anterior chamber, which in turn makes it possible, if necessary, to perform reoperation after an unsuccessful ad-externo trabeculotomy without re-traumatizing the sclera and conjunctiva. It should be noted that the main complication in all studies is the hyphema, which is completely absorbed within a few days. Conclusion. Based on these studies, it can be concluded that the proposed GATT technique is relevant, and meets all modern standards of minimally invasive glaucoma surgery (MIGS): micro-incision, minimal trauma, is able to effectively reduce IOP, has a high level of safety and quick recovery. Key words: glaucoma, primary open-angle glaucoma, secondary glaucoma, gonioassociated trabeculotomy, minimally invasive glaucoma surgery, surgical treatment of glaucoma

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Surgical stimulation of uveoscleral outflow is an alternative to cyclodestructive procedures

Clinical ophthalmology ◽

10.32364/2311-7729-2021-21-1-9-13 ◽

2021 ◽

Vol 21 (1) ◽

pp. 9-13

Author(s):

E.A. Korchuganova ◽

◽

A.Yu. Kazantzeva ◽

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Secondary Glaucoma ◽

Open Angle ◽

Uveoscleral Outflow ◽

Surgical Stimulation ◽

Diode Laser Cyclophotocoagulation ◽

Stimulation Of

Aim: to assess clinical efficacy and safety of surgical scleral rejection (SSR) vs. transscleral diode laser cyclophotocoagulation (TSCPC) in primary open-angle glaucoma (POAG) and secondary glaucoma (SG). Patients and Methods: study (prospective) group included 84 patients with POAG and SG after SSR. Control (retrospective) group included 80 patients after TSCPC. In addition, the patients were distributed by age and the stage and type of glaucoma, i.e., 128 patients were diagnosed with POAG and 36 patients were diagnosed with secondary thrombotic glaucoma. Follow-up was 24 to 36 months. IOP measurements, tonography (to assess the coefficient outflow facility / COF), ultrasound biomicroscopy of the anterior segment, visual acuity measurement, and visual field testing were performed. Results: no complications after SSR were reported in patients with POAG and SG. In contrast, postoperative complications (choroidal effusion, hyphema, and uveitis) were reported in 14% of patients after TSCPC. Long-term IOP-lowering efficacy of both procedures was similar (87% after SSR and 89% after TSCPC). In POAG, greater IOP reduction was seen after TSCPC (by 39.11%) compared to SSR (by 31.58%) (p<0.05). Meanwhile, in patients with SG, treatment outcomes were similar (IOP reduced by 36.78% after TSCPC and by 35.26% after SSR). In longterm follow-up, PVF reduced by 10.76% vs. baseline after TSCPC but increased by 11.19% vs. baseline after SSR (p≤0.05). Surgery resulted in the improvement or stabilization of visual functions. Ultrasonography has demonstrated that outflow pathways (intrascleral space and filtering bleb) remain functional after SSR in long-term follow-up. Conclusion: SSR is an alternative to cyclodestructive procedures in POAG and SG. Sclera being the final point of the uveoscleral outflow is a perspective entity to develop surgical approaches to glaucoma treatment. Keywords: surgical scleral resection, uveoscleral outflow, sclera, primary open-angle glaucoma, secondary glaucoma, glaucoma surgery, transscleral diode laser cyclophotocoagulation. For citation: Korchuganova E.A., Kazantzeva A.Yu. Surgical stimulation of uveoscleral outflow is an alternative to cyclodestructive procedures. Russian Journal of Clinical Ophthalmology. 2021;21(1):9–13. DOI: 10.32364/2311-7729-2021-21-1-9-13.

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LASER TRABECULOPLASTY II IN SECONDARY GLAUCOMA AND AFTER FAILED TRABECULECTOMY IN PRIMARY OPEN ANGLE GLAUCOMA

Acta Ophthalmologica ◽

10.1111/j.1755-3768.1983.tb01489.x ◽

2009 ◽

Vol 61 (6) ◽

pp. 1016-1020 ◽

Cited By ~ 4

Author(s):

ANJA TUULONEN ◽

P. JUHANI AIRAKSINEN

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Secondary Glaucoma ◽

Open Angle ◽

Laser Trabeculoplasty

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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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