Effectiveness of combined glaucoma and cataract surgery with the use of a modified anti-glaucoma surgery

2021 ◽  
pp. 41-44
Author(s):  
O.I. Orenburkina ◽  
◽  
A.E. Babushkin ◽  
G.Z. Israfilova ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Antihypertensive Drugs ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Functional Results ◽  
Open Angle ◽  
Combined Operation ◽  
Combined Intervention

Purpose. To evaluate the clinical and functional results of a combined intervention – simultaneous cataract phacoemulsification (femtolaser assisted in some cases) and a developed partially fistulizing anti-glaucoma surgery in patients with primary open-angle glaucoma (POAG). Material and methods. 15 patients (45 eyes) aged 65-73 years with stage I-III POAG. The frequency of complications, dynamics of visual acuity's visual functions, and ophthalmotonus were analyzed before, during, and 6 months after surgery. Results. By the end of observation, the level of normalized IOP was defined in all patients, while in 78.6% of cases without drug correction and in 21.4% with the help of antihypertensive drugs (on average, 1.1±0.5). At the day of discharge from the hospital visual acuity after a simultaneous combined operation averaged 0.53±0.05, in the long term-0.77±0.06, while stabilization of glaucoma optical neuropathy after surgery occurred in 92.9%. Conclusion. A simultaneous combined intervention, including cataract phacoemulsification with a developed partially fistulizing anti-glaucoma operation, is an effective way to increase visual acuity, normalize ophthalmotonus and stabilize glaucoma optical neuropathy as well as reduce the drug load. Key words: cataract, glaucoma, surgical treatment, phacoemulsification, anti-glaucoma surgeries.

Results of a new modification of anti-glaucoma surgery in the treatment of primary open-angle glaucoma in combination with cataract

2021 ◽  
pp. 67-70
Author(s):  
M.M. Bikbov ◽  
◽  
O.I. Orenburgkina ◽  
A.E. Babushkin ◽  
G.Z. Israfilova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Visual Functions ◽  
Group 2 ◽  
Group 1

Purpose. To study the effectiveness of the developed partially fistulizing glaucoma surgery in the treatment of primary open-angle glaucoma (POAG) in combination with complicated cataract. Material and methods. 28 patients (28 eyes) were examined, including 13 patients (13 eyes) with I–III stages of POAG, operated according to the method of glaucoma surgery developed by us (group 1), and 15 patients (15 eyes) with a combination of previously unoperated glaucoma with incomplete complicated cataracts, who underwent a combined intervention – simultaneous phacoemulsification of cataracts with the specified variant of partially fistulizing glaucoma intervention (group 2). The analysis of the frequency of complications, the dynamics of visual functions, visual acuity and ophthalmotonus before surgery, at the time of discharge from the hospital, and in the longterm (6–9 months) after surgery was carried out. Results. In group 1, in the long term, the absolute hypotensive effect was recorded in 81.8% of cases, visual functions remained the same – in 90.9%. In group 2, by the end of follow – up, the level of normalized intraocular pressure was recorded in all patients, while in 78.6% of cases without drug correction and in 21.4% – with the help of antihypertensive drugs. Visual acuity in group 2, after a single-stage combined operation by the day of discharge from the hospital, averaged 0.53±0.05, in the long-term – 0.77±0.06, while the stabilization of glaucoma optic neuropathy after surgery occurred in 92.9%. Conclusion. Glaucoma surgery according to the proposed method in the studied long-term periods in patients with POAG provided a sufficiently high hypotensive effect and the preservation of visual functions. Combined single-stage intervention was an effective way to increase visual acuity, normalize ophthalmotonus and stabilize glaucoma optic neuropathy, as well as reduce drug load. Key words: primary open-angle glaucoma, cataract, partially fistulizing glaucoma surgery, cataract phacoemulsification.

Problems of treatment of primary openangle glaucoma in combination with thrombosis of the central retinal vein

GlaucomaNews ◽  
2020 ◽  
pp. 65-69
Author(s):  
T.E. Lipatkina ◽  
◽  
Е.V. Karlova ◽  
A.V. Zolotarev ◽  
◽  
...  
Keyword(s):  
Macular Edema ◽  
Primary Open Angle Glaucoma ◽  
Antihypertensive Drugs ◽  
Open Angle Glaucoma ◽  
Vascular Wall ◽  
Open Angle ◽  
Retinal Edema ◽  
Long Term Preservation ◽  
Central Retinal Vein

Patients with primary open-angle glaucoma (POAG) and ophthalmic hypertension have an increased likelihood of developing occlusions (thrombosis) of the central retinal vein. Different groups of antihypertensive drugs differ in their mechanism of action and may affect concomitant ocular pathology, in particular, retinal edema, which occurs, for example, in occlusion of the central retinal vein. Used in most patients with glaucoma, prostaglandin analogs can contribute to the long-term preservation of macular edema due to the effect on the permeability of the vascular wall. Preparations of other pharmacological groups, reducing the production of aqueous humor, on the contrary, may contribute to its regression. Therefore, the question of choosing a drug for antihypertensive therapy in patients with primary open-angle glaucoma and concomitant macular edema is relevant and is for further study.

scholarly journals Two-Year Outcomes of Ab Interno Trabeculectomy with the Trabectome for Chinese Primary Open Angle Glaucoma: A Retrospective Multicenter Study

2018 ◽  
Author(s):  
Yalong Dang ◽  
Xiao Wang ◽  
Yujie Cen ◽  
Ying Hong ◽  
Ping Huang ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Safe Procedure ◽  
Open Angle ◽  
Trabectome Surgery ◽  
History Of ◽  
Ab Interno Trabeculectomy ◽  
Ab Interno

To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open-angle glaucoma (POAG) patients. This was a multicenter, retrospective study and included POAG patients with or without visually-significant cataracts. The primary outcome was intraocular pressure (IOP) reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2-years. Success was defined as: 1) IOP < 21 mmHg and at least 20% IOP reduction from baseline after 3 months at any two consecutive visits, and 2) no additional glaucoma surgery required. A total of 42 patients were enrolled; thirteen had a history of failed glaucoma surgery. Twelve patients underwent Trabectome surgery combined with phacoemulsification while the remainder underwent Trabectome surgery alone. Overall, the mean preoperative IOP was 21.4±1.23 mmHg. The Trabectome lowered IOP to 18.5± 0.94 mmHg at 2 years (P<0.05). The number of glaucoma medications also decreased from a baseline of 2.0±0.9 to 1.2± 0.21 at 2 years (P=0.04). The overall success was 78%, with patients undergoing combined surgery having a higher success than those with Trabectome surgery alone (100% vs. 76%). No major complications were seen. The Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.

scholarly journals Hydrus Microstent

2020 ◽  
pp. 59-71
Author(s):  
Panagiotis Laspas ◽  
Norbert Pfeiffer
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Term Treatment ◽  
Open Angle ◽  
Pseudoexfoliation Glaucoma ◽  
Long Term Treatment ◽  
Clinically Significant ◽  
Favorable Safety

Abstract The Hydrus® Microstent (Ivantis Inc., Irvine, CA, USA) is an 8-mm intracanalicular scaffold microinvasive glaucoma surgery (MIGS) device which reduces intraocular pressure (IOP) by bypassing the trabecular meshwork and by dilating and scaffolding the Schlemm’s canal. Indications for Hydrus Microstent implantation include primary open-angle glaucoma and pseudoexfoliation glaucoma and it can be implanted either in combination with cataract surgery or as a solo procedure. Studies have shown that the Hydrus Microstent lowers IOP to the mid-teens and reduces glaucoma medication use for up to 2 years. Hydrus Microstent implantation is associated with a favorable safety profile, with adverse effects being generally mild, transient, and self-resolving. Clinically significant and long-standing hypotony or other potentially sight-threatening complications have not been described so far with Hydrus Microstent implantation. This chapter summarizes the design, mechanism of action, surgical technique, and clinical outcomes of the Hydrus Microstent, which is a promising long-term treatment modality for patients with mild-to-moderate primary open-angle glaucoma.

Evaluation of the impacts of some antihypertensive drugs on hydrodynamics in patients with primary open-angle glaucoma

2020 ◽  
pp. 49-50
Author(s):  
K.K. Abulkasimova ◽  
◽  
M.K. Karimova ◽  
M.A. Zakirhodjayeva ◽  
◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Antihypertensive Drugs ◽  
Open Angle Glaucoma ◽  
Open Angle

Актуальность. Одним из главных патогенетических звеньев, определяющих характер течения глаукомы, является нарушение гидродинамики глаза. Цель. Сравнительная оценка влияния гипотензивных препаратов на гидродинамику глаза у больных с первичной открытоугольной глаукомой с нестабилизированным уровнем внутриглазного давления (ВГД). Материал и методы. На базе РСНПМЦМГ нами обследованы 60 больных (106 глаз) с ПОУГ I, II и III стадии с нестабилизированным уровнем ВГД и были разделены на 2 группы: 1-группа – 30 больных (52 глаза), которым в качестве гипотензивного средства применялся препарат Офтан-Тимолол 0,5% («Santen») 2 раза в сутки, 30 больным (54 глаза) 2-группы был назначен новый гипотензивный препарат Прессимол («Aseptica») 0,5% 2 раза в день. Динамическое и контрольное исследование гидродинамики глаза проводили до лечения, через 10 дней и через 1 месяц в процессе лечения по методу упрощенной тонографии по А.П. Нестерову. Результаты. В обеих группах отмечалось достоверное снижение коэффициента Беккера (КБ) в среднем в 1,9 раза по сравнению с исходным (р<0,05), а P0 снизилось в среднем на 1,4–1,7 мм.рт. ст. Среднее значение коэффициента легкости оттока достигло 0,49 мм3/мин. Однако, продукция водянистой влаги менялась в значительной степени, на 16-19% от исходного уровня. Выводы. Указанные препараты в обеих исследуемых группах достоверно нормализовали показатели гидродинамики глаз больных глаукомой за счет снижения выработки водянистой влаги.

scholarly journals Efficacy of Microwave Pulse Diode Laser and Argon Laser Trabeculoplasty in Patients with Primary Open Angle Glaucoma

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Asma Shams ◽  
Narain Das ◽  
Noman Rashid ◽  
M. Nasir Bhatti ◽  
Beenish Khan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diode Laser ◽  
Microwave Pulse ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Argon Laser ◽  
Open Angle ◽  
Argon Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Group B

Purpose:  To compare the efficacy of the microwave pulse diode laser and argon laser trabeculoplasty in primary open angle glaucoma. Study Design:  Quasi experimental study. Place and Duration of Study:  Shaheed Mohtarma Benazir Bhutto Medical College Lyari and Sindh Government Lyari General Hospital, Karachi, from October, 2017 to March, 2018. Material and Methods:  One hundred and sixty patients, between 42 to 61 years with visual acuity of perception of light to 6/36 were enrolled. Patients diagnosed with POAG were included and patients with intraocular pressure of more than 40 mm Hg, previous glaucoma surgery or laser treatment and narrow angle on gonioscopy were excluded. Ophthalmic examination included visual acuity, slit lamp examination, fundus examination and visual field status using Humphrey perimeter. Patients were divided into two groups. Group A received microwave pulse diode laser (810) and Group B received argon laser trabeculoplasty. Average follow up period was 6 months. Success was assessed objectively by measuring intra ocular pressure and subjectively by visual acuity. Results:  The average time-period for each procedure was 15 ± 5 minutes. In Group A, mean IOP at first week, first month, third month and sixth month was 20.79, 16.34, 16.21and 16.09 mm Hg respectively. While in Group B, IOP at first week, first, third and sixth month was 16.52, 15.76, 13.62, and 12.54 mm Hg at (P < 0.001 in both groups). Conclusion:  Both microwave pulse diode laser and argon laser trabeculoplasty are effective in lowering intra ocular pressures in patients with primary open angle glaucoma.

scholarly journals Neuroinflammation in Primary Open-Angle Glaucoma

2020 ◽  
Vol 9 (10) ◽  
pp. 3172 ◽  
Author(s):  
Stefania Vernazza ◽  
Sara Tirendi ◽  
Anna Maria Bassi ◽  
Carlo Enrico Traverso ◽  
Sergio Claudio Saccà
Keyword(s):  
Oxidative Stress ◽  
Immune Response ◽  
Trabecular Meshwork ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Antioxidant Defences ◽  
Age Related ◽  
Wide Range

Primary open-angle glaucoma (POAG) is the second leading cause of irreversible blindness worldwide. Increasing evidence suggests oxidative damage and immune response defects are key factors contributing to glaucoma onset. Indeed, both the failure of the trabecular meshwork tissue in the conventional outflow pathway and the neuroinflammation process, which drives the neurodegeneration, seem to be linked to the age-related over-production of free radicals (i.e., mitochondrial dysfunction) and to oxidative stress-linked immunostimulatory signaling. Several previous studies have described a wide range of oxidative stress-related makers which are found in glaucomatous patients, including low levels of antioxidant defences, dysfunction/activation of glial cells, the activation of the NF-κB pathway and the up-regulation of pro-inflammatory cytokines, and so on. However, the intraocular pressure is still currently the only risk factor modifiable by medication or glaucoma surgery. This present review aims to summarize the multiple cellular processes, which promote different risk factors in glaucoma including aging, oxidative stress, trabecular meshwork defects, glial activation response, neurodegenerative insults, and the altered regulation of immune response.

scholarly journals The Effects of Trabeculectomy on Pseudoexfoliation Glaucoma and Primary Open-Angle Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Fan Li ◽  
Guangxian Tang ◽  
Hengli Zhang ◽  
Xiaowei Yan ◽  
Lihua Ma ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Success Rate ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Success Rates ◽  
Pseudoexfoliation Glaucoma ◽  
Long Term Effects ◽  
Surgical Success

Purpose. To compare long-term effects of trabeculectomy on pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG). Methods. This retrospective case-control study included 53 eyes of PXG and 76 eyes of POAG. Intraocular pressure (IOP), number of antiglaucoma medications used, surgical success rate, and occurrence of complications were observed and statistically analyzed in both groups at 3 and 6 months and at 1, 3, and 5 years after trabeculectomy. Surgical success was defined according to the following 3 criteria: (1) IOP ≤ 21 mmHg; (2) IOP ≤ 18 mmHg; (3) IOP ≤ 15 mmHg. Complete success is defined as patients met these criteria without medical treatment, and qualified success is defined as patients met these criteria with medical treatment (≤3 medications). Cumulative probabilities of success were compared using the Kaplan–Meier survival analysis. Results. For the 3 criteria, there were no statistically significant differences in complete and qualified success rates between the two groups at 3 and 6 months after trabeculectomy (P>0.05). For criterion A, complete success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion B, complete and qualified success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion C, complete and qualified success rates in PXG at 1, 3, and 5 years after surgery were lower than those in POAG, the differences were statistically significant (P<0.05). Conclusions. The short-term success rates of both types of glaucoma were similar; however, the long-term success rate of PXG was significantly lower, and it was difficult to achieve long-term control of IOP at a low target level.

Sign in / Sign up

Export Citation Format

Share Document