scholarly journals PRIMARY CONGENITAL GLAUCOMA;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Shabeer Ahmad Bhutto ◽  
Naeem Akhtar Katpar ◽  
Safdar Ali Abbasi
Keyword(s):  
Case Series ◽  
Congenital Glaucoma ◽  
Slit Lamp ◽  
Success Rates ◽  
Interventional Study ◽  
Primary Congenital Glaucoma ◽  
Medical College ◽  
Surgical Expertise ◽  
Paediatric Ophthalmology ◽  
Corneal Diameter

Objectives: The objective of this study is to compare the surgical outcome between modified trabeculotomy v/s combined modified trebeculotomy & trebeculectomy in primary congenital glaucoma. Study Design: Interventional case series. Setting: Paediatric Ophthalmology Department, Chandka Medical College. Period: June 2016 to June 2017. Method: This is a comparative study done to compare the outcomes of trabeculectomy and combined trabeculotomy and trabeculectomy. For comparison a prospective interventional study conducted in paediatric ophthalmology, Chandka Medical College during the duration of August 2014 to August 2016 was chosen. After examination by slit lamp and under anaesthesia, combined modified trabeculotomy and trabeculectomy was performed. Results: A total of 45 eyes of 29 patients with primary congenital glaucoma underwent modified trabeculotomy, 15 (51.72%) were males and 14 (48.28%) were females. Mean age of patients was 2.29 ± 3.70 years. On the other hand, combined modified trabeculotomy and trabeculectomy was performed in 22 eyes of 17 patients out of which 08 (47.06%) were males and 09 (52.94%) were females. Mean age ± standard deviation was 3.37 ± 4.40 years. Statistically significant reduction in IOP, corneal diameter and axial length were found. Conclusion: Combined trabeculotomy-trabeculectomy has better outcomes than trabeculotomy alone. It requires greater surgical expertise and time. Higher success rates are reported in previous studies due to dual outflow of aqueous humour.

scholarly journals Trabeculectomy in Congenital Glaucoma; Experience in Helpers Eye Hospital Quetta

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Mahtab Mengal ◽  
M Afzal Khan ◽  
Aimal Khan ◽  
Manzoor Ahmed ◽  
Rabia Khawar Chaudhry ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Trauma Surgery ◽  
Case Series ◽  
Posterior Segment ◽  
Congenital Glaucoma ◽  
Primary Congenital Glaucoma ◽  
Effective Operation ◽  
Operative Complications ◽  
Corneal Diameter

Purpose: To evaluate outcomes of trabeculectomy in terms of IOP control and its safety in terms of peroperativeand post-operative complications in Primary Congenital Glaucoma.Study Design: Interventional Case-Series.Place and Duration of Study: Helpers Eye Hospital, Quetta, from June 2017 to December 2018.Material and Methods: Thirty eyes of 17 patients were included in this case series after diagnosis of primarycongenital glaucoma. Patients with secondary congenital glaucoma due to trauma, surgery, inflammation, SturgeWeber Syndrome, Neurofibromatosis, cataract, uveitis, aphakia and pseudophakia were excluded from the study.Informed consent was taken from parents. Examination under anesthesia was done before surgery to recordpreoperative IOP, corneal diameter and anterior and posterior segment abnormalities. Primary trabeculectomywas done. Post-operative IOP and corneal diameter was recorded at 1st, 3rd and 6th month and every 6 monthsthereafter under general anesthesia. IOP at 12th month of surgery was the final outcome which was consideredsignificant if IOP was less than 21 mm Hg with stable corneal diameters.Results: Mean preoperative IOP was 25.8 mm Hg. Twenty-three (76.66%) eyes out of 30 eyes were consideredsuccessful with mean IOP of 15.3 mm Hg at last follow-up while 7 (23.33%) cases of failure were observed withpostoperative mean IOP of 27.71 mm Hg. These patients underwent additional surgeries to control IOP.Hyphema was the only complication observed in this study. Postoperative cataract developed in 5 eyes.Conclusion: Primary trabeculectomy is an effective operation and safe surgery for primary congenital glaucoma

scholarly journals Combined trabeculotomy-trabeculectomy with antimetabolite and releasable suture: outcome with primary congenital glaucoma in a north Indian population

2015 ◽  
Vol 7 (1) ◽  
pp. 16-25 ◽  
Author(s):  
S Dubey ◽  
A Agrawal ◽  
L Chauhan ◽  
S Mukherjee ◽  
G Douglas
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Indian Population ◽  
Case Series ◽  
Congenital Glaucoma ◽  
North Indian Population ◽  
Success Rates ◽  
Primary Congenital Glaucoma ◽  
The Mean

Objective: To determine the surgical outcomes of combined trabeculotomy- trabeculectomy with mitomycin-C and releasable suture in children with primary congenital glaucoma (PCG) in a North Indian population. Design: Retrospective, interventional, consecutive, non-comparative case series. Materials and methods: The medical records of 137 eyes of 77 patients who underwent combined trabeculotomy- trabeculectomy with 0.2 mg/ml mitomycin C (MMC) either bilaterally (49 patients) or unilaterally (28 patients) between January 2004 and March 2012 were reviewed retrospectively. The main outcome measures were postoperative intraocular pressures, corneal clarity and diameter, duration of follow-up, success rate and complications. Results: The mean preoperative intraocular pressure reduced from 34 ± 7 mm Hg (range 15- 54 mm Hg) to 17 ± 7 mm Hg (range 5 - 32 mm Hg) with a mean reduction of 44 % (P < 0.001). The mean follow-up period was 24.4 ± 10.3 months (range 6 – 48 months). Complete success defined as intraocular pressure < 21 mm Hg without any medication and clinically stable glaucoma at last follow-up was achieved in 113 eyes (83 %) while a ‘quali¿ed success’ of intraocular pressure < 21 mm Hg with one medication was achieved in ten eyes (7 %). The Kaplan-Meier survival analysis revealed success rates (at ‘n’ months) of 90 % (6), 85 % (12), 82 % (24), 80 % (36) and 77 % (48). There were no signi¿cant intraoperative or postoperative complications.Conclusion: Primary combined trabeculotomy-trabeculectomy with mitomycin-C and releasable suture offers a viable surgical option in Northern Indian infants with primary congenital glaucoma. The use of 0.2 mg/ml mitomycin C for 2 minutes improves the overall success while the releasable suture decreases the risk of postoperative complications especially associated with the use of antimetabolites.

Factors influencing the outcome of goniotomy and trabeculotomy in primary congenital glaucoma

2019 ◽  
pp. bjophthalmol-2018-313387 ◽  
Author(s):  
Yasmine El Sayed ◽  
Amanne Esmael ◽  
Nader Mettias ◽  
Zeinab El Sanabary ◽  
Ghada Gawdat
Keyword(s):  
Linear Regression Analysis ◽  
Female Gender ◽  
Congenital Glaucoma ◽  
Multivariate Linear Regression Analysis ◽  
Strongly Correlated ◽  
Success Rates ◽  
Primary Congenital Glaucoma ◽  
Factors Influencing ◽  
Younger Age ◽  
Age At Surgery

PurposeTo study the prognostic factors influencing intraocular pressure (IOP) reduction and success rates of paediatric goniotomy and trabeculotomy.PatientsData from patients aged ≤12 years who underwent goniotomy or trabeculotomy for primary congenital glaucoma from 2013 to 2016 were reviewed. The analysis included 452 eyes of which 120 eyes of patients with a median age (IQR) of 6 months (4.1–11 months) underwent goniotomy, and 332 eyes of patients with a median age of 5.2 months (2.3–9.3 months) underwent trabeculotomy.MethodsMultivariate linear regression analysis was used to predict the correlation of preoperative and operative risk factors to the per cent IOP reduction, while multivariate logistic regression was done to determine independent predictors of failure. Failure was defined as a final IOP >18 mm Hg while on medications or the need for another glaucoma procedure.ResultsIn the goniotomy group, the median IOP reduction was 19.4% and was positively correlated to a high initial IOP (p≤0.001) while in the trabeculotomy group, it was 36.8% and mostly influenced by preoperative IOP (p≤0.001), corneal clarity (p=0.04), gender (p=0.04) and consanguinity (p=0.03). The failure rate in the goniotomy group was 56% and was influenced by the preoperative cup-to-disc ratio, while in the trabeculotomy group it was 30% and strongly correlated to positive consanguinity (p≤0.001), higher preoperative IOP (p=0.003), female gender (p=0.01) and younger age at surgery (p=0.03).ConclusionSeveral factors can predict the outcome of angle surgery and can help in deciding the appropriate surgical intervention in paediatric glaucoma. Trabeculotomy seems to be superior to goniotomy in primary congenital glaucoma.

Psychosocial indicators of primary congenital glaucoma and filtering surgeries impacts on children and family’s quality of life

2021 ◽  
pp. 112067212110483
Author(s):  
Andrea Oliveira da Silva ◽  
Christiane Rolim-de-Moura ◽  
Nara Lúcia Poli Botelho ◽  
Carolina PB Gracitelli ◽  
Nívea Nunes Ferraz
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Optic Disk ◽  
Congenital Glaucoma ◽  
Eye Drops ◽  
Primary Congenital Glaucoma ◽  
Corneal Diameter

Purpose: To identify psychosocial indicators and evaluate the filtering surgeries impacts on quality of life (QOL) of children with primary congenital glaucoma (PCG) and their family. Methods: Parents of children with bilateral PCG who underwent filtering surgery were included. Data were collected through: (a) psychological inquiry to determine psychosocial indicators; (b) Children’s Visual Function Questionnaire (CVFQ). The associations between the CVFQ scores and visual acuity, intraocular pressure, optic disk cupping, horizontal corneal diameter, axial length, number of surgeries, and hypotensive eye drops were investigated. The statistical significance level was considered as p ⩽ 0.05. Results: The mean age of the nine mothers interviewed and their children (six boys and three girls) was 29 ± 5 years and 35 ± 18 months, respectively. The psychosocial indicators determined were: emotional impact of the diagnosis, disease knowledge, mother and family’s feelings on facing the surgical treatment, surgical result comprehension, treatment adherence, child's emotional and behavioral reactions, social support, and future expectations. In CVFQ analysis, QOL score was strongly associated with visual acuity ( r = −0.79; p = 0.01). Besides the treatment score was correlated to intraocular pressure ( r = −0.68; p < 0.05), optic disk cupping ( r = −0.85; p = 0.03), and corneal diameter ( r = −0.69; p = 0.02). Correlations were not found for number of surgeries and eye drops. Conclusions: This study confirmed the PCG surgical treatment impact on QOL and determined psychosocial indicators which may favor the suitable actions in psychological treatment and follow-up of the children and families.

Five-year results of viscotrabeculotomy versus conventional trabeculotomy in primary congenital glaucoma: A randomized controlled study

2020 ◽  
pp. 112067212092245
Author(s):  
Ahmed S Elwehidy ◽  
Sherein M Hagras ◽  
Nader Bayoumi ◽  
Ayman E AbdelGhafar ◽  
Amani E Badawi
Keyword(s):  
Intraocular Pressure ◽  
Congenital Glaucoma ◽  
Long Term Results ◽  
Controlled Study ◽  
Success Rates ◽  
Mean Values ◽  
Primary Congenital Glaucoma ◽  
Significant Difference

Purpose To assess the long-term results of viscotrabeculotomy in infants with primary congenital glaucoma and to compare its outcome with conventional trabeculotomy. Patients and methods A prospective randomized comparative study included infants with primary congenital glaucoma younger than 2 years. Patients were divided into two groups: viscotrabeculotomy group and conventional trabeculotomy group. Preoperative and postoperative intraocular pressures, corneal diameter, intraoperative and postoperative complications, and success rates were compared between two groups. All the patients were followed up for 5 years. Results The study included 154 eyes of 92 infants distributed randomly among the two groups; 78 and 76 eyes in viscotrabeculotomy and conventional trabeculotomy groups, respectively. In both groups, there was a statistically significant intraocular pressure reduction at all time points of the follow-up periods compared to the preoperative values (p < 0.0001). At 5 years, viscotrabeculotomy group showed significant reduction of the mean postoperative intraocular pressure (49.47%) than conventional trabeculotomy group (48.64%) (p < 0.0001). Intraocular pressure was statistically lower in viscotrabeculotomy starting from 12th month and till the end of the follow-up. At 5 years, the total success rate of viscotrabeculotomy group was 89.74% compared to 85.53% in conventional trabeculotomy group without significant difference (p = 0.487). The postoperative mean values of the cup/disk ratio in viscotrabeculotomy group showed statistically lower values compared to conventional trabeculotomy group (p = 0.019). Postoperative hyphema was statistically higher in conventional trabeculotomy group (p < 0.0001). All eyes that underwent a reoperation before 5 years follow-up were excluded from the statistical workup of the study after reoperation, except for calculation of success/failure. Conclusion Viscotrabeculotomy and conventional trabeculotomy proved to be effective in cases of primary congenital glaucoma. Viscotrabeculotomy appeared to have prolonged stability in controlling the intraocular pressure with higher success rates and lower complications.

scholarly journals To evaluate effect of intraocular pressure control on central corneal thickness, horizontal corneal diameter and axial length in primary congenital glaucoma

2021 ◽  
Vol 7 (2) ◽  
pp. 385-388
Author(s):  
Gunjan P Tank ◽  
Kamini M Prajapati ◽  
Rupal Bhatt ◽  
Amita Chauhan ◽  
Mariam Mansuri ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Axial Length ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Pressure Control ◽  
Posterior Segment ◽  
Congenital Glaucoma ◽  
Common Symptom ◽  
Primary Congenital Glaucoma ◽  
Corneal Diameter

To evaluate the effect of intraocular pressure (IOP) on central corneal thickness (CCT), horizontal corneal diameter (HCD), axial length (AL) in patients with primary congenital glaucoma (PCG) after antiglaucoma surgery. In this hospital based interventional study 36 patients (66 eyes) of PCG who underwent antiglaucoma surgery were included in the study. For each patient visual acuity, anterior and posterior segment examination, IOP, AL, CCT, HCD and refraction (in clear media) were recorded pre and post operatively (3 weeks, 3 months, 6 months). B scan ultrasonography was done to measure AL and to rule out posterior segment pathology. Surgery was performed by a glaucoma expert (by a single surgeon). Bilateral involvement was present in 83.33% with the most common symptom being photophobia and watering (30.56% each). The mean IOP, CCT, HCD, VCD and AL before surgery were 26.88+/-2.78 mmHg, 614.38+/-89.41 µ, 14.41+/-1.26mm, 13.19+/-1.46mm and 24.78+/-2.21mm and at 6 months were 13.85+/-1.93 mmHg, 548.56+/-63.13 µ, 14.62+/-0.49 mm, 13.34+/-1.10 mm and 25.73+/-1.36mm respectively. 59.1% of the patients had corneal clearing at 6 months. Control of IOP affects various parameters of eye like CCT, HCD and AL. Early surgery is the definitive line of management for controlling IOP in PCG patients.

scholarly journals Peripartum hysterectomy: a five year review at a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3590
Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
College Hospital ◽  
Peripartum Hysterectomy ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Suboptimal Care

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 

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