Lens induced glaucoma in a tertiary eye care centre in Western Nepal

Introduction: Lens induced glaucoma due to hypermature cataracts is an important cause of secondary glaucoma in the developing world. The most common etiology of lens induced glaucoma is phacomorphic glaucoma from untreated senile cataract. Objectives: To study the demographics, clinical presentations and surgical outcome of lens induced glaucoma (LIG). Materials and methods: It is the prospective case series of fifty three patients eyes with LIG over a 6 months period from June 2015 to November 2015. All cases of lens induced glaucoma underwent cataract surgery. Data including demographics, clinical presentations, surgical outcome were analysed using Statistical Package for Social Studies 20.0. Results: The mean age was 61.5 years (Standard deviation 8.9) with predominantly women (30, 56.6%) were affected. Phacomorphic glaucoma (38, 71.7%) was the main cause of lens induced glaucoma, followed by phacolytic glaucoma (15, 28.3%). The main clinical symptoms were reduced vision (100%), eye pain (96.2%) and redness of eyes (62.3%). All patients (100%) presented with visual acuity of <3/60 or worse and intraocular pressure (IOP) more than 40 mm Hg (34, 64.2%). All 53(100%) patients underwent cataract surgery and all of them had tremendously reduced intraocular pressure with a mean 13.9 mmHg and vision had improved from >6/18 as noted in 16(30.2%) cases. Conclusions: The main clinical presentations of LIG are triad of acute reduced vision, eye pain and redness. The better final BCVA is found when there is an early presentation and less IOP at the time of presentation Public awareness, early detection and early intervention aids in good visual recovery and control of intraocular pressure in LIG.

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Clinical characteristics and treatment of secondary glaucoma, glaucoma suspects and ocular hypertension after congenital cataract surgery

European Journal of Ophthalmology ◽

10.1177/1120672121991356 ◽

2021 ◽

pp. 112067212199135

Author(s):

Katharina Eibenberger ◽

Barbara Kiss ◽

Ursula Schmidt-Erfurth ◽

Eva Stifter

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Ocular Hypertension ◽

Congenital Cataract ◽

Case Series ◽

Secondary Glaucoma ◽

Visual Axis ◽

Retrospective Case ◽

Pediatric Cataract ◽

Congenital Cataract Surgery

Objective: To evaluate changes in intraocular pressure after congenital cataract surgery in a real-world setting. Methods: This retrospective case series included all children aged 0–2 years undergoing lens extraction due to congenital cataract. Development of an elevated intraocular pressure was divided into three groups: secG, suspG and OHT. Further, risk factors for IOP changes, the therapeutic approach and functional outcome were assessed during follow-up. Results: One hundred and sixty-one eyes of 110 patients aged 0–2 years were included, whereof 29 eyes of 17 children developed secondary glaucoma (secG; 11 eyes/8 patients), glaucoma suspect (suspG; three eyes/three patients) or ocular hypertension (OHT; 15 eyes/10 patients). No difference in surgrical procedure ( p = 0.62) was found, but age at cataract surgery differed significantly ( p = 0.048), with the secG group (1.74 ± 1.01 months) being the youngest (suspG: 3.93 ± 1.80 months; OHT group: 5.91 ± 5.36 months). Secondary surgical intervention was significantly higher in the secG (4.64 ± 3.41) followed by the suspG (2.00 ± 2.65) and OHT groups (0.40 ± 0.74; p < 0.001). Postoperative complications including nystagmus ( p = 0.81), strabismus ( p = 0.98) and amblyopia ( p = 0.73) showed no difference, in contrast to visual axis obscuration which was more common in the secG group ( p = 0.036). Conclusion: Initial lensectomy and anterior vitrectomy procedure together with or without IOL implantation seems to have no influence for the development of IOP changes after pediatric cataract surgery. However, children who developed secondary glaucoma had cataract surgery significantly earlier, within the first 2–3 months of life. Glaucoma surgery was required to achieve final IOP control in most eyes. The development of secondary glaucoma was also associated with a significant increase in surgical re-treatments.

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Effect of Cataract Surgery on Intraocular Pressure in Glaucoma Patients

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i1.1167 ◽

2020 ◽

Vol 37 (1) ◽

Author(s):

Shua Azam ◽

Abdul Hameed Talpur ◽

Mahak Shaheen ◽

Sadia Bukhari

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Open Angle Glaucoma ◽

Case Series ◽

Angle Closure ◽

Inclusion Criteria ◽

Primary Angle Closure Glaucoma ◽

Closed Angle ◽

Operative Assessment

Purpose: To determine the change in intraocular pressure after cataract surgery in patients diagnosed with glaucoma. Study Design: Interventional case series. Place and Duration of Study: Glaucoma Clinic. Al-Ibrahim Eye Hospital (AIEH) Karachi, Pakistan from May to October, 2019. Methods: Thirty-eight patients diagnosed with glaucoma and cataract and registered in glaucoma clinic were recruited for this study. Inclusion Criteria was age > 41 years and patients diagnosed with primary open/closed angle glaucoma and cataract. Patients with secondary glaucoma, history of trabeculectomy and any other ocular diseases were excluded from the study. Pre-operative assessment was done for phacoemulsification. In post-operative examination, first and second follow-up IOP was measured. Data analysis was done on statistical package for social science (SPSS) version 20.0. Statistical changes were present in the form of bar chart, frequency and graphs. The mean standard deviation for pre-operative, post-operative 1st and 2nd follow-up IOP was calculated. Results: A total of 38 participants and 48 eyes satisfied the inclusion criteria. Out of 48 eyes, 39 (81.3%) eyes were diagnosed with Primary open angle glaucoma and 9 (18.8%) eyes with Primary Angle Closure Glaucoma. The pre-operative mean IOP was 16.56 ± 6.67 mm Hg and post-operative mean IOP at first follow-up was 13.39 ± 4.04 mm Hg. At second follow-up at one-month mean IOP was 12.14 ± 2.28 mm Hg. Conclusion: Phacoemulsification produces a useful decrease in IOP in glaucoma patients. Key Word: Glaucoma, Cataract, Phacoemulsification, Intraocular Pressure.

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Outcomes of sequential pterygium and cataract surgery: A prospective case series

IP International Journal of Ocular Oncology and Oculoplasty ◽

10.18231/2455-8478.2018.0010 ◽

2018 ◽

Vol 4 (1) ◽

pp. 30-35

Keyword(s):

Cataract Surgery ◽

Case Series ◽

Prospective Case Series

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12-month interim results of a prospective study of patients with mild to moderate open-angle glaucoma undergoing combined viscodilation of Schlemm’s canal and collector channels and 360° trabeculotomy as a standalone procedure or combined with cataract surgery

European Journal of Ophthalmology ◽

10.1177/1120672121998234 ◽

2021 ◽

pp. 112067212199823

Author(s):

Iwona Grabska-Liberek ◽

Patrycja Duda ◽

Monika Rogowska ◽

Julita Majszyk- Ionescu ◽

Agnieszka Skowyra ◽

...

Keyword(s):

Cataract Surgery ◽

Open Angle Glaucoma ◽

Case Series ◽

Open Angle ◽

Schlemm’S Canal ◽

Schlemm's Canal ◽

Prospective Case Series ◽

A Prospective Study ◽

Time Point

Purpose: To characterize clinical outcomes of combined viscodilation of Schlemm’s canal and collector channels and 360° trabeculotomy as a standalone procedure or combined with cataract surgery in eyes with mild to moderate open-angle glaucoma (OAG). Methods: In this prospective case series, the OMNI glaucoma surgical platform (Sight Sciences, Menlo Park, CA) was utilized to perform the procedure either combined with phacoemulsification or as a standalone procedure. Changes from baseline in intraocular pressure (IOP) and IOP-lowering medications were evaluated through the first 12 months of a planned 24-month follow-up period. Results: Among 17 eyes of 15 subjects, mean IOP was reduced from 20.4 mmHg to 12.7–13.7 mmHg through 12 months of follow-up ( p < 0.001 at every time point) and mean medications reduced from 2.5 to 0.1–0.6 ( p < 0.001 at every time point). IOP reductions in eyes undergoing standalone surgery were approximately 2–4 mmHg greater at each time point compared to eyes undergoing surgery combined with phacoemulsification; this may be related to a higher baseline IOP in the former eyes (22.1 vs 18.5 mmHg). Six eyes developed hyphema, of which three required washout for elevated IOP on the first postoperative day; six additional eyes had IOP elevations that resolved with medical management. Conclusion: Viscodilation of Schlemm’s canal and collector channels paired with ab interno trabeculotomy performed with a single integrated instrument (OMNI), whether as standalone or combined with phacoemulsification, effectively lowers both IOP and the need for IOP-lowering medications through 12 months of follow-up.

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One Year Outcomes and Stability of a Novel Scleral Anchored Intraocular Lens

Journal of Ophthalmology ◽

10.1155/2021/3838456 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Edoardo Abed ◽

Matteo Forlini ◽

Edlira Bendo ◽

Aurelio Imburgia ◽

Alessandro Mularoni ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Intraocular Lens ◽

Anterior Segment ◽

Case Series ◽

Specular Microscopy ◽

Iop Measurement ◽

Prospective Case Series ◽

One Year

Purpose. To assess one year results and stability of the implantation of a scleral anchored intraocular lens (IOL). Design. Interventional prospective case series. Methods. Sixty eyes of 60 patients affected by either aphakia or IOL dislocation were included in this study. Patients underwent vitrectomy, scleral fixation of the IOL, and, if present, dislocated IOL removal. Patients were evaluated preoperatively and at 1, 3, 6, and 12 months after surgery by best-corrected distance visual acuity (BCVA) assessment, intraocular pressure (IOP) measurement, corneal specular microscopy, and optical coherence tomography (OCT) of both the macula and anterior segment. Results. At twelve months, mean BCVA significantly improved ( p < 0.0001 ), and none of the patients experienced a decrease of visual acuity. A 10% decrease of endothelial cell count occurred after surgery. Cystoid macular edema occurred in three patients (5%). A transient increase of intraocular pressure was noted in 7 cases (12%). At one month, horizontal and vertical IOL tilt was 1.04 ± 0.87 and 0.74 ± 0.71 degrees, respectively, and did not significantly change in the follow-up ( p > 0.05 ). None of the patients had decentration or dislocation of scleral-fixated IOL during the follow-up. Conclusion. Implantations of scleral plug fixated IOL provide good visual results, low complication rate, and excellent stability of the lens until one-year follow-up.

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Clinical Presentation and Outcome of Ribavirin Treated RT-PCR Confirmed Lassa Fever Patients in ISTH Irrua: A Pilot Study

Research in Health Science ◽

10.22158/rhs.v1n2p68 ◽

2016 ◽

Vol 1 (2) ◽

pp. 68 ◽

Cited By ~ 1

Author(s):

Akhere D. Asogun ◽

Oboratare Ochei ◽

Victor Moody ◽

Chukwuyem Abejegah ◽

Emmanuel Okoh

Keyword(s):

Late Onset ◽

Public Awareness ◽

Case Series ◽

Case Fatality ◽

Hemorrhagic Fever ◽

Lassa Fever ◽

Laboratory Findings ◽

Early Presentation ◽

Federal States ◽

Case Series Study

Background: Lassa fever is a viral hemorrhagic fever that is endo-epidemic in Edo state, with case fatality of 90-100% if not treated. It has been claimed that early treatment with Ribavirin reduces mortality to less than 20%. This study was carried out to assert/confirm or refute/reject this claim.Aim: To review the clinical features, laboratory findings of Lassa fever and the outcome of confirmed cases treated with Ribavirin.Methodology: The study was a case series study of the first 41 cases that were treated with Ribavirin in the Lassa fever isolation ward from 28th November 2010 to 26th May 2011.Results: Up to 63.4% of cases presented late (onset of illness greater than 6 days at presentation). Fever remains the predominant presenting feature of the disease (97.5%). Of the cases that were admitted, 41 were treated, 31 recovered and 9 died, giving a case-fatality rate of 22%. One discharged against medical advice. Conclusion: Lassa fever victims still present late at the hospital and fever remains the predominant presenting feature. Early Ribavirin treatment improves treatment outcome of Lassa fever in confirmed cases.Recommendations: The Federal, States and Local government area council members must make efforts to create public awareness on early presentation, diagnosis and prompt treatment with Ribavirin.

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Clinical Research on Lens Cortex Removal Assisted by Hydropolish

10.21203/rs.3.rs-254307/v1 ◽

2021 ◽

Author(s):

Lin Yao ◽

Haiqing Bai

Keyword(s):

Retrospective Study ◽

Clinical Research ◽

Cataract Surgery ◽

Case Series ◽

Time Saving ◽

Group 2 ◽

Prospective Case Series ◽

Phacoemulsification Cataract Surgery ◽

Entire Procedure ◽

Group 1

Abstract Background: This retrospective study investigated the efficiency and safety of lens cortex removal assisted by a fluid-based capsular polishing technique, hydropolish. Study design: Prospective case series.Methods: Sixty patients were included in this study. All these patients underwent phacoemulsification cataract surgery using different sequences of surgical steps and were divided into two groups; hydropolish before irrigation/aspiration (I/A) (Group 1, 30 eyes) and I/A before hydropolish (Group 2, 30 eyes). Hydropolish and I/A cortex time, and time of the entire procedure were noted. Results: The hydropolish time was longer in group 1 than that in group 2 (P ≤ 0.001). The I/A cortex time and hydropolish and I/A cortex time together were not different between the two groups (P = 0.294 and P = 0.258, respectively). However, the time of the entire procedure was shorter in group 1 (P = 0.002). Conclusions: Lens cortex removal assisted by hydropolish is a safe, time saving, and simple surgery.

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Lens induced glaucoma: An experience in tertiary eye care center in eastern Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v8i2.17006 ◽

2017 ◽

Vol 8 (2) ◽

pp. 161-166 ◽

Cited By ~ 3

Author(s):

Rakshya Pant Sitoula ◽

Indrajit Sarkar ◽

Devdutta Nayak ◽

Sanjay Kumar Singh

Keyword(s):

Cataract Surgery ◽

Care Center ◽

Hand Movement ◽

Case Series ◽

Corneal Edema ◽

Visual Outcome ◽

Late Presentation ◽

Delayed Presentation ◽

Poor Visual Outcome ◽

Prospective Case Series

Introduction: Lens Induced Glaucoma (LIG), is one of commonest cause of secondary glaucoma due to senile cataracts. The purpose of this study was to see the outcome of cataract surgery in patients with LIG. Methods: This was a prospective case series of 40 patients with LIG who presented to our hospital between April to June 2014. The purpose of this study was to look into the age and sex distribution, causes for delayed presentation, immediate post-operative visual outcome and the reasons for poor visual outcome. Result: There were 23 phacomorphic cases and 17 phacolytic glaucoma patients included in our study. The mean age at presentation was 63±10 years. Female to male ratio was 2.1:1. The majority of patients 57% presented after 2 weeks of symptoms and the reason for late presentation in more than half of the patients (52.5%) was financial constraints. At presentation, mean preoperative intra ocular pressure was 39±10 mm Hg. Following surgery, 36 of 40 eyes (90%) had an IOP less than 21 mm Hg at discharge. Visual acuity was either hand-movement or just perception of light in all eyes before surgery. At discharge, 26 of 40 operated eyes (65%) achieved 6/60 or better, 2 (5%) had less than 6/60 and 12 (30%) less than 3/60. The reasons for poor VA in these 12 patients were optic atrophy in 5 patients, uveitis in 5 patients, macular cause in one and corneal edema in one. Conclusion: Cataract surgery proves to be effective in lowering the Intraocular pressure and visual recovery in patients with lens induced glaucoma.

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Changes in preoperative corneal measurements following same-day intraocular pressure testing with rebound tonometry

Therapeutic Advances in Ophthalmology ◽

10.1177/2515841419892070 ◽

2020 ◽

Vol 12 ◽

pp. 251584141989207

Author(s):

Kenneth A. Beckman ◽

Jodi I. Luchs ◽

Mark S. Milner ◽

Richard W. Yee

Keyword(s):

Intraocular Pressure ◽

Patient Flow ◽

Case Series ◽

Corneal Topography ◽

Rebound Tonometry ◽

Pressure Testing ◽

Significant Difference ◽

Prospective Case Series ◽

And Control ◽

Corneal Staining

Purpose: To evaluate the extent to which rebound tonometry affects corneal surface properties and preoperative corneal measurements. Setting: Four cornea specialty private practices. Design: Prospective case series. Methods: Visual acuity testing, corneal topography, keratometry, and grading of corneal staining were performed on both eyes of 60 randomly selected, previously scheduled patients. Technicians then performed rebound tonometry on one randomly selected eye only. Immediately following, intraocular pressure measurement, corneal topography, keratometry, and corneal staining were repeated on both eyes. Results: None of the 60 study eyes developed increased staining scores following intraocular pressure testing with the Icare ic100. For corneal staining, mean keratometry, and total corneal cylinder, no statistically significant difference was found from the first measurement to the second measurement between the study eyes and control eyes. Conclusion: Rebound tonometry with the Icare ic100 may be used on any patient at any time during the exam without affecting the results of other tests, allowing clinicians to test intraocular pressure prior to preoperative cataract or refractive surgery measurements on the same day. This may allow for significant improvement in patient flow in the office and save patients from the cost and time of extra visits.

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Free fat grafting in superficial parotid surgery to prevent Frey's syndrome and improve aesthetic outcome

The Journal of Laryngology & Otology ◽

10.1017/s0022215113001394 ◽

2013 ◽

Vol 128 (S1) ◽

pp. S44-S49 ◽

Cited By ~ 17

Author(s):

L S Chan ◽

M S Barakate ◽

T E Havas

Keyword(s):

Clinical Symptoms ◽

Case Series ◽

Fat Grafting ◽

Aesthetic Outcome ◽

Frey’S Syndrome ◽

Inexpensive Method ◽

Benign Pathology ◽

Parotid Surgery ◽

Frey's Syndrome ◽

Prospective Case Series

AbstractBackground:Frey's syndrome and cosmesis are important considerations in parotid surgery. Placement of an interpositional barrier can prevent these complications; however, surgical technique and efficacy remain controversial.Methods:A prospective case series was collected comprising all patients undergoing primary superficial parotidectomy for benign pathology with abdominal free fat grafting between June 2007 and December 2010, performed by a single surgeon. A survey was also distributed to otorhinolaryngology consultants across Australia to assess current practice.Results:Twenty-eight patients were included. No patient had clinical symptoms of Frey's syndrome. Seventy-five per cent of patients were completely satisfied with their aesthetic outcome, 18 per cent scored 4/5 and the remaining 7 per cent (2 patients) scored 3/5. The survey revealed that 79 per cent of respondents did not use interpositional grafts.Conclusion:Abdominal free fat is ideal for grafting as it is an effective, safe, simple, accessible, fast and inexpensive method of providing an interpositional graft.

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