scholarly journals Our Experience With Micropulse Cyclophotocoagulation in the Therapy Of Glaucoma

2020 ◽  
Vol 76 (1) ◽  
pp. 29-34
Author(s):  
Elena Nutterová ◽  
Šárka Pitrová ◽  
Ján Lešták
Keyword(s):  
Intraocular Pressure ◽  
Laser Energy ◽  
Open Angle Glaucoma ◽  
Neovascular Glaucoma ◽  
Normal Tension Glaucoma ◽  
Angle Closure ◽  
Pigmentary Glaucoma ◽  
Laser Iridotomy ◽  
Primary Angle Closure Glaucoma ◽  
Retrospective Assessment

The objective of this study was a retrospective assessment of two-year experience with micropulse cyclophotocoagulation (MP CPC) in the therapy of various types of glaucoma. Material and method: The cohort of patients consisted of 47 people, out of which 16 men and 31 women. An average age of males was 58.9 years (the range from 35 to 78 years), and an average age of females was 64.7 years (the range from 33 to 86 years). Both eyes were treated in three patients, and therefore the total number of assessed eyes was 50. Patients who underwent the therapy were in different stages of glaucoma disease, with various types of primary and secondary glaucoma. Most of the patients were those with primary open angle glaucoma (POAG): 26 patients, followed by patients with secondary pseudoexfoliative glaucoma (PEXG): 9 patients; diagnoses of the remaining patients: 4 patients – secondary pigmentary glaucoma (PG), 3 patients - primary angle closure glaucoma (PACG), 2 patients normal tension glaucoma (NTG), 3 patients - Posner-Schlossman syndrome, 1 patient - Cogan-Reese syndrome, 1 patient - neovascular glaucoma and 1 patient – secondary traumatic glaucoma. On the operated eye prior to the surgery 3 patients underwent laser iridotomy, 4 patients trabeculectomy, 4 patients EX-PRESS® implant, 3 patients EX-PRESS® implant and trabeculectomy and 1 patient transscleral cyclophotocoagulation. During surgery we opted for from 2,000 to 2,250 mW infrared laser with 810 nm wavelength which uses a micropulse system of laser energy emission. For the procedure we used a new MP3 application probe. 30% drop in intraocular pressure (IOP) compared to the baseline IOP values was set as a success. Results: Our results correlated with the most of available studies when we achieved drop in the values of intraocular pressure by the minimum of 30% in 53.4% of the eyes. The effect of therapy failed in 9 eyes (18%) where we subsequently selected a different therapeutic procedure. Conclusion: MP CPC is a non-incisional laser treatment with minimum complications. It is characterized by a high safety profile and predictability of results. In our study we achieved drop in the values of intraocular pressure by the minimum of 30% in 53.4% of treated eyes. Its use is not limited by the type of glaucoma disease. In the event of insufficient effect, it may be repeated.

Glaucoma

2016 ◽  
Author(s):  
Andrew Tatham ◽  
Peng Tee Khaw
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Open Angle Glaucoma ◽  
Clinical Skill ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Normal Tension Glaucoma ◽  
Aqueous Fluid ◽  
Angle Closure ◽  
Pigmentary Glaucoma

This chapter explores glaucoma. It starts off with an outline of optic nerve head anatomy and then describes aqueous fluid dynamics and the pathogenesis of glaucoma. It then goes on to discuss the clinical skill areas of optic nerve head assessment in glaucoma, glaucoma imaging devices, tonometry and tachymetry, gonioscopy, and perimetry. The chapter also details ocular hypertension, primary open-angle glaucoma, primary angle closure, and secondary angle closure. In addition, it discusses normal tension glaucoma, steroid-induced glaucoma, traumatic glaucoma, inflammatory glaucomas, pseudoexfoliative glaucoma, pigmentary glaucoma, and neovascular glaucoma. It then covers aqueous misdirection, iridocorneal endothelial syndrome and iridocorneal dysgenesis, ocular hypotensive agents, laser therapy for glaucoma, and glaucoma surgery.

scholarly journals Effect of Cataract Surgery on Intraocular Pressure in Glaucoma Patients

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.

scholarly journals The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Sarah C. Xu ◽  
Angela C. Gauthier ◽  
Ji Liu
Keyword(s):  
Intraocular Pressure ◽  
Disease Progression ◽  
Contact Lens ◽  
Open Angle Glaucoma ◽  
Normal Tension Glaucoma ◽  
Angle Closure ◽  
Blink Rate ◽  
Disease States ◽  
Wide Range ◽  
Contact Lens Sensor

Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments.

Glaucoma

2012 ◽  
Author(s):  
Julie Huntbach ◽  
Amar Alwitry
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Clinical Skills ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Acute Angle ◽  
Angle Closure ◽  
Pigmentary Glaucoma ◽  
Open Angle

The chapter begins by discussing optic nerve head anatomy and aqueous fluid dynamics, before covering the key clinical skills, namely optic nerve head assessment in glaucoma, tonometry and pachymetry , gonioscopy, and perimetry. It also covers the key areas of clinical knowledge, including ocular hypertension, primary open-angle glaucoma, acute angle closure, normal-tension glaucoma, steroid-induced glaucoma, traumatic glaucoma, inflammatory glaucomas, pseudoexfoliative and pigmentary glaucoma, neovascular glaucoma, malignant glaucoma, iridocorneal endothelial syndrome and iridocorneal dysgenesis, ocular hypotensive agents, laser therapy for glaucoma, and glaucoma surgery. The chapter concludes with three case-based discussions, on open-angle glaucoma, angle closure glaucoma, and steroid glaucoma.

scholarly journals Detection of Glaucoma in a Cohort of Chinese Subjects with Systemic Hypertension

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Rita A. Gangwani ◽  
Jonathan Chan ◽  
Jacky Lee ◽  
Alfred Kwong ◽  
Jimmy S. M. Lai
Keyword(s):  
Open Angle Glaucoma ◽  
Frequency Doubling ◽  
Normal Tension Glaucoma ◽  
Angle Closure ◽  
Systemic Hypertension ◽  
Ophthalmological Examination ◽  
Primary Angle Closure Glaucoma ◽  
Frequency Doubling Technology ◽  
Iop Measurement ◽  
Chinese Subjects

Purpose. To determine the presence and type of glaucoma in a cohort of adult Chinese subjects with systemic hypertension.Methods. This prospective cohort study included 200 hypertensive Chinese adults aged >40 years old who underwent screening via frequency doubling technology (FDT) perimetry and intraocular pressure (IOP) measurement by noncontact tonometry (NCT) in a general outpatient clinic. Those withIOP>21 mmHg and/or visual field (VF) defects on FDT were referred for complete ophthalmological examination. The diagnosis of glaucoma was based on an abnormal VF on Humphrey Field Analyzer (HFA) by Hodapp-Parrish-Anderson's criteria and an increased vertical cup-disc ratio (VCDR).Results. The mean age of the subjects was64.66±9.47years, and the male:female ratio was 92 : 108. All patients were hypertensive with a mean blood pressure (BP) of131.1±15.1/76.6±11.1 mmHg whilst on systemic antihypertensive medication. Of the 111 patients that had an abnormal initial screening, 14 (7.9%) were confirmed to have glaucoma with the highest prevalence of normal tension glaucoma (NTG) (6.2%), followed by primary angle closure glaucoma (PACG) (1.1%) and primary open angle glaucoma (POAG) (0.5%). The positive predictive value of FDT perimetry was 71%.Conclusion. Nearly 8% of the adults with systemic hypertension had glaucoma, and NTG was the most prevalent type.

Four Years Later: A Clinical Update on Latanoprost

2003 ◽  
Vol 13 (2) ◽  
pp. 162-175 ◽  
Author(s):  
E. Ravinet ◽  
A. Mermoud ◽  
R. Brignoli
Keyword(s):  
Blood Flow ◽  
Open Angle Glaucoma ◽  
Cataract Extraction ◽  
Normal Tension Glaucoma ◽  
Ocular Blood Flow ◽  
Ciliary Muscle ◽  
Angle Closure ◽  
Pigmentary Glaucoma ◽  
Long Term Treatment ◽  
Pulsatile Ocular Blood Flow

Purpose Almost five years have elapsed since the introduction of latanoprost on several markets and considering the large number of publications dealing with it, the authors felt that it was worth re-evaluating the drug. Methods The criterion used to select trials for inclusion in the review was: all articles mentioning the drug in common electronic data-bases; these were then screened and considered, on the basis of methodological quality. Results Experimental data suggest that latanoprost acts by remodeling the extracellular matrix in the ciliary muscle, thus increasing the flow of aqueous humor through the ciliary muscle bundles of the uveoscleral pathway. POAG Latanoprost persistently improves the pulsatile ocular blood flow in primary open angle glaucoma (POAG). Recent trials confirmed the greater IOP-lowering efficacy of latanoprost vs. timolol, dorzolamide, brimonidine and unoprostone. Trials lasting up to 24 months showed that latanoprost is effective in long-term treatment of POAG and ocular hypertension (OH), with no signs of loss of efficacy when compared to timolol or dorzolamide. Latanoprost provides better control of circadian IOP. Non-responders to b-blockers should preferably be switched to latanoprost monotherapy before a combination therapy is started. The possibility of a fixed combination of latanoprost and timolol has been explored, with promising results. NTG Latanoprost is effective in normal tension glaucoma (NTG), lowering IOP, improving pulsatile ocular blood flow and increasing ocular perfusion pressure. Other Glaucomas Latanoprost may provide effective IOP control in angle-closure glaucoma after iridectomy, in pigmentary glaucoma, glaucoma after cataract extraction and steroid-induced glaucoma. However, latanoprost was effective in only a minority of pediatric cases of glaucoma and is contraindicated in all forms of uveitic glaucoma. Safety In the articles reviewed, new or duration-related adverse events were reported.

scholarly journals Ultrasound cycloplasty in Chinese glaucoma patients: Results of a 6-month prospective clinical study

2021 ◽  
Author(s):  
Qin Luo ◽  
Wenwen Xue ◽  
Yulan Wang ◽  
Bin Chen ◽  
Shuangshuang Wang ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Safety Evaluation ◽  
Angle Closure ◽  
Prospective Clinical Study ◽  
Success Rates ◽  
Therapeutic Success ◽  
Primary Angle Closure Glaucoma ◽  
Operative Complications ◽  
Post Operative Complications

Purpose: The aim of this study was to evaluate the short-term efficacy and safety of ultrasound cycloplasty (UCP) procedure in Chinese glaucoma patients. Methods: As a single-centre, prospective, non-comparative study, 23 eyes of 23 patients suffering from glaucoma with uncontrolled intraocular pressure (IOP) ≥ 21 mmHg underwent a multi-dose UCP treatment with the activations of 6, 8 or10 sectors. Types of glaucoma include primary open-angle glaucoma (POAG) (7/23), primary angle closure glaucoma (PACG) (9/23) and secondary glaucoma (SG) (7/23). A complete ophthalmic examination including intraocular pressure (IOP) measurements was performed before UCP procedure and at 1 day, 1 month, 3months and 6 months after the procedure. An IOP reduction of ≥20% and IOP > 5 mmHg without increasing hypotensive medication at the follow-up visit was defined as therapeutic success. The post-operative complications were also recorded and compared to baseline for safety evaluation. Results: The mean baseline IOP of 23 treated eyes was 37.2 ± 12.1 mmHg. The IOP reduction after UCP procedure were 23%, 49%, 33% and 34% at 1 day, 1 month, 3 months and 6 months, respectively. Thus, the corresponding overall therapeutic success rates reached 61% (14/23), 83% (19/23), 65% (15/23) and 61% (14/23), respectively. Baseline IOPs of 8 and 10 sectors group (37.0 ± 9.9 mmHg and 50.1 ± 12.2 mmHg) were significantly higher than that of 6 sectors group (30.1 ± 8.2 mmHg). Therapeutic success rates of 6, 8 and 10 sectors groups reached 44% (4/9), 56% (5/9) and 100% (5/5), respectively. There were the highest percentage of IOP reduction (50% and 41%) and therapeutic success rate (6/7; 86% and 7/9; 78%) in SG group and PACG groups respectively. In addition, pre-operative ocular pain symptoms of four patients were all disappeared within one week after UCP. No serious intra-operative or post-operative complications occurred. Conclusion: UCP procedure is an effective and well-tolerated treatment to reduce IOP in Chinese glaucoma patients, which offered a novel alternative for glaucoma treatment.

scholarly journals EFFECTIVENESS OF MICROPULSE MP3 CYCLODIODE LASER IN CONTROLLING INTRAOCULAR PRESSURE WITHOUT ACETAZOLAMIDE

2020 ◽  
Vol 35 (4) ◽  
pp. 223-228
Author(s):  
Dr Sahira Wasim
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Normal Tension Glaucoma ◽  
Angle Closure ◽  
P Value ◽  
Fisher Exact Test ◽  
Safe Alternative ◽  
Case Series Study ◽  
Department Of Ophthalmology

ABSTRACT Background: Glaucoma is a 2ndleading cause of irreversible blindness worldwide. Primary surgical procedures include trabeculectomy with or without anti-metabolites, as well as glaucoma drainage devices. Cycloablation lowers IOP by destruction of ciliary body epithelium and stroma, thus reducing aqueous production. Objective: To determine effectiveness of micropulse mp3 cyclodiode laser in controlling intraocular pressure without acetazolamide. Study design: Descriptive case series study Place and duration of study: Department of Ophthalmology, Liaquat National Hospital, Karachi for 6 months duration Material and Methods: In our study total 98 patients of either gender with age 20 to 50 years, following inclusion criteria (Chronic open angle glaucoma, Neovascular, Refractory, Uveitic, Trauma induced glaucoma, and Post vitrectomy induced glaucoma) and exclusion criteria (Primary angle closure and Normal tension glaucoma) were included. Descriptive statistics were calculated. Frequencies and percentages were computed for qualitative variables. Quantitative variables were presented as mean±standard deviation. The mean baseline IOP was compared with mean IOP of 3 months using student t-test. Effect modifiers were controlled through stratification. Fisher exact test was used to see the association of effectiveness with stratified groups. P-value ≤0.05 was considered as significant. Results: Among total 98 patients, 63.3% were male and 36.7% were female. Mean age was 48.46±13.39 years. The effectiveness of Micropulse Mp3 Cyclodiode Laser was observed in 85.7% cases. Significant mean difference was found for pre-op IOP with IOP after 3 months for right eye and left eye. Insignificant association of effectiveness was found with gender, age, type and procedure. Conclusion: Micro pulse MP3 appears to be a promising, safe alternative procedure with potential advantages as well as high level of effectiveness. Keywords: Micropulse Mp3 Cyclodiode Laser, Intraocular Pressure, Acetazolamide

Sign in / Sign up

Export Citation Format

Share Document