scholarly journals Management of Intraocular Pressure Elevation After CO2 Laser-Assisted Sclerectomy Surgery in Patients With Primary Open-Angle Glaucoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Min Chen ◽  
Yuxiang Gu ◽  
Yumei Yang ◽  
Qi Zhang ◽  
Xin Liu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Nd:Yag Laser ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Chinese Patients ◽  
Open Angle ◽  
Case Series Study ◽  
Iop Elevation

Purpose: To report the safety and efficiency of carbon dioxide (CO2) laser-assisted sclerectomy surgery (CLASS) in Chinese patients with primary open-angle glaucoma (POAG) and the management of unexpected postoperative intraocular pressure (IOP) elevation.Methods: This was a prospective case series study. A total of 23 eyes from 23 patients with POAG who underwent CLASS were involved and followed-up for 12 months. The primary outcomes included the changes in best corrected visual acuity (BCVA), IOP, and medications before and after CLASS. The secondary outcomes were success rate and postoperative laser interventions.Results: The mean age of the patient was 42.6 ± 16.0 years. There was no significant change in BCVA and visual field at baseline and 12 months after CLASS. The number of medications was significantly reduced after CLASS. The IOP was also significantly decreased and remained well controlled during the follow-up period, except for a transient elevation at 1 month postoperatively, due to the occurrence of peripheral anterior synechiae (PAS). Generally, 17 patients (73.9%) were treated with neodymium-doped yttrium aluminum garnet (Nd:YAG) laser synechiolysis to remove iris obstruction in the filtration site and seven patients (30.4%) underwent Nd:YAG laser goniopuncture to deal with scleral reservoir reduction. Only one patient (4.3%) received surgical repositioning due to iris incarceration. The complete success rate and total success rate at 12 months were 69.6 and 95.7%, respectively.Conclusion: CLASS was a safe and effective approach for Chinese patients with POAG. Peripheral anterior synechiae (PAS), iris incarceration, and scleral reservoir reduction were common causes of unexpected postoperative IOP elevation. Individualized Nd:YAG laser intervention helps to improve the long-term outcomes after CLASS.

scholarly journals Role of minimally invasive glaucoma surgery in the management of chronic open-angle glaucoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ojasvi Sharma ◽  
Didar Abdulla ◽  
Anthony King ◽  
Monali Chakrabarti ◽  
Tarun Sharma
Keyword(s):  
Success Rate ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Complication Rates ◽  
Open Angle ◽  
Patient Demographics ◽  
Significant Difference ◽  
Advanced Glaucoma

AbstractTo compare the safety and efficacy of phacoemulsification combined with ab-interno trabeculectomy (Trabectome) and phacoemulsification combined with I-Stent inject in patients with medically uncontrolled primary open-angle glaucoma (POAG). A retrospective comparative case series. 70 eyes of 66 patients completed 2 years follow up after these treatments performed in 2017–2018. 35 eyes of 33 patients underwent combined Phaco-Trabectome (PT); and 35 eyes of 33 patients underwent combined Phaco-I-Stent inject (Pi). Patient demographics and preoperative characteristics are comparable. A 20% drop in IOP was achieved in 27 eyes (77.14%) in PT group and 28 eyes (80%) in Pi group (p = 0.77). Success rate (target IOP achieved and maintained for 2 years) in advance glaucoma was 25% in PT group and 30.7% in Pi group (p = 0.90). In mild to moderate glaucoma, success rate was 85.71% in PT group and 90% in Pi group (p = 0.67). There was no significant difference between two groups with regards to mean reduction in glaucoma medications and complication rates. Trabectome and I-Stent combined with phacoemulsification are equally efficacious and safe for treating patients with medically uncontrolled mild and moderate primary open-angle glaucoma (POAG). However, they are not an effective treatment for patients with advanced glaucoma.

scholarly journals Effects of Preoperative Intraocular Pressure Level on Surgical Results of Microhook Ab Interno Trabeculotomy

2021 ◽  
Vol 10 (15) ◽  
pp. 3327
Author(s):  
Masaki Tanito ◽  
Kazunobu Sugihara ◽  
Aika Tsutsui ◽  
Katsunori Hara ◽  
Kaoru Manabe ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Pressure Level ◽  
Surgical Results ◽  
Open Angle ◽  
Success Rates ◽  
Factors Associated ◽  
Ab Interno

To assess the roles of preoperative intraocular pressure (IOP) level on the IOP reducing efficacy of microhook ab interno trabeculotomy (µLOT), 126 consecutive open-angle glaucomatous eyes (90 primary open angle glaucoma, 36 exfoliation glaucoma) of 126 Japanese subjects (60 men, 66 women; mean age ± standard deviation, 70.5 ± 11.4 years) who underwent µLOT alone (25 eyes, 20%) or combined µLOT and cataract surgery (101 eyes, 80%) were retrospectively included, and subdivided into four groups based on the quartile of preoperative IOP: Q1, ≤15 mmHg; Q2, 15–18 mmHg, Q3, 18–21 mmHg, and Q4, >21 mmHg. Preoperative and 12 months postoperative IOPs and numbers of antiglaucoma medications were compared among IOP groups. Factors associated with postoperative IOP were assessed using multivariate analysis, and the success of IOP control was assessed with various definitions. Postoperatively, IOP was significantly higher in Q3 (p < 0.0146) and Q4 (p = 0.0320) groups than Q1 group, while the number of medications was not significantly different among four IOP groups (p = 0.1966). Older age was associated with lower postoperative IOP, and higher preoperative IOP was associated with higher postoperative IOP, while sex, glaucoma type, surgical procedure, lens status, extent of trabeculotomy incision, and preoperative number of medications were not associated with postoperative IOP. The success rates for IOP ≤ 18 and ≤15 mmHg were higher in lower preoperative IOP groups (i.e., Q1 and Q2) than higher preoperative IOP groups (Q3 and Q4), while the success rate for ≥20% IOP reduction was higher in higher preoperative IOP groups than in lower preoperative IOP groups; the success rate for ≥0% IOP reduction was equivalent among groups. By reviewing the previous studies in ab interno trabeculotomy/goniotomy procedures, positive correlation between preoperative and postoperative IOPs was preserved throughout the studies and surgical procedures. After the µLOT, larger %IOP reduction was achieved in higher preoperative IOP groups than in lower preoperative IOP groups, while postoperative IOP was still lower than in lower preoperative IOP groups.

scholarly journals Progression of Corneal Endothelial Insult by Chronic Elevation of intraocular Pressure: A prospective Observational Comparative Study Among Primary Open Angle Glaucoma Patients

2021 ◽  
Author(s):  
Elshimaa A.Mateen ◽  
Hatem Gamal Ammar ◽  
Khulood Muhammad Sayed
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Significant Negative Correlation ◽  
Control Group ◽  
P Value ◽  
Open Angle ◽  
Advanced Stages ◽  
Iop Elevation ◽  
Glaucoma Group

Abstract Purpose: To evaluate specular microscopic changes of corneal endothelial cells (CEC) count and morphology in correlation to retinal nerve fiber layer RNFL changes detected by visual field (VF) and OCT in early and advanced primary open-angle glaucoma (POAG).Methods: A prospective observational comparative study was conducted on patients with POAG versus non-glaucomatous patients of the same age group. Specular microscopy, VF test, OCT scans of RNFL, and macular ganglion cell complex (GCC) were performed. Glaucoma group was further subdivided into early and advanced stages.Results: The study included 130 eyes of 130 subjects, 70 were eyes with POAG (glaucoma group), 60 were healthy eyes (control group). Both groups were comparable regarding mean age and sex.In the early glaucoma group, a significant negative correlation was found between the coefficient of variation (CV%) and superior PRNFL thickness (r=-0.5, p-value=0.018). A significant negative correlation was also found between percentage of cellular hexagonality (HEX%) and vertical cup/disc (C/D) ratio (r=-0.43, p-value= 0.035). A significant positive correlation was found between HEX% and (superior, inferior) PRNFL thickness (r=0.53, 0.5 and p-value= 0.008, 0.015) respectively.Mean CEC count was significantly lower in the advanced glaucoma group than in the control group (2958.7±371.2 vs 3085±172.5, p value=0.043). Conclusions: CEC is affected by chronic intraocular pressure (IOP) elevation just like the PRNFL and macular GCC. CEC morphology is insulted in the early stages of POAG while the count can withstand chronic IOP elevation till advanced stages were both are affected.

scholarly journals Juvenile open angle glaucoma –A case series study

2021 ◽  
Vol 7 (2) ◽  
pp. 448-451
Author(s):  
Shams Mohammed Noman
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Age Of Onset ◽  
Open Angle Glaucoma ◽  
Clinical Manifestations ◽  
Case Series ◽  
Open Angle ◽  
Case Series Study ◽  
Pre Treatment ◽  
Field Defects

Juvenile open angle glaucoma is a rare form of glaucoma that differs from primary open angle glaucoma in its age of onset and magnitude of intraocular pressure.Juvenile open angle glaucoma has its onset between 3-40 years of age with relatively high intraocular pressure. For the documentation and describe clinical manifestations management and outcome of management of the patients diagnosed as Juvenile open-angle glaucoma at the glaucoma department, CEITC, Chittagong, Bangladesh. This is a hospital based prospective observational case series review. 20 patients who were diagnosed as Juvenile open-angle glaucoma from November 2010 to December 2011 were included in this study.Patient particulars history with main causes of hospital presentations were recorded. Ophthalmic examinations and management given were documented. Similar relevant details were recorded for different follow-up periods. 40 eyes of 20 patients were included in this study. There were 16 male and 4 female. All cases were bilateral. Age more than 18yrs. (18-35) in 16 patients and below 18yrs. (5-18) in 4 patients. 15 patients came from rural area and 5 patients from urban. Pretreatment average IOP in the both eyes was 32±3mmhg, which was 15±1mmhg after treatment. 24 of 40 eyes were presented with advance field defects. 85% (17 patients) had myopic refractive error. In 18eyes pre treatment presenting visual acuity was &#60;6/60 and &#62;6/60 in the rest of the eyes. Visual acuity was improved after treatment. In 21 patients (53%) IOP was controlled with 2-3 medications. In 19 eyes (48%) IOP was controlled with filtration surgery. As Juvenile open-angle glaucoma presented with high IOP and advance field defect, early diagnosis, appropriate investigations and medical or surgical management is mandatory to stabilize IOP and to prevent progression of field defects.

Clinical efficacy of osteopathic correction in the complex treatment of patients with unoperated open-angle glaucoma

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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