scholarly journals Results of Rectangular and Triangular Shaped Scleral Flaps in Trabeculectomy in Terms of Control of Intra Ocular Pressure (IOP) and Complications

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Qirat Qurban ◽  
Zeeshan Kamil ◽  
Khalid Mahmood

Purpose: To compare between the results of rectangular and triangular shaped scleral flaps in trabeculectomy for primary open angle glaucoma. Study design: Quasi experimental study Place and Duration of Study: Khalid eye clinic, Karachi, from July 2018 to June 2019. Methods: This study included 24 patients of either gender and age from 40 to 65 years. Patients with a diagnosis of primary open angle glaucoma refractory to medical treatment were included by convenient sampling technique. They were divided into two groups. Group A underwent trabeculectomy with rectangular shaped scleral flap whereas Group B underwent trabeculectomy with triangular shaped scleral flap. The main outcome measures were intraocular pressure reduction, anterior chamber depth and post-operative complications. All patients were followed up for a period of two months. Results: Mean age was 52.1± 6.72 years. Mean pre-operative intraocular pressure in group A was 24.4±2.13 mmHg and 23.5±1.64 mmHg in group B. Mean post-operative IOP was 11.6±1.51 mmHg in group A and 13.4±1.67 mmHg in group B with p-value of 0.11. Pre-operative anterior chamber depth (ACD) was grade 4 both groups. It remained same in all patients of group A but two patients of group B changed to grade 3 ACD. Two patients of group B developed hypotony on the first post-operative day. They did not require revision suturing and were managed conservatively. Conclusion: Both types of scleral flap are effective in reducing IOP but rectangular scleral flap reduced IOP more as compared to triangular scleral flap but the difference was not statistically significant. Keywords: Trabeculectomy, Intra ocular pressure, Open angle glaucoma.

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Alina Popa-Cherecheanu ◽  
Raluca Claudia Iancu ◽  
Leopold Schmetterer ◽  
Ruxandra Pirvulescu ◽  
Valeria Coviltir

Purpose. To compare changes in intraocular pressure (IOP), axial eye length (AEL), and refractive outcome in primary open-angle glaucoma patients undergoing cataract surgery and trabeculectomy in dependence of the sequence of surgeries. Materials and Methods. We retrospectively analysed 48 eyes. The changes in refraction, intraocular pressure, and axial eye length were analysed after surgery. In group A (21 subjects), phacoemulsification was performed before trabeculectomy, and in group B (27 subjects), trabeculectomy was performed before phacoemulsification with a minimum time span between interventions of 6 months. Results. The reduction in IOP and the decrease in AEL after trabeculectomy were significant after 6 and 12 months postsurgery (p<0.001 each). The decrease in AEL was 0.42 ± 0.11% at 6 months after surgery and 0.40 ± 0.13% after 12 months from surgery; this decrease in AEL was comparable between the groups. The refractive outcome was significantly different between the groups (group A: 0.35 ± 0.75 dpt, group B: −0.05 ± 0.36 dpt, p=0.018); in group A, trabeculectomy caused a hyperopic shift of 0.34 ± 0.44 dpt (p=0.002) at 12 months postsurgery. Conclusion. IOP reduction after trabeculectomy causes AEL shortening. The effect on refractive outcome depends on the sequence of surgeries. Better refractive outcome is achieved if phacoemulsification is performed after trabeculectomy.


Author(s):  
Zakaullah Gopang ◽  
Shabeer Ahmed Bhutto ◽  
Naeem Akhtar Katpar ◽  
Arslan hassan Rajper ◽  
Vijay Nagdev

Objective: To determine the effect on intraocular pressure following primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma. Study Design: This is a prospective and experimental Study. Setting: Study carried out at Ophthalmology Department, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 01-03-2020 to 31-08-2020 (06 Months). Materials and Methods: The patients with primary open angle glaucoma were selected from glaucoma clinic after taking careful history and clinical examination. Patients selected for trabeculectomy into two groups. Group A includes 43 patients while Group B also includes 43 patients. Among Group A patients adjunctive MMC 0.2mg/ml for a period of 3 minutes was used during trabeculectomy as a primary procedure (Test Group) while Group B patients were operated without MMC 0.2% (Control Group). Follow-up period of 06 months was observed in both groups. The span of study was from 01-03-2020 to 31-08-2020. Results: The total of 86 Eyes of 86 patients of POAG were included in this study. Group A patients were operated for trabeculectomy with MMC while group B patients were operated for trabeculectomy without MMC. The mean IOP before surgery of Group-A was 25.39±2.42 mmHg while in Group-B it was 26.23±4.23mmHg. At day 1 of surgery in Group-A patients IOP was 13.20±3.05 mmHg while in Group-B patients IOP, was 14.09±4.04 mmHg. After 3 months in Group-A, IOP was 13.04±3.81 mmHg in Group-B IOP was 14.01±4.18 mmHg. Out of 43 patients in Group-A, 41(95.3%) were succeeded while in Group-B, 39(90.7%)were succeeded. Significant result was found for IOP reduction after 6 months of surgeryin group-A IOP was 13.48 + 2.86 mmHg while in group-B, IOP was 15.09 ±2.64 (P=0.754). Conclusion: Trabeculectomy with MMC as a primary procedure seems to be more effective than trabeculectomy without MMC.


2021 ◽  
Author(s):  
Luis Nino-de-Rivera ◽  
Diego Cervera ◽  
Paola Castillo-Juarez

This Chapter focuses in the electrophysiological bases to support Trans Palpebral Electrical Stimulation TPES as a new alternative to control Intraocular Pressure IOP. Primary open Angle Glaucoma POAG is described in our approach as a dysfunction of the membrane potential of TM cells due to the dysfunction of the Maxi potassium depended Calcium Channels BKCa2+ of the Trabecular Mesh TM. We review through the paper the main contributions about Trabecular mesh dysfunction related with Voltage dependent ionic channels. We also present in this paper new results in controlling intra ocular pressure IOP during one year of trans palpebral Electric stimulation in patients with Primary open-angle glaucoma (POAG).


2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Emil Goosen ◽  
Linda Visser ◽  
Ben Sartorius

Objective: To compare the outcomes of selective laser trabeculoplasty (SLT) on treatmentnaive, primary open-angle glaucoma (POAG) patients with those of SLT on patients previously treated medically and/or surgically. Secondary objectives: To establish whether age, race or gender influenced SLT outcomes.Design: A retrospective chart review of patients who received SLT therapy for POAG between June 2011 and January 2015.Subjects: Group A: Treatment-naive patients (n = 15). Group B: Prior medical therapy and/or prior surgery (n = 69).Methods: Group A: Patients were treated with SLT therapy as first line, with medical treatment added as needed. Group B: Patients were treated with SLT therapy as additional therapy to medication and/or surgery. All patients were followed up for at least 1 year.Main outcome measures: A reduction in intraocular pressure (IOP) of at least 20% from baseline was considered significant.Results: The following percentage reduction in IOP was found in the different groups: Group A 50.7%, Group B 32.0%, Africans 52.2%, Indians 29.8% and Caucasians 28.87%.Conclusion: In our study patients, SLT achieved significant reductions in IOPs in treatmentnaive as well as previously surgically and medically treated eyes with POAG. Statistically significant higher reductions in IOP at 1 year after SLT was seen in treatment-naive eyes, patients older than 70 years when compared with younger patients, female patients (54%) when compared with male patients (30%) and in patients of African (52%) descent compared with Caucasians (30%).


2016 ◽  
Vol 94 (6) ◽  
pp. e460-e467 ◽  
Author(s):  
Jingyi Cheng ◽  
Xiangmei Kong ◽  
Ming Xiao ◽  
Xinghuai Sun

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