scholarly journals Composite drainage in glaucoma surgery

2021 ◽  
Vol 20 (2) ◽  
pp. 51-56
Author(s):  
T. K. Botabekova ◽  
V. P. Erichev ◽  
N. A. Aldasheva ◽  
A. A. Bulgakova ◽  
G. K. Hachatryan
Keyword(s):  
Polyethylene Glycol ◽  
Polylactic Acid ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Hypotensive Effect ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Open Angle ◽  
Refractory Glaucoma ◽  
Primary Glaucoma

PURPOSE. To assess the hypotensive effectiveness, frequency and nature of intra- and postoperative complications in patients with various clinical manifestations of refractory glaucoma.MATERIALS AND METHODS. The study included 196 patients (196 eyes) with various forms, stages and clinical manifestations of glaucoma. There were 142 patients with primary glaucoma, among them 120 with open-angle glaucoma and 22 with angle-closure glaucoma. Among the patients with primary glaucoma, 85 had pseudophakia (77 with openangle and 8 with angle-closure forms); 57 had a native lens (43 with open-angle and 14 with angle-closure forms of the disease). Secondary glaucoma was presented mainly by patients with neovascular (21) and postuveal (16) glaucoma. The intraocular pressure (IOP) level in the group as a whole ranged from 16 to 50 mm Hg (on average 30.1±2.6 mm Hg). In all presented cases of surgical intervention, the Glautex drainage was used, which is a bioresorbable composite biomaterial based on polylactic acid (polylactide) and polyethylene glycol (manufactured by “HiBiTech”, Russia). Standard methods of patient examination were used. RESULTS.In patients with POAG, the IOP averaged 13.7± 4.7 mm Hg one week after surgery and 16.1±3 mm Hg 12 months after surgery. The absolute success of the operation was noted in 71 patients with POAG (59.2%); the relative hypotensive effect — in 85.8%. In primary angle-closure glaucoma, the same indicators were 47.6 and 61.1%, respectively. In the group of patients with neovascular and postuveal glaucoma, the hypotensive effect was as expected lower and amounted to 42.8 and 50.0%, respectively. The restart of therapy at different periods of observation was done in 78.3%. Complications, their frequency and nature, noted by us in the operated patients, could be attributed to those typical for fistulizing operations in refractory glaucoma. The most common complication was ciliochoroidal detachment, which was seen in all groups, but percentage-wise was more common in patients with PACG, neovascular and postuveal glaucoma.CONCLUSION. Composite drainage based on polylactic acid (polylactide) and polyethylene glycol (glautex) is an effective and safe solution to the issue of surgical treatment of glaucoma. The antihypertensive effectiveness of the Glautex drainage implant depends on the severity of the glaucomatous process and the timeliness of the surgical intervention. The frequency and nature of complications depends on the degree of refractoriness of glaucoma, initial clinical characteristics of the process, and patients' multimorbidity.

Glaucoma at a tertiary referral eye hospital in Nepal

1970 ◽  
Vol 3 (2) ◽  
pp. 123-127
Author(s):  
I Paudyal ◽  
SS Thapa ◽  
G Paudyal ◽  
R Gurung ◽  
S Ruit
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Applanation Tonometry ◽  
Acute Angle ◽  
Secondary Glaucoma ◽  
Angle Closure Glaucoma ◽  
Field Analysis ◽  
Angle Closure ◽  
Open Angle ◽  
Tertiary Referral

Background: Glaucoma is an important cause of blindness. Objective: To report the distribution of various types of glaucoma among patients presenting to a tertiary eye hospital in Nepal. Materials and methods: All new patients visiting the hospital between March 2007 and February 2008 underwent a comprehensive eye examination. Whenever glaucoma was suspected, patients were referred to fellowship-trained glaucoma specialists. Patients received a comprehensive glaucoma workup including applanation tonometry, stereoscopic examination of the optic nerve head performed by the glaucoma specialists, and a Humphrey visual field analysis (SITA 24 - 2). Results: 447 patients were newly diagnosed with glaucoma. 171 (38.2 %) patients had primary open-angle glaucoma (POAG), while 143 (32 %) had primary angle-closure glaucoma (PACG). The average age of presentation of patients with POAG was 65.78 ± 9.1 years, while the average age for PACG patients was 54.6 ±12.8 years. 30 (21 %) patients with PACG had acute angle-closure on presentation, while 113 (79 %) had chronic angle closure glaucoma. 107 (75 %) of these patients with PACG had visual acuity of less than 3/60 (20/ 400) in the worse eye at presentation. The most common form of secondary glaucoma was lens-induced (5.3 %), followed by neovascular (3.2 %) and uveitic glaucoma (3.2 %). Conclusion: The most common glaucoma seen in a tertiary referral eye hospital of Nepal is primary open-angle glaucoma. Among the angle-closure glaucoma, chronic angle-closure is the most common. Lens-induced glaucoma is still the commonest cause of secondary glaucoma. Keywords: glaucoma, open-angle, angle-closure, lens-induced DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5263 Nepal J Ophthalmol 2011; 3(2): 123-127

scholarly journals Glaucoma Screening in Family Members of Glaucoma Patients at a Tertiary Eye Hospital in Eastern Region of Nepal

2021 ◽  
Vol 13 (2) ◽  
pp. 128-136
Author(s):  
Ravi Dhar Bhandari ◽  
Bandana Khanal ◽  
Manish Poudel ◽  
Mohan Krishna Shrestha ◽  
Suman Shamsher Thapa
Keyword(s):  
Family History ◽  
Early Detection ◽  
Open Angle Glaucoma ◽  
Family Members ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Eastern Region ◽  
Open Angle ◽  
Cross Sectional ◽  
First Degree Relatives

Introduction: The second most common cause of blindness in the world is glaucoma. Family history plays an important role in early detection and management of patients with glaucoma. The main objective of this study was to determine the prevalence of glaucoma in first degree relatives of Primary open angle glaucoma (POAG) and Primary angle closure glaucoma (PACG) patients. Glaucoma awareness among the first degree relatives was also assessed.    Materials and methods: A  cross sectional hospital based study was designed to examine and diagnose glaucoma among first degree relatives of patients with POAG and PACG, attending the outpatient department at Ramlal Golchha Eye Hospital in the Eastern region of Nepal from June 2016 to May 2017. A comprehensive eye examination was conducted by a glaucoma specialist at the hospital. All subjects underwent vision screening, refraction, slit lamp biomicroscopy, intraocular pressure (IOP) measurement, gonioscopy and a dilated fundus examination. All glaucoma suspects and those diagnosed with glaucoma were enrolled for visual field examination.Results:  Two hundred and twenty-seven first degree relatives of 72 patients were invited for the examination. Out of 227 individuals, 131 (males 67.94%, females 32.06%) agreed to participate in the study. A total of 23 (17.56%) individuals were diagnosed with glaucoma, 10 (43.47%) as POAG and 13 (56.52%) as PACG. Fourteen percent of parents, 22% of siblings and 9% of off-springs had open angle glaucoma. Among 13 PACG participants, 26.08% of parents, 26.08% of siblings and 4.34% of off-springs had angle closure glaucoma. Awareness among first degree relatives diagnosed with glaucoma was 21.74%.  Conclusion:  The prevalence of glaucoma among first degree relatives of glaucoma patients was higher than individuals without family history of glaucoma. Promoting awareness on glaucoma and the timely screening of family members can lead to early detection and prevention of blindness from the disease.  

scholarly journals Primary Outcomes of Patients with Chronic Angle-Closure Glaucoma Treated with Combined Phacoemulsification, Viscogoniosynechialysis, and Endocyclophotocoagulation

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Juan Carlos Izquierdo Villavicencio ◽  
Natalia Agudelo Arbelaez ◽  
Bárbara Rubio Lastra ◽  
Imelda Ramirez ◽  
Fabiola Quezada ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Combined Treatment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Glaucoma Medication ◽  
Yag Laser ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
Best Corrected Visual Acuity

Purpose/Objective. To evaluate the effectiveness of combined phacoemulsification, viscogoniosynechialysis (VGSL), and endocyclophotocoagulation (ECP) in patients with moderate chronic angle-closure glaucoma (CACG) with peripheral anterior synechia (PAS) ≥90 not controlled with glaucoma medications and previous iridotomy yag laser. Materials and Methods. We retrospectively reviewed records from patients with cataract and uncontrolled chronic angle-closure glaucoma despite maximal tolerated medical therapy and iridotomy yag laser who received combined treatment with phacoemulsification with posterior capsular lens implantation, VGSL, and ECP 360°. We evaluated intraocular pressure (IOP), glaucoma medications, and best corrected visual acuity (BCVA) preoperatively and during follow-up.Results. A total of 29 eyes from 22 patients received surgical intervention. Mean follow-up was 6 months. Mean preoperative IOP was 18.2 mmHg, and postoperatively, IOP was 13.5, 12.2, and 12.8 mmHg at 1, 3, and 6 months, respectively. Complete success was 37.9%, and relative success was 72.4%. Mean BCVA was 0.4 logMAR preoperative and 0.3 logMAR 6 months after surgery. Glaucoma medication fell significantly from 2.34 ± 1.66 preoperatively to 1.31 ± 2.6 postoperatively p<0.001. Overall, 44.8% of the patients did not require glaucoma medications at 6 months. There were no visual significant complications. Conclusion. Combined treatment with phacoemulsification with posterior capsular lens implantation, VGSL, and ECP is effective and safe in reducing IOP and number of glaucoma medications with stable BCVA at 6 months.

Comparison of the Prevalence of Plateau Iris Configurations Between Angle-closure Glaucoma and Open-angle Glaucoma Using Ultrasound Biomicroscopy

2011 ◽  
Vol 20 (5) ◽  
pp. 315-318 ◽  
Author(s):  
Hideki Mochizuki ◽  
Joji Takenaka ◽  
Yosuke Sugimoto ◽  
Michiya Takamatsu ◽  
Yoshiaki Kiuchi
Keyword(s):  
Open Angle Glaucoma ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Open Angle
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