scholarly journals Comparative analysis of intraocular pressure dynamics after phacoemulsification with intraocular lens implantation in eyes with primary glaucoma

2021 ◽  
Vol 20 (3) ◽  
pp. 49-57
Author(s):  
A. V. Kolesnikov ◽  
E. V. Ban ◽  
M. A. Kolesnikova ◽  
L. V. Mironenko ◽  
A. I. Prozorova ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Comparative Analysis ◽  
Intraocular Lens ◽  
Initial Level ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Preoperative Level ◽  
Number Of Patients ◽  
Closed Angle

PURPOSE. To conduct a comparative analysis of changes in intraocular pressure (IOP) after cataract phacoemulsification with implantation of intraocular lens (IOL) in comorbidity with primary open-angle (POAG) and primary closed-angle glaucoma (PACG).METHODS. The study analyzed the dynamics of IOP changes after cataract phacoemulsification in 65 patients (89 eyes) with comorbid PACG and 46 patients (58 eyes) with comorbid POAG, aged 50 to 92 years. Thirty-five (53.85%) patients with POAG had history of glaucoma surgery, and 12 (20.69%) patients with PACG had been treated with laser iridectomy. The disease was in the initial stage in 14.6% of POAG patients and 5.15% of PACG patients; moderate stage — in 55.05% and 47.19%, respectively; advanced stage — in 30.34% and 24.14%. Intraocular pressure in POAG was compensated in 84.5% and subcompensated in 15.5% of patients; in PACG it was compensated in 77.6%, subcompensated in 12.6%, and uncompensated in 10.4% of patients. Compensation of IOP was achieved either by previous surgeries, or application of local antihypertensive medications. Patients with subcompensated and elevated IOP received the maximum possible amount of hypotensive medications. The follow-up period ranged from 1 month to 2 years.RESULTS. Patients were divided into three groups according to postoperative IOP levels: the first group with IOP equal to preoperative level, the second group — with IOP below the initial level, and the third group with IOP above the initial level. The IOP levels were consistent with preoperative values at all follow-up periods in most of study patients, and after 2 years their portion exceeded 70%, while in POAG it was somewhat higher than in PACG (77.42% against 71.43%). The IOP below the preoperative level was observed in eyes with initial and moderate open-angle and closed-angle glaucoma, with the amount decreasing with longer follow-up (from 63.16% at 3 months to 16.13% after 2 years in POAG, and from 62.74% to 19.04% in PACG). In the early postoperative period, number of POAG and PACG patients in this group was comparable, but after 8 months it included more PACG patients. Elevation of IOP in both forms of glaucoma was most often observed in faradvanced stage in the early post-op period after phacoemulsification, subsequently their number decreased and by two years it decreased by almost twice (6.45% vs. 11.84% in POAG and 9.53% vs. 15.69% in PACG). During the entire follow-up period, the number of patients with ophthalmic hypertension in PACG was 30% higher than in POAG.CONCLUSION. The study showed that in most cases phacoemulsification has a stabilizing effect in patients with cataracts in combination with glaucoma. The hypotensive effect of the operation was observed in initial and advanced stages of glaucoma, when the drainage system of the eye was still preserved, and in the long term it was observed in a larger percentage of cases in angle-closure glaucoma compared to open-angle glaucoma. An increase in intraocular pressure relative to the preoperative level was observed in advanced glaucoma throughout the entire follow-up period, and the number of patients with angleclosure glaucoma was one-third higher than the number of patients with open-angle glaucoma. The obtained ambiguous results of intraocular pressure measurements after phacoemulsification of cataract with implantation of IOL in combination with various forms of glaucoma dictate the need for further study of this problem.

scholarly journals Transpalpebral Electrical Stimulation as a Novel Therapeutic Approach to Decrease Intraocular Pressure for Open-Angle Glaucoma: A Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Félix Gil-Carrasco ◽  
Daniel Ochoa-Contreras ◽  
Marco A. Torres ◽  
Jorge Santiago-Amaya ◽  
Fidel W. Pérez-Tovar ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Intraocular Pressure ◽  
Pilot Study ◽  
Open Angle Glaucoma ◽  
Constant Current ◽  
Open Angle ◽  
Naive Group ◽  
Treatment Naïve ◽  
The Mean

Purpose. To determine the effect on intraocular pressure of transpalpebral specific exogenous voltages in a cohort of open-angle glaucoma patients. Methods. This is a prospective, comparative, and experimental pilot study. The electrical stimuli applied consisted of 10 Hz, biphasic, nonrectangular current pulses (100 μA) delivered from an isolated constant current stimulator. At intake, baseline IOP measurements were obtained from each eye. The measurement was repeated before and after microstimulation until the end of the treatment. Results. Seventy-eight eyes of 46 patients diagnosed with POAG were studied: 58 eyes with maximum tolerated medical treatment and 20 eyes without treatment (naïve). The mean baseline IOP on the treated POAG group was 19.25 mmHg ± 4.71. Baseline IOP on the naïve group was 20.38 mmHg ± 3.28. At the four-month follow-up visit, the mean IOP value on the treatment group was 14.41 mmHg ± 2.06 (P<0.0001). The obtained mean IOP measurement on the treatment-naïve group was 15.29 mmHg ± 2.28 (P<0.0001). Conclusions. The hypotensive response obtained using transpalpebral electrical stimulation on POAG patients, both on treatment-naïve patients and on patients receiving maximum tolerable treatment, was statistically significant when comparing basal IOP measurements to those obtained at the four-month follow-up visit.

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.

Outcomes of micropulse transscleral cyclophotocoagulation in primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma

2020 ◽  
pp. 112067212091423 ◽  
Author(s):  
Oya Tekeli ◽  
Helin Ceren Köse
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Secondary Glaucoma ◽  
Open Angle ◽  
Pseudoexfoliation Glaucoma ◽  
Transscleral Cyclophotocoagulation ◽  
The Mean ◽  
Glaucoma Group

Purpose: The aim of this study is to compare the outcomes of micropulse transscleral cyclophotocoagulation between primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. Methods: Outcomes of 96 consecutive patients with refractory, end-stage glaucoma treated with micropulse transscleral cyclophotocoagulation were retrospectively reviewed. Follow-up examinations were performed on a regular basis until 12 months postoperatively. Surgical successes were defined as maintaining intraocular pressure ⩽18 mmHg and ⩾20% reduction in intraocular pressure (criteria A), ⩽15 mmHg intraocular pressure and ⩾25% reduction in intraocular pressure (criteria B), and ⩽12 mmHg intraocular pressure and ⩾30% reduction in intraocular pressure from baseline (criteria C). Results: Ninety-six eyes of 96 patients (50 (52%) females, 46 (48%) males) were included. Among all eyes, 32 were primary open-angle glaucoma, 30 were pseudoexfoliation glaucoma, and 34 were other types of secondary glaucoma. The mean age was 59.37 ± 11.45 (range: 20–91) years. The mean follow-up period was 14.2 ± 3.9 (range: 12–16) months. At 12 months, the success rates of primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma group were 68.75%, 66.6%, and 64.7% (p = 0.185) for criteria A; 56.25%, 53.3%, and 50% (p = 0.153) for criteria B; and 43.75%, 43.3%, and 38.2% (p = 0.146) for criteria C. Four patients (12.5%) in primary open-angle glaucoma group, 5 patients (16.6%) in pseudoexfoliation glaucoma group, and 14 (41.2%) patients in other secondary glaucoma group required reoperation during the follow-up (p < 0.05). Conclusion: Micropulse transscleral cyclophotocoagulation is an equally effective method of lowering intraocular pressure in patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. The rate of reoperation was higher in refractory secondary glaucoma patients.

scholarly journals Comparison of the efficacy and safety of bimatoprost (0.03 %) and travoprost (0.004 %) in patients with primary open angle glaucoma

2013 ◽  
Vol 5 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Ashish Chander ◽  
H Kapoor ◽  
S Thomas
Keyword(s):  
Intraocular Pressure ◽  
Side Effect ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Efficacy And Safety ◽  
Once Daily ◽  
The Mean ◽  
To Receive

Purpose: To compare the efficacy and safety of bimatoprost (0.03 %) and travoprost (0.004 %) in patients with primary open angle glaucoma (POAG). Subjects and methods: Patients with POAG were randomized to receive either bimatoprost or travoprost once daily. Detailed ocular examination was done and intraocular pressure (IOP) was measured at 9.00 am, 1.00 pm and 4.00 pm at the baseline and at 1, 2, 4, 6 and 12 weeks of therapy. Results: A total of 31 patients were analysed. The patients were randomly divided into two groups (Bimatoprost group = 16; Travoprost group = 15). Both the groups had a statistically significant reduction from the baseline IOP at all follow up visits at 9.00 am, 1.00 pm and 4.00 pm. The mean IOP decreased from a baseline of 25 ± 2.32 mm Hg to 15.93 ± 1.79 mm Hg after 12 weeks in the bimatoprost group (p < 0.001), and from 24.2 ± 1.60 mm Hg to 16.53 ± 1.56 mm Hg in the travoprost group (p < 0.001). A better mean reduction of IOP was obtained with bimatoprost than with travoprost at the end of the study at 12 weeks (p = 0.03). Mild ocular redness was the commonest side effect in both the groups but was not significant in either group. Conclusion: Both drugs lowered IOP effectively but bimatoprost showed a greater reduction in the mean IOP than did travoprost at 12 weeks and both are safe for ocular use. Nepal J Ophthalmol 2013; 5(9):75-80 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7831

scholarly journals Complex use of energetic surgery in treatment of patients with primary open-angle glaucoma and cataract on the background of pseudoexfoliative syndrome

2021 ◽  
Vol 14 (3) ◽  
pp. 25-34
Author(s):  
Benta G. Dzhashi ◽  
Sergei V. Balalin
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Visual Functions ◽  
Incipient Stage ◽  
Laser Trabeculoplasty

BACKGROUND: Glaucoma remains one of the current problems of modern ophthalmology. The combination of glaucoma and cataract is observed in 1738.6% of cases, and glaucoma with pseudoexfoliative syndrome in 2050% of primary open-angle glaucoma cases. AIM: The aim of this work is to develop an effective and safe technology of complex energetic surgical treatment of the incipient primary open-angle glaucoma stage and cataract on the background of pseudoexfoliation syndrome on the basis of modified laser, hydrodynamic and ultrasound methods use. MATERIALS AND METHODS: 187 patients (187 eyes) with the incipient stage of primary open-angle glaucoma, cataract and pseudoexfoliation syndrome were examined. In the main group (111 eyes), selective laser trabeculoplasty followed by femtosecond laser-assisted cataract surgery with hydrodynamic trabeculocleaning was performed. Patients in the control group (76 eyes), after selective laser trabeculoplasty, underwent phacoemulsification according to the standard technique. RESULTS: The developed technology allowed to reach the hypotensive effect in 35.2% (t=23.0; р 0.001) of baseline intraocular pressure values, of individual intraocular pressure level without adding IOP-lowering medications in 27% of cases, stabilization of visual functions and morphometric indices of the optic disc during 2 years of follow-up in 97.3% of cases unlike the selective laser trabeculoplasty with subsequent phacoemulsification (21.2, 5.3 and 81.6% respectively). The patients of the main group had significantly lower energy expenditure during the stage of phacoemulsification, a lower percentage of postoperative inflammatory reaction was noted, and a persistent hypotensive effect with stabilization of visual functions was achieved based on the results of a two-year follow-up. CONCLUSIONS: Femtosecond laser-assisted phacoemulsification, performed as part of complex treatment in patients with cataract and incipient stage of primary open-angle glaucoma, is a sparing method that minimizes surgical trauma and achieves a persistent hypotensive effect, reduces intraocular pressure to an individual level and stabilizes visual functions in 97.3% of cases.

scholarly journals Efficacy and Safety of Argon Laser Trabeculoplasty in Lowering Intraocular Pressure as Adjunctive Treatment to Primary Open Angle Glaucoma

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Uzma Fasih, Erum Shahid Arshad Sheikh
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Argon Laser ◽  
Adjunctive Treatment ◽  
P Value ◽  
Open Angle ◽  
Argon Laser Trabeculoplasty ◽  
Laser Trabeculoplasty

Purpose: To assess efficacy and safety of argon laser trabeculoplasty (ALT) to lower intra ocular pressure (IOP) as adjunctive treatment in primary open angle glaucoma (POAG) patients. Study Design: Descriptive Cross Sectional. Place and Duration of Study: Ophthalmology Department, Abbassi Shaheed Hospital from May 2016 to August, 2017. Materials and Methods: Primary open glaucoma patients were selected from eye OPD. Patients with Inflammatory, angle closure, traumatic glaucoma were excluded. Pre laser and Post laser IOP was measured at 1st week then at 1, 3 and 6 months. Data was collected and analyzed on SPSS version 20. There were 114 patients Results: There were 69 (61%) male patients. Mean age of patients was 60.53 ± 10.71 years. Mean pre laser Intraocular pressure was 23.98 ± 10.01 mm Hg. Mean post laser IOP at one month was 15.6 ± 3.25 and at 6 months was 14.8 ± 3.28 mm Hg. Overall mean reduction of IOP was 9.18 mm Hg from baseline, with p value less than < 0.005. Pre laser 3 medications were used by 20 (18%) and 2 medications by 49 (43%). At 6 months follow-up 4 (3.5%) patients were on 3 medications and 31 (37%) were on 2 medications. It has a p value < 0.005. Drug free patients at 6 months follow-up were 37 (33%). Mild iritis was seen in 7 (6.14%) patients. Conclusion: Argon Laser Trabeculoplasty is effective and safe method to control IOP in POAG when used as an adjunct to medical therapy. It also decreases number of drugs used by patients. Key Words: Argon laser trabeculoplasty, intraocular pressure, primary open angle glaucoma.

Glaucoma: An Old Problem Seeking New Solutions

2002 ◽  
Vol 06 (03) ◽  
pp. 81-83
Author(s):  
Wallace S. Foulds
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Closed Angle

The article discusses about glaucoma as an old problem to new solutions. It touches on intraocular pressure, closed angle glaucoma and open angle glaucoma.

Penetrating deep sclerectomy in primary open-angle and pseudoexfoliative glaucoma

2019 ◽  
Vol 30 (2) ◽  
pp. 264-268
Author(s):  
Vassilios Kozobolis ◽  
Eleni Kalogianni ◽  
Haris Sideroudi
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Open Angle Glaucoma ◽  
Positive Outcome ◽  
Deep Sclerectomy ◽  
Open Angle ◽  
Pseudoexfoliative Glaucoma ◽  
Satisfactory Outcome ◽  
Department Of Ophthalmology

Purpose: To evaluate the outcomes of a new antiglaucoma surgical method, a modification of the standard deep sclerectomy, the penetrating deep sclerectomy. Participants: Patients with medically uncontrolled primary open-angle glaucoma or pseudoexfoliative glaucoma were prospectively, in a consecutive way, enrolled in this study. Methods: The study was conducted in Glaucoma Unit, Department of Ophthalmology, University of Hospital of Alexandroupolis, Greece, in 29 eyes of 29 patients. In a fornix-based surgical procedure, all eyes underwent the proposed penetrating deep sclerectomy (deep sclerectomy plus trabeculectomy) with the use of mitomycin C applied intraoperatively (0.2 mg/mL for 2 min). The follow-up period was 3 years. Ocular examination was conducted before the operation and at 1, 3, 6, 12, 18, 24, and 36 months postoperatively. Results: The average reduction in intraocular pressure at the end of follow-up was 11.24 (57.88%). The complete success rate (intraocular pressure ⩽21 mm Hg without medication) after 3 years was 58.6%. The qualified success rate (intraocular pressure ⩽21 mm Hg without or with medication) was 75.86%. Postoperatively, the mean number of medication dropped from 3.75 ± 0.89 to 0.89 ± 0.98. Low postoperative complications were recorded. Conclusion: During the 3-year follow-up period, penetrating deep sclerectomy presented very positive outcome. The addition of a controlled perforation of the trabeculo-Descemet’s membrane in deep sclerectomy, playing the role of an early goniopuncture, seems to ensure a satisfactory outcome and is not associated with additional complications.

scholarly journals 12-month clinical outcomes of combined phacoemulsification and ab interno trabeculectomy for open-angle glaucoma in the United Kingdom

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252826
Author(s):  
Ejaz Ansari ◽  
Deva Loganathan
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Medication Use ◽  
Retrospective Chart Review ◽  
Mean Deviation ◽  
Open Angle ◽  
Ab Interno Trabeculectomy ◽  
Kahook Dual Blade ◽  
Ab Interno

Background/Objectives To describe intraocular pressure (IOP) and ocular hypotensive medication outcomes of combined phacoemulsification and ab interno trabeculectomy with the Kahook Dual Blade (KDB; New World Medical, Inc, Rancho Cucamonga, CA) in adults with cataract and open-angle glaucoma (OAG). Subjects/Methods Retrospective chart review of existing medical records. Data collected included intraocular pressure (IOP) and IOP-lowering medication use preoperatively and through up to 24 months postoperatively. Paired t-tests were utilized to compare preoperative to postoperative mean IOP and mean medications used. Results Data from 32 eyes of 26 subjects were analyzed. Subjects were predominantly Caucasian (25/26) had mean (standard error) age of 79.3 (1.2) years, and eyes had moderate-advanced OAG (mean visual field mean deviation -8.3 [1.3] dB). Mean IOP was 19.8 (0.8) mmHg at baseline and 15.5 (0.6) mmHg (p<0.0001) after mean follow-up of 11.5 (1.0) months; IOP reductions of ≥20% were achieved in 20/32 eyes (62.5%). Mean medication use declined from 2.4 (0.2) medications per eye at baseline to 0.5 (0.2) at last follow-up (p<0.0001); 23/32 eyes (71.9%) were medication-free at last follow-up. No vision-threatening complications were observed. Conclusions Combined phacoemulsification and ab interno trabeculectomy with the KDB safely provided mean IOP reductions of 21.7% and mean IOP medication reductions of 83% after mean follow-up of 12 months in eyes with moderate to advanced OAG. This procedure provides medication-independence in most eyes with statistically and clinically significant IOP reductions.

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