Angle Recession in Patients with Closed Globe Injury

Purpose: To determine the frequency of angle recession following closed globe injury in patients presenting to the department of ophthalmology of a tertiary care hospital of Pakistan. Study Design: Descriptive observational study. Place and Duration of Study: Study was conducted at Eye-A Unit, Hayatabad Medical Complex, Peshawar from 14th March 2017 to 14th Sept 2017. Methods: One hundred and sixty three patients were selected for this study after applying WHO sample size calculation formula. Patients with history of closed globe injury were recruited through consecutive sampling technique. A detailed history regarding trauma, causative agent, duration of injury and site of impact was taken. Ocular examination including visual acuity and detailed examination of both anterior and posterior segment was carried out using slit lamp biomicroscope. Gonioscopy was performed to check the presence and extent of angle recession. Results: Mean age was 33 ± 8.82 years. Seventy five percent patients were male and 25% female. Type of trauma included; 57 (35%) patients had road traffic accidents, 33 (20%) patients had stone injuries, 37 (23%) patients had sports injuries while 36 (22%) patients had eye trauma due to other types like fall, fight, glass injuries, chemical exposures etc. In 90 (55%) patients, right eye was affected while 73 (45%) patients had trauma in left eye. Duration of trauma was ? 2 days in 124 (76%) patients while mean duration was 1 day with SD ± 1.034. Conclusion: Frequency of angle recession was 28% following closed globe injury. Key Words: Angle recession, closed globe injury, ocular trauma.

Clinical Study To Evaluate The Outcome Of Primary AGV Implantation In Angle Recession Glaucoma Following Blunt Ocular Trauma In Indian Eyes

Purpose—To Highlight The Efficacy Of Primary AGV Implantation In Angle Recession Glaucoma Following Blunt Ocular Trauma In Indian Eyes.Design- A retrospective analytical studyMaterials & Methods— This study included 52 patients of angle recession glaucoma, who presented between Mar 2006 to Feb 2016, out of which 38 patients had undergone primary AGV implantation while the rest were managed with topical anti-glaucoma medications. Preoperative data included age, sex, type & mode of injury, duration of injury, assessment of BCVA and IOP. Extent of angle recession was observed by gonioscopy. The intraocular pressure, visual acuity and number of anti-glaucoma medications were measured postoperatively. The success of this technique was analyzed by using a Kaplan-Meier cumulative survival curve.Results—Following AGV implantation the mean IOP was significantly reduced to 8.7±2.2 at 1st day, 10.1±2.2 at 7th day, 14.2±3.4 at 3rd month, 15.6±3.7 at 1 year and 15.6±3.6 at 3rd year follow-up showing statistically significant values (p<0.001) at each visit. The IOP was successfully controlled at last follow up without topical treatment. Mean BCVA at 3 year post AGV was 0.41±1.5 (logMAR) which was statistically significant (p<0.001).The success rate by Kaplan- Meier survival curve analysis was 90% at the mean follow up duration of 29.47±3.39 months. Overall surgical complications were noted in the form of prolonged hypotony, hyphema in 7 patients (13.5%).Conclusions—In medically uncontrolled post-traumatic angle recession glaucoma Primary AGV Implantation is a safe and effective surgical procedure with lesser complication rates providing long term IOP control in younger population .

Traumatic glaucoma mimicking primary open angle glaucoma

Backgrounds To retrospectively analyze the clinical and ocular features in eyes with traumatic glaucoma misdiagnosed as primary open angle glaucoma (POAG). Methods We reviewed nineteen eyes with traumatic glaucoma misdiagnosed and collected their ocular and supplementary examination results. Results The outpatient age was 47.1±12.8 years old. The traumatic history was from 1 to 40 years. The history of hand or stone was present about 21.1% of patients, followed by balls (15.8%) and wooden stick (15.8%). The peak IOPs were 33.0±10.6mmHg. Iridodialysis was seen in 2 patients. Trabecular pigmentation grade more than 3 was noticed in 15 patients. Angle recession was found in all patients. No patient was found lens location and fundus damage. Conclusions Patients with long traumatic history, mild ocular signs and insidious symptoms were more likely to be misdiagnosed. It might be more prudent to diagnose as POAG while there was significant difference in the condition of both eyes.