Clinical Analysis on Glaucoma

There have been limited reports about the prevalence and its characteristics of glaucoma in Korea. To clarify further, we retrospectively analyzed the data of 1482 patients with glaucoma from January 1993 to December 1994. The prevalence of glaucoma was 0.58%. The type of glaucoma consisted of secondary glaucoma 33.9%, primary open angle glaucoma(POAG) in 33.2%, angle closure glaucoma(ACG) 28.0%, normal tension glaucoma 4.0% and congenital glaucoma 0.9%. The mean age of the patients with POAG was 55.2+/-16.5 and that of ACG was 64.7+/-9.2. In POAG, the age group over 40 years old occupied 79.7% while 99.3% was the age group over 40 years in ACG. The incidence rate of men was higher than women in POAG but in women it was 3.6 times higher than men in ACG. Secondary glaucomas due to diseases of uveal tract, neovascular glaucoma, steroid induced glaucoma, and aphakic (or pseudophakic) glaucoma were 37.0%, 18.9%, 16.5%, and 15.7% respectively.

Comperieon of the Tono-Pen and the Goldmann Applanation Tonometry in Csreening Test

Tono-Pen was portable, miniaturized digital electronic tonometer. We compared Tono-Pen with Goldmann applanation tonometer through the mass screen studies on 634 eyes of 317 patients to evaluate the reliability of the Tono-Pen in determining intraocular pressure(IOP). We found 60% of the Tono-Pen readings to be within +/-1.5 mmHg of the Goldmann applanation tonometry readings and 85% to be within +/-2.5 mmHg difference. The correlation coefficient between the readings of the two instruments was 0.85. The Tono-Pen tonometry corresponded well to the Goldmann applanation tonometry in the 11 to 20 mmHg interval. We concluded that Tono-Pen tonometry is very useful in screening test to measure the intraocular pressure.

Comparison of Efficacy between beta-Blockers in Normal Volunteers

We performed a double-masked, cross-over study of beta-blockers in 20 normal volunteers. The subjects were divided into 4 groups, and 4 different drugs(1% Bentos(R), 0.5% Betagan(R), 2% Mikelan(R) and Placebo) were administered to the 4 groups respectively for each session. The experiment consisted of 4 session, each session being a one week period of drug administration and a subsequent 3 week period of washout. The drugs were administered unilaterally eyery 12 hours for 1 week, and the IOP of the both eyes was measured at 1, 3, 5, 7, 10 hours, 1 day, 1 week, 2, 3, and 4 weeks from the time of initial administration. We also investigated the side effects. The results were as follows: 1. There was no statistically significant difference in the effect of lowering the intraocular pressure(IOP) between the 3 different beta-blockers. 2. The beta-blockers lowered the mean IOP up to a maximum of 18.7-21% of its original value 3 hours after administration and 15-16.2%, after 1 week. 3. In the contralateral eyes, there was statistically a significant mean IOP decrease after 1, 3, 5, hours, 1 day and 1 week and a mean IOP decrease was 4.1%-4.9% after 1 week. 4. There was a statistically significant IOP decrease of 5.4%-6.7% at 1 week after the cessation of administration. 5. There was no statistically significant alteration of blood pressure, pulse rates, pupillary diameter, corneal sensitivity and Schirmer's test results due to drug administration. 6. The most common ocular side effect was a burning sensation following topical administration of beta-blockers. And the frequency of side effects was highest in 1% Bentos(R), foliowed by 0.5% Betaga(R) and 2% Mikelan(R).

Transpupillary Argon Laaer Cyclophotocoagulation

Transpupillary argon laser cyclophotocoagulation has been proposed as an alternative to conventional glaucoma surgery. The procedure involves phoptocoagulation of cilliary process to decrease intraocular pressure by reducing aqueous production. We report our experience with 3 advanced glaucoma patients, who received transpuillary cyclophotocoagulation. Their ciliary process was well visualized by gonioscopy. All visible process were treated up to a maximum of 1800 at one setting and treated again a few weeks later, so total transpupiJIary argon laser cyclophotocoagulation were performed 3 or 4 times. After surgery, each patient was maintained on preoperative glaucoma medication. As a result of this study, one of these patients was sucessfully controled and other one of them had effect of 20mmHg Intraocular pressure reduction.