ABSTRACT
Objectives: To investigate the incidence and risk factors of glaucoma after open globe injury [OGI]
Methods: The medical records of all patients admitted with the diagnosis of OGI at the Department of Ophthalmology, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia and had undergone primary repair from January 1996 to December 2011 were retrospectively reviewed
Results: For the 15-year study period, 775 patients who underwent repair of an OGI were identified. The overall risk of post-traumatic glaucoma was 5.3% [41/775] with a mean +/- SD follow-up period of 12+/-6.5 months. Univariate analysis revealed that Zone II injury [p=0.027], penetrating ocular injury [p=0.0008], lens injury [p=0.011], vitreous hemorrhage [p=0.002], and presence of intraocular foreign body [p<0.0001] were significantly associated with glaucoma. Age of more than 18 years was critical [p=0.054]. Following logistic regression, penetrating ocular injury [p=0.019], lens injury [p=0.002], and vitreous hemorrhage were significant [p=0.037]
Conclusion: Glaucoma after OGI is not uncommon. Zone II injury, penetrating ocular injury, lens injury, presence of vitreous hemorrhage, and presence of an intraocular foreign body were significant risk factors for developing post-traumatic glaucoma
ABSTRACT
To evaluate the clinical efficacy and safety of controlled contact transscleral diode laser Cyclophotocoagulation [COCO] procedure in reducing the Intraocular Pressure [IOP] among patients with refractory glaucoma. Thirty two patients [35 eyes] with refractory glaucoma in prospective clinical studies were treated with trans-sclera diode laser in a controlled manner. The energy power used was 5 W in adults and 3 W in children, exposure time was 0.5 s, a total of 16 shots were applied over ciliary body and four shots in each quadrant. Pre and postoperative IOP were measured at different postoperative visits. Snellen visual acuity, the number of anti-glaucoma medications and associated complications were also recorded. Student Ttest was used to compare the pre and post intervention lOPs, while Wilcoxon Signed Ranks test was used, to detect significance change in medication dependency. The mean [SD] follow up time was 80.2[ +/- 9.6] months, range [36-84] m, where the mean IOP was significantly reduced from 35.1 mm Hg [ +/- 10.7] before intervention to 18.8 mm Hg [ +/- 7.3] after intervention, in the final visit [P < 0.0001]. Complete success was achieved in seven eyes [20%], 22 eyes [62.8%] showed qualified successes and complete failure was reported in six eyes [17.1%]. The overall success rate was 82.8% [95% CI: 70.4-95.3]. Visual acuity improved
Subject(s)
Humans , Female , Male , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Intraocular Pressure , Visual Acuity , Hospitals, UniversityABSTRACT
Purpose: To quantify the number of cases and clinical course of Acanthamoeba keratitis treated at the King Khaled Eye Specialist Hospital [KKESH] between December 1982 and May 2005, and to review their clinical course and response to medical and surgical therapy. Retrospective review of medical records of all patients with Acanthamoeba keratitis diagnosed by the KKESH Microbiology or Pathology Laboratory since the opening of the hospital. During a period of over 22 years, only six cases of confirmed Acanthamoeba keratitis were diagnosed and treated at KKESH. In two cases the diagnosis was made by cornea1 biopsy, while four cases required examination of a histopathologic specimen obtained at the time of therapeutic keratoplasty to establish the diagnosis. One eye was cured by medical therapy, while five eyes required one [4 eyes] or two [1 eye] therapeutic penetrating keratoplasty [PKP] to achieve a clinical cure. Three eyes achieved good visual acuity [20/40, 20/50, 20/60], one eye achieved fair visual acuity [20/160], and two eyes suffered profound visual loss [hand motions]. The incidence of Acanthamoeba keratitis may be less in Saudi Arabia than that reported in Western countries although the clinical course is similarly complicated, with most cases requiring therapeutic keratoplasty for definitive eradication of the organism