[Vascular profil of patients with normal tension glaucoma]

Glaucoma can be caused by multiple factors essentially the vascular factors. The aim of this article is to study the vascular profile of patients with normal tension glaucoma in the purpose to better understanding his pathogenesis and to making appropriate therapeutic decision. 39 patients with normal tension glaucoma were investigated. Each patient had complete ophtalmologic examination with visuel field examination, a medical examination, a biological investigation and a vascular supraaortic doppler. One or several vascular risk factor are found in the majority of our patients. 25% of the patients aggravate their visual field. 40% are diabetic, 56% are hypertensive, 40% have a lipidic disturbance and 30% have a vasospastic syndrome. Vascular risk factors play an important role in the physiopathology of normal tension glaucoma, and the prognosis depend on the treatment of these factors

Laser contribution in angle closure glaucoma

A better understanding of angle-closure glaucoma mechanisms is necessary to indicate the appropriate treatment the aim of our study is to discuss the laser indication in various type of angle-closure glaucoma the study investigate 25 eyes of 22 patients who had an angle-closure glaucoma. The mechanisms are an anterior chamber angle blockage in 19 eyes, a plateau iris structure in 4 eyes and a nanophtalmos in 2 eyes laser peripheral iridotomy is the most used technic; it was practised in 19 eyes. Argon laser iridoplasty was practised in 4 cases of plateau iris structure and in 2 patients who had a residual angle closure with a functional iridotomy. laser is an effective alternative in the treatment of angle-closure glaucoma and can alleviate the need for high-risk filtering surgery

[Efficacy of the Ahmed glaucoma valve implant in eyes with refractory glaucoma]

Implantation of glaucoma drainage devices is currently considered as a good alternative to the traditional treatment of refractory glaucoma. To evaluate the efficacy and safety of the Ahmed glaucoma valve implant in eyes with refractory glaucoma. This retrospective study included 27 eyes from 27 patients with refractory glaucoma treated with the Ahmed glaucoma valve implant between February 1995 and January 2000. We reviewed the final intraocular pressure and incidence of complications in all patients. The most common aetiology of refractory glaucoma was open-angle glaucoma [48.1%] followed by neovascular glaucoma [29.6%]. After a mean follow-up of 35.74 months [range 9-52 months], the mean intraocular pressure decreased from 35.66 mm Hg before surgery to 14 mm Hg on the last follow-up visit after surgery. Thus, the procedure was successful in 69.23%of cases. Nine patients [33.33%] achieved reduced intraocular pressure without additional antiglaucomatous medication. Transient postoperative hypotony of<5 mm Hg occurred in 14.8%of patients. This was, with transient hyphaema, the most common postoperative complication. The Ahmed glaucoma valve implant seems to be effective and safe for the management of refractory glaucoma. However, it is less effective in case of neovascular glaucoma