Intraocular pressure fluctuation before and after strabismus surgery: a systematic review

Introduction: Intraocular pressure [IOP] can be influenced by several factors including corneal thickness, gender, refractive error, and the presence of diabetes mellitus. In the present study, we systematically reviewed published literature to find association between variations of IOP due to strabismus surgery

Method: PubMed and Scopus were systematically searched with the following search terms: [intraocular pressure OR IOP] AND [strabismus] for the articles in which the fluctuation of IOP before and after strabismus surgery had been evaluated. All types of articles including case series, cross-sectional, clinical trials, and cohort studies with no time limitation were included in this study. Systematically searches, selection of articles, and the extraction of data were performed by two reviewers independently

Result: 1617 out of 1674 articles were excluded due to duplication or irrelevancy. After step by step process of article selection, 57 relevant articles were included for further evaluation. However, only 8 articles met the inclusion criteria

Conclusions: The results of this report showed that IOP may vary due to strabismus surgery, and it decreases after the surgery

Central corneal thickness in Iranian congenital glaucoma patients

To compare central corneal thickness [CCT] in subjects with controlled primary congenital glaucoma [PCG] and nonglaucomatous subjects and to investigate the correlation between CCT and intraocular pressure [IOP] in the study population. Twenty-three consecutive PCG cases with controlled IOP and no clinical evidence of corneal edema comprised the Study Group. There was an interval of at least 2 months between last intraocular surgery and inclusion in the study. Twenty-one subjects with strabismus or lacrimal drainage insufficiency who did not have glaucoma or any history of intraocular surgery or ocular trauma comprised the control group. The Control Group was age and sex-matched. Data from ultrasonic pachymetry and applanation tonometry were analyzed for differences between groups. Correlation of the study parameters was investigated. A P-value less than 0.05 was statistically significant. Data from both eyes of subjects in the Study Group and Control Group were included in the original analysis. Mean CCT was statistically significantly higher in the Study Group compared to the Control Group [589.42 +/- 53.44 æm vs. 556.14 +/- 30.51 æm, respectively; P=0.001]. There was a significant correlation between CCT and IOP [r=0.63; P<0.0001]. Similar statistically significant outcomes were observed when only one eye per subject was used in a reanalysis of the data for the Study and Control Groups. Patients with PCG who had controlled IOP have statistically significantly thicker corneas than nonglaucomatous age and sex-matched subjects The thicker cornea could significantly alter IOP measurement with applanation tonometry. Pachymetry should be considered an essential part of the evaluation for PCG

Office-based slit-lamp needle revision with adjunctive Mitomycin-C for late failed or encapsulated filtering blebs

The purpose of this study was to assess the results of bleb needling in glaucomatous patients with late failed filtering blebs. A retrospective case series of 27 eyes of 27 patients was considered. All patients underwent needle bleb revision with adjuvant mitomycin-C performed at the slit lamp, during an office visit. Complete success was defined as postneedling intraocular pressure [IOP]=21 mmHg without any antiglaucoma medications and qualified success was IOP=21 mmHg with topical antiglaucoma medications. There were 12 eyes with encapsulated blebs and 15 eyes with flat blebs. The mean interval between index filtering surgery and bleb revision was 32.74 +/- 15.36 months. Mean IOP was 25.07 +/- 4.80 mmHg before surgery and 19.66 +/- 4.97 mmHg at last postoperative follow-up. The mean follow-up was 20.31 +/- 15.63 months. Complete and qualified successes were 7.4% and 51.9%, respectively. Cumulative rates of success at 1, 2, 3, and 4 years were 76%, 65%, 49%, and 37%, respectively. The mean number of antiglaucoma medications was reduced from 3.15 +/- 0.36 preoperatively to 2.33 +/- 1.21 postoperatively [P<0.001]. Slit-lamp needle revision in office is a simple and effective method for treating late encapsulated or flat filtering blebs without significant complications even for late bleb failure

Early-onset pseudoexfoliation syndrome following multiple intraocular procedures

To present early-onset ocular manifestations of pseudoexfoliation syndrome in young patients who had undergone multiple intraocular procedures. This is an observational case series, introducing four cases with histories of multiple intraocular procedures for glaucoma. All reported cases demonstrated typical manifestations of pseudoexfoliation unilaterally in the eye that had undergone multiple surgeries. The diagnosis of pseudoexfoliation was made prior to the age of 50 in all subjects and the earliest manifestation was at the age of 18 in a case with primary congenital glaucoma. The role of multiple surgical procedures, in addition to genetic predisposition, should be further investigated as a possible inciting factor predisposing to pseudoexfoliation in younger individuals.

Short-term outcomes of collagen crosslinking for early keratoconus

To assess the efficacy of collagen crosslinking with riboflavin and ultraviolet A [UVA] radiation for treatment of early keratoconus. Thirty-one eyes of 22 patients with early keratoconus were included in this study. All patients underwent slit lamp examination and assessment of uncorrected visual acuity [UCVA], best spectacle-corrected visual acuity [BSCVA], intraocular pressure, corneal topography and pachymetry. Collagen crosslinking was performed without epithelial removal. Riboflavin was applied to the cornea every 3 minutes 30 minutes before UVA irradiation and every 5 minutes thereafter. Patients were re-assessed 1, 3, and 6 months after treatment. Postoperatively, UCVA increased by 2 Snellen lines and BSCVA was improved by 1.7 Snellen lines [P < 0.001]. Spherical equivalent refractive error was reduced by 0.55 D, and maximum and mean K values were decreased by 0.65 D and 0.51 D respectively [P < 0.05 for all comparisons]. Evidence of regression was present in 71% of treated eyes. Collagen crosslinking demonstrated significant improvement in vision with reduction in corneal power and spherical equivalent refractive error in eyes with early keratoconus