Post mydriasis rise in intraoccular pressure with tropicamide in normal individuals, glaucoma cases with and without rapid progression

Background: Rise in intraoccular pressure [IOP] may have significant effects on optic disc

Objective: To compare postmydriasis rise in intraoccular pressure with tropicamide in normal individuals and glaucoma cases with or without rapid progression

Subjects and Methods: Study design: Quasi-experimental. Sampling Technique: Non-Randomized, consecutive sampling. This study was performed on 116 eyes of 116 patients reporting at Eye Department, Combined Military Hospital [CMH], Lahore from 1[st] August 2012 to 30[th] April 2013. They were assigned to three groups based on their glaucoma profile: Group A: Normal subjects without raised IOP or glaucomatous visual field loss. Group B: Diagnosed cases of glaucoma without significant visual field defect progression. Group C: Diagnosed cases of glaucoma with significant visual field defect progression over last two years. SPSS version 16 Software was used for statistical analysis to compare intra-ocular pressure changes postmydriasis in the three groups

Results: IOP rise post-mydriasis was low [1.89 mmhg] in normal individuals whereas the spike was statistically significant in glaucoma patients [5.88 mmHg]. Diagnosed cases of glaucoma with worst prognosis has a relatively higher IOP spike [10.6 mmhg] as compared to those with slower visual field defects [5.88 mmhg] progression.[p<0.05]

Conclusion: Our study showed a significant rise in IOP in glaucoma patients with and without rapid progression as compared to normal subjects. Post-mydriasis IOP spike is a reliable diagnostic and prognostic provocative test for glaucoma suspects and diagnosed cases. However, the negative effects of raised IOP on an already compromised optic nerve head must be kept in mind

Comparison of intraocular pressure lowering effect of Latanoprost and Timolol combination versus Latanoprost alone in Primary Open Angle Glaucoma

To compare the intraocular pressure [IOP] lowering effect of topical drug combination [Latanoprost and Timolol] with Latanoprost alone in patients of Primary Open Angle Glaucoma [POAG]. Randomized controlled Trials [RCT]. Armed Forces Institute of Ophthalmology [AFIO] Rawalpindi from December 2009 to May 2011. A total of 240 eyes of 120 patients [68 males and 52 females] were included in the study. The patients were randomized into two groups of 60 each using random numbers table. Group A [60 patients, 12Q eyes] were put on topical drug combination of Latanoprost and Timolol eye drops and Group B [60 patients, 120 eyes] were treated with topical Latanoprost eye drops alone. IOP assessments were done at baseline, 2 weeks, 4 weeks and 8 weeks intervals after initiation of treatment. Both the groups were age matched with mean age in Group A was 56.39 +/- 8.50 years and in Group B was 55.61 +/- 8.95 years [p=0.09]. Both groups showed significant IOP decrease from the baseline at each follow up interval. However after 8 weeks of start of treatment, pressure lowering effect in group A [14.73 +/- 2.50 mmHg] was significantly more as compared to Group B [9.10 +/- 2.51 mmHg] [p<0.001]. Combination therapy of Latanoprost and Timolol is more effective as compared to monoyherapy with Latanoprost in lowering IOP of patients with POAG

Comparison of post-operative astigmatism following phacoemulsification with sutured versus un-sutured wound closure

To compare corneal astigmatism induced by sutured and sutureless wound closure of the main incision, after phacoemulsification, in patients attending the Eye department, Military Hospital, Rawalpindi. Quasi experimental study. Armed Forces Institute of Ophthalmology, Rawalpindi, from 20th May, 2006 to 19th May, 2007. Sixty patients were included in this study divided in two equal groups. Phacoemulsification with foldable IOL was done in all patients by the same surgeon with same surgical technique. Main incision was closed with a single suture in group A and left sutureless with stromal hydration in group B. Keratometry was performed preoperatively, at day one and 4 weeks post operatively. Postoperative astigmatism in sutured and sutureless groups at the end of first week was [1.00 D +/- 0.38] and [0.88 D +/- 0.35] respectively. At one month postoperatively astigmatism was [0.76 +/- 0.43] and [0.66 +/- 0.32] respectively in the two groups. There was statistically no significant difference between the postoperative astigmatism at one month between the two groups [p> 0.05]. There is statistically no significant difference between post-operative astigmatism after phacoemulsification between a 3.2 mm self-sealing incision whether closed without suture or secured by a single suture