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@#AIM: To compare the effectiveness of diode transscleral cyclophotocoagulation(CPC)and transscleral cyclocryotherapy(CCT)for the intraocular pressure(IOP)control and postoperative complications of absolute glaucoma. <p>METHODS: This was a prospective case observation study. Totally 85 cases with absolute glaucoma which were admitted by Tianjin Eye Hospital were randomly assigned in 2 groups to receive either CPC or CCT. IOP, the numbers of anti-glaucoma medication, inflammatory reaction of anterior segment and postoperative ocular pain which was evaluated by Visual Analogue Scale(VAS)in two groups were recorded at eight points in time: the day before surgery and 1d, 3d, 1wk, 2wk, 1mo, 3mo and 6mo after surgery. The generalized estimated equation was used to compare all the indexes before and after operation and the difference of success rate between the two surgical methods. <p>RESULTS: Compared with CPC group, IOP of CCT group decreased less than that before surgery at 1, 3d, 1, 2wk, 1mo after surgery, VAS score decreased less than that before surgery at 3d, 1, 2wk, 1mo after surgery, and the number of anti-glaucoma drugs decreased less than that before surgery at 1, 3d, 1, 2wk after surgery(<i>P</i><0.05). Compared with CPC group, the complete success rate of CCT group was higher than that at 1d after surgery at 3d, 1, 2wk, 1, 3, 6mo after operation, but only the difference of 3, 6mo after surgery was statistically significant(<i>P</i><0.05). Compared with CPC group, anterior chamber flash grade of CCT group increased more than that before surgery at 3d, 1, 2wk, 1mo after surgery, conjunctival congestion grade increased more than that before surgery at 1, 3d, 1, 2wk after surgery, corneal edema grade increased more than that before surgery at 3d, 1, 2wk, 1mo after surgery(<i>P</i><0.05).<p>CONCLUSION: Compared with CPC, the rate of IOP reduction after CCT was slower, the inflammatory reaction of anterior segment and discomfort of eyeball were more severe and lasted longer. Therefore, the duration of anti-inflammatory drugs and anti-glaucoma medications should be extended after the surgery.
ABSTRACT
Objetivo: comparar los resultados del tratamiento, mediante ciclofotocoagulación transescleral con láser diodo utilizando sonda Nidek y sonda G-Probe, a ojos con glaucoma absoluto doloroso de pacientes atendidos en el Servicio de Glaucoma del Instituto Cubano de Oftalmología Ramón Pando Ferrer durante un año. Métodos: se realizó un estudio comparativo-prospectivo a 50 ojos distribuidos aleatoriamente en dos grupos: 25 ojos sometidos al procedimiento con sonda Nidek y 25 ojos tratados con sonda G-Probe. Se analizaron y compararon las variables presión intraocular, dolor, medicamentos hipotensores utilizados, así como complicaciones posoperatorias antes y después de aplicado el tratamiento. Resultados: los 50 ojos antes del tratamiento eran hipertensos; tres meses después los valores de la presión intraocular eran considerados normales para ambos grupos de estudio. Se mostró una variación estadísticamente significativa (p= 0,0000) respectivamente. Todos los pacientes referían dolor ocular previo. En ambos grupos se redujo satisfactoriamente el componente doloroso y se obtuvieron resultados similares. Se redujo significativamente el número de medicamentos hipotensores, y la mayor parte de los ojos no requirió más terapia farmacológica después de los tres meses. El número de complicaciones asociadas fue discretamente superior en los ojos tratados con sonda Nidek. La uveítis y los picos hipertensivos en el posoperatorio inmediato fue lo más destacado con el uso de ambas sondas. Conclusiones: la ciclofotocoagulación transescleral con láser diodo reduce las cifras de presión intraocular y el componente doloroso con ambas sondas satisfactoriamente. La mayoría de los ojos tratados no requiere terapia farmacológica hipotensora después de 3 meses de realizada. El procedimiento ciclodestructivo es seguro y causa un número discreto de complicaciones con el uso de ambas sondas(AU)
Objective: compare the results of treatment with diode laser transscleral cyclophotocoagulation using Nidek probe and G-probe for eyes with painful absolute glaucoma of patients cared for at the Glaucoma Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology during one year. Methods: a prospective comparative study was conducted of 50 eyes randomly distributed in two groups: 25 treated with Nidek probe and 25 with G-Probe. The following variables were analyzed and compared: intraocular pressure, pain, hypotensive drugs used, and postoperative complications before and after application of the treatment. Results: before treatment, the 50 eyes were hypertensive, whereas three months later intraocular pressure values were considered to be normal in both study groups. A statistically significant variation was found (p= 0.0000). All the patients stated having had ocular pain previously. The two groups showed a satisfactory reduction in pain, with similar results between them. The number of hypotensive drugs was significantly reduced, and most eyes did not require any more drug therapy after three months. The number of associated complications was slightly higher in the eyes treated with Nidek probe. Uveitis and hypertensive peaks in the immediate postoperative period were the most outstanding events with the use of both probes. Conclusions: diode laser transscleral cyclophotocoagulation satisfactorily reduces intraocular pressure values and pain with the use of both probes. Most of the eyes treated do not require hypotensive drug therapy after 3 months. The cyclodestructive procedure is safe, causing a slight number of complications with the use of both probes(AU)
Subject(s)
Humans , Glaucoma, Neovascular/therapy , Laser Coagulation/methods , Lasers, Semiconductor/therapeutic use , Comparative Study , Prospective StudiesABSTRACT
AIM: To observe the effect of combined goniosynechialysis in treating absolute glaucoma after trabeculectomy. METHODS:Phacoemulsification combined goniosynechialysis was performed on 16 patients ( 16 eyes ) with absolute glaucoma after trabeculectomy, and they were followed up for 6 ~12mo, The postoperative intraocular pressure ( IOP ) and anterior chamber depth, preoperative and postoperative medication types (quantity), preoperative and postoperative 1 month's status of anxiety and depression, symptoms of ocular surface were observed. RESULTS: The IOP decreased significantly after phacoemulsification combined goniosynechialysis. The mean IOP was 35. 00±15. 43mmHg preoperatively, and it was 12. 00±6. 69mmHg, 15. 00±4. 26mmHg and 15. 3±5.2mmHg on 1d, 6 and 12mo after the surgery. The statistic difference was found between preoperative and postoperative (t=6. 22, PCONCLUSION: Phacoemulsification combined goniosynechialysis in treating absolute glaucoma after trabeculectomy is a safe and effective surgical option.
ABSTRACT
Glaucoma is a chronic, progressive optic neuropathy caused by group of ocular conditions which lead to damage of optic nerve with loss of visual function. The objective of the study is to assess the average number of drugs per prescription, formulations being prescribed, various categories of drugs being prescribed and the category most often used in glaucoma patients in ophthalmology. This is a retrospective hospital based study carried out in the department of ophthalmology at A.J institute of medical sciences, Mangalore. The study period was from July 2012 to July 2013. Total number of prescriptions analyzed were 344 , in which total of 1,064 drugs were prescribed. Analysis of the prescriptions showed that average number of drugs per prescription was 3.09. The maximum number of drugs prescribed were in the form of eye drops (76.56%), followed by ointments (12.06%), tablet (4.2%), capsules (3.94%), syrup (2.16%) and injection (1.08%). The dosage form was indicated for 94%, frequency of drug administration for 96% drugs and duration of treatment for only 78% of the drugs prescribed. Around 48.44% of diagnosis accounted for primary open angle glaucoma. Rest 32.96% and 18.6% acconting for angle closure glaucoma and absolute glaucoma respectively. The number of antibiotics prescribed was 600 (56.43%), out of these 413 (68.79%) antibiotics were prescribed in the form of drops, 174 (29.06%) as ointment and 13 (2.15%) orally. Number of encounters with anti-inflammatory and antiallergic drugs was 118 (11.12%), mydriatics and cycloplegics 105 (9.84%), miotics 28 (2.6%), lubricant and miscellaneous eye drops 209 (19.63%) and multivitamins 4 (0.38%). Prescription writing errors were at its minimum thereby avoiding irrational prescriptions. Duration of treatment and prescribing by generic name were very low.
ABSTRACT
We have performed recession of all 4 rectus muscle in 8 eyes with neovascular or absolute glaucoma. The visual acuity of these eyes ranged fram no light perception to recognition of hand motion. As the purpose of surgery was to destroy all anterior ciliary arteries from the rectus muscles, after performing 2mm recessions on all 4 rectus muscles we applied cryotherapy on the oclera from he original rite to the mear insertion site. The cases were followed up for periods ranging from 3 to 19 months, with an average of 10.3 months. At the end of follow-up periods, we observed a statistically significant drop (p<0.05) in the intraocular pressure level, from the preoperative leveI of 49.8 +/- 7.9 mmHg (mean +/-SD) to 36.6 +/- 18.1 mmHg without any additional medical therapy. However, the decreases were not notable. In the treatment of neovascular glaucoma for absolute glaucoma, we have found that simultaneous disruption of all anterior ciliary arteries through anterior segment ischemia will not result in a satisfactory decrease in postoperative intraocular pressure.
Subject(s)
Ciliary Arteries , Cryotherapy , Follow-Up Studies , Glaucoma , Glaucoma, Neovascular , Hand , Intraocular Pressure , Ischemia , Muscles , Visual AcuityABSTRACT
Twenty two patients with variant types of absolute glaucoma were treated by surface cyc-lodiathermy. Follow-up time averages 3.5 years, without medication, intra-ocular pressure (IOP) was well controlled in 13 patients; IOP was decreased by 50% and the symptoms were relieved in two patients. The effective rate was 68%. In this paper, the technique and comp-lication of this operation were introduced. The technique rather simple. The effect of the operation is satisfactory, and complication is few. Therefore, we adopt cyclodiatharmy is a better procedure for absolute glaucoma