ABSTRACT
Surgical intervention is mandatory in the case of documentation of the progression of glaucomatous optic neuropathy despite the administration of maximal tolerated medical therapy, and in cases where compliance is poor. Minimal complications, good long-term intraocular pressure (IOP) control, and precisely titrated target IOPs resulting in avoidance of visual impairment are the primary goals of surgical intervention. This article is an attempt to provide a broad overview of the therapeutic options available to the glaucoma surgeon. The available surgical modalities have undergone modifications and refinements over time, with a view to improve patient outcomes and visual recovery, yet are fraught with intra- and postoperative complications. The risk and benefits of each of the available surgical options must be critically evaluated and customized to fit the needs of the particular patient. There is insufficient evidence at present to establish the superiority of any of these surgeries over the other.
ABSTRACT
Entre las enfermedades oculares, el glaucoma, está contemplado entre aquellas que más cambios han sufrido en muchos de sus variados aspectos con el decursar de los años. Objetivo: Describir el comportamiento clínico epidemiológico del glaucoma neovascular en el Servicio de Glaucoma del Centro Oftalmológico Carlos J Finlay de la provincia de Camagüey. Método: Se realizó un estudio descriptivo, longitudinal y retrospectivo para determinar el comportamiento clínico epidemiológico del glaucoma neovascular en pacientes atendidos en dicho centro durante el período del 1 de enero del 2006 al 31 de octubre del 2007. El universo estuvo constituido por sesenta pacientes y la muestra quedó constituida por cincuenta y dos de ellos. Las variables estudiadas fueron: grupos de edades, sexo, color de la piel, antecedentes patológicos personales generales, antecedentes patológicos personales oculares, síntomas, signos, agudeza visual y variantes de tratamiento en cada paciente. Resultados: Se encontraron un total de cincuenta y dos pacientes con glaucoma neovascular. Predominaron el grupo de edades de más de 60 años, el sexo masculino y la raza blanca. Primó la Diabetes Mellitus como antecedente patológico personal general y la Retinopatía Diabética como antecedente patológico ocular. Conclusiones: El glaucoma neovascular ocupa un lugar importante dentro de la oftalmología, si se tiene en cuenta sus fatales consecuencias oculares, se expone la descripción de sus características.
Among the ocular diseases, glaucoma is considered among those that more changes have suffered in many of its varied aspects with the course of the years. Objective: To describe the clinical epidemic behavior of the neovascular glaucoma in the Glaucoma Service at the Ophthalmologic Center Carlos J Finlay" of Camagüey province. Method: A descriptive, longitudinal and retrospective study was conducted to determine the clinical epidemic behavior of the neovascular glaucoma in patients attended in the Glaucoma Service at the Ophthalmologic Center Carlos J. Finlay of Camagüey province from January 1st, 2006 to October 31st, 2007. The universe was constituted by sixty patients and the sample was conformed by fifty-two of them. The studied variables were: age groups, sex, skin color, general personal pathological antecedents, ocular personal pathological antecedents, symptoms, signs and visual acuity and treatment variants in each patient. Results: A total of fifty-two patients with neovascular glaucoma were found. The age group of more than 60 years, the masculine sex and the white race prevailed. Diabetes mellitus as general personal pathological antecedent and diabetic retinopathy as ocular pathological antecedent predominated. Conclusions: The neovascular glaucoma occupies an important place in ophthalmology, if it is take into account its ocular fatal consequences; the description of its characteristics is exposed.
Subject(s)
Humans , Eye Diseases , Glaucoma, Neovascular/diagnosis , Glaucoma, Neovascular/epidemiology , Epidemiology, Descriptive , Longitudinal Studies , Retrospective StudiesABSTRACT
Su rgical treatment of glaucoma has been classified as cyclodestructive(reducing inflow)or filtering(increasing outflow).Cyclodestructive procedures have traditionally been reserved for eyes with poor visual prognoses and refractory glaucomas including post-trauma,aphakia,congenital and developmental glaucoma.Since Uram described the first use of endoscopic cyclophotocoa gulation(ECP)in 1992,short and long-term outcomes for ECP have been promising.In the present article,we conduct a Pubmed search and review of published English Iiterature on endoscopic cyclophotocoagulation and comparison with limited results in a single Singapore ophthalmic tertiary hospital.Safety and efficacy of ECP and combined phacoemulsification-ECP procedures in treatment of pediatric and adult glaucomas of various etiologies and severities is reported.Local short-term unpublished results from a single Singapore tertiary ophthalmic service is reported and concurs with previously published results.Published reports and current experience with ECP has demonstrated that ECP with direct visualization of the target tissues avoids the complications associated with blind'trans-scleral cyclophotocoagulation by applying optimum energy to target tissue ciliary epithelium with endoscopic visualization and infrared laser wavelength application.Significant financial barriers exist to introducing this service.It is safe and effective in controlling IOP and reducing reliance on anti-glaucoma medications.Wide spread acceptance and use of this technique awaits large scale randomized controlled studies.