Vision-related quality of life in patients with a history of congenital glaucoma.

PURPOSE: To assess the vision-related quality of life in adult patients with a history of primary congenital glaucoma. METHODS: In a cross-sectional hospital-based study eligible patients with a history of primary congenital glaucoma aged more than 18 were recruited in the study. Patients with secondary glaucoma and monocular patients were excluded. All patients underwent a complete ophthalmologic examination. The subjects were requested to answer a Persian approved version of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) questionnaire. RESULTS: A total of 23 congenital glaucoma patients have enrolled in the study. The mean age was 29.22 (9.3 SD) and mean IOP was 13.82 (5.19 SD) and 15.69 (5.26 SD) in right and left eyes, respectively. The mean number of medications was 1.13 (1.25 SD) in the right and 1.30 (1.18 SD) in the left eyes. Among all scores of NEI-VFQ-25, the lowest score belonged to mental health 53.71 (29.72) and the highest score was color vision score 83.69 (20.79). We found a significant influence of visual field defect on many subscales including general health and general vision (p = 0.007, R = +0.65) and (p = 0.002, R = +0.71) respectively. The Mean Defect (MD) was associated with low social functioning and peripheral vision too (p = 0.035, R = +0.53) and (p = 0.001, R = +0.76) respectively. Age had a negative impact on the general vision subscale (p = 0.003, R = -0.59). CONCLUSION: Our study showed that visual field defect was strongly associated with many subscales scores in (NEI VFQ-25) questionnaire.

Effect of subconjunctival Bevacizumab injection on the outcome of Ahmed glaucoma valve implantation: a randomized control trial.

IMPORTANCE: The effect of subconjunctival Bevacizumab injection on the outcome of Ahmed glaucoma valve (AGV) implantation. BACKGROUND: Evaluation of efficacy and safety of subconjunctival Bevacizumab injection adjunctive to AGV implantation. DESIGN: Prospective and randomized clinical trial. PARTICIPANTS: Fifty eyes of 50 patients with diagnosis of glaucoma that were candidate for AGV surgery were included. METHODS: In 25 eyes, conventional AGV surgery (group 1) and in 25 eyes AGV surgery with subconjunctival Bevacizumab (group 2) was performed by block randomization MAIN OUTCOME MEASURES: The primary outcome measure was surgical success. Outcome measures were compared at postoperative month 3, 6 and 12. RESULTS: Mean age of patients was 58.76 ± 12.11 and 51.36 ± 15.44 years in group 1 and 2 respectively (P = 0.06). Mean intraocular pressure (IOP) at baseline was 24.88 ± 7.62 mmHg in group 1 and 27.52 ± 8.57 mmHg in group 2 which decreased to15.4 ± 4.4 mmHg in group 1 and 13.42 ± 2.9 mmHg in group 2 (P < 0.00) at last follow up. Surgical success was defined in two level: postoperative IOP ≤ 21 mmHg with at least 20% reduction in IOP (Criterion A), either with no medication (complete success) or with no more than two medications (qualified success) and criterion B with the same definition but the IOP ≤ 18 mmHg The cumulative success according to criterion A and B was 77.8%, 72.2% in group 1 and 89.5% in group 2, respectively, at the end of follow-up. CONCLUSIONS AND RELEVANCE: Subconjunctival injection of Bevacizumab adjunctive to AGV implantation leads to higher success rate compared with AGV alone in one year follow-up.

Effect of yellow-tinted intraocular lens on standard automated perimetry and short wavelength automated perimetry in patients with glaucoma.

PURPOSE: To investigate the effect of cataract surgery and yellow-tinted intraocular lens (IOLs) implantation on perimetry indices of short-wavelength automated perimetry (SWAP) and standard automated perimetry (SAP) testing in patients with coexisting cataract and glaucoma. MATERIALS AND METHODS: In this prospective comparative case series, phacoemulsification with implantation of yellow-tinted Acrysof Natural IOL was performed in 16 eyes of 16 patients with visually significant cataract (best-corrected visual acuity (VA) better than 20/120) and mild to moderate glaucoma. Pre- and postoperative values for VA and for perimetry indices including mean deviation (MD), pattern standard deviation (PSD), and foveal threshold (FT) from both SAP and SWAP testing were compared. RESULTS: Postoperative VA improved significantly after cataract surgery and yellow-tinted IOL implantation (P < 0.001). After cataract extraction and IOL implantation, MD and FT on SWAP testing improved significantly (P = 0.001); however, there was no statistically significant change with SAP testing between the pre- and postoperative perimetry indices. There was no statistically significant change in PSD with either SAP or SWAP testing postoperatively. The differences between pre- and postoperative values for all perimetry indices under study were not significant when comparing SAP with SWAP tests, except for MD which had improved statistically significantly in SWAP testing (P = 0.03). CONCLUSIONS: In mild to moderate glaucoma patients with cataracts, the perimetry indices of SWAP testing improved after phacoemulsification and yellow-tinted IOL implantation. This suggests that the yellow-tinted IOLs have less effect on SWAP testing than visually significant cataracts.