RESUMO
BACKGROUND: Topical life long anti glaucoma medication forms the mainstay of treatment of primary open angle glaucoma. Their long term usage can cause changes in conjunctival epithelium. METHODS: Hundred cases of primary open angle glaucoma were divided into four groups of 25 patients each. Each group was put on Timolol, Pilocarpine, Brimonidine and Latanoprost respectively. Ocular surface changes were monitored using Schirmer's test, tear film break up time (BUT) and conjunctival impression cytology. RESULT: Altered Schirmer's test value was seen in 40% of patients and reduced tear film BUT values in 26%, at the end of one year. These changes were more in patients treated with timolol. Changes in conjunctival cytology such as decrease in goblet cell density, squamous metaplasia and presence of inflammatory cells were seen in significant number of patients at the end of one year treatment. There was direct relation of duration of treatment to various ocular surface changes. CONCLUSION: Ocular surface changes are seen in significant number of patients of primary open angle glaucoma at the end of one year follow up with topical anti glaucoma therapy. Conjunctival impression cytology is a non invasive technique to monitor these changes.
RESUMO
BACKGROUND: To evaluate and compare efficacy and outcome after single site phacotrabeculectomy and conventional combined surgery in cases of coexisting primary open angle glaucoma and cataract. METHODS: This prospective study on fifty patients of concurrent primary open angle glaucoma and cataract, who had undergone combined surgery as single site phacotrabeculectomy or conventional single site trabeculectomy with extracapsular lens extraction with IOL implantation in 25 cases each. Evaluation was based on operative and postoperative complications, control of IOP and visual outcome. The follow up period ranged between twelve months to eighteen months. RESULTS: The mean medically controlled preoperative intraocular pressure was 22 mm of Hg (Range 18 to 35 mm of Hg) by applanation method of tonometry. The range of postoperative intra-ocular pressure after one year was 11 to 22 mm of Hg in first and 14 to 26 mm Hg in second group. Failure to maintain optimum postoperative IOP without Beta-blocker was more frequent after conventional combined procedure. There was no significant difference in incidence and pattern of postoperative complications. CONCLUSION: Phacotrabeculectomy provides effective and sustained visual recovery and adequate control of intraocular pressure as compare to conventional combined procedure.
RESUMO
20 out of 25 patients of Branch Retinal Vein Occlusion (BRVO), with macular oedema of more than six months duration and less than one year, with visual acuity (VA) less than 6/18 corrected and without retinal neovascularisation (NVE) or capillary non-perfusion (CNP) were subjected to argon-green laser photocoagulation applied in a macular grid fashion. At the end of two years 14/20 (70%) laser treated eyes in comparison to 2/5 (40%) of the non-laser group had corrected visual acuity of 6/12.
RESUMO
30 cases of open angle glaucoma with cataract who underwent phacoemulsification, PMMA phaco profile IOL implantation and trabeculectomy through same incision were critically evaluated. The mean controlled, preoperative intra ocular pressure was 20 mm of Hg (range 18 to 35 mm of Hg) by aplanation method. Mean post operative pressure after 12 months was 13 mm of Hg (range 11 to 22 mm of Hg) intra operative hyphaema, post operative uveitis were noted problems. Periodic, post operative optic disc and field evaluation remained static in 66% cases. Visual acuity of 6/12 or better was achieved in 60% cases. Failure to restore glaucoma control without medication was seen in 13.3% cases after 9-12 months. The combined phacotrabeculectomy is an effective single step technique of managing concurrent glaucoma with cataract.
RESUMO
Phacoemulsification surgery is rapidly emerging as accepted latest surgical technique for the management of cataract. Retrospective analysis of first fifty cases of phacoemulsification surgery performed in our setup were critically evaluated to assess efficacy and adaptability of this procedure in Armed Forces setup. Results of initial twenty five cases were compared qualitatively with subsequent cases. Equipment settings, operative constraints, post-operative complications, effects on induced astigmatism, visual outcome and patient's rehabilitation were critically evaluated. Corneal striate, iris chaffing, posterior capsular rent were noted initial problems. Induced astigmatism was ranging between 0.5 to 1.0 Dioptre with early decay and complete stabilisation within four weeks. Inspite of excellent visual outcome, complex technique, steep and long learning curve restricts its application to institutional setup.
RESUMO
As part of our ongoing structure-activity studies of the vesicular acetylcholine transporter ligand 2-(4-phenylpiperidino)cyclohexanol (vesamicol, 1), 22 N-hydroxy(phenyl)alkyl derivatives of 3 beta-phenyltropane, 6, and 1-methylspiro[1H-indoline-3,4'-piperidine], 7, were synthesized and tested for binding in vitro. Although a few compounds displayed moderately high affinity for the vesicular acetylcholine transporter, no compound was more potent than the prototypical vesicular acetylcholine transporter ligand vesamicol. However, a few derivatives of 6 displayed higher affinity for the dopamine transporter than cocaine. We conclude that modification of the piperidyl fragment of 1 will not lead to more potent vesicular acetylcholine transporter ligands.
