scholarly journals Intraocular pressure and biomechanical corneal properties measure by ocular response analyser in patients with primary congenital glaucoma

2015 ◽  
Vol 94 (5) ◽  
pp. e293-e297 ◽  
Author(s):  
Lucía Perucho-González ◽  
Jose María Martínez de la Casa ◽  
Laura Morales-Fernández ◽  
Paula Bañeros-Rojas ◽  
Federico Saenz-Francés ◽  
...  
2021 ◽  
pp. 112067212110104
Author(s):  
Mehmet Talay Koylu ◽  
Fatih Mehmet Mutlu ◽  
Alper Can Yilmaz

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.


2019 ◽  
Vol 30 (3) ◽  
pp. 525-532
Author(s):  
Laura Morales-Fernández ◽  
José María Martínez-de-la-Casa ◽  
Blanca Benito-Pascual ◽  
Federico Saénz-Francés ◽  
Enrique Santos-Bueso ◽  
...  

Objective: To assess incidence and risk factors of cataract extraction in patients with primary congenital glaucoma, surgical outcome, and complications. Material and method: Retrospective cohort study, in which 108 patients with primary congenital glaucoma were included. Data collected were need for cataract extraction and at what age, intraocular pressure at diagnosis of primary congenital glaucoma, required antiglaucomatous surgeries, possible mutation in the CYP1B1 gene, and final visual acuity. Among the patients who required cataract extraction were visual acuity, intraocular pressure, and complications, evaluated preoperatively and postoperatively. The data were analysed with STATA. Results: A total of 198 eyes of 108 patients were included, with a median follow-up of 8 years (range: 5–53). In all, 32 eyes (16.2%) of 24 patients (22%) required cataract extraction. The median age for cataract extraction was 12.94 years (interquartile range: 2.42–22). The main identified risk factors associated with cataract extraction were antiglaucomatous surgeries (hazard ratio 1.48, p < 0.001) and valvular implant (hazard ratio 2.78, p < 0.001). Lens was implanted in 30/32 eyes and the main complications were intraocular pressure decontrol ( n = 13), capsular fibrosis ( n = 7), corneal decompensation ( n = 4), lens subluxation ( n = 4), and endophthalmitis ( n = 1). Visual acuity improvement was observed after cataract extraction in 66.67% of eyes. Conclusions: There is a high incidence of cataract surgery in patients with primary congenital glaucoma, but generally outside of pediatric age. A greater risk of cataract extraction was identified in those patients with a greater number of antiglaucomatous surgeries, especially after valvular implantation. Despite the high rate of complications related to cataract extraction in primary congenital glaucoma, good visual improvement was observed after surgery.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ashraf Bor’i ◽  
Salah M. Al-Mosallamy ◽  
Tamer G. Elsayed ◽  
Wael M. El-Haig

Purpose. To evaluate the safety and efficacy of a novel modified subscleral trabeculectomy technique in management of primary congenital glaucoma. Methods. This study included 25 infants diagnosed of having bilateral primary congenital glaucoma. For each patient, one eye was assigned to undergo subscleral trabeculectomy with trimming of the edges of the scleral bed (group I), while the contralateral eye underwent subscleral trabeculectomy with application of mitomycin C (0.4 mg/ml for 3 min) (group II). All the patients were followed up for a period of 14 ± 3 months (range 13–22 months). Results. 25 eyes were included in each group. Patients’ mean age was 2.5 ± 0.5 months (range 1.8–6.5 months). The mean preoperative intraocular pressure was 31 ± 4.9 mmHg and 32.1 ± 4.0 mmHg in group I and II, respectively. The mean postoperative intraocular pressure was 9.0 ± 1.0, 11.0 ± 3.2, 12.5 ± 0.9, 13.0 ± 2.9, and 15.5 ± 1.5 mm Hg in group I and was 10.3 ± 1.2, 12.0 ± 2.5, 13.5 ± 1.7, 15.0 ± 1.5, and 17.1 ± 2.8 mm Hg in group II at the first week and 1, 3, 6, and 12 months, respectively. There was no statistically significant difference between the mean intraocular pressure values recorded at both groups preoperatively and at each follow-up visit. Failure necessitating further surgical interventions was recorded in 4 eyes (16%) in group I as compared to 3 eyes (12%) in group II (P>0.05). Postoperative complications included mild hyphema, which occurred in one eye (4%) in group I and 2 eyes (8%) in group II, and shallow anterior chamber in 3 eyes (12%) in group I and in 2 eyes (8%) in group II. One eye (4%) in group I developed drawn-up pupil. Choroidal effusion developed in one eye (4%) at each group. Conclusion. Trimming the edges of the scleral bed adjacent to the sclera flap is a safe and effective surgical step which can be added to the subscleral trabeculectomy procedure to effectively control the intraocular pressure in patients with primary congenital glaucoma, sparing them the hazards associated with mitomycin C application.


Author(s):  
Reza Razeghinejad ◽  
Zahra Tajbakhsh ◽  
Masoumeh Beigom Masoumpour ◽  
M. Hossein Nowroozzadeh

Purpose: To assess intraocular pressure (IOP) changes after the water drinking test (WDT) in patients with primary congenital glaucoma (PCG). Methods: In this prospective interventional study, 20 eyes of 20 patients with PCG were included. All patients had undergone trabeculotomy. Six out of twenty eyes had received a glaucoma drainage device (GDD) implantation. IOP was measured using an air-puff tonometer at baseline, and 15, 30, 45, and 60 min after WDT. The repeated-measures analysis of variance test was used to compare the mean IOPs at different time points. Results: The mean (± standard deviation) of participants’ age was 9.9 ± 2.7 years (range, 6 to 16 years), and 8 (40%) participants were male. The mean IOPs at baseline and 15, 30, 45, and 60 minutes after the WDT were 15.8 ± 3.7, 18.6 ± 3.4, 19.0 ± 3.8, 17.9 ± 3.8, and 16.9 ± 3.5 mmHg, respectively (P < 0.001). Pairwise comparisons revealed that the mean IOPs after 15 and 30 min were significantly greater than the baseline IOP (P < 0.001 and P = 0.002, respectively); however, the difference in mean IOPs after 45 and 60 min were not statistically significant from the baseline IOP. The averages of IOP peak and IOP fluctuation after the WDT were 20.0 ± 3.5 and 4.2 ± 2.9 mmHg, respectively. IOP fluctuation in those who underwent trabeculotomy alone was twice that of those with GDDs, but the difference was not statistically significant (5.0 vs 2.5 mmHg; P = 0.08). Conclusions: In patients with PCG, WDT induced significant IOP elevation 15 and 30 min after the test, which returned to pre-test values after 45 min.


2018 ◽  
Vol 29 (4) ◽  
pp. 379-385 ◽  
Author(s):  
Amanne Esmael ◽  
Yomna M Ismail ◽  
Abdelrahman M Elhusseiny ◽  
Alaa E Fayed ◽  
Hala M Elhilali

Objectives: To investigate agreement between intraocular pressure measurements by the rebound tonometer and handheld Perkins applanation tonometer in children with and without primary congenital glaucoma and test agreement with intraocular pressure and age variations. Materials and methods: A prospective non-interventional comparative study done on 223 eyes of 115 children, 161 normal eyes, and 62 eyes with primary congenital glaucoma. Intraocular pressure measurements were obtained in the upright position by rebound tonometer first, followed by installation of topical anesthetic eye drops (benoxinate), then measured by Perkins applanation tonometer. Results: For all eyes, mean difference between Perkins applanation tonometer and rebound tonometer was −0.59 ± 2.59 mmHg, p = 0.001. Regression analysis with (r) = 0.9, (r2) = 0.79, and p < 0.001. In primary congenital glaucoma: there was a mean difference of −.79 ± 2.82 (p = 0.032), a good correlation with (r) = 0.94, (r2) = 0.87%, and 95% level of agreement: –6.34 to +4.76. In normal eyes: mean difference was −.52 ± 2.5 (p = 0.01), correlation: (r) = 0.8, (r2) = 0.64, and p = 0.001. The 95% level of agreement −5.41 and +4.36 mmHg. In intraocular pressure ⩽ 15 mmHg: mean difference −0.89 ± 2.15 mmHg, 95% level of agreement between −5.1 and +3.32 mmHg, p < 0.001. In intraocular pressure >15 mmHg: mean difference was 0.04 ± 3.28 mmHg, 95% level of agreement −6.38 and +6.46 mmHg, p = 0.914. Conclusion: There is a good correlation between rebound tonometer and Perkins applanation tonometer in children with and without primary congenital glaucoma; however, rebound tonometer overestimates the intraocular pressure, and in intraocular pressure >15 mmHg there is less agreement between the two devices. Hence, in higher intraocular pressure measurement caution should be taken when interpreting rebound tonometer readings, and a confirmatory measurement using Perkins applanation tonometer is advised.


2021 ◽  
pp. 112067212110483
Author(s):  
Andrea Oliveira da Silva ◽  
Christiane Rolim-de-Moura ◽  
Nara Lúcia Poli Botelho ◽  
Carolina PB Gracitelli ◽  
Nívea Nunes Ferraz

Purpose: To identify psychosocial indicators and evaluate the filtering surgeries impacts on quality of life (QOL) of children with primary congenital glaucoma (PCG) and their family. Methods: Parents of children with bilateral PCG who underwent filtering surgery were included. Data were collected through: (a) psychological inquiry to determine psychosocial indicators; (b) Children’s Visual Function Questionnaire (CVFQ). The associations between the CVFQ scores and visual acuity, intraocular pressure, optic disk cupping, horizontal corneal diameter, axial length, number of surgeries, and hypotensive eye drops were investigated. The statistical significance level was considered as p ⩽ 0.05. Results: The mean age of the nine mothers interviewed and their children (six boys and three girls) was 29 ± 5 years and 35 ± 18 months, respectively. The psychosocial indicators determined were: emotional impact of the diagnosis, disease knowledge, mother and family’s feelings on facing the surgical treatment, surgical result comprehension, treatment adherence, child's emotional and behavioral reactions, social support, and future expectations. In CVFQ analysis, QOL score was strongly associated with visual acuity ( r = −0.79; p = 0.01). Besides the treatment score was correlated to intraocular pressure ( r = −0.68; p < 0.05), optic disk cupping ( r = −0.85; p = 0.03), and corneal diameter ( r = −0.69; p = 0.02). Correlations were not found for number of surgeries and eye drops. Conclusions: This study confirmed the PCG surgical treatment impact on QOL and determined psychosocial indicators which may favor the suitable actions in psychological treatment and follow-up of the children and families.


2015 ◽  
Vol 10 (1) ◽  
pp. 43 ◽  
Author(s):  
Athar Zareei ◽  
MohammadReza Razeghinejad ◽  
MohammadHosein Nowroozzadeh ◽  
Yadollah Mehrabi ◽  
Mohammad Aghazadeh-Amiri

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ibrahim Al-Obaida ◽  
Adi Mohammed Al Owaifeer ◽  
Khabir Ahmad ◽  
Rizwan Malik

Abstract Whilst axial length (AxL) from ultrasound examination is a useful clinical parameter for monitoring progression in younger children with glaucoma, distinguishing AxL changes due to raised intraocular pressure (IOP) from age is often challenging. Existing normograms have included a limited number of children with glaucoma. The aim of this study was to evaluate the relationship between AxL with age and IOP in children with primary congenital glaucoma (PCG) and develop a model for expected AxL increase with age. All children (n = 208; 397 eyes) with PCG who attended our tertiary eye care facility from June 2014 and July 2018 and had AxL and IOP measurements were included. The relationship of AxL with age and IOP was studied by applying a LOWESS fit and then mixed effects models. In the final model, age was the most significant factor influencing the growth of AxL (coefficient age 3.14[95% CI 2.91–3.35, p < 0.001], coefficient age2 − 0.53[95% CI, − 0.59 to − 0.47, p < 0.001]), and this association was influenced by the interaction of IOP with sex (p = 0.098 for girls relative to boys), the number of antiglaucoma medications (AGM [p < 0.001 for ≥ 3 AGM]) and glaucoma surgery (p = 0.015). This model enabled us to derive predicted values for clinical use in children with PCG to predict those with progressive glaucoma.


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