scholarly journals Short Term Outcome of Goniotomy with Kahook Dual Blade in the Management of Primary Open Angle Glaucoma-A Retrospective Interventional Case Series

2019 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Open Angle ◽  
Short Term ◽  
Term Outcome ◽  
Point Versus ◽  
The Mean ◽  
Kahook Dual Blade

Objectives: To describe short-term efficacy of goniotomy with trabecular meshwork excision using the Kahook Dual Blade (KDB, New World Medical Inc., Rancho Cucamonga, CA) in patients with Primary Open Angle Glaucoma, (POAG) either as a standalone or plus Phacoemulsification (phaco). Method and Patients: A retrospective review of 12 eyes of 9 patients who had goniotomy with Kahook dual blade either as a standalone or combined with cataract surgery by phacoemulsification from April 2017 to July 2018 at Eye Foundation Hospital, Ikeja, Lagos. The patients were follow-up for a minimum of 6 months. Results: The mean age of the patients was 66.4±8.8 years. Mean preoperative intraocular pressure (IOP) for all eyes was 18.58±5.42mmHg. From day 1 through the 6th Month of postoperative follow-up, the mean IOP ranged from 18.58±9.26mmHg to 12.27±1.68mmHg representing reductions of 0-6.31mmHg (0-34%; p<0.05 at each time point versus baseline except for day 1). For the Phaco+KDB group, the baseline mean IOP was 19.25±4.56mmHg while the mean IOP postoperatively from day 1 to 6 months ranged from 19.13±8.99mmHg to 12.13±1.89mmHg representing reductions of 0.12mmHg to 5.13mmHg (0.6-30.2%; p<0.05 only from 1 month to 6 months). At baseline, the mean IOP for the eyes that had KDB goniotomy as a standalone was 17.25±7.45mmHg and postoperatively ranged from 17.50±11.09mmHg to 12.67±1.67mmHg representing reductions of -0.25-9.08mmHg (-1.45%-41.7%; p<0.05 at one week, 3 and 6 months only versus baseline). Conclusion: KDB either as a standalone or with phaco recorded at least 30% reduction in IOP after 6 months of followup in these series.

scholarly journals Efficacy and Safety of Timolol-Dorzolamide Fixed-Combination Three Times a Day Versus Two Times a Day in Newly Diagnosed Open Angle Glaucoma

2018 ◽  
Author(s):  
Mohammad Pakravan ◽  
Afsaneh Naderi Beni ◽  
Shahin Yazdani ◽  
Hamed Esfandiari
Keyword(s):  
Blood Pressure ◽  
Primary Open Angle Glaucoma ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Efficacy And Safety ◽  
The Mean

Purpose: To compare the therapeutic efficacy and safety of dorzolamide/timolol fixed-combination in newly diagnosed primary open angle glaucoma patients. Methods: In this prospective, interventional case series, newly diagnosed primary open angle glaucoma (POAG) patients that had not been treated for glaucoma were included. Patients were started on Cosopt twice a day (BID) for 1 month and then switched to three times a day (TDS) for additional 1 month. Patients underwent comprehensive ophthalmic examination, diurnal intraocular pressure (IOP), blood pressure (BP) and 24-hours heart rate (HR) measurements at baseline, month 1( BID), and month 2( TDS). IOP, systolic and diastolic pressures were measured at 8:00 AM,12:00 AM, 4:00 PM, 8:00 PM and 12:00 PM. Throughout the study, all adverse events were recorded and monitored by the investigators. Results: In 31 POAG patients that completed the study ,mean baseline IOP was 23.1&plusmn;3.15 mmHg . IOP was decreased significantly 16.5 &plusmn; 2.21 at 1 month (P &lt; 0.0001) and 13.9 &plusmn; 2.23 mmHg at 1 and 2 month follow up. (P &lt; 0.0001) IOP was significantly lower in month 2 compared to month 1 (P = 0.0004). While Cosopt BID significantly reduced the mean 24-hour systolic BP and mean 24-hour HR from baseline (P &lt; 0.0001), the mean 24-hour systolic BP and HR remained unchanged 2ith Cosopt TDS compared to BID (P = 0.62). Conclusions: Cosopt TDS has a superior IOP-lowering effect than Cosopt BID in POAG patients with comparable safety profile.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;

Outcomes of micropulse transscleral cyclophotocoagulation in primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma

2020 ◽  
pp. 112067212091423 ◽  
Author(s):  
Oya Tekeli ◽  
Helin Ceren Köse
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Secondary Glaucoma ◽  
Open Angle ◽  
Pseudoexfoliation Glaucoma ◽  
Transscleral Cyclophotocoagulation ◽  
The Mean ◽  
Glaucoma Group

Purpose: The aim of this study is to compare the outcomes of micropulse transscleral cyclophotocoagulation between primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. Methods: Outcomes of 96 consecutive patients with refractory, end-stage glaucoma treated with micropulse transscleral cyclophotocoagulation were retrospectively reviewed. Follow-up examinations were performed on a regular basis until 12 months postoperatively. Surgical successes were defined as maintaining intraocular pressure ⩽18 mmHg and ⩾20% reduction in intraocular pressure (criteria A), ⩽15 mmHg intraocular pressure and ⩾25% reduction in intraocular pressure (criteria B), and ⩽12 mmHg intraocular pressure and ⩾30% reduction in intraocular pressure from baseline (criteria C). Results: Ninety-six eyes of 96 patients (50 (52%) females, 46 (48%) males) were included. Among all eyes, 32 were primary open-angle glaucoma, 30 were pseudoexfoliation glaucoma, and 34 were other types of secondary glaucoma. The mean age was 59.37 ± 11.45 (range: 20–91) years. The mean follow-up period was 14.2 ± 3.9 (range: 12–16) months. At 12 months, the success rates of primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma group were 68.75%, 66.6%, and 64.7% (p = 0.185) for criteria A; 56.25%, 53.3%, and 50% (p = 0.153) for criteria B; and 43.75%, 43.3%, and 38.2% (p = 0.146) for criteria C. Four patients (12.5%) in primary open-angle glaucoma group, 5 patients (16.6%) in pseudoexfoliation glaucoma group, and 14 (41.2%) patients in other secondary glaucoma group required reoperation during the follow-up (p < 0.05). Conclusion: Micropulse transscleral cyclophotocoagulation is an equally effective method of lowering intraocular pressure in patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. The rate of reoperation was higher in refractory secondary glaucoma patients.

scholarly journals Comparison of the efficacy and safety of bimatoprost (0.03 %) and travoprost (0.004 %) in patients with primary open angle glaucoma

2013 ◽  
Vol 5 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Ashish Chander ◽  
H Kapoor ◽  
S Thomas
Keyword(s):  
Intraocular Pressure ◽  
Side Effect ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Efficacy And Safety ◽  
Once Daily ◽  
The Mean ◽  
To Receive

Purpose: To compare the efficacy and safety of bimatoprost (0.03 %) and travoprost (0.004 %) in patients with primary open angle glaucoma (POAG). Subjects and methods: Patients with POAG were randomized to receive either bimatoprost or travoprost once daily. Detailed ocular examination was done and intraocular pressure (IOP) was measured at 9.00 am, 1.00 pm and 4.00 pm at the baseline and at 1, 2, 4, 6 and 12 weeks of therapy. Results: A total of 31 patients were analysed. The patients were randomly divided into two groups (Bimatoprost group = 16; Travoprost group = 15). Both the groups had a statistically significant reduction from the baseline IOP at all follow up visits at 9.00 am, 1.00 pm and 4.00 pm. The mean IOP decreased from a baseline of 25 ± 2.32 mm Hg to 15.93 ± 1.79 mm Hg after 12 weeks in the bimatoprost group (p < 0.001), and from 24.2 ± 1.60 mm Hg to 16.53 ± 1.56 mm Hg in the travoprost group (p < 0.001). A better mean reduction of IOP was obtained with bimatoprost than with travoprost at the end of the study at 12 weeks (p = 0.03). Mild ocular redness was the commonest side effect in both the groups but was not significant in either group. Conclusion: Both drugs lowered IOP effectively but bimatoprost showed a greater reduction in the mean IOP than did travoprost at 12 weeks and both are safe for ocular use. Nepal J Ophthalmol 2013; 5(9):75-80 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7831

scholarly journals Ab Interno vs. Ab Externo Microcatheter-Assisted Circumferential Trabeculotomy in Treating Patients With Primary Open-Angle Glaucoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Weijia Zhang ◽  
Yiwei Wang ◽  
Chen Xin ◽  
Yang Sun ◽  
Kai Cao ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Open Angle ◽  
Success Rates ◽  
Criterion A ◽  
The Mean ◽  
Group 2 ◽  
Ab Interno ◽  
Group 1

Background: Circumferential trabeculotomy have evolved from ab externo to ab interno approach. Both procedures may lower IOP, but it is unclear which maybe a superior approach.Purpose: To compare the outcomes of ab interno and ab externo circumferential trabeculotomy in patients with primary open-angle glaucoma.Design: Retrospective, comparative case series.Participants: Primary open angle glaucoma patients undergoing ab interno (40 patients in Group 1) or ab externo (54 patients in Group 2) circumferential trabeculotomy, with about one half of them having prior incisional glaucoma surgery.Methods: Outcomes including intraocular pressure (IOP), glaucoma medications and surgical complications were analyzed.Main Outcome Measures: IOP, medications and surgical success defined as an IOP of ≤ 21 mmHg and a reduction of IOP ≥20% from baseline (criterion A) or IOP ≤ 18 mmHg and a reduction of IOP 20% from baseline (criterion B) with (qualified success) or without (complete success) medications.Results: At 1 year, IOP decreased by 37.1% (26.0–14.8 mmHg) in Group 1 and 39.5% (28.5–15.1 mmHg) in Group 2. Medications decreased from 3.5 in Group 1 and 3.6 in Group 2 pre-operatively to 0.6 ± 1.0 and 0.3 ± 0.6 post-operatively, respectively. Success rates did not differ significantly between groups based on criterion A (complete and qualified success: 68.7 and 81.9% in Group 1, and 75.3 and 90.4% in Group 2, respectively) or criterion B (complete and qualified success: 58.2 and 79.3%in Group 1, and 69.5 and 88.4% in Group 2, respectively). For eyes with prior filtration surgeries, the mean percent reduction of IOP (41.7 ± 32.7% in Group 1, 39.7 ± 27.8% in Group 2, P = 0.724) and the mean medication reduction (2.9 ± 1.6 in Group 1, 3.4 ± 1.0 in Group 2, P = 0.454) were not significantly different.Conclusions: Ab interno circumferential trabeculotomy achieved comparable outcomes to ab externo trabeculotomy and may be an effective surgical option for patients with primary open-angle glaucoma.

scholarly journals Comparison of the Effect of Trabeculectomy in Controlling Intraocular Pressure in Pseudo-Exfoliaiton and Primary Open Angle Glaucoma Patients

2019 ◽  
pp. 1-7
Author(s):  
S. Kavuncu ◽  
H. H. Erbil
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Study Groups ◽  
First Year ◽  
Open Angle ◽  
Significant Difference ◽  
The Mean

Objective: The aim of this study is to compare the efficacy of the trabeculectomy in controlling intraocular pressure in patients with primary open-angle and pseudo-exfoliation glaucoma. Materials and Methods: The medical data of a sum of 69 eyes of which 36 (52,2%) with primary open angle glaucoma (POAG) and 33 (47,8%) with pseudo-exfoliation (PEG), who have medically uncontrolled glaucoma and had undergone primary trabeculectomy in Göztepe Education and Research Hospital were evaluated in this retrospective study. Postoperatively, data at the first day, at the first month, and at the last examination evaluated in the study. Success of the surgery is defined as measurement of intraocular pressure under 21 mmHg with (incomplete success) or without (complete success) additional medications following the end of the first year follow-up examinations. Results: POAG group consists of 36 patients of which 16 male, 20 female and PEG group consists of 33 patients of which 21 male and 12 female. The mean age was 67.2±9.1 (42-80) years in POAG group and 70.7±6.6 (55-80) years in PEG group. There was no statistically significant difference between POAG and PEG groups in visual acuity, mean intraocular pressure, c/d ratio and the number of antiglaucomatous medications preoperatively and postoperatively (p>0.05). There was a statistically significant difference in groups between post and preoperative values in visual acuity, mean intraocular pressure, c/d ratio and the number of antiglaucomatous medications (p<0.05) Success of the trabeculectomy was 41,7% (complete success), 41,7% (incomplete success) and remaining 16,6% was unsuccessful, in POAG group and success rate in PEG group was 51.5%, 27,3% and 21,2% respectively. There was no statistically significant difference between groups (p=0.738). Conclusion: Trabeculectomy is an effective surgery in lowering intraocular pressure in both of the study groups equally.

scholarly journals Mid-term results of patterned laser trabeculoplasty for uncontrolled ocular hypertension and primary open angle glaucoma

2021 ◽  
Vol 14 (8) ◽  
pp. 1199-1204
Author(s):  
Gustavo Espinoza ◽  
◽  
Angelica Pedraza-Concha ◽  
Ignacio Rodríguez-Una ◽  
Maria Fernanda Acuna ◽  
...  
Keyword(s):  
Adverse Events ◽  
Ocular Hypertension ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Adjunctive Treatment ◽  
Open Angle ◽  
Laser Trabeculoplasty ◽  
The Mean ◽  
Mid Term Results

AIM: To describe the safety and efficacy of patterned laser trabeculoplasty (PLT) as an adjunctive treatment in primary open angle glaucoma (POAG) and ocular hypertension (OHT) after 18-month follow-up in Hispanic population. METHODS: A single-center, retrospective study was conducted. All patients with OHT or POAG undergoing PLT from June 2016 to August 2016 were included in the study. Investigated parameters were intraocular pressure (IOP), the number of IOP-lowering medications, best corrected visual acuity (BCVA), laser parameters and postoperative adverse events. Primary efficacy outcome measures were the proportion of eyes achieving an IOP reduction ≥20% at 18mo versus baseline medicated IOP or a reduction in the number of medications while maintaining IOP values. RESULTS: From 40 PLT-treated eyes (mean baseline IOP 20.3±1.7 mm Hg), 24 patients were analyzed (age 63.4±7.3y). The mean IOP reductions from baseline across visits (months 1, 3, 6, 9, 12, and 18) ranged from 14.1% to 20.8%. Success rate after 18-month follow-up was 61.7% with a mean IOP of 16±3.2 mm Hg (P<0.001). The number of glaucoma IOP-lowering medications per eye (preoperative 2.1±1.1 and postoperative 2.3±1.1, P=0.86) and the mean BCVA (preoperative 0.10±0.22 and postoperative 0.11±0.22 logMAR, P=0.42) remained stable. Adverse events comprised transitory IOP spikes in 4 eyes (10%) and peripheral anterior synechiae in 7 eyes (17.5%). CONCLUSION: Mid-term results of PLT show that this procedure may be an efficacious and safe technique to approach medically uncontrolled OHT or POAG patients.

scholarly journals Stab Incision Glaucoma Surgery: A Modified Guarded Filtration Procedure for Primary Open Angle Glaucoma

2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Soosan Jacob ◽  
Michele Figus ◽  
Dhivya Ashok Kumar ◽  
Ashvin Agarwal ◽  
Amar Agarwal ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Single Step ◽  
Visual Field Defects ◽  
Open Angle ◽  
Filtration Surgery ◽  
Stab Incision

Purpose. To describe a modified guarded filtration surgery, stab incision glaucoma surgery (SIGS), for primary open angle glaucoma (POAG).Methods. This prospective, interventional case series included patients with POAG (IOP ≥21 mmHg with glaucomatous visual field defects). After sliding superior conjunctiva down over limbus, 2.8 mm bevel-up keratome was used to create conjunctival entry and superficial corneoscleral tunnel in a single step starting 1.5 mm behind limbus. Lamellar corneoscleral tunnel was carefully dissected 0.5–1 mm into cornea and anterior chamber (AC) was entered. Kelly Descemet’s punch (1 mm) was slid along the tunnel into AC to punch internal lip of the tunnel, thereby compromising it. Patency of ostium was assessed by injecting fluid in AC and visualizing leakage from tunnel. Conjunctival incision alone was sutured.Results. Mean preoperative IOP was27.41±5.54 mmHg and mean postoperative IOP was16.47±4.81 mmHg (n=17). Mean reduction in IOP was38.81±16.55%. There was significant reduction of IOP (p<0.000). 64.7% had IOP at final follow-up of <18 mmHg without medication and 82.35% had IOP <18 mmHg with ≤2 medications. No sight threatening complications were encountered.Conclusion. Satisfactory IOP control was noted after SIGS in interim follow-up (14.18±1.88months).

Clinical outcomes of viscocanalostomy and phacoviscoviscocanalostomy in primary open angle glaucoma: Two years follow-up

2021 ◽  
pp. 112067212110640
Author(s):  
Reza Soltani-Moghadam ◽  
Ebrahim Azaripour ◽  
Yousef Alizadeh ◽  
Hassan Behboudi ◽  
Zahra Moravvej ◽  
...  
Keyword(s):  
Success Rate ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Success Rates ◽  
Antiglaucoma Medication ◽  
Prospective Comparative Study ◽  
The Mean ◽  
Effective Procedures

Purpose To compare the outcomes of phacoviscocanalostomy and viscocanalostomy in patients with primary open angle glaucoma. Methods This non randomized, prospective comparative study included 168 eyes of 168 patients with primary open angle glaucoma (POAG). Phacoviscocanalostomy was performed in 94 eyes with POAG and cataract and viscocanalostomy was performed in 74 eyes with POAG. Preoperative and postoperative intraocular pressures (IOP), number of antiglaucoma medication, intraoperative and postoperative complications were recorded throughout the follow-up period. Results The mean follow-up after surgery was 20.13 ± 7.9 months. Mean IOP decreased significantly 1 month after surgery in both groups (p < 0.001) and remained significantly lower from its preoperative value at all follow-up visits. The postoperative mean IOP at the last follow up in phacoviscocanalostomy and viscocanalostomy was 14.98 ± 4.8 mmHg and 16.84 ± 5.0 mmHg, respectively (p = 0.001). Complete success rate in phacoviscocanalostomy and viscocanalostomy groups was 83.1% and 56.8%, respectively (p = 0.008). Qualified success rate was achieved in 89.4% eyes in the phacoviscocanalostomy group and 83.8% of viscocanalostomy group (p = 0.534). The Best corrected visual acuity (BCVA) in phacoviscocanalostomy group improved significantly post-operatively (p = 0.001). Postoperative antiglaucoma medication in both groups were significantly less than the preoperative values (p = 0.001). Conclusions Both Phacoviscocanalostomy and viscocanalostmy are effective procedures in the control of IOP in patients with POAG with and without cataract. Higher complete success rates and BCVA were achieved in phacoviscocanalostomy. Therefore, phacoviscocanalostomy and viscocanalostomy are recommended in eyes with medically uncontrolled primary open-angle glaucoma with and without coexisting cataract.

Comparative study of the efficacy of selective laser trabeculoplasty as initial or adjunctive treatment for primary open-angle glaucoma

2018 ◽  
Vol 29 (5) ◽  
pp. 524-531 ◽  
Author(s):  
Tomaž Gračner
Keyword(s):  
Intraocular Pressure ◽  
Standard Deviation ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Adjunctive Treatment ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
The Mean

Aim: The aim of this study is to compare the efficacy of selective laser trabeculoplasty as initial or adjunctive treatment for primary open-angle glaucoma in a retrospective chart review. Methods: 28 eyes of 28 patients with newly diagnosed primary open-angle glaucoma, who formed the initial selective laser trabeculoplasty group, and 31 eyes of 31 patients suffering from medical uncontrolled primary open-angle glaucoma, who formed the adjunctive selective laser trabeculoplasty group, were treated with 180° selective laser trabeculoplasty. Patients were evaluated 1, 3, 6, 12, 18 and 24 months after treatment. Success was defined as an intraocular pressure lowering exceeding 20% of pretreatment intraocular pressure. Results: The mean follow-up time was 20.25 months (standard deviation = 8.1) for the initial selective laser trabeculoplasty group and 18.87 months (standard deviation = 8.8) for the adjunctive selective laser trabeculoplasty group (p = 0.538). No significant difference was found between the two groups for mean pretreatment intraocular pressure (21.43 mmHg (standard deviation = 3.2) vs 21.97 mmHg (standard deviation = 2.6); p = 0.766), for mean intraocular pressures and mean intraocular pressure reductions during whole follow-up period. At all follow-up visits, the mean percent intraocular pressure reduction was smaller in the adjunctive selective laser trabeculoplasty group than in the initial selective laser trabeculoplasty group, and such a difference was significant at 1 month (21.55% vs 26.79%; p = 0.039) and 24 months (24.82% vs 28.10%; p = 0.041). According to the Kaplan–Meier survival analysis, the 24-month success rate was 71.4% in the initial selective laser trabeculoplasty group and 71% in the adjunctive selective laser trabeculoplasty group, with no differences between the groups (p = 0.913). Conclusion: Selective laser trabeculoplasty is equally efficient in reducing intraocular pressure as initial or adjunctive treatment for primary open-angle glaucoma over 24 months.

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