Management Of Glaucoma Patients Research Articles

Cataract surgery combined with glaucoma surgery.

This review evaluates the surgical management of glaucoma in patients undergoing cataract surgery. Combining both procedures present challenges in balancing intraocular pressure (IOP) control, minimizing postoperative complications, and achieving optimal refractive outcomes. Recent studies highlight the effectiveness of combined glaucoma and cataract surgeries, with traditional filtering surgeries and MIGS showing significant IOP reduction. The abundance of long-term studies shows that MIGS can offer an effective and safer alternative when carefully tailored to meet the specific needs of each patient. Combining glaucoma and cataract surgery is a promising approach for patients with coexisting conditions. While traditional surgeries offer robust IOP reduction, MIGS procedures offer better safety profiles with fewer complications and more predictable refractive results. Surgeons must carefully consider the timing and choice of procedures, with further research required to develop standardized treatment algorithms.

Asymmetric Glaucoma and Corresponding Hearing Impairment.

Background/Objectives: This study aims to explore the potential relationship between unilateral or asymmetric glaucoma and ipsilateral hearing impairment. Methods: In this retrospective study, visual and hearing functions were assessed in patients with unilateral or asymmetric glaucoma. Correlations between retinal nerve fiber layer (RNFL) thickness, visual field mean deviation (MD) values, and pure tone audiometry (PTA) measurements across various frequencies were analyzed to explore potential associations between visual and ipsilateral hearing functions. Differences in PTA values between ears ipsilateral to the more affected glaucomatous eyes and the contralateral ears were studied for statistical significance. Results: Twenty-six patients with unilateral or asymmetric glaucoma were included in the study. Significant differences in hearing thresholds between the ears corresponding to the more severely glaucomatous eyes and the contralateral ears were found at 0.7, 1, 1.5, and 3 kHz (p < 0.05). Additionally, a statistically significant difference was observed in the speech frequencies (0.5, 0.7, 1, 1.5, 2, 3, and 4 kHz) between ears corresponding to glaucomatous or more affected glaucomatous eyes and the contralateral ears (p = 0.016). Furthermore, a moderately positive correlation was found between differences in MD and PTA values at 0.125 kHz (r = 0.50; p = 0.01). Conclusions: This study highlights a potential association between unilateral or asymmetric glaucoma and ipsilateral hearing impairment, particularly at speech-relevant frequencies. These findings underscore the importance of integrated sensory assessment in the management of glaucoma patients, suggesting that early detection and intervention for concurrent hearing loss could enhance overall quality of life.

Glaucoma in Pathological Myopia, Diagnosis and Treatment Approaches

The rising global prevalence of myopia is contributing to an increase in pathological myopia (PM). Myopia has been extensively documented as a risk factor for primary open-angle glaucoma. However, glaucomatous changes in eyes with PM typically occur at normal intraocular pressures. Moreover, the unique anatomical alterations observed in PM result in distinctive differences in the clinical appearance of the optic nerve head and peripapillary region. Consequently, the evaluation of optic nerve cupping is more challenging in these cases than in those of normal eyes. Therefore, the diagnosis and treatment of glaucoma in this patient group is challenging. Furthermore, these patients may present with established visual field defects that can mimic glaucoma. On the other hand, optical coherence tomography is less useful for the detection and monitoring of disease due to the lack of normative data for these anatomically unique eyes. The most crucial factor in detecting early glaucomatous changes is the monitoring of the progression of retinal nerve fiber layer thinning over time. Consequently, the most effective method of monitoring glaucoma patients with PM is through longitudinal follow-up. Finally, the medical and surgical management of glaucoma in patients with pathologic myopic glaucoma presents its own unique challenges.

Management of glaucoma in patients with ocular surface disease

Glaucoma and ocular surface disease (OSD) are common diseases in the elderly population. As the prevalence of both conditions increases with age, they often occur together and can present in a spectrum of disease ranging from mild to severe.The management of glaucoma in patients with OSD is challenging, especially when the treatment of glaucoma, for which topical medications are usually the first choice, can further compromise the ocular surface and exacerbate the signs and symptoms of dry eye disease. In patients with glaucoma and co‐existing ocular surface disease, both need to be treated, depending on the severity of each disease and the likelihood of loss of visual function. Frequent visual field testing is required to monitor and assess the progression of glaucoma. In patients with OSD, the visual field is often unreliable and makes it difficult to diagnose and detect the progression of glaucoma.In early to moderate open‐angle glaucoma or ocular hypertension, selective laser trabeculoplasty is a good option for initial treatment as it delays the need for topical treatment. In advanced disease, the lowest number of preservative‐free eye drops should be prescribed, or glaucoma surgery should be performed.

Compliance in glaucoma management: Challenges decoded - A review

The first line treatment for glaucoma, a chronic condition which is the second biggest cause of irreversible vision loss in the globe, is self-administered topical ocular hypotensive drops. Medication adherence is a major issue in the management of glaucoma patients. Numerous obstacles to patients’ compliance have been discovered in the literature, ranging from elements related to the drug delivered, interactions between patients and their doctors, and elements related to patients’ behaviours and lifestyles. Patients who do not take their medications as directed run the danger of not getting the expected results, which frequently results in irreversible vision loss. We have reviewed available literature regarding patient compliance in the disease management of glaucoma and formulated a few recommendations based on the latest research in the field to practically apply in practice to increase compliance in this chronic condition.

Frequency of moderate to high myopia in primary open-angle glaucoma in tertiary care hospital

Introduction: Glaucoma is one of the leading causes of irreversible blindness in the adult population worldwide with Primary Open-Angle Glaucoma being its most common type. Moderate to high myopia is one of the various risk factors associated with POAG. Early detection and management of glaucoma in patients can slow down its progression and prevent vision loss.&#x0D; Objective: To evaluate the frequency of moderate to high myopia in Primary Open Angle Glaucoma (POAG) and to find out the association between myopia and POAG.&#x0D; Methodology: A total of 100 participants were included in this cross-sectional study through consecutive sampling techniques. Refractive error was measured through an auto refractometer. Glaucomatous Patients were diagnosed as POAG on clinical findings (elevated IOP and optic nerve changes), visual field loss, and/or retinal nerve fiber layer (RNFL) defects. The anterior chamber angle was evaluated with the Van Herrick technique. Association between myopia and independent variables were statistically determined.&#x0D; Results: The mean age of all the participants was 52.36 ± 15.350. The frequencies of low, moderate, and high myopia were 34%, 12.5%, and 4% respectively. Male gender had a significant association with the high prevalence of low myopia in patients with POAG (p-value &lt;0.05). Illiteracy and low and middle-class socioeconomic background were the other significant risk factors. &#x0D; Conclusion: Myopia is the major risk factor in POAG and other factors like illiteracy and a poor socioeconomic background attributed to it should be screened and assessed so that earlier detection in the population can prevent vision loss.

Lockdown: The Impact on Management of Glaucoma in a Suburban Tertiary Centre in Malaysia.

The COVID-19 pandemic brought the world to a standstill in 2020. Many countries have imposed lockdowns, known as the movement-control order (MCO) in Malaysia, to prevent transmission of the disease. The objective of this study is to evaluate the impact of the MCO on the management of glaucoma patients in a suburban tertiary hospital. We conducted a cross-sectional study of 194 glaucoma patients between June 2020 and August 2020 in the glaucoma clinic at Hospital Universiti Sains Malaysia. We evaluated the patients' treatment, visual acuity, intraocular pressure (IOP) measurements, and potential signs of progression. We compared the results with those of their last clinic visits prior to the MCO. We studied 94 (48.5%) male and 100 (51.5%) female glaucoma patients with a mean age of 65 ± 13.7. The mean duration between pre-MCO and post-MCO follow-up was 26.4 ± 6.7 weeks. There was a significant increase in the number of patients with deterioration of visual acuity, and one patient lost his vision after the MCO. There was also a significant elevation of the mean IOP of the right eye: pre-MCO, 16.7 ± 7.8 mmHg, compared to post-MCO, 17.7 ± 8.8 mmHg (p = 0.027). The cup-to-disc ratio (CDR) for the right eye increased significantly from pre-MCO, 0.72 ± 0.18, to 0.74 ± 0.19 post-MCO (p < 0.001). However, there were no significant changes in IOP or CDR in the left eye. Twenty-four patients (12.4%) missed medications during the MCO period, and 35 patients (18%) required additional topical medications due to the progression of the disease. Only one patient (0.5%) required admission due to uncontrolled IOP. Lockdown, as a preventive step in the COVID-19 pandemic, indirectly caused the progression of glaucoma and uncontrolled IOP.

Longitudinal Choriocapillaris Vascular Density Changes in Different Types of Primary Open-Angle Glaucoma.

To evaluate longitudinal changes in choriocapillaris perfusion in patients with glaucoma with four phenotypes of optic disc damage and to explore associated factors with decreased choriocapillaris vessel density (CVD). This prospective longitudinal study included 96 eyes of 96 patients with primary open-angle glaucoma (POAG). Patients with POAG was differentiated into the optic disc phenotypes of focal ischemic type (FI), myopic type (MY), senile sclerotic type (SS), and generalized enlargement type (GE). Patients were followed up every three months. Simple linear regression was used to investigate the factors associated with a reduction in CVD. The median follow-up time was 2.5 years (range, 2.0-3.0 years). Choriocapillaris perfusion tended to decrease over time, with CVD decreasing significantly faster in the FI type than in the other three types (P < 0.001). The percentage decrease in the FI type was 7.85%, 10.89%, and 8.88% faster than MY, SS and GE, respectively, after correcting for age, gender, axial length, intraocular pressure, mean deviation, retinal nerve fiber layer (RNFL), and image quality score. In multivariate regression, decreased CVD was independently associated with the rate of RNFL thinning. FI type had the fastest rate of CVD decline in the four phenotypes of optic disc damage, and decreased CVD was positively correlated with the rate of RNFL thinning. The role of the choriocapillaris in the pathogenesis and therapeutic potential of glaucoma require further attention to facilitate better management of glaucoma patients.

Atteinte de la surface oculaire chez les patients glaucomateux : avis d’experts et algorithme de prise en charge en Algérie

The main goal of treatment for any glaucoma patient is to reduce the intraocular pressure. Unfortunately, the long-term use of glaucoma medications causes deleterious effects on the ocular surface, leading to impaired quality of life and failed glaucoma surgery. In addition, adverse effects of medications are a barrier to adherence and compliance, and this directly affects efficacy. It is therefore essential to regularly assess the ocular surface of glaucoma patients in order to detect any signs of damage early and act accordingly. Although the TFOS DEWS 2 now offers a strategy for diagnosing ocular surface pathologies, some examinations are unfortunately not feasible in Algeria due to lack of time and/or knowledge on the part of some ophthalmologists or are simply inaccessible to others. Algerian experts (members of the ACOS club) met for the purpose of proposing an algorithm for the management of Algerian glaucoma patients, based on the recommendations of the DEWS, their own practice and the results of a preliminary national survey of ophthalmologists. The proposed algorithm allows evaluation of the ocular surface of the glaucoma patient in current practice by any Algerian ophthalmologist. Management of glaucoma patients should include a systematic examination of the ocular surface. The choice of treatment should be determined by the ocular surface condition of the glaucoma patient.

Взаимосвязь индивидуальных биомеханических особенностей глаза со значениями офтальмотонуса при использовании современных методов офтальмотонометрии

A thorough analysis of the intraocular pressure (IOP) measurements is crucial for making diagnosis and decisions concerning the management of glaucoma patients. At the same time, there is a large inter-individual variability of ocular anatomical and physiological parameters impacting such measurements. IOP has been identified as a potential independent risk factor for the glaucoma progression. However, in clinical practice it is not always possible to achieve its accurate quantitative evaluation. Currently, multiple modern devices are available to determine IOP indicators and biomechanical properties of the eye. In addition, various clinical algorithms have been proposed for adjusting these indicators and thus to ensure an adequate interpretation of IOP measurements. However, there are still no clear guidelines on how to use the correction factors. In turn, the interpretation of measurement results with consideration of new (biomechanical) characteristics of the eye's support structure, requires a detailed analysis of the received data to establish correlations between non-standard parameters and specific characteristics of the glaucoma progression. This review presents an assessment of the latest ophthalmotonometry methods and their individual characteristics based on the available clinical experience. Keywords: ophthalmotonometry, biomechanical properties of the eye, intraocular pressure, glaucoma. For citation: Kats M.D. The relationship between the individual biomechanical properties of the eye and the intraocular pressure measurements based on modern methods of ocular tonometry. Russian Journal of Clinical Ophthalmology. 2023;23(2):86–93 (in Russ.). DOI: 10.32364/2311- 7729-2023-23-2-86-93.

The effectiveness and tolerability of fixed-dose combination netarsudil 0.02%/latanoprost 0.005% at a tertiary glaucoma center.

To assess real-world effectiveness and tolerability of fixed-dose combination netarsudil 0.02%/latanoprost 0.005% (FCNL) in management of glaucoma patients in a tertiary eye care center. This retrospective cohort study included glaucoma patients initiated on FCNL from January 2018 to July 2021 with at least 1-month follow-up. Demographic and clinical data were collected at baseline and at follow-up visits through 12months. Patient-solicited side effects were recorded at each visit. Maximum glaucoma pharmacotherapy was defined as surgery/laser being the next treatment option following an intensive pharmacotherapy regimen, or when pharmacotherapy could not be increased due to allergy/intolerance or all pharmacologic mechanisms already being in use. Seventy-nine eyes of 47 patients were included. Mean age was 67.7 ± 14.7years. Baseline IOP was 18.7 ± 4.9mmHg; mean change in IOP (∆IOP) each study visit compared to baseline ranged from - 1.6 ± 3.5 to - 4.4 ± 4.1mmHg (all p < 0.05). The eyes on maximum glaucoma pharmacotherapy (73.4%) had similar ∆IOP compared to those on non-maximal therapy at each visit (p > 0.2 for all). Forty-three (54.4%) eyes were switched from a prostaglandin analog alone, producing a 1-month IOP reduction of - 4.7 ± 3.9mmHg at 1month which remained significant at each visit for the 12-month study period (all p < 0.05). Across all study visits, conjunctival hyperemia was documented in 26 (32.9%) eyes. Subjective blurry vision was reported in 22 (27.8%) eyes without significant worsening of visual acuity at any visit (all p > 0.05). Six (7.6%) and 7 (8.9%) eyes required further medical or surgical/laser intervention, respectively. Kaplan-Meier analysis revealed no significant difference in the need for subsequent medical or surgical intervention between those on maximum and non-maximal pharmacotherapy (p > 0.4). FCNL was well-tolerated and demonstrated a significant and sustained reduction in IOP, even as last-line therapy before incisional or laser surgery in those on maximum glaucoma pharmacotherapy. FCNL is a viable treatment option for glaucomatous eyes before consideration of surgical intervention.

Attitudes and Perceptions Toward the Use of Medical Marijuana by Glaucoma Specialists.

With expanding legality of medical marijuana (MMJ) in the United States, it is important for ophthalmologists to have greater understanding of the implications of MMJ and glaucoma treatment and how it can impact their patients. Previous work has demonstrated that inhaled tetrahydrocannabinol can lower intraocular pressure. The stance of the American Glaucoma Society (AGS) is that MMJ is not an acceptable treatment for glaucoma. The purpose of this study is to evaluate the glaucoma specialists' perceptions and attitudes toward the use of MMJ for glaucoma. An electronic survey was sent to members of the AGS which addressed attitudes and perceptions on the use of MMJ in the management of glaucoma. Study questions included practitioner demographics, previous experiences with patients discussing the topic, prescribing patterns, and knowledge regarding the use of MMJ for the treatment of glaucoma. Thirty-seven percent of respondents reported having patients who cited using MMJ for their glaucoma, and 38% of respondents were asked about MMJ by their patients at least once per week. Fifty-five percent of respondents had patients who asked them for MMJ prescriptions. When asked if they felt if there was a possible role for marijuana in the management of glaucoma patients, 27% of survey takers responded yes. Fourteen percent of survey respondents kept information on MMJ in their office. Finally, 76% of participants responded they would be interested in additional education on the topic. Over 25% of the glaucoma specialists responded that MMJ had a role in the treatment of glaucoma, despite the recommendation of the professional society. This group was least likely to have received education on the topic. Given the expanding legality and curiosity of patients with regards to marijuana in the United States, it is important for ophthalmologists to have a greater understanding of the implications of marijuana in glaucoma.

Comparative Study between Generic versus Brand Latanoprost in treatment of Open Angle Glaucoma Patients

Abstract Background Glaucomas are a group of optic neuropathies characterized by progressive degeneration of retinal ganglion cells. Degeneration of these nerves results in cupping, a characteristic appearance of the optic disc and visual loss. Glaucoma can remain asymptomatic until it is severe, resulting in a high likelihood that the number of affected individuals is much higher than the number known to have it. Without adequate treatment glaucoma can progress to visual disability and eventual blindness which is irreversible. Many types of glaucoma are usually controlled with daily medical treatment consisting of eye drops lowering IOP. Some do this by reducing the amount of aqueous fluid the eye makes. Others reduce pressure by helping aqueous fluid flow better through the drainage angle. A generic medicine is defined as a product having the same qualitative and quantitative composition in active ingredients, as well as the same pharmaceutical form, as the reference medicine and whose bioequivalence has been shown by adequate bioavailability studies, also its low price makes it more affordable. Aim of the Work To evaluate intra ocular pressure control and compliance of the patient using a generic prostaglandins eye drops in comparison to a brand one in the management of glaucoma patients and its safety profile, to determine the value of the generic drug in glaucoma management. Patients and Methods This is a prospective interventional cross over study was done on 30 patients recruited from Glaucoma Clinic of National Eye Center, Rod El Farag from January 2019 to July 2019. Results The mean baseline IOP of both main groups on day 0 was 23.9 ± 3.3 mmHg at 9 AM, 23.6 ± 2.7 mmHg at 1 PM, 23.6 ± 2.3 mmHg at 6 PM before treatment with original or generic latanoprost (P = 1). Both treatments reduced the IOP from baseline (day 0 of each drug) at each time-point, and for the three diurnal IOP measurements at 3 months. Original latanoprost had a greater efficacy than generic latanoprost after 3 months, Original Latanoprost reduced the IOP after 3 months of treatment by -8.6 ± 0.84 mmHg at 9.00 AM, 7.4 ± 1.2 mmHg at 1.00 PM hours and -6.4 ± 1.8 mmHg at 6.00 PM, While Generic latanoprost reduced IOP after 3 months by -7.03 ± 0.95, -5.8 ± 1.1 and -4.9 ± 1.8 mmHg, respectively. Conclusion Original latanoprost has a tendency of better efficacy and tolerability with low incidence of conjunctival hyperaemia and ocular irritation compared with the generic latanoprost in management of open angle glaucoma patient.

Efficacy and Safety of Sutureless Trabeculectomy with Using Porous Collagen (Ologen) in Management of Glaucoma Patients.

PurposeThis study aims to investigate the safety, efficacy and feasibility of sutureless trabeculectomy using a porous collagen matrix that contains a connected porous structure (Ologen) in the control of intraocular pressure (IOP) in glaucoma patients.MethodsThe study includes 25 eyes from 24 patients that met the inclusion criteria. All eyes underwent trabeculectomy with the Ologen implant that provides a space with a dynamic and physiological aqueous reservoir system. The operation was considered successful if IOP is <15 mmHg without need of IOP-lowering drops at 18 months of follow-up.ResultsThe target IOP was achieved in 21 out of the 25 eyes (84%), the remaining four eyes all had an IOP of 16 mmHg at 18 months. Short-term complications consisted of seven cases of bleb leakage treated with bandage contact lens and one case of mild choroidal effusion which resolved after observation alone.ConclusionsWe can conclude that this technique can provide safety, effectiveness and short learning curve for ophthalmology trainees with lower incidence of perioperative and postoperative complications. Further studies may be required to prove stability and long-term efficacy in management of glaucoma patients.

High-intensity focused ultrasound in the treatment of glaucoma: a narrative review

ABSTRACT Introduction: Ultrasound Cyclo-Plasty (UCP) using High-Intensity Focused Ultrasound (HIFU) is a recently developed cyclodestructive procedure. It can be applied to the target area, avoiding any effect on surrounding tissues. This review aims to present the actual role of HIFU in the management of glaucoma patients. Areas covered: The PubMed database was consulted in November2020. The search terms used were: ‘high intensity focused ultrasound treatment,’ ‘cyclo-ablation’‘cyclo-destruction’‘cyclo-plasty.’ Relevant aspects about UCP are discussed in this review, particularly the probe development, the histological effects, and the mechanism of action. Furthermore, UCP indications are reported. Besides, technical limitations are evident, such as mild adverse events, severe adverse events, and long-termoutcomes, including reducing hypotensive medications, additional glaucoma surgery, and comparison with other cyclodestructive techniques. Finally, future perspectives about HIFU applications and improvements are reported. Expert opinion: Ultrasound Cyclo-Plasty(UCP) procedure is simple to perform and can be applied to almost all glaucoma types and eyes. It can be considered asafe and effective procedure. However, its mechanism of action is not entirely understood, resulting in different IOP lowering. Nevertheless, focalized and selective ciliary body coagulation with HIFU opened the possibility of anew therapeutic approach against glaucoma disease.

Comparison of intra-ocular pressure measurement with four different methods of tonometry

The aim of this study was to measure the intraocular pressure (IOP) by Perkins hand held tonometer, non contact tonometer(NCT) and rebound tonometer with the Gold standard GAT and to analyse their correlation with varied CCT. Cross-sectional, hospital- based study that included 200 patients from the glaucoma department. After complete eye evaluation, the IOP measurement was performed sequentially in the same order- NCT, RT, Perkin’s and GAT. CCT was then measured for all the patients. The intra-ocular pressure within the eyes was compared by paired “t” test and between the right and left eyes were compared by the independent “t” test. Mean age of the patients was 54.5±13.5 years. The mean IOP of Right and Left eyes measured with GAT were 15.9±6.2 and 16.3±7.0 mm/Hg, that with Perkins were 15.7±6.2 and 16.3±7.0 mm/Hg respectively. Both eyes’ mean IOP were 15.4±6.7 and 15.9±7.4 mm/Hg by Icare. The mean IOP measured by NCT were 16.4±6.7 and 16.9±8.0 mm/Hg. The mean CCT of right eye was 528.9± 29.6 and left eye was 530.6±29.6 microns. All the four instruments namely GAT, Perkin’s, Icare ic100 and NCT were influenced by CCT. IOP remains the only alterable factor in the management of glaucoma patients. Numerous methods have been devised to measure IOP accurately. The IOP measured with Perkin’s, NCT and Icare are comparable but GAT remains the gold standard.

Terapia láser transescleral de micropulsos en el manejo de los pacientes de glaucoma

ObjectiveTo evaluate the efficacy and safety of MicroPulse® transscleral laser therapy (TLT) in the management of glaucoma patients. MethodsA prospective, interventional, non-comparative case series was conducted in the department of ophthalmology, Ain Shams University Hospital on 61 eyes of 46 patients with various glaucoma types and of severity, ranging from mild to severe. In addition to best-corrected visual acuity (BCVA), intraocular pressure (IOP) and the number of glaucoma medications were recorded before and after treatment, along with the postoperative need for systemic carbonic anhydrase inhibitors (CAI), success rates, number of treatment sessions and postoperative complications. Success was defined as an IOP of 6-18mmHg or at least a 30% decrease from preoperative IOP in the absence of any vision-threatening complications during the 6-month follow-up period. ResultsMicroPulse TLT was performed on 61 glaucomatous eyes. Eleven of the 61 eyes (18%) that did not achieve IOP between 6-18mmHg, or at least a 30% decrease from baseline at 6 months, had a repeat MicroPulse TLT session.At 6 months follow-up post a single MicroPulse TLT session, the mean IOP reduction was 35.9±14.2%; and 6 months after the second session, it was 36.2±17.5% (P<.001). The success rate after the first session was 73.8% which increased to 78.7% after the second session. The mean anterior chamber (AC) cell reaction was+1.9±.8 at 1 day,+1.0±.7 at 1 week, and+.2±.4 at 1 month postoperatively. No cells were detected in any of the cases at 3 and 6 months follow-up (P<.001). The average number of anti-glaucoma eye drops before MicroPulse TLT was 2.6±1.0. Postintervention, the average number of anti-glaucoma eye drops was 1.7±1.2, and sustained at 6 months follow-up after the last treatment session (P<.001). There were no significant complications were noted. One eye developed transient hypotony for 3 months after MicroPulse TLT. ConclusionsMicroPulse TLT is safe and effective in lowering IOP in a variety of glaucoma types and severity.

Outcome of trabeculectomy versus Ahmed glaucoma valve implantation in the surgical management of glaucoma in patients with Sturge–Weber syndrome

AimsTo compare the surgical outcomes of trabeculectomy versus Ahmed glaucoma valve (AGV) implantation in the surgical management of glaucoma in patients with Sturge–Weber syndrome (SWS).MethodsA retrospective chart review was performed...

Comparison of the Icare ic100 Rebound Tonometer and the Goldmann Applanation Tonometer in 1,000 Eyes

Background: Measurement of intraocular pressure (IOP) forms a crucial component in the diagnosis and management of glaucoma. Many devices have been developed to measure IOP with Goldmann applanation tonometry (GAT) considered the gold standard for IOP measurement. Objectives: The objective was to compare the IOP measured using Icare ic100 and GAT. Methods: This cross-sectional study measured IOP in 1,000 eyes (500 left and 500 right) using the Icare ic100 and GAT. Central corneal thickness (CCT) was measured using a hand-held pachymeter. IOP measurements were investigated in all eyes, by IOP substrata, by CCT group, by number of topical glaucoma medications, and diagnosis. Results: There was moderate agreement between ic100 and GAT IOP measurements (intraclass correlation coefficient 0.73). Mean IOP was significantly lower when measured by ic100 than by GAT (12.1 vs. 16.2 mm Hg, p < 0.0001). Mean ic100 IOPs were also significantly lower than mean GAT IOPs within each IOP strata ≤12 (7.9 vs. 9.7 mm Hg, p < 0.0001), 13–21 (12.1 vs. 16.6 mm Hg, p < 0.0001), and ≥22 (18.4 vs. 25.2 mm Hg, p < 0.0001) and within each subanalysis. Conclusions: The Icare tonometer consistently under estimated IOP compared to GAT, irrespective of CCT ranges and other subgroup analyses. The mean difference of 4.2 mm Hg can have significant clinical implications, particularly in the management of glaucoma patients.

Efficiency YAG Laser PI (Peripheral Iridotomy) in Management of Glaucoma Patients in Bangladesh

Efficiency YAG Laser PI (Peripheral Iridotomy) in Management of Glaucoma Patients in Bangladesh