Management Of Secondary Glaucoma Research Articles

Celebration to Consequence: Case Report of Late Onset Ocular Effects of Firework Injuries

Firework-related injuries, particularly ocular trauma, pose a significant public health concern during cultural celebrations. We explore the case of a 20-year-old male who sustained firework-induced ocular trauma at the age of seven, subsequently developing traumatic cataract and glaucomatous optic atrophy. The patient presented with decreased vision and pain in the left eye (LE), 13 years post-injury. He underwent cataract surgery nine years after the incident, with subsequent development of glaucomatous optic atrophy. Examination revealed visual acuity impairment, exotropia, and pupil abnormalities in the LE, along with scleral thinning and corneal opacity. Posterior segment evaluation showed optic nerve cupping and hemorrhages. Gonioscopy indicated angle recession and synechiae in the LE. Optical coherence tomography revealed retinal nerve fiber layer defects. Elevated intraocular pressure in the LE was successfully managed with anti-glaucoma medication. Firework-related ocular trauma can lead to long-term complications, including traumatic cataract and glaucomatous optic atrophy. Timely cataract surgery and vigilant follow-up are essential for early detection and management of secondary glaucoma. Regulatory measures to mitigate firework-related injuries are imperative to prevent such incidents and preserve visual health.

Diagnosis and management of secondary glaucoma: Dural fistula and intracranial hypotension

Glaucoma can occur as a secondary disorder in two situations. Firstly, where there is episcleral venous hypertension. In cases of dural fistula the diagnosis is straightforward: presentation, diagnosis and management will be discussed. In other situations the aetiology of episcleral venous hypertension is controversial, such as the Radius Maumenee syndrome. Secondly there has been recent interest in the importance of the pressure gradient across the lamina cribrosa. The occurrence of papilloedema in cases of low intra‐ocular pressure is well established while glaucomatous optic nerve damage in cases of intra‐cranial hypotension is controversial. The evidence will be reviewed.

Postoperative glaucoma following cataract surgery in children

Aims/Purpose: The aim of this work is to investigate the prevalence of secondary glaucoma and its associated risk factors in children undergoing congenital cataract surgery.Methods: A retrospective study was performed, spread over 8 years, from January 2014 to October 2021, in the paediatric ophthalmology department at the August 20 Hospital in Casablanca. It includes 516 eyes of children operated on for congenital cataract and aged under 16.Results: Development of glaucoma was defined as IOP > 22 mmHg, increased corneal diameter, increased cup to disc ratio, and reduced anterior chamber depth. We mainly evaluated the following risk factors: age at the time of surgery, unilateral or bilateral cataract, presence of microcornea, performance of posterior capsulotomy with anterior vitrectomy and primary implantation.Conclusions: Congenital cataract surgery at an early age increases the risk of developing glaucoma, whether the eye is aphakic or pseudophakic. The management of secondary glaucoma is heavy, the visual prognosis is compromised, hence the interest of long‐term follow‐up.

Management of cataract surgery in Lowe syndrome.

To evaluate the ophthalmic and anesthesiologic management of cataract surgery in children with Lowe syndrome receiving lens removal, the development and management of secondary glaucoma. This retrospective case series included 12 eyes of 6 children with genetically verified Lowe syndrome receiving cataract removal. Information regarding the type and duration of surgery and total anesthesia time were recorded. Additionally, intra- and postoperative complications were noted as well as clinical examinations such as visual acuity and funduscopy. All children received simultaneous bilateral cataract surgery at the mean age of 8.98±3.58wk. Lensectomy combined with posterior capsulotomy and anterior vitrectomy was performed in all children. The mean time for cataract surgery per eye was 35.83±8.86min, whereas the total time of surgery was 153.33±22.11min. The mean extubation time and duration at recovery room was 42.33±22.60min and 130.00±64.37min, respectively. During surgery, a decrease of oxygen saturation below 93% was found in only one child. During the postoperative follow-up, nystagmus (6 children) and strabismus (5 children) was commonly found in contrast to no case of visual axis opacification. Secondary glaucoma developed in five eyes of three children, which was treated with topical eye drops in only one child. A trabeculectomy was performed in both eyes of one child, whereas removal of syechia and an iridectomy in one eye of one child. Bilateral simultaneous cataract surgery under general anesthesia is a safe surgical procedure in Lowe syndrome children. The glaucoma screening with intraocular pressure measurements is crucial in the postoperative management of Lowe syndrome patients to avoid additional visual impairment.

Small gauge vitrectomy for vitreous amyloidosis and subsequent management of secondary glaucoma in patients with hereditary transthyretin amyloidosis

We conducted a retrospective observational study including 31 eyes of 20 patients in order to investigate the efficacy of 25-gauge vitrectomy for vitreous opacity with minimal conjunctival invasion and subsequent management of intraocular pressure (IOP) secondary to hereditary transthyretin amyloidosis. We followed up these patients for an average of 44.7 ± 32.6 months. The primary outcome was best corrected visual acuity (BCVA) at 1 month after surgery and at the final follow-up visit, with management of subsequent IOP elevation. Secondary outcomes included the post-vitrectomy IOP survival rate, to determine the frequency of IOP elevation requiring glaucoma surgery. Mean age at vitrectomy was 55.4 ± 9.1 years. Logarithm of the Minimum Angle of Resolution (LogMAR) BCVA showed immediate improvement from 0.73 ± 0.62 to 0.00 ± 0.22 at 1 month (p = 4.1 × 10−7), an improvement that was maintained up to the final follow-up visit, when IOP was maintained at 13.1 ± 5.2 mmHg. The survival rate of post-vitrectomy IOP control was 0.51, 0.38, and 0.23 at 12, 24, and 60 months, respectively. A poor post-vitrectomy IOP survival rate suggests that removing vitreous amyloid via 25-gauge vitrectomy is not sufficient to guarantee good visual function; subsequent careful follow-up and proper glaucoma management is also required in order to achieve this goal.

Management of secondary glaucoma in patients with nanophthalmos

Objective To investigate the management of secondary glaucoma in patients with nanophthalmos. Methods The data of 16 eyes of 9 cases of nanophthalmos with secondary glaucoma from Dec.2013 to May 2018 were analyzed retrospectively.All cases received different treatment according to their clinical characters. Results Their treatment methods included laser peripheral iridotomy, trabeculectomy combined with anterior chamber angioplasty, and phacoemulsification intraocular lens implantation combined with anterior chamber angle separation or trabeculectomy. After surgery some cases received local drug therapy or reoperation according to different conditions. IOP were controlled. Conclusion Laser peripheral iridotomy, phacoemulsification and intraocular lens implantation combined with anterior chamber angle separation are effective in the early stage of secondary glaucoma in patients with nanophthalmos. Trabeculectomy and other external filtration are not recommended. After surgery, the intraocular pressure is controlled by drugs and cyclophotocoagulation if the intraocular pressure is still difficult to be controlled. Key words: Nanophthalmos; Glaucoma, secondary; Treatment

Common clinical types and management of secondary glaucoma after ocular trauma

Common clinical types and management of secondary glaucoma after ocular trauma

Management of secondary glaucoma in patients with uveitis

AbstractPurpose To report the clinical course of patients with uveitic glaucoma.Methods The medical records of the patients diagnosed with uveitic glaucoma at the Glaucoma Service of the Department of Ophthalmology were reviewed retrospectively.Results Twenty eight patients (38 eyes) presented, of whom 20 were male and 8 were female. The mean age was 50.4±16.5. Eighteen patients had disease unilaterally and 10 bilaterally. Uveitis was associated Behçet’s disease in 6 patients, and idiopathic in 22 patients. All patients initially received topical medical therapy. Sixteen eyes were treated with monotherapy and 22 eyes with multitherapy. Surgical procedures (trabeculectomy or combined phacotabeculectomy) were performed in 20 eyes in which medical therapy failed. Secondary surgical procedures such as bleb revision or drainage implantation were needed in 6 eyes.Conclusion Secondary glaucoma associated with uveitis is an underappreciated, vision‐threatening complication and a challenging condition to manage.

Yag laser iridectomy in the management of secondary glaucoma caused by seclusion pupillae in patients with uveitis

Yag laser iridectomy in the management of secondary glaucoma caused by seclusion pupillae in patients with uveitis

Treatment of glaucoma in young nanophthalmic patients.

To evaluate the criteria of diagnosis and management of secondary glaucoma in young nanophthalmic patients. Considering the anatomic features and clinical characteristics, 22 eyes of 11 patients were identified as bilateral nanophthalmos. Intraocular pressures (IOP) were checked with Goldmann applanation or Keeler pulse-air 2000 tonometer, and Nd-Yag laser was used for iridotomies. Prophylactic V-shaped unsutured sclerectomies over the pars plana were combined with trabeculectomy, and Mitomycin C (MMC) in 0.2 mg/ml concentration was applied. Among 22 eyes of bilateral nanophthalmic patients 8 eyes had secondary angle-closure glaucoma. Laser iridotomies were performed in 6 eyes. Laser iridotomy and supplemental medical therapy were sufficient in 4 out of 6 eyes. Mean IOP dropped from 26.4 to 14.5 mmHg in these patients. Due to continuous increase of IOP in the other patients, they underwent trabeculectomy with V-shaped sclerostomy and intraoperative MMC application. Mean IOP dropped from 39.3 mmHg to 19.3 mmHg. Postoperative uveal effusion on other major complications were not observed. Mean age of these patients was 14.6 years during treatment. Management of glaucoma in nanophthalmus is complicated. Initial treatment is medical. If it is insufficient, laser iridotomies and V-shaped sclerostomies with filtration surgery can be performed at any age.