Mean Intraocular Pressure Values Research Articles

The effect of ketofol anesthesia on intraocular pressure in pediatric strabismus surgery

Background/Aim: Keeping intraocular pressure (IOP) within normal limits is an important goal in the anesthetic management of pediatric strabismus surgery. While propofol is commonly used as an induction agent since it provides smooth laryngeal mask insertion, it has the undesirable side effect of dose-dependent cardiorespiratory depression. On the other hand, ketamine acts as a sympathetic cardiorespiratory stimulant; however, its effect on IOP is controversial. The aim of this study was to determine the effect of the combination of ketamine and propofol (ketofol) on IOP in pediatric strabismus surgery compared to propofol alone. Methods: Participants included patients aged between 2 and 18 years who underwent strabismus surgery. They were divided into two groups according to type of anesthesia induction: propofol and ketofol. Patient characteristics, surgical data, hemodynamic parameters, oculocardiac reflex (OCR), and IOP were compared between the two groups. Results: Forty-five children with a mean age of 7.7 years were enrolled in the study. The patients were assigned into two groups: propofol alone (n=26) and ketofol (n=19). The groups were similar in patient characteristics, surgical data, and hemodynamic parameters (P<0.05 for each). IOP was measured at four points: before anesthesia, at 1 minute following induction, at 3 minutes following laryngeal mask airway (LMA) insertion, and at the end of surgery. All IOP values were within normal limits. No significant differences in mean IOP values were found between the groups (P>0.05 for each). There was also no significant difference in OCR between the groups (P=1.000). Conclusions: Compared to propofol alone, ketofol had a similar effect on IOP, OCR, and hemodynamic parameters. These results suggest that ketofol can be safely used in the induction of anesthesia in pediatric patients undergoing strabismus surgery.

Clinical outcomes of Ahmed glaucoma valve implantation in primary open-angle glaucoma and pseudoexfoliative glaucoma.

To investigate the clinical outcomes of Ahmed glaucoma valve (AGV) implantation in primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG). The patients who underwent AGV implantation for POAG and PEXG between January 2015 and December 2021 in a single tertiary center eye clinic were reviewed retrospectively. Thirty-one eyes with the diagnosis of POAG constituted Group 1 and 40 eyes with the diagnosis of PEXG constituted Group 2. The primary outcome measures were intraocular pressure (IOP) changes after AGV implantation and surgical success at the last visit. We evaluated complete and qualified surgical success using the following three criteria: (1) IOP ≤ 21mmH g, (2) IOP ≤ 18mmHg, and (3) IOP ≤ 15mmHg, as well as the absence of any serious complications, such as light perception loss and phthisis bulbi, and additional de novo glaucoma surgery. The mean follow-up times were 25.2 (± 21.4) months and 27.6 (± 19.8) months for Groups 1 and 2, respectively (p > 0.05). In Groups 1 and 2, the mean preoperative IOPs were 31.9 ± 9.4mmHg and 32.3 ± 8.4mmHg, respectively, which significantly reduced to 14.5 ± 0.7mmHg and 11.6 ± 0.6mmHg, respectively at the last postoperative visit (p < 0.001 for both). The mean IOP value at the last visit was statistically significantly lower in Group 2 (p = 0.006). At the last visit, the number of eyes with qualified success according to criteria 1, 2, and 3 was 26 (83.9%), 25 (80.6%), and 18 (58.1%), respectively, in Group 1 and 39 (97.5%), 39 (97.5%), and 32 (80%), respectively, in Group 2. The comparison of the qualified success rates showed statistically significantly higher rates in Group 2 for criterion 2 (p = 0.038). AGV implantation had high success rates in both POAG and PEXG, but at the final visit, lower IOP levels were reached in the latter.

Nonsuperotemporal quadrant implantation of the Ahmed glaucoma valve using modified long scleral tunnel technique for intraocular pressure control.

As superotemporal implantation of the Ahmed glaucoma valve is not always feasible in cases of refractory glaucoma, this study examined the characteristics and surgical outcomes of cases in which the valve was implanted in a nonsuperotemporal quadrant using a modified long scleral tunnel technique. This retrospective case-control study included 37 eyes with nonsuperotemporal quadrant--Ahmed glaucoma valve implantation in Group 1 and 69 eyes with superotemporal Ahmed glaucoma valve implantation in Group 2. The demographic characteristics of these groups, surgical outcomes, including complications, further surgical interventions, and surgical success rates were compared. Surgical success was defined as an intraocular pressure not exceeding 21 mmHg, accompanied by a minimum reduction of 20% in intraocular pressure from the baseline without any additional intraocular pressure-lowering procedures, and the absence of light perception loss or phthisis bulbi. Group 1 had significantly higher numbers of eyes with secondary glaucoma and preoperative surgical procedures than Group 2 (p<0.05). Both groups had mean preoperative intraocular pressure values, and mean intraocular pressure values at the last visit of 34.2 and 27.9 months, 35.5 ± 1.5 and 35.8 ± 1.2 mmHg, and 14.5 ± 5 and 14.9 mmHg, respectively. Although both groups had 70.2% and 75.8% as their five-year cumulative probability of success, respectively, the rates of complications, revisional surgery, and additional surgical procedures did not differ significantly (p>0.05). The modified long scleral tunnel technique for Ahmed glaucoma valve implantation in nonsuperotemporal quadrants achieves intraocular pressure control and complication rates comparable to superotemporal implantation.

Investigating the prevalence of primary open-angle glaucoma among patients with systemic hypertension: A cross-sectional study

Background: Primary open-angle glaucoma (POAG) is a significant cause of irreversible blindness worldwide. Aims and Objectives: This study aimed to investigate the prevalence of POAG among hypertensive patients. Materials and Methods: A comprehensive analysis was conducted on 200 hypertensive patients, categorizing them by gender, age groups, and blood pressure ranges. POAG was diagnosed using standardized criteria, and mean intraocular pressure (IOP) values were compared between POAG patients and normal individuals. The study also assessed the change in IOP across various ranges of systolic and diastolic blood pressure (SBP and DBP). Results: Among the hypertensive population, 5% of males and 3% of females were diagnosed with POAG, indicating a slightly higher prevalence in males. POAG incidence was notably higher in the 60–69 years of age group, suggesting a potential correlation with older age. Analysis of mean IOP values demonstrated significantly higher readings in both eyes of POAG patients compared to normal individuals, aligning with the hallmark of glaucoma. The distribution of hypertensive patients across different SBP and DBP ranges revealed that higher SBP levels (140–149 mmHg and ≥160 mmHg) were associated with more POAG cases. Similarly, elevated DBP levels (90–99 mmHg) showed the highest number of POAG cases. Conclusion: Our study suggests a slightly higher prevalence of POAG in male hypertensive patients and highlights older age as a potential risk factor. Elevated IOP, a characteristic feature of glaucoma, was confirmed in POAG patients. In addition, our findings indicate a potential association between higher SBP and DBP levels and an increased likelihood of POAG, emphasizing the importance of blood pressure management in glaucoma care.

Микроимпульсная циклофотокоагуляция в комбинированном лечении неоваскулярной глаукомы

Purpose. To evulate the efficiency of micropulse cyclophotocoagulation (MP-CPC) in the combined treatment of patients with secondary refractory neovascular glaucoma with object vision. Material and methods. The study involved 30 patients (30 eyes) with neovascular glaucoma (NVG) in the stage of partial or complete blockade of the iridocorneal angle with decompensated intraocular pressure (IOP) resistant to drug therapy, who had object vision. Two study groups were formed, 15 eyes each. The first main group is represented by patients whom performed MP-CPC (Cyclo G6 Glaucoma Laser System by IRIDEX), as a stage of combined treatment before implantation of Ahmed glaucoma valve (IAGV). The second control group included patients who initially were treated by this type of drainage surgery without preliminary micropulse laser exposure. The follow-up period was 18 months. Results. The implementation of MP-CPC in the main group led to a significant decrease in IOP on the 1st day after treatment from 27.5±6.1 to 23.6±4.6 mm Hg, with the maximum attainment of normal values on the 3rd day of observation, which averaged 20.3±4.4 mm Hg. (p&lt;0.05). By the end of the 1st month, an increase in mean IOP values to subcompensated values was recorded – 24.4±6.3 mm Hg. After valve drainage implantation, by the end of the 1st month of observation, IOP in the main group was 19 (16.5; 22.0) mm Hg, and in the control group it was 24.5 (20.5; 25.8) mm Hg. (p&lt;0.05). After 18 months of the postoperative period, the level of ophthalmotonus in the main group is 15.5 (15.0; 18.2), and in the control group – 16.5 (15.0; 19.5) mm Hg. (p&gt;0.05). A significant decrease in the amounts of hypotensive drugs in the main group was revealed: 1 (0; 2) versus 2 (1; 3) in the control group (p=0.03). In both groups, there was no significant deterioration in visual functions during the entire observation period. Conclusions. MP-CPC can be considered as a preliminary stage in the combined treatment of neovascular refractory glaucoma, as it reduces the risk of preoperative ophthalmohypertension before valve surgery, leads to a significant decrease in the amounts of hypotensive drugs in the late postoperative period, thereby improving the effectiveness treatment of patients with neovascular refractory glaucoma who have object vision. Key words: micropulse cyclophotocoagulation, neovascular glaucoma, valve's Ahmed

The Complications of Cataract Surgery in Patients with Pseudoexfoliation

Abstract The senile cataract represents the blurring of the crystalline lens after the age of 65. It occurs due to metabolic changes in the crystalline lens which occur over the years. The only effective way to treat cataract is the surgical one. Pseudoexfoliation is an age related systemic disorder. PEX represents the accumulation fibrillar material in the extracellular matrix of the tissue. The most known ocular manifestation of the PEX are the collection at iris pupillary margin and anterior lens capsule. This accumulation is associated with many intraoperative and postoperative complications in patients scheduled for cataract surgery. The aim of the study was to investigate the prevalence of the surgical complications during phacoemulsfication in patients with PEX. The study included 91 patients scheduled for cataract surgery divided into two groups (PEX group 46, control group 45 patients). Poor intraoperative midryasis, zonular dehiscence, postoperative corneal edema, anterior chamber inflammation, elevated intraocular pressure and tear film instability had particularly higher rate of occurring in PEX group comparing to the control group (p&lt;0.001). The highest mean value of intraocular pressure was observed in PEX group on the first postoperative day 25.6 ± 1.1 mmHg, while the best corrected visual acuity was measured in control group 0.71 ± 1.2 one month after phacoemulsification. Cataract surgery in patients with PEX carries great risk, but with adequate preoperative planning, the awareness of the potential complications, can provide safe and routine phacoemulification in these patients.

Determination of reference values for tear production and intraocular pressure in Pygoscelis penguins of the Antarctic Peninsula

BackgroundAccording to the literature review, this is the first study investigating tear production (TP) and intraocular pressure (IOP) in the Pygoscelis penguins living in their natural habitat. The study aimed to establish normal values for standard ocular tests in the genus Pygoscelis, namely, the Adélie (Pygoscelis adeliae), gentoo (Pygoscelis papua), and chinstrap (Pygoscelis antarctica) penguins, in four different islands of Antarctica. Sampling was made by specifically using the left eye of the penguins. The Schirmer's tear test type I (STT-I) and the Tonovet® (rebound tonometer) were used to measure the TP and the IOP, respectively.ResultsThe mean TP and IOP values of 129 Adélie, chinstrap, gentoo, and 120 adult Adélie, gentoo penguins were determined as 10.2 ± 4.0 mm/min and 38.9 ± 13.2 mmHg, respectively. No statistical difference was detected between the penguin species for the mean IOP values, while the difference was determined in all the locations. However, statistical differences in the mean TP values were determined between all locations.ConclusionThe results of this study provide a reference range of Schirmer's tear test (STT) and IOP values in Pygoscelis penguins and show that the IOP is significantly affected by locations. This result can be attributed to the harsh climatic conditions of the Antarctic Peninsula that change very quickly. The described data may help diagnose clinical pathological findings in Pygoscelis penguins.The STT and rebound tonometry appears to be safe and reproducible methods in Pygoscelis penguins, as the results were obtained quickly and were well tolerated by the birds.Based on our results, we propose that similar studies can be initiated in crowded colonies of three penguin species of this genus on the Antarctic Peninsula, the southern Shetland Islands, and other frequently visited islands in Antarctica.

Effect of Butorphanol with and without Medetomidine on Intraocular Pressure in Cats

This study aimed to determine the effects of intramuscular administration of butorphanol with and without medetomidine on intraocular pressure (IOP) in cats. Sixteen clinically normal cats were used. Cats were randomly received two-treatment regimen. The first regimen was 0.2mg/kg butorphanol, and the second regimen was a mixture of 0.1mg/kg butorphanol and 0.05mg/kg medetomidine. IOP values were recorded before treatment (T0) and following the treatment at 10 (T10), 20 (T20), 30 (T30), and 40 min (T40) in both groups. Administration of butorphanol with and without medetomidine did not cause a statistically significant change in IOP values. The IOP did not change over time (p = 0.41). The mean values of IOP in butorphanol, and butorphanol-medetomidine groups were 20.00 ± 2.29 and 20.38 ± 2.35 mm Hg, respectively. In conclusion, intramuscular administration of butorphanol with or without medetomidine had no significant effect on IOP in cats.

Twenty-Four-Hour Intraocular Pressure in Chronic Primary Angle-Closure Disease.

Primary angle closure and primary angle closure glaucoma may exhibit normal intraocular pressure. Twenty-four-hour intraocular pressure fluctuation is highest in primary angle closure glaucoma. The degree of peripheral anterior synechiae was associated with a 24-hour intraocular pressure pattern in primary angle-closure disease without laser iridotomy. The purpose of this study was to study 24-hour intraocular pressure (IOP) patterns in eyes with chronic primary angle-closure disease and evaluate associations between peripheral anterior synechiae (PAS) and 24-hour IOP pattern. In this prospective cohort study, 59 eyes of 35 Asian patients with chronic primary angle-closure disease underwent complete ocular examinations at Ramathibodi Hospital, Mahidol University. Twenty-four-hour IOP records were obtained using Goldmann applanation tonometry at 2-hour intervals. Peak, mean, and trough 24-hour IOP values and 24-hour IOP fluctuation (difference between peak and trough values) were compared among groups. None of the participants received any treatment before complete data collection. Even univariable analysis demonstrated a significant difference in peak, mean, and trough IOP and 24-hour IOP fluctuation between the 3 groups; the magnitude of trough IOP was not higher than 21mmHg in all groups. In multivariable analysis, PAC and PACG eyes showed significantly higher peak IOP ( P =0.020 and 0.006, respectively) and 24-hour IOP fluctuation ( P =0.048 and 0.001, respectively) compared with PACS eyes. In comparison between combined PACS and PAC eyes versus PACG eyes, PACG eyes revealed significantly higher 24-hour IOP fluctuation. The degree of PAS was associated with peak and mean IOP values and with 24-hour IOP fluctuation in PAC and PACG eyes. Twenty-four-hour IOP fluctuation was highest in PACG eyes. Although PAC and PACG eyes showed higher peak IOP and 24-hour IOP fluctuation values, compared with PACS eyes, trough IOP in PAC and PACG eyes were mostly below 21mmHg. In addition, the degree of PAS was associated with a 24-hour IOP pattern in either PAC or PACG eyes.

Intraocular Pressure Values using IcareⓇ Rebound Tonometer and Correlation with Postconceptional Age in Premature Infants.

This study aimedto determine a normative range of intraocular pressure (IOP) values measured with Icare rebound tonometer in premature infants and evaluate IOP variation over time and its correlation with the progression of postconceptional age (PCA). By doing so, we also evaluated advantages of this IOP-measuring method in this population when compared to more traditional methods. We conducted a single-center prospective study that included premature infants (gestational age 32 weeks) who were admitted to the neonatal intensive care unit (NICU) in Hospital Professor Doutor Fernando Fonseca. The study took place between January and December 2021. IOP was measured using Icare tonometer on the occasion of the first retinopathy of prematurity (ROP) screening requested by the NICU and again after a two-week interval if PCA was still 37 weeks. IOP measurements were stopped at 37 weeks or if the infant was discharged. The evaluated outcomes were mean IOP values and their correlation with PCA. Thirty-four eyes of 17 preterm infants with a mean gestational age of 29.4 2.3 weeks and a mean birth weight of 1222.9 361.9 gr were evaluated. The mean IOP registered was 16.1 6.4 mmHg, with a median value of 15.3 mmHg. The top 90 percentile was 22.1 mmHg and the bottom 10 percentile was 9.0 mmHg. The average IOP reduction was 4.8 6.7 mmHg (P = 0.0019) within the two-week interval of PCA. The mean IOP in premature infants was 16.1 6.4 mmHg and this value significantly decreased by 4.8 6.7 mmHg every two weeks of PCA.

Ocular examination findings and selected ophthalmic diagnostic tests in African green monkeys (Chlorocebus aethiops sabaeus).

To document ocular lesions and establish ophthalmic diagnostic test reference values in a colony of African green monkeys (Chlorocebus aethiops sabaeus). Fifty one geriatric (GAGM, 19-30 years old), 10 adult (AAGM, 5-9 years old) and 10 juvenile (JAGM, <2 years old) African green monkeys housed in a single Caribbean research colony. Ocular biomicroscopy, indirect fundoscopy, Schirmer tear test (STT), rebound tonometry (TonoVet®) and corneal fluorescein staining were performed. Mixed ANCOVA tests were performed to compare STT and IOP between groups. Common ocular lesions in GAGM included vitreal degeneration (27/51, 51/102 eyes) and cataracts (21/51, 32/102 eyes). Vitreal degeneration was also common in AAGM (8/10, 16/20 eyes) and infrequent in JAGM (3/10, 6/20 eyes). Cataracts were not present in any JAGM or AAGM. All eyes in all three groups had perilimbal corneal pigmentation and faint lace-like anterior corneal stromal opacification. Median (range) STT values were 16.0 (18) mm/min in GAGM. Mean (SD) STT values were 14.2 (4.6) mm/min in AAGM, and 8.9 (3.4) mm/min in JAGM. Median (range) IOP values were 16.5 (27) mmHg in GAGM. Mean (SD) IOP values were 18.0 (2.8) mmHg in AAGM, and 14.1 (2.2) mmHg in JAGM. JAGM had significantly lower STT and IOP values compared to AAGM (p = .0449, .0057, respectively) and GAGM (p = .0002, .0130, respectively). Spontaneous ocular lesions were common in geriatric monkeys in this research colony. IOP and STT values were lower in juvenile African green monkeys relative to adult or geriatric animals.

Safety and Efficacy of Prostaglandin Analogues in the Immediate Postoperative Period after Uneventful Phacoemulsification

Prostaglandin analogues (PGAs) have been associated with the development of pseudophakic macular edema (PME) in complicated cataract cases, but evidence on their effects in uncomplicated phacoemulsification remains controversial. This two-arm, prospective, randomised study included patients with glaucoma or ocular hypertension under PGA monotherapy who were scheduled for cataract surgery. The first group continued PGA use (PGA-on), while the second discontinued PGAs for the first postoperative month and reinitiated use afterwards (PGA-off). Topical non-steroidal anti-inflammatory drugs (NSAIDs) were routinely administered to all patients during the first postoperative month. The patients were followed up for three months and the primary outcome was PME development. Secondary outcomes were corrected distance visual acuity (CDVA), central and average macular thickness (CMT and AMT), and intraocular pressure (IOP). The analysis included 22 eyes in the PGA-on group and 33 eyes in the PGA-off group. No patient developed PME. CDVA was not significantly different between the two groups (p = 0.83). CMT and AMT showed a small but statistically significant increase until the end of follow-up (p &lt; 0.001). Mean IOP values had no significant differences between the groups at each visit (p &gt; 0.05). At the end of follow-up, the IOP values were significantly lower than baseline in both groups (p &lt; 0.001). In conclusion, PGA administration with concomitant topical NSAIDs appears to be a safe practice in the early postoperative period of uncomplicated phacoemulsification.

A brief history of the evolution of tonometers and comparison of goldmann applanation tonometer versus non–contact tonometer and their correlation to central corneal thickness

: This study was designed to evaluate and compare differences between Goldmann applanation tonometer’s (GAT) values and non-contact tonometer’s (NCT) values In various central corneal thickness(CCT).: This prospective study of 100 eyes of 50 subjects was done for the age group of 25 yrs – 75 yrs, who did not have any glaucomatous changes in the optic disc. Intraocular pressure readings were taken by GAT and NCT was measured within a fixed time range of 10:00 AM to 1:00 PM to minimize the effect of diurnal variation. CCT and NCT readings were measured by NIDEK 530P while GAT was performed by Appasamy ref AATM-K001 after 20 minutes and was recorded from both eyes of 50 subjects. Then the CCT effect was correlated with the intraocular pressure values, which were obtained by GAT and NCT.: The data were recorded from 100 eyes of 50 subjects, of whom 24 were females and 26 were males.The mean age was 51.22 ± 2.7 years, while the mean CCT value was 530.6 ± 5.7 µ.The mean IOP values respectively for NCT and GAT were 15.41 ± 0.6 mmHg, and 15.11 ± 0.5 mmHg, respectively (Table 1). The data shows a significantly strong positive correlation between NCT and CCT (r= 0.73, P&amp;#60; .0001), and a strong positive correlation between GAT and CCT (r= 0.55, P&amp;#60; .0001) (Table 2, 5 and 6).The Pearson coefficient value between NCT and GAT was also strong (r = 0.76, P&amp;#60; .00001)(Table 3). The findings in our study correlate with earlier research. It demonstrates that, with the application of appropriate correction factors for CCT, NCT can be considered a good screening tool for the measuring Intraocular pressure.

Effects of topical prostaglandin therapy on corneal layers thickness in primary open-angle glaucoma patients using anterior segment optical coherence tomography.

To evaluate the effects of latanoprost, bimatoprost, and travoprost eye drops and their preservatives on each corneal layer thickness in patients with primary open-angle glaucoma (POAG). We retrospectively analyzed 79 eyes of 79 patients with POAG who were receiving prostaglandin therapy. Patients were divided into three subgroups according to monotherapy with latanoprost, bimatoprost, and travoprost during a mean of 43.14 ± 19.12months follow-up period. In addition, the central corneal epithelial thickness (CET), central corneal stromal thickness (CST), and total central corneal thickness (CCT) were measured by anterior segment optical coherence tomography (AS-OCT) at baseline and every six months after treatment initiation at each visit between 9 and 12 o'clock in the morning. Furthermore, intraocular pressure (IOP) was measured with Goldmann applanation tonometry (GAT) after AS-OCT measurements at each visit. All three groups were not significantly different in age, gender, follow-up period, and mean intraocular pressure values (p > 0.05 for all). The reduction of CCT in the latanoprost, bimatoprost, and travoprost groups was 6.53 ± 3.17, 18.59 ± 8.42, and 10.1 ± 1.13µm, respectively. The decrease in CST values was 4.65 ± 1.54, 15.84 ± 7.47, 9.69 ± 1.45µm, and CET values were 1.88 ± 1.66, 2.75 ± 0.73, 0.41 ± 0.54µm in all groups, respectively. A statistically significant thinning was observed in all corneal layers (p < 0.05) except the CST values in the latanoprost group and CET values in the travoprost group. However, no significant difference was found in the average reduction of CET, CST, and CCT values among the three groups (p > 0.05). Topical treatment with latanoprost, bimatoprost, and travoprost affects each layer of the cornea separately according to the active and protective substances contained in these eye drops. On the other hand, the thinning effect on the corneal layers was similar in these three drugs because there was no significant difference between the three groups in the total amount of thinning of the corneal layers during the follow-up period.

Evaluation of structural and vascular changes in the choroid after uneventful phacoemulsification surgery.

Objective: The aim of this study was to evaluate structural and vascular changes in the choroid after phacoemulsification surgery. Methods: This research comprised 50 eyes of 50 individuals who received uneventful surgical treatment for cataracts. Intraocular pressure, axial length, subfoveal choroidal thickness, and choroidal thickness in the nasal and temporal areas at 1,500-micron distance from the fovea were measured before surgery and at one and three months after surgery. At the same evaluation times, the choroidal luminal area and choroidal stromal area were calculated with the binarization method using image J software, and the choroidal vascular index (CVI) was calculated by dividing the luminal area by the total area. In addition, total surgery time and effective phacoemulsification time were recorded. Results: The patients had a mean age of 64.7 ± 8.5 years. The mean total operative time was 13.9 ± 3.8 minutes, and the mean effective phacoemulsification time was 3.8 ± 2.1 minutes. The mean intraocular pressure value was 14.4 ± 3.4 mmHg before surgery, and 13.2 ± 2.9 mmHg at the first month and 13.0 ± 2.1 mmHg at the third month postoperatively. Although there was a decrease in the intraocular pressure after surgery, no significant difference was found (p>0.05 for all). The axial length measured during the first and third months postoperatively did not significantly differ from the evaluation undertaken preoperatively (p>0.05 for all). A significant increase was detected in the subfoveal, nasal, and temporal choroidal thicknesses at the first postoperative month compared to the preoperative values (p<0.05), but no significant difference was found at the third month postoperatively (p>0.05). The mean CVI was 61.6 ± 3.5% preoperatively, 65.2 ± 4.2% at the first postoperative month, and 65.9 ± 3.9% at the third postoperative month. The increase at the first and third postoperative months was significant when compared to the evaluation made preoperatively (p=0.004 and p<0.001, respectively). Conclusion: Structural and vascular choroidal changes in the after-cataract surgery are important. In this study, it was observed that after uneventful phacoemulsification, the choroidal thickness increased at the first postoperative month and reached the preoperative values at the third month. It was also determined that CVI increased at the first and third postoperative months. CVI can offer an idea about whether cataract surgery is a predisposing factor in diseases involving the choroid. Abbreviations: CVI = choroidal vascular index.

Long term results of photodynamic therapy in intraocular tumors

PurposeTo report long term results of photodynamic therapy (PDT) as treatment for intraocular tumors MethodsRetrospective interventional case series of 15 patients. All patients treated with standard-fluence PDT (83 s; 50 J/cm2) using verteporfin. Outcome measuresTumor diameter, tumor thickness, subretinal fluid resolution, best-corrected visual acuity,intraocular pressure and PDT complications. Results10 patients (66.7% of total patients) were diagnosed with choroidal hemangioma, 3 patients (20% of total patients) were diagnosed with choroidal melanoma, and 2 patients (13,3% of total patients) were diagnosed with choroidal osteoma.. Mean follow-up time was 33±18 months. The mean visual acuity was determined as 1.29 ± 0.98 logMAR in the examinations just before the PDT application. At the end of the follow-up period, the mean visual acuity was calculated as 1.41 ± 1.07 logMAR. While VA increased in 3 (20%) patients and decreased in 5 (33.3%) patients; It was determined that VA value did not change after treatment in 7 (46.7%) patients. The mean lesion diameter before PDT was 6573 ± 2115 µm (range; 1500–10,000 µm). The mean tumor thickness before PDT was 3624 ± 1404 µm (range; 600–6000 µm). The mean lesion diameter after treatment was 6026 ± 2521 µm (range; 0–9000 µm), and the mean tumor thickness after treatment was 2280 ± 1740 µm (range; 0–6000 µm).After the PDT, tumor size decreased in 8 (53.3%) patients, increased in 3 (20%) patients, and no change in tumor size was observed in 4 (26.7%) patients. Mean IOP values of all patients were 14.06 ± 3.17 mmHg before treatment; after treatment, it was measured as 13.46 ± 1.70 mmHg. After the treatment, geographic atrophy developed in 1 (6.7%) patient, cystoid macular edema developed in 1 (6.7%) patient, Retinal Pigment Epithelium (RPE) and choroidal atrophy developed in 1 (6.7%) patient. ConclusionThere are not enough cases of each to clearly distinguish between these 3 types of ocular cancers.However PDT may be a good option in the treatment of intraocular tumors with the chance of selective treatment and successful response.

Динамика изменения внутриглазного давления при интравитреальном введении афлиберцепта и бролуцизумаба при лечении неоваскулярной формы возрастной макулярной дегенерации

Purpose. To study the dynamic changes of intraocular pressure (IOP) produced by intravitreal injection (IVI) of aflibercept and brolucizumab in patients with neovascular form of age-related macular degeneration (nAMD). Material and methods. This study included 40 patients with nAMD, who were randomly divided into 2 groups of 20 people. In 1st group, patients received aflibercept, in group 2nd – brolucizumab. IOP was measured with an ICare Pro point contact tonometer before IVI (T0), 1 minute (T1), 30 minutes (T2), 60 minutes (T3) after IVI. Measurement of IOP was performed during the first injection. Mathematical and statistical processing of the obtained data was performed using the statistical program SPSS 23.3. A p &lt; 0.05 value was considered statistically significant. Results. In the two groups, the dynamic changes of IOP was the same: IVI increased immediately, returned to normal within 30–60 minutes. Mean IOP values before the start of treatment were comparable in the two groups (p = 0.89), 1 min after IVI anti-VEGF drugs, the mean IOP was significantly higher in 2nd group compared to 1st group (p = 0.002), 30 min and 60 min after IVI IOP in 1st and 2st groups were not differ statistically (p = 0.36, p = 0.68, respectively). The number of patients with IOP 1 min after IVI more than 35 mm Hg in 2nd group was 75 %, while in 1st group – 50 %. Conclusions. In this study, we compared for the first time the dynamic changes of IOP after IVI of aflibercept and brolucizumab. To further study it is necessary to analyze longterm results in a larger sample of patients. Keywords: brolucizumab, aflibercept, intraocular pressure

ASSOCIATION OF INTRAOCULAR PRESSURE CHANGES IN DIFFERENT DEGREES OF MYOPIA

Introduction: Myopia, also known as “short-sightedness” or “near-sightedness,” is an increasingly widespread condition around the world. Myopia is commonly defined as a spherical equivalent (SE) ≤ 0.5 dioptres (D) and develops mainly during childhood and early adulthood when excessive elongation of the eye causes images of distant objects to fall in front of the retina with the eye at rest, resulting in a blurred distance vision. Myopia can be classified according to age of onset, clinical variety, etiology, and degree. According to the degree, myopia can be classified as mild/low myopia (-0.25D to -2.75D);moderate/medium myopia (-3.00D to -6.00D) and high myopia (Above -6.00D).Aim and Objective: To investigate the intraocular pressure changes in the different degrees of myopia. Material and Methods: This study was a clinical study carried out at the department of ophthalmology, rukmani birla hospital,Jaipur. An informed consent was gotten from all the subjects who were part of the study.Clinical tests performed on the subjects include case history, visual acuity, external eye examination, ophthalmoscopy, static retinoscopy and subjective refraction. The subjects with myopia were grouped into three according to the degree of myopia. Their intraocular pressure was measured using the indentation tonometry. Data was collected and uploaded into the Statistical Package for Social Sciences (SPSS) version 21 and the one-way ANOVA was used to test the null hypotheses at 0.05% level of significance and 95% confidence interval. Result: The study included a Sample size of 100 Patients.The table showed that 50 (50.00%) of the subjects had mild myopia;42 (42.00%) had moderate myopia and 8 (8.00%) had high myopia.IOP of 10 - 15 were 20 (20.00%);16 -20,26 (26.00%);21 – 25,4 (4.00%);26 – 30,0 (0.00%).Minimum,maximum and mean IOP values for low myopes were 10.3,30.6 and 17.13 mmHg respectively.For medium myopes,the minimum,maximum and mean IOP values were 11, 22 and 16.63 mmHg respectively. For high myopes, the minimum, maximum and mean IOP values were 18.8, 22 and 20.15 mmHg respectively. SPSS data analysis using the one-way ANOVA at 0.05 level of significance showed that there was a significant difference [P(0.036) &lt; 0.05] in the IOP values between the different degrees of myopia. Conclusion: In conclusion, there was a significant difference in the IOP of different degrees of myopia.Eye care practitioners are advised to closely monitor the IOP of their myopic patients.For young children,as the myopia progresses,the IOP should also be monitored.

A Prospective Randomized Study Comparing 27-Gauge Vitrectomy to 23-Gauge Vitrectomy for Epiretinal Membranes and Full-Thickness Macular Holes.

To compare the surgical and clinical outcomes of 27-gauge vitrectomy and 23-gauge vitrectomy. We conducted a single-center, prospective, randomized study. Fifty-three patients affected by vitreoretinal interface disorders (epiretinal membranes and macular holes) were randomly scheduled to undergo 27-gauge (28 patients) or 23-gauge (25 patients) pars plana vitrectomy. The presence of any potential factor of increased baseline inflammation or eye anatomy influencing the surgery was criteria for exclusion. The time of surgery, postoperative intraocular pressure (IOP), state of sclerotomy wounds, rate of complications, postoperative pain, and indicators of inflammation were studied. We also introduced a new parameter to compare intraocular inflammation after surgery, given by the change in the number of intraretinal hyperreflective foci (HRF). The 27-gauge vitrectomy was 1.28 min longer than 23-gauge vitrectomy (P < 0.05). The day after surgery, the mean IOP value was significantly higher in the 27-gauge group (16.12 mmHg versus 13.04 mmHg in the 23-gauge group,P < 0.05), but this difference disappeared in successive follow-ups and the sclerotomy wounds closed after 2 weeks in the both groups. The rate of postoperative hypotony did not significantly differ in the two groups (10.71% in the 27-gauge group and 8% in the 23-gauge group the day after the surgery,P = 0.94). Less postoperative eye redness was seen in 27-gauge eyes (value 1 on the scale) compared to 23-gauge (value 2 on the scale) (P < 0.05), but there was no significant difference in intraocular inflammation (cells, Tyndall, and number of HRF,P > 0.05 for all). The 27-gauge vitrectomy may have better outcomes in terms of IOP maintenance and cause less redness after the surgery but with a slightly prolonged surgery time and no other differences under other parameters (inflammation, rate of complications, postoperative pain, visual gain, and closure of the sclerotomy wounds).

Comparison of four tonometers in the measurement of intraocular pressure in healthy horses.

Measurement of the intraocular pressure (IOP) is a useful diagnostic tool in equine ophthalmology. Handheld tonometers, such as Tonovet and Tonovet Plus (rebound), Tono-Pen AVIA Vet (applanation), and Kowa HA-2 (applanation using the Goldmann methodology) are used to obtain IOP measurements in veterinary medicine. To compare and evaluate the accuracy of four handheld tonometers in measuring IOP using different methodologies in healthy horses. In vivo experiment and cross-sectional survey of healthy horses. Intraocular pressure was measured in 72 eyes of 36 horses. An in vivo study was conducted on sedated horses to compare the real IOP values obtained using manometry versus those obtained using tonometry, and a field study was conducted on unsedated healthy horses with normal eyes to measure the IOP values using different tonometers. In the in vivo study, the mean IOP values using ocular manometry was 24.9± 4.0 mmHg (range, 20.0-30.0 mmHg). The mean IOP values using tonometry were: Tonovet, 25.7± 5.8 mmHg (range 19.5-33.0 mmHg); Tonovet Plus, 24.8± 7.1 mmHg (range 13.2-33.2 mmHg); Tono Pen AVIA Vet, 19.2± 4.7 mmHg (range 13.1-26.5 mmHg); and Kowa Ha-2, 24.1± 1.2 mmHg (range 22.8-25.8 mmHg). In the field study, the IOP values were: Tonovet, 30.7± 5.6 mmHg (range 21.7-38.0 mmHg); Tonovet Plus, 29.6± 6.7 mmHg (range 16.2-38.6 mmHg); Tono-Pen AVIA Vet, 27.3± 5.8 mmHg (range 14.6-37.1 mmHg); and Kowa HA-2, 23.4± 2.2 mmHg (range 20.2-28.7 mmHg). This study included only healthy horses and a limited number of animals in the in vivo study. There was a strong correlation between the IOP values and manometry for all tonometers. IOP should be estimated using the same tonometer over time, and the bias of the tonometer used, such as overestimation (rebound tonometer) and underestimation (applanation tonometer), should be acknowledged. A normal reference value for each tonometer should be established in horses.