Postoperative Intraocular Pressure Values Research Articles

Outcomes of early versus delayed trabeculotomy for primary congenital glaucoma.

In patients with primary congenital glaucoma (PCG), elevated intraocular pressure (IOP) causes abnormal eye growth. This study compared the outcomes of children with PCG who underwent ab externo trabeculotomy (TROC) at age ≤ 6months (early TROC) and of those who underwent TROC at age > 6months (delayed TROC). Intraocular pressure, horizontal corneal diameter (HCD), central corneal thickness (CCT) and axial length (AL) were compared before TROC and at 1-, 3-, 6- and 12-month follow-up visits between the groups of children who underwent TROC until or after 6months of age. The ALs of these groups were also compared with the ALs of healthy age-matched eyes examined under the same conditions. Trabeculotomy was performed in 43 children: 18 (33 eyes) aged 6months (group 1) and 25 (37 eyes) aged >6months (group 2); the mean ages were 86.56 ± 53.64 and 504.48 ± 448.14 days, respectively. The mean pre- and 12-month postoperative IOP values were 15.97 ± 4.78/16.62 ± 4.85 and 9.77 ± 2.88/10.93 ± 4.83 mmHg, respectively. Delayed TROC was associated with abnormal AL in 31 (88.6%) out of 37 eyes, while after early TROC, only 13 (41.9%) out of 33 eyes had abnormal AL (chi-square, 8.00; p= 0.03). In multivariable analysis, each 1-mmHg increase in preoperative IOP was associated with a 0.25-mmHg increase at 12 months (p= 0.04). On average, the mean IOP of the delayed TROC group was higher than that of the early TROC group by 3.72 mmHg at postoperative month 12 (95% CI=0.44-6.99; p= 0.02). Compared with delayed TROC, early TROC is associated with reduced IOP and substantially reduced incidence of abnormal AL at postoperative month 12.

Comparison of different correction formulas and measurement methods for the accurate determination of intraocular pressure after SMILE and FS-LASIK surgery

BackgroundTo compare the accuracy of non-contact tonometry, Pentacam, and corneal visualization Scheimpflug technology (Corvis ST) for the measurement of intraocular pressure (IOP) after small incision lenticule extraction (SMILE) or femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery.MethodsA total of 49 patients (98 eyes) undergoing FS-LASIK or SMILE surgery at West China Hospital, Sichuan University from January to March 2021 were enrolled in this prospective, comparative, self-controlled study. IOP values were measured with non-contact tonometer, Pentacam, and Corvis ST before surgery and 1 month after surgery. Pentacam-derived postoperative IOP values were corrected using five correction formulas (Ehlers, Shah, Dresden, Orssengo-Pye, and Kohlhaas), while Corvis ST-derived values were corrected using a single formula.ResultsIn the SMILE group, no significant differences were observed between the IOP values corrected with the Shah formula before and after surgery (t = 0.17, P = 0.869), whereas postoperative IOP values corrected with the other formulas were significantly different from the corresponding preoperative measurements (P < 0.05). In the FS-LASIK group, postoperative IOP values corrected with the Ehlers, Shah, or Corvis ST formulas were significantly different from the corresponding preoperative IOP measurements (P < 0.05), but no significant differences were observed between pre- and postoperative IOP values corrected with the Dresden (t = − 0.08, P = 0.941), Orssengo-Pye (t = − 0.52, P = 0.604), or Kohlhaas (t = 1.22, P = 0.231) formulas.ConclusionsPentacam’s Shah correction formula seemed to be the most appropriate method for accurately measuring postoperative IOP in patients undergoing SMILE surgery, while the Dresden, Orssengo-Pye, and Kohlhaas correction formulas of Pentacam were identified as the most reliable methods for estimating IOP in patients after FS-LASIK surgery.

Efficacy comparison of combined trabeculectomy with MMC and gonioscopy-assisted transluminal trabeculotomy.

To compare the efficacy of gonioscopy-assisted transluminal trabeculotomy combined with cataract surgery (PGATT) and trabeculectomy combined with cataract surgery (PTRAB) in open-angle glaucoma patients. A multi-centered, retrospective, non-randomized study included 67 PGATT patients and 70 PTRAB patients. We compared preoperative intraocular pressure (IOP), best-corrected visual acuity (BCVA) compared with early and final IOP, medication numbers, and BCVA levels. Success was determined as IOP reduction > 20% from baseline, IOP between 5 and 21mmHg, preoperative IOP of higher than 21mmHg with medication and postoperative IOP of less than 21mmHg without medication for surgeries performed for intolerance to medication, postoperative IOP < 21mmHg as well as < 18mmHg separately without medications, and no need for further glaucoma surgery. Preoperative IOP values were 28.61 ± 6.02mmHg in PTRAB group and 23.99 ± 8.00mmHg in PGATT group (P < 0.0001). Early postoperative IOP values were found lower in PTRAB group as 12.19 ± 3.41mmHg and as 15.69 ± 4.67mmHg in PGATT group (P < 0.0001). Last follow-up IOP reading were lower in PGATT group (P = 0.009). IOP difference values were found higher both in early and last postoperative periods in PTRAB group (respectively, P < 0.0001, P = 0.018). Success rates were found higher in both at lower than 21 and 18mmHg levels in PGATT group (respectively, P = 0.014, P = 0.010). We found the PGATT combined procedure to be a well-tolerated, effective procedure that can lower IOP both early and late in the postoperative period with different rates of IOP success compared with the combined PTRAB procedure.

Intraocular Pressure Elevation Following the Use of Topical Dexamethasone Ointment After Squint Surgery.

Purpose:To describe the pattern of intraocular pressure (IOP) changes after squint surgery in eyes of black Africans at the University College Hospital, Ibadan, Nigeria.Materials and Methods:This was a retrospective review of the clinical records of patients who underwent squint surgery between 2010 and 2019. Data on demographic characteristics, preoperative and postoperative intraocular pressure values, co-existing ocular pathology, type of strabismus, surgery performed, frequency and duration of postoperative topical steroid use and treatment received for elevated intraocular pressure were collected and descriptively summarised.Results:Thirty-six (39.1%) out of 92 patients who had squint surgery during the study period met study inclusion criteria. Mean age was 20.5 ± 13.6 years. All patients were administered Maxitrol® ointment postoperatively. Baseline, peak and net change in IOP were 12.9 ± 2.6 mmHg, 21.3 ± 6.8 mmHg and 8.39 ± 7.2 mmHg respectively. Thirty-one (86.1%) patients had elevation in IOP from baseline; 21 (67.7%) of these had significant IOP elevation. Topical steroid therapy was tailed off rapidly for all patients with significant IOP elevation. Twelve patients were commenced on topical IOP lowering medications, with normalization of intraocular pressure in majority of them by three months after surgery.Conclusion:Elevated intraocular pressure with the use of topical dexamethasone ointment after squint surgery was common in this study and majority of the patients had significant elevation in intraocular pressure. Close monitoring of the intraocular pressure of black patients, especially children, on topical steroid medication after squint surgery is strongly recommended.

Phacoemulsification with Kahook Dual Blade goniotomy in eyes with medically treated glaucoma: analysis of surgical outcomes and success predictors.

The purpose of this study was to investigate the postoperative outcomes and evaluate the success predictors of phacoemulsification with Kahook Dual Blade goniotomy for cataract and glaucoma management in eyes with primary open-angle glaucoma. This was a retrospective, non-comparative; inter ventional case series in which all patients with primary open-angle glaucoma who underwent phacoemulsification with Kahook Dual Blade goniotomy between June 2018 and April 2019 were enrolled. All the participants had a minimum follow-up period of 6 months. Preoperative and postoperative intraocular pressure values (at 1, 3, and 6 months), number of antiglaucoma medications, best-corrected visual acuity, surgical complications, and any subsequent related events or procedures were recorded. A logistic regression analysis was performed to investigate the association between the different variables and surgical outcomes. A total of 47 patients (57 eyes) were included (mean age, 70.5 ± 7 years). The mean intraocular pressure was reduced from 15.5 ± 4.2 mmHg to 12.2 ± 2.4 mmHg at the last follow-up visit (p<0.001). The mean number of antiglaucoma medications decreased significantly from 1.9 ± 1.0 to 0.6 ± 1.0 during the same period (p<0.001). On the basis of the predefined criterion (intraocular pressure reduction ≥20% and/or reduction ≥1 medication), the 6-month success rate was 86%. A higher preoperative intraocular pressure value (odds ratio [OR]= 2.01; p=0.016) and greater percentage of initial (30 days) intraocular pressure reduction (OR= 1.02; p=0.033) were sig nificantly associated with surgical success. Our findings suggest that phacoemulsification with Kahook Dual Blade goniotomy is an effective and safe alternative for cataract management in eyes with primary open-angle glaucoma that positively impacts intraocular pressure control and medication burden. Eyes with higher baseline intraocular pressure and a more pronounced initial response to the procedure appeared to present better outcomes at 6 months. Further studies are needed to evaluate the long-term efficacy and safety profile of the procedure.

Risk factors for hypertensive phase after Ahmed glaucoma valve implantation.

To investigate the risk factors and the clinical characteristics of the hypertensive phase (HP) after Ahmed glaucoma valve (AGV) implantation. This retrospective study included 60eyes of 57 patients who underwent AGV implantation and with at least 1-year follow-up. HP was defined as intraocular pressure (IOP) > 21mmHg in the first 3months after the surgery. Independent samples t-test and Chi-square test were used to compare differences in patients with the HP and the non-HP groups. Univariable and multivariable logistic regression analyses were used to determine the risk factors for the development of the HP. Statistical significance was assumed at p < 0.05 level. HP was observed in 31 eyes (51.7%) with an average peak IOP of 27.6 ± 4.5mmHg (range 22-40mmHg). The resolution of HP was noted in 27eyes (87.1%) at the 3rd month postoperative visit. The number of glaucoma medications at the last postoperative visit and IOP values from 1month to 1year were significantly higher in the HP group (all p < 0.05). Patients with traumatic glaucoma showed the highest rate (83.3%) of HP development. In the multivariable analysis, a preoperative IOP > 30mmHg (p = 0.03, OR:5.82; reference: ≤ 25mmHg) and younger age (41-64years, p = 0.02, OR:8.49; ≤ 40years, p = 0.001, OR:19.62; reference: ≥ 65years) were independently associated with the occurrence of HP. Hypertensive phase was observed in half of the patients undergoing AGV implantation. A higher mean preoperative IOP and younger age were risk factors for HP development. Although the majority resolved at the 3-month visit, eyes with HP had higher mean IOPs and required more IOP lowering medications.

Comparative Study between Corneal Topographic Changes Following Phacoemulsification and Small Incision Cataract Surgery

Background: Phacoemulsification has become the routine procedure for cataract extraction for most of the surgeons because of its smaller incision and rapid visual rehabilitation. Also, manual small incision cataract surgery (MSICS) with its sutureless relatively smaller incision, compared to conventional extracapsular cataract extraction, has similar advantages to phacoemulsification in addition to its lower risk to corneal endothelium especially in hard cataracts and elder patients. Objective: To compare the effect of phacoemulsification and small incision cataract surgery on corneal topography in a prospective randomized study. Patients and methods: 80 eyes were included in this study. Patients were divided into two groups: Group A (40 eyes) underwent phacoemulsification and Group B (40 eyes) underwent MSICS. Both groups were studied preoperatively and postoperatively regarding uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), keratometry, and corneal topography. Results: There was a significant difference between preoperative and postoperative uncorrected visual acuity (UCVA) during the follow up period (p value < 0.001) among both study groups. There was no significant difference in preoperative as well as postoperative intraocular pressure (IOP) or between preoperative and postoperative IOP values in both study groups. There was significant increase in the mean central corneal thickness during first postoperative week in both studied groups (p value <0.001). In MSICS group there was minimal significant increase in astigmatism within the first weak and first month of follow up (p value 0.041). Conclusion: Cataract surgery using phacoemulsification or small incision cataract surgery was found to yield excellent visual results with no significant difference as regards to central corneal thickness, keratometric readings, and postoperative astigmatism or perioperative complications.

The Results of Trabeculectomy with Antimetabolites in Elderly Patients: A Retrospective Study

Objective: To examine the effectiveness and results of primary trabeculectomy with 5-fluorouracil (group 1) or mitomycin-C (group 2) in elderly patients.&#x0D; Materials and Methods: This was a retrospective study including 67 eyes with primary open-angle glaucoma that underwent primary trabeculectomy with group 1 or group 2. Patients who were followed up for less than 1 year or were under 55 years of age were excluded from the study. Surgical success was evaluated according to a decrease in cup/disk ratio and reduction of intraocular pressure without any topical medication.&#x0D; Results: The mean ages of participants were 65.7 years (range 59–88) and 65.9 years (range 59–74) in groups 1 and 2, respectively. The mean preoperative and postoperative intraocular pressure values were 31.3 ± 5.7 mmHg (range 17–46) and 14.8 ± 0.4 mmHg (range 10–21) in group 1 (p &lt; 0.001) and 31.5 ± 7.4 mmHg (range 18–52) and 14.8 ± 2.9 mmHg (range 10–21) in group 2 (p &lt; 0.001).&#x0D; Conclusion: The use of 5-fluorouracil or mitomycin-C during primary trabeculectomy is associated with high postoperative success rates. There were no significant differences between 5-fluorouracil and mitomycin-C in terms of intraocular pressure reduction.

Primary outcomes of Baerveldt glaucoma implants with a modified technique to control intraocular pressure in different cases of glaucoma.

To describe the outcomes of Baerveldt glaucoma implants implanted via a modified technique with regard to early intraocular pressure (IOP) reduction in cases of uncontrolled glaucoma. The medical records of patients who had Baerveldt glaucoma implants of 350 or 250mm2 implanted via a modified technique and were followed up for a period of at least 6months were reviewed. The primary outcome measures were the mean IOP and number of glaucoma medications at each visit. We evaluated complete success rates at 1day, 1week and 1month, defined as IOP values [Formula: see text] 5mmHg and ≤ 21mmHg prior to ligature rupture. A total of 42 eyes had Baerveldt glaucoma implants and met the inclusion criteria. The mean preoperative intraocular pressure (IOP) was 34.2 ± 11.2mmHg. The postoperative mean IOP values were 15.1mmHg ± 8.8 (p < 0.05), 17.7 ± 7.1mmHg (p < 0.05), 12.3 ± 4.0mm Hg (p < 0.05) at 1day, 1month, and 6months, respectively. The rate of complete success on the first day was 78%, at the first month was 69%, and at 6months was 95.2%. The number of glaucoma medications used was significantly lower at 6months (P = < 0.001). The modified surgical technique using Baerveldt implants enables a safe, effective, and reliable IOP control in early postoperative patients with uncontrolled glaucomas.

Ex-Press® versus Baerveldt implant surgery for primary open-angle glaucoma and pseudo-exfoliation glaucoma.

To compare surgical outcomes between Ex-Press® (EXP) and Baerveldt glaucoma implant (BGI) surgeries for primary open-angle glaucoma (POAG) and pseudo-exfoliation glaucoma (PEXG) patients. This was a retrospective single-facility study. The inclusion criteria were that the patient's preoperative intraocular pressure (IOP) was > 21mmHg and the post-surgery follow-up was > 1year. We recruited 161 patients who had undergone a trabeculectomy with EXP (89 eyes) or BGI surgery (72 eyes). We compared these groups' postoperative IOP values and postoperative glaucoma medications, the reduction rate of corneal endothelial cell density (ECD), surgical outcomes, complications, the hospital stay duration, and the number of visits within 3months post-surgery. Both the EXP and BGI surgeries could significantly decrease the IOP. When the surgical success was defined postoperative IOP ≤ 21mmHg, the surgical outcome of BGI was significantly better than EXP (p = 0.0148). When the surgical success was defined postoperative IOP ≤ 18, 15 , and 12mmHg, the surgical outcomes between BGI and EXP surgeries were not significantly different (p = 0.0815, p = 0.331, and p = 0.910). The mean ECD reduction rate was significantly faster in the EXP group. The BGI patients had significantly shorter stays in the hospital and fewer visits within 3months post-surgery (p < 0.0001). BGI surgery could provide comparable surgical outcomes as EXP surgery for POAG or PEXG patients with high preoperative IOP. BGI surgery has some advantages: fewer post-surgery visits, less postoperative interventions, and a lower ECD reduction rate.

Retrospective Audit of Phacomorphic Glaucoma in Last 12 Years in a Tertiary Eye Care Centre, New Delhi, India

Introduction: Phacomorphic glaucoma is a type of secondary glaucoma caused by lens swelling in eyes with mature or intumescent cataract. It is encountered more commonly in developing countries. Its management includes initial lowering of Intraocular Pressure (IOP) followed by definitive treatment of removal of lens by cataract surgeries. The visual prognosis remains unpredictable due to the irreversible optic nerve damage that may have incurred in a matter of few days. It is equally pertinent to know the postoperative IOP values and whether these patients would require long term Anti-Glaucoma Medications (AGM). The role of Laser Peripheral Iridotomy (LPI) in IOP control preoperatively in such patients also needs to be evaluated. Aim: To assess the visual outcome, IOP control and the requirement of AGM after cataract surgery in phacomorphic glaucoma. Materials and Methods: This was a retrospective, observational study conducted from March 2019 to January 2020 on all patients diagnosed with phacomorphic glaucoma at the tertiary eye care centre. The primary variables were IOP and visual acuity. All patients underwent a complete ophthalmic examination. Cataract surgery was done after instituting treatment for IOP control. Preoperative LPI was done according to consulting doctors’ discretion. Trabeculectomy was combined with cataract surgery based on surgeons’ decision. Patients were followed for 6 weeks postoperatively. Fisher-test and paired t-test were used for statistical analysis. Results: A total of 118 patients (25 males and 93 females, mean age 64.55±6.35 years) were recruited in the study and 94 patients followed-up till last visit at 6 weeks. The mean presenting IOP was 39.55±12.55 mmHg. The mean IOP at day-1 postoperatively was 14.66±4.55 mmHg, the difference was statistically significant (p-value &lt;0.001). There was a significant drop in IOP seen postoperatively at day 1 and 6 weeks (p&lt;0.001). At 6 weeks, the mean IOP was 13.19±3.83 mm Hg. A combined cataract extraction and trabeculectomy did not result in statistically significant difference in the final IOP values. At 6 weeks follow-up, 87.23% patients did not require any AGMs; 63.83% patients gained good vision, 26.59% gained borderline vision and 9.58% had poor vision. LPI resulted in a better IOP control preoperatively (p=0.003). Conclusion: Cataract surgery alone results in good IOP control in phacomorphic glaucoma without a need for long term AGMs. However, to prevent permanent angle damage and disc changes an early surgical intervention is required. LPI appears to have a beneficial role in controlling the preoperative IOP in these eyes.

High risk of intraocular pressure rise with difluprednate post collagen cross-linking for keratoconus

Purpose: To report intraocular pressure (IOP) after use of difluprednate ophthalmic solution 0.05% (Durezol®; Novartis AG, Basilea, Switzerland) post corneal cross-linking (CXL) versus prednisolone (Pred-Forte®; Allergan Inc., Irvine, CA, USA). Methods: A retrospective single-center case series evaluation of 34 keratoconus patients ages 16-“41 (36 eyes) who underwent CXL with Avedro's KXL System® (Avedro Inc; Waltham, MA) between August 2016 and August 2017. Post-CXL, six eyes were given difluprednate and 30 were given prednisolone. IOP was recorded using Reichert model 30 pneumatonometer. Those that exhibited increased IOP at 3 days were given anti-glaucoma medications and changed to fluorometholone or loteprednol. Results: IOP's 3 days' postoperative (24.167 ± 5.23) in the difluprednate group were significantly higher than preprocedure (16.5 ± 2.258). In the prednisolone group, 3 days postprocedure the mean IOP (14.2 ± 3.199) was not significantly higher than preoperatory IOP mean (16.8 ± 4.232). The difference between IOP 3 days' postprocedure and before was 7.667 ± 4.546 for the difluprednate group and 2.567 ± 2.648 for the prednisolone group. These were compared using an unpaired t-test (t value = 3.750 ± 1.297) with P = 0.0007. Discussion: This study shows statistically significant difference in postoperative and preoperative IOP values after the use of difluprednate or prednisolone in young patients postCXL. Measuring the pachymetry on follow-up examinations could help see if changes in corneal thickness affect measured IOP. A controlled prospective double-blind study could confirm a greater increase in IOP following difluprednate versus prednisolone use, but due to the high risk, we do not recommend this study.

A Comparison of Scleral Tunnel and Pericardial Graft Implantation Techniques in Patients undergoing Ahmed Glaucoma Valve Implantation

The purpose of this study was to compare the two methods autologous scleral flap (scleral tunnel) and pericardial patch graft of tube covered in Ahmed glaucoma valve (AGV) in refractory glaucoma with respect to the tube exposure, infection, level of Intraocular Pressure (IOP), and any other complications due to applications of each technique. A retrospective chart review of 113 eyes in 102 patients with refractory glaucoma who underwent ahmed glaucoma valve (AGV) implantation (39 eyes in scleral tunnel and scleral flap group &amp;ldquo;first group&amp;rdquo; and 74 eyes in pericardium graft group&amp;rdquo; second group&amp;rdquo;) was performed. The procedures in these eyes were performed between January 2007 and October 2015 in a tertiary eye care hospital in KSA. The mean age was 56 &amp;plusmn; 19 (8 months- 83 years) in the Scleral tunnel group and 50 &amp;plusmn; 27 (1- 78 years) in the Pericardium group (p = 0.023). Fifty-six males and 57 females were included in the study. Medians of the follow-up were 48 &amp;plusmn; 25.5 months (3 &amp;ndash; 89) for the Scleral tunnel group and 29 &amp;plusmn; 21.4 months (2 &amp;ndash; 92) for the Pericardium group, and it is statistically significant (P &amp;lt; 0.001). According to the findings, preoperative diagnosis in the two groups included neovascular glaucoma (NVG) found in 21 eyes (53.8%) in the Scleral tunnel group versus 18 eyes (24.3%) in the Pericardium group (p = 0.009). Exposure of the valve was found in 15 eyes (20.27%) in Pericardium graft group versus 2 eyes (5.12%) only in scleral tunnel group (p = 0.002). These exposed valves lead to endophthalmitis in 5 cases in the second group and no single case in scleral tunnel group was detected (P &amp;lt; 0.001). The postoperative IOP values were statistically insignificant in all different time periods.&#x0D; &#x0D; Scleral tunnel method has less exposure rate than the pericardium graft.&#x0D; &#x0D; The purpose of this study was to compare the two methods autologous scleral flap (scleral tunnel) and pericardial patch graft of tube covered in Ahmed glaucoma valve (AGV) in refractory glaucoma with respect to the tube exposure, infection, level of Intraocular Pressure (IOP), and any other complications due to applications of each technique. A retrospective chart review of 113 eyes in 102 patients with refractory glaucoma who underwent ahmed glaucoma valve (AGV) implantation (39 eyes in scleral tunnel and scleral flap group &amp;ldquo;first group&amp;rdquo; and 74 eyes in pericardium graft group&amp;rdquo; second group&amp;rdquo;) was performed. The procedures in these eyes were performed between January 2007 and October 2015 in a tertiary eye care hospital in KSA. The mean age was 56 &amp;plusmn; 19 (8 months- 83 years) in the Scleral tunnel group and 50 &amp;plusmn; 27 (1- 78 years) in the Pericardium group (p = 0.023). Fifty-six males and 57 females were included in the study. Medians of the follow-up were 48 &amp;plusmn; 25.5 months (3 &amp;ndash; 89) for the Scleral tunnel group and 29 &amp;plusmn; 21.4 months (2 &amp;ndash; 92) for the Pericardium group, and it is statistically significant (P &amp;lt; 0.001). According to the findings, preoperative diagnosis in the two groups included neovascular glaucoma (NVG) found in 21 eyes (53.8%) in the Scleral tunnel group versus 18 eyes (24.3%) in the Pericardium group (p = 0.009). Exposure of the valve was found in 15 eyes (20.27%) in Pericardium graft group versus 2 eyes (5.12%) only in scleral tunnel group (p = 0.002). These exposed valves lead to endophthalmitis in 5 cases in the second group and no single case in scleral tunnel group was detected (P &amp;lt; 0.001). The postoperative IOP values were statistically insignificant in all different time periods.&#x0D; &#x0D; Scleral tunnel method has less exposure rate than the pericardium graft.

Does adjuvant intracameral triamcinolone acetonide increase the effectiveness of phacotrabeculectomy? A Case-Control Study.

To investigate the effect of intracameral triamcinolone acetonide (TA) on surgical success in 5-fluorouracil (5-FU) supported primary phacotrabeculectomy (PT) cases. This retrospective study included 23 eyes (study group) of 23 patients who underwent TA during PT and 26 eyes (control group) of 26 patients without TA. PT patients in the study group received 1 mg TA intraoperatively at the end of surgery. Pre- and postoperative visual acuity, intraocular pressure (IOP), and number of antiglaucoma drugs used were compared. Postoperative complications and need for 5-FU injection were evaluated for both groups. Mean age was 64.1 2 ± 1.91 (48-86) years in the control group and 66.52 ± 2.02 (52-86) years in the study group (p = 0.824). Comparison of pre- and postoperative IOP values showed significant decreases in postoperative IOP levels at all-time points in both the control and study groups (p &lt; 0.001). The only significant difference between groups was on postoperative first day (study group: 9.22 ± 1.41 mmHg; control group: 6.35 ± 2.17 mmHg, p &lt; 0.001). Need for postoperative 5-FU injection was significantly more common in the control group (p = 0.023). Intracameral injection of 1 mg TA at the end of PT surgery did not yield superior results in postoperative IOP compared to PT alone, and the two groups showed similar IOP reduction. When given as an adjunct to PT, 1 mg TA suppresses anterior segment inflammation and reduces the need for 5-FU injection.

Comparison of trabectome and microhook surgical outcomes

Several methods can be applied for a trabeculotomy, including the uses of thread, a blade, cauterization, and a hook. We compared the outcomes of trabectome surgery and microhook surgery. We analyzed the cases of 133 eyes that underwent trabectome (72 eyes) or microhook (61 eyes) surgery and were followed for > 1year. We defined failure as a < 20% reduction in the postoperative intraocular pressure (IOP) value or requiring additional glaucoma surgery. We used three surgical success definitions: ≤ 21, ≤ 18, and ≤ 15mmHg IOP reduction. A Kaplan-Meier survival analysis was performed for the surgical outcomes. We compared the trabectome and microhook groups' postoperative IOP values, number of glaucoma medications, and postoperative complications. At 1year postsurgery, the trabectome surgeries decreased the IOP significantly from 24.6 ± 7.3 to 13.3 ± 3.7mmHg, and the microhook surgeries significantly decreased the IOP from 24.1 ± 9.2 to 12.5 ± 3.9mmHg. The two groups' 1-year postoperative IOP values were not significantly different (p = 0.310). The surgical outcomes of the trabectome surgeries were significantly better than those of the microhook surgeries (≤ 21mmHg: p = 0.0049, ≤ 18mmHg: p = 0.0029, and ≤ 15mmHg: p = 0.0393). There were three patients with ciliary detachment in the microhook surgery group. Trabectome surgery provided significantly better surgical outcomes than microhook surgery. The risk of postoperative ciliary detachment should be considered in microhook surgery cases.

New ophthalmic dual-viscoelastic device in cataract surgery: a comparative study

ObjectiveTo compare the performance and safety in cataract surgery of two ophthalmic viscoelastic devices (OVDs), each having separate dispersive and cohesive characteristics and different concentrations.Methods and analysisIn this prospective, randomised,...

Elevated intraocular pressure in paediatric cataract surgery in a reference centre

Abstract Objective To study elevated postoperative intraocular pressure (PIOP) after paediatric cataract surgery in a reference center and to compare the results obtained with the most relevant world literature. Materials and methods A retrospective observational study was conducted, collecting information from clinical records of 99 patients (142 eyes) operated on due to unilateral or bilateral paediatric cataracts between 2000 and 2008. Results The proportion of eyes with PIOP ≥ 20 mmHg and bilateral cataracts was higher, 79.3%, than the proportion of eyes with PIOP ≥ 20 mmHg and a unilateral cataract, 20.7% (p = 0.032). The proportion of eyes with PIOP ≥ 20 mmHg between the eyes with cataract surgery before one month of age was higher, 50%, than between the eyes in which the cataract surgery was performed after one month of age, 17.2% (p = 0.009). PIOP values ≥ 20 mmHg were associated with a lower best corrected visual acuity at 5 years after cataract surgery (p = 0.020). The proportion of eyes with PIOP ≥ 20 mmHg and without intraocular lenses was higher, 69%, than the proportion of eyes with PIOP ≥ 20 mmHg and intraocular lenses, 31% (p Conclusions A PIOP > 20 mmHg was observed in 20.4% of eyes in a 5-year follow-up period, appearing more frequently in eyes with bilateral cataract than unilateral, and in aphakic eyes more than pseudophakic eyes. Elevation of the PIOP was associated with the performance of cataract surgery at early ages.

Presión intraocular elevada en catarata pediátrica intervenida en un centro de referencia

ObjectiveTo study elevated postoperative intraocular pressure (PIOP) after paediatric cataract surgery in a reference centre and to compare the results obtained with the most relevant world literature. Materials and methodsA retrospective observational study was conducted, collecting information from clinical records of 99 patients (142 eyes) operated on due to unilateral or bilateral paediatric cataracts between 2000 and 2008. ResultsThe proportion of eyes with PIOP≥20mmHg and bilateral cataracts was higher, 79.3%, than the proportion of eyes with PIOP≥20mmHg and a unilateral cataract, 20.7% (P=.032). The proportion of eyes with PIOP≥20mmHg between the eyes with cataract surgery before one month of age was higher, 50%, than between the eyes in which the cataract surgery was performed after one month of age, 17.2% (P=.009). PIOP values≥20mmHg were associated with a lower best corrected visual acuity at 5 years after cataract surgery (P=.020). The proportion of eyes with PIOP≥20mmHg and without intraocular lenses was higher, 69%, than the proportion of eyes with PIOP≥20mmHg and intraocular lenses, 31% (P<.001). ConclusionsA PIOP>20mmHg was observed in 20.4% of eyes in a 5-year follow-up period, appearing more frequently in eyes with bilateral cataract than unilateral, and in aphakic eyes more than pseudophakic eyes. Elevation of the PIOP was associated with the performance of cataract surgery at early ages.

Safety & efficacy of single subconjunctival triamcinolone 5 mg depot vs topical loteprednol post cataract surgery: less drop cataract surgery.

To do a randomized prospective interventional study for comparing the effects of a single subconjunctival triamcinolone acetonide (SCTA) injection to tapering topical loteprednol in patients undergoing phacoemulsification surgery under topical anesthesia. A total of 400 patients were randomized into 2 groups; Group A (200 patients) received 5 mg SCTA at the end of surgery and topical ketorolac tromethamine (0.5%) with ofloxacin (0.3%) combination for 3wk. Group B (200 patients) received tapering topical loteprednol etabonate (0.5%) along with ofloxacin (0.3%) and ketorolac tromethamine (0.5%) for 3wk. Outcomes evaluated were intraocular pressure (IOP), anterior chamber cells/flare and macular oedema postoperatively at 1, 6 and 12wk. Baseline parameters were almost similar in both the groups. No statistical difference was seen between the preoperative and postoperative IOP values for Group A (P=0.82) and Group B (P=0.61) and postoperative IOP values in between both groups (P=0.14) at 1wk. Incidence of cells/flare postoperative was statistically not significant (P=0.82) in both groups at all follow up visits. Postoperative macular oedema was not observed at any follow up visit. SCTA appears to be an effective alternative to prolong postoperative topical steroid use.

The comparison of three different correction formulas and the modified Ehler's algorithm in the evaluation of intraocular pressure after lasik

Aim: The aim of this study is to assess the correlation between the preoperative intraocular pressure (IOP) and the postoperative corrected IOP values calculated by using the modified Ehler’s algorithm and the three formulas after laser asisted in situ keratomileusis (LASIK) surgery.Material and Methods: The medical records of the patients to whom LASIK was performed to correct myopia and/or astigmatism between June 2018 and December 2018 were analyzed. The corrected preoperative and postoperative IOP values calculated with modified Ehler’s correction factor algorithm were compared. In addition, the corrected postoperative IOP values were calculated with Formula 1, Formula 2 and Formula 3 and the corrected postoperative IOP values were compared with the uncorrected preoperative IOP. Paired t-test was performed to compare the preoperative and postoperative IOP values. The Pearson correlation coefficients were calculated to analyze the correlation between preoperative IOP values and postoperative corrected IOP values.Results: The statistically significant difference was not observed between preoperative IOP and postoperative corrected IOP for formula two and formula 3 (p=0.42 and 0.80, respectively). There was significant difference between preoperative and postoperative IOP corrected with modified Ehler’s algorithm (p=0.03). In addition, a significant difference between preoperative IOP and postoperative IOP corrected with formula 1 was observed (p0.01). The mean of the difference between preoperative IOP and postoperative IOP corrected with formula was 3.1±1.4 mmHg (ranging 1.99 to 4.35 mmHg) and the mean of the difference between preoperative and postoperative IOP corrected with modified Ehler’s algorithm was 1.4±1.5 mmHg (ranging 0.1 to 2.6 mmHg). There was no correlation between preoperative IOP and postoperative corrected IOP values for Ehler algorithm and three formulas.Conclusion: Formulas 2 and 3 could be used to acquire a hint about the increased IOP, but none of them is the exact way to assess IOP correctly following LASIK. There is need for new solutions in this field. Keywords: LASIK; intraocular pressure; correction formula; the modified Ehler’s algorithm.