Long-term Results of Deep Sclerectomy with Small Collagen Implant in Korean
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Deep sclerectomy (DS), one of the non-penetrating glaucoma surgeries, has been reported to be a safe and effective surgical procedure which provides long-term intraocular pressure (IOP) control in the management of open-angle glaucoma.Several studies comparing surgical outcomes of DS with those of trabeculectomy have also shown that DS provides less but comparable IOP reduction with fewer complications [1,2].However, the surgical outcomes of DS may have racial differences.Although East Asian eyes are reported to ethnically differ in many aspects from other races, there are few reports about the long-term surgical results of DS in Asian populations.This report evaluates the long-term results of DS with small collagen implants in Korean open-angle glaucoma (OAG) patients. Materials and MethodsAfter the approval of the institutional review board, 65 subjects with planned deep sclerectomy with collagen implant (DSCI) with or without the adjunctive use of mitomycin C due to primary and secondary OAG were retrospectively collected.All subjects were Korean (single ethnic group).All surgical procedures were performed by a single surgeon.A one-third scleral thickness, limbal-based, 5.0 mm × 5.0 mm scleral flap was dissected.In the cases using mitomycin C, pieces of surgical sponge soaked with 0.Keywords:
Mitomycin C
Selective laser trabeculoplasty (SLT) is applied to reduce intraocular pressure in primary open angle glaucoma therapy. It selectively subjects trabecular pigmented cells to a pulsed, frequency-doubled Nd:YAG laser. The biostimulatory effect on trabecular macrophages was also postulated even in low-pigmented angles. The aim of the study was to assess the hypotensive effectiveness of SLT depending on the degree of iridocorneal angle pigmentation.Sixty-three eyes of 53 patients with primary open angle glaucoma (POAG) were included in this study and than divided into three subgroups, dependind of iridocorneal angle pigmentation. All subjects underwent SLT on 270 degrees of the angle. Intraocular pressure (IOP) was assesed at baseline and 6 weeks after the laser procedure.Six weeks post-SLT mean IOP reduction was 2.63 mm Hg. The degree of IOP reduction showed a significant correlation with angle pigmentation. Intraocular pressure fell by 2.06 mm Hg, 2.46 mm Hg and 4.75 mm Hg in subgroups with low, marked and high pigmentation, respectively.The SLT procedure most effectively reduces IOP only in the subgroup of POAG patients with marked angle pigmentation and it is equal to clinically succesfull hypontesive therapeutic effect, according to European Glaucoma Society guidelines. However, lower hypotensive effect in other study subjects may also be the valuable addition to pharmacological therapy of glaucoma.
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Purpose To evaluate intraocular pressure (IOP) variations after automated visual field examination in patients with primary open-angle glaucoma and in healthy subjects. Patients and Methods Intraocular pressure was measured in 49 patients (94 eyes) with primary open-angle glaucoma and in 13 healthy subjects (26 eyes) before and immediately after automated visual field examination. All patients had stable IOP and were using local medication to treat glaucoma. The visual field test was performed with a Humphrey 630 VF analyzer and the Central 30–2 full-threshold program. Results Mean IOP increased significantly in glaucomatous patients immediately after automated visual field examination (P < 0.01), and returned to pretest values after 1 hour (P = 0.2). Mean IOP variation was 2.38 (range, −6–11) mm Hg. In 42 (44.68%) glaucomatous eyes, IOP increased more than 2 mm Hg, with a mean increase of 5.5 mm Hg. Elderly glaucoma patients showed a significantly higher IOP rise than younger patients. No significant IOP variation was detected in healthy subjects. Conclusion Intraocular pressure varied significantly and tended to increase immediately after automated visual field examination in patients with primary open-angle glaucoma. Age seemed to contribute to these IOP changes, but other factors could be involved.
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Optic disk
Optic cup (embryology)
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OBJECTIVE To research the central corneal thickness(CCT)in the patients with ocular hypertension or primary open angle glaucoma,and to investigate the effects of CCT on the intraocular pressure measured with Goldmann tonometer METHODS Central corneal thickness and intraocular pressure was determined in the thirty-six eyes of 18 patients with primary open angle glaucoma,26 eyes of 15 patients with ocular hypertension,and 36 eyes of 18 volunteers without glaucoma or ocular hypertension with ultrasound corneal thickness measuring equipment and Goldmann tonometer The data were analyzed statistic RESULTS The average of CCT was 572 76±37 42(μm)in the ocular hypertension group,and 548 41±34 15(μm)in the primary open angle glaucoma group IT was 547 22± 34 68(μm)in the control group It is obvious that the CCT values in the ocular hypertension group are higher than that in the primary open angle glaucoma group and normal control group There was not a significant difference of CCT values between the later two groups( P 0 05)Of patients in 46% eyes IOP was normal after their IOP was corrected CONCLUSION CCT is one of the most important factors during measurement on intraocular pressure The CCT value should be measured when ocular hypertension was determined
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Optic disc
Gonioscopy
Optic disk
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To evaluate day-and-night intraocular pressure (IOP) profiles in normal and glaucomatous eyes.
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Aim: To evaluate the relation between central corneal thickness (CCT), intraocular pressure (IOP) and vertical cup-disc ratio in Primary open angle glaucoma (POAG) compared to normal and to find out correlation between Central corneal thickness and disease severity in POAG.
Materials and Methods: Cross sectional study. Hundred patients on treatment for POAG and hundred age matched subjects were studied. Central corneal thickness was measured using ultrasound pachymeter. Intraocular pressure was measured by applanation tonometry. Statistical analysis was done using SPSS version 18.
Results: The mean CCT in glaucoma patients was 528.03±33.37 ?m in right eye and 529.69±34. 14 µm in the left eye. The mean value obtained for the control group was 541.46±31.20µm in right eye and 541.25±30.32 in left eye. There was no statistical significance in mean CCT values in males and females. CCT was found to decrease with age in both groups. In glaucoma patients there was a positive correlation of CCT with IOP, and a negative correlation with vertical cup-disc ratio (VCDR). Patients with severe glaucoma had thinner cornea.
Conclusion: The average CCT obtained for normal as well as glaucoma patients in our study was lower than the suggested value of 555µm as a risk factor for development of glaucoma by Ocular hypertension study group. Patients with severe glaucoma had thinner cornea. Hence our population maybe at a greater risk of developing glaucoma. In patients with POAG, CCT helps to identify patients with thinner cornea who may be at a higher risk of progression, and require more aggressive control.
Keywords: Central corneal thickness, Intraocular pressure, POAG- disease severity
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【Objective】 To investigate the role of nocturnal intraocular pressure (IOP) monitoring in the diagnosis of primary open angle glaucoma (primary open angle glaucoma, POAG). 【Method】 Fifty-night eyes from 30 out-patients with glaucomatous optic nerve damage and diurnal IOP monitoring ≤21 mmHg were included. Nocturnal IOP monitoring, optical coherence tomography (OCT), Heidelberg retina tomography (HRT) and Humphrey visual field were performed to all of the included subjects. 【Result】 In nocturnal IOP monitoring, the IOP was more then 21 mmHg in 14 patients (28 eyes, 46.7%), who were classified into hypertension open angle glaucoma group (HPG). Another 16 patients (31 eyes, 53.3% ) with IOP still under 21 mmHg were classified into normal pressure glaucoma group (NPG). The peak of IOP occurred at 5: 00 am and 2: 00 am in HPG and NPG groups, respectively. Compared with the NPG group, the base line of IOP (P = 0.033 ～ 0.000) and the amplitude of IOP fluctuation (P = 0.011) were significantly higher in HPG group. There were no significant differences in parameters of OCT and HRT, and visual field defects. 【Conclusion】 IOP is the most important factor in identifying HPG and NPG, and nocturnal IOP monitoring is influential in the diagnosis of POAG.
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Background: To evaluate biomechanical parameters of the cornea provided by Corvis ST in patients with ocular hypertension, primary open-angle glaucoma, and amyloidotic glaucoma and to compare with healthy controls. Methods: This was a cross-sectional study of patients with ocular hypertension, primary open-angle glaucoma, and amyloidotic glaucoma that underwent Corvis ST imaging. Primary outcome was the comparison of corneal biomechanical parameters between study groups after adjusting for age, gender, Goldmann intraocular pressure (GAT-IOP), and prostaglandin analogues medication. Secondary outcome was the comparison of different IOP measurements in each group. Results: One hundred and eighty-three eyes from 115 patients were included: 61 with primary open-angle glaucoma, 32 with amyloidotic glaucoma, 37 with ocular hypertension and 53 were healthy controls. Amyloidotic glaucoma group had smaller radius (p=0.025), lower deflection amplitude at highest concavity (p=0.019), and higher integrated radius (p=0.014) than controls. Ocular hypertension group had higher stiffness parameter at first applanation (p=0.043) than those with primary open-angle glaucoma, and higher stress–strain index (p=0.049) than those with amyloidotic glaucoma. Biomechanically corrected intraocular pressure was significantly lower than Goldmann intraocular pressure in group with primary open-angle glaucoma (p=0.005) and control group (p=0.013), and Goldmann intraocular pressure adjusted for pachymetry in group with primary open-angle glaucoma (p=0.01). Conclusion: Eyes with amyloidotic glaucoma have more deformable corneas, while eyes with ocular hypertension have less deformable corneas. These findings may be linked to the susceptibility to glaucomatous damage and progression. There were significant differences between Goldmann applanation tonometry and biomechanically corrected intraocular ocular pressure provided by Corvis ST. Keywords: corneal biomechanics, ocular hypertension, glaucoma, amyloidosis, Goldmann tonometry
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