The influence of local IOP-lowering therapy on the anterior segment tissues and outcome of glaucoma filtering surgery (original) (raw)
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Ophthalmology journal, 2021
Purpose. The article presents the results of a comparative analysis of the effectiveness of surgical treatment of open-angle glaucoma using the Ex-Press P-200 filtering device and the Anti-glaucoma A3 implant. Materials and methods. Using simple sequential sampling, 52 patients (59 eyes) were divided into 2 groups. The first group was implanted with Ex-Press P-200, the second with Anti-glaucoma implant A3. The follow-up period for patients ranged from 6 months to three years. At each visit, a standard ophthalmic examination was performed. For tonometry, the ICare TA01i portable non-contact tonometer was used. To assess the stabilization of the glaucoma process, we performed static (threshold) automatic perimetry using the Pericom perimeter and optical coherence tomography (OCT) of the optic nerve heads using a Spectralis HRA-OCT tomograph (Heidelberg Engineering). Conclusions. The implantation of devices of both types led to a persistent decrease in intraocular pressure, maintenance...
Ophthalmologic vedomosti, 2015
Introduction. For the past several decades, there has been a discussion as to whether elevated intraocular pressure is just ocular hypertension in a healthy eye, or a sign of glaucoma. Objective. To study the IOP values in patients with primary open-angle glaucoma at the beginning of the study and to correlated them with the disease progression and to determine optimal IOP levels. Material and methods. The final protocol included data from 812 right eyes of 637 glaucoma patients and 175 healthy subjects; the latter formed the control group. The mean age of examined patients was 71.8 ± 0.28 years; 72.00 (66.00; 77.00). Mean disease duration in glaucoma patients was 5.41 ± 0.17 years. The following parameters were assessed: visual acuity, clinical refraction, IOP level by Maklakov tonometry, central corneal thickness and IOP-lowering medication use. Results. In the age group - between 60 and 69 y.o., the IOP level in patients with advanced glaucoma was significantly higher than in pat...
Medicina v Kuzbasse, 2019
Purpose – to analyze long-term results of meridional cyclodialysis ab interno (MCai) with implantation of a supraciliary metalic implant (SMI) in decreasing intraocular pressure (IOP) in patients with glaucoma. Material. A total of 50 glaucoma cases were operated upon. In all cases MCai was performed. In the study group (29 cases), to keep the cyclodialysis cleft open, after MCai a SMI was implanted. Rest 21 cases served as control. Surgically, ciliary body was gently detached from sclera at 4-5 o'clock position with the help of a specially designed spatula inserted through a clear corneal incision, creating a cleft of 2,5 mm wide and 5-6 mm deep. Outcome measures: IOP change, use of hypotensive medications, need for repeat glaucoma surgery and complications. Minimum follow-up period – 18 months. Results. Baseline IOP, which was 28.9 ± 4.7 и 30.2 ± 7.2 mmHg in study and control groups respectively, at 18 months reduced to 19.6 ± 1.6 (р = 2Е-08) and 20 ± 1.4 mmHg (p = 0.0006). Us...
VEGF inhibitors in glaucoma surgery
Ophthalmologic vedomosti, 2016
Vascular endothelial growth factor (VEGF) is a signaling protein, that controls vasculogenesis, angiogenesis, vascular support and stimulates permeability of small blood vessels. The following isoforms are presently known: VEGF-A, VEGF-B, VEGF-C, VEGF-В and PGF. VEGF-A, that regulates neoangiogenesis and fibroblast formation, is thought to play the most important role in human organism. Increased expression of VEGF may lead to development and aggravation of pathological conditions including oncology. The article presents a review of preclinical and clinical studies of the main VEGF-inhibitors - bevacizumab and ranibizumab, as well as a brief account on other existing medications of this group. It describes ophthalmological indications for the use of antiangiogenetic agents, as well as the ways of their possible off-label use. The review presents investigations of intravitreal and intracameral injections of VEGF-inhibitors in patients with retinal, chorioidal, iris, and anterior cham...
Zaporozhye Medical Journal
Aim. To analyze the effect of dosed endotrabeculectomy in combination with non-penetrating deep sclerectomy on the level of intraocular pressure (IOP) and aqueous humor outflow from the anterior chamber. Materials and methods. The study involved 12 patients (12 eyes) who underwent dosed endotrabeculectomy with ab interno approach in combination with non-penetrating deep sclerectomy surgery. All the patients had moderate or severe trabecular pigmentation by gonioscopy. The follow-up period was 12 months. Measurement of IOP was performed according to Maklakov before and after surgery (on the 7th day, 1st, 3rd, 6th and 12th month). Tonography was performed according to Nesterov (using the simplified method) at the same time periods. The outflow facility coefficient and Becker’s coefficient were determined. The number of local antihypertensive agents used within that period was also observed. A combined drug was counted as two – according to the number of active substances. Results. The...
Srpski arhiv za celokupno lekarstvo, 2012
Introduction. It is important to know the risk factors for visual field defect progression in order to predict the future development of glaucoma. Objective. To investigate the influence of visual field initial sensitivity on the rate of visual field progression. Methods. A minimum of five visual fields were performed using computerized perimetry (Octopus) over a mean follow- up 4-year period (48.85?17.84 months) in 64 persons (114 eyes) with primary open angle glaucoma. The rate of change of the whole central visual field and each of the seven regions of the field were measured by linear regression analysis of the mean sensitivity value versus time. Based on the slope of the regression line of visual field mean sensitivity over time the eyes were divided into two groups: the group with stable and the group with progressive visual field. The comparison of the mean sensitivity of the whole central visual field between the groups was performed using the Mann-Whitney U-test. The Spearm...
Health and Ecology Issues, 2015
Objective: to determine the efficiency of the treatment for glaucoma and its accompanying costs in patients with II-III stages of open-angle glaucoma. Material and methods. The multicenter study which was conducted by 35 investigators in 29 clinical centers in 4 CIS countries from December 2013 to April 2014 took into account the results of the treatment of 115 patients (187 eyes) with glaucoma. The cost and «cost-effectiveness» of the intraocular pressure (IOP)-lowering treatment were calculated with the account of IOP-level compensation. Results. The average cost-effectiveness was 13.94 ± 0.66 rubles/day, which was comparable to the theoretical cost of the treatment but 32 % exceeded the price that patients actually paid for the treatment. As for the monotherapy with prostaglandin preparations and the fixed combination of beta-adrenoblocker and prostaglandin analogue (BB + PG), the difference between the actual price and cost-effectiveness was 44 %. At the same time, this differen...
Russian Ophthalmological Journal
Purpose. To evaluate the change in the functional activity of retinal ganglion cells (RGCs) in response to intraocular pressure (IOP) drop in patients with newly diagnosed early stage primary open-angle glaucoma (POAG) using a pattern electroretinogram (PERG). Material and methods. A prospective non-randomized cohort study included 12 patients (24 eyes) including 5 men, 7 women, aged 63.42 ± 2.96 years with newly diagnosed early stage POAG in at least one eye, who underwent PERG (Diopsys Nova, Diopsys, Inc.) in addition to an ophthalmologic examination. After being diagnosed with POAG, all patients were prescribed prostaglandin analogues as monotherapy. One and four months into the treatment, repeated examinations took place. Results. At these time points, a significant decrease in IOP was noted, accompanied by an increase in PERG parameters , which indicates an improvement in the functional activity of RGCs, yet no linear relationship between the IOP decrease and the improvement in...
Primary glaucoma etiology: current theories and researches
Ophthalmology Reports, 2015
The article presents a review of latest researches related to various aspects of primary glaucoma and optic neuropathy etiology. The effect of somatic factors on glaucoma progression is described. Arguments in favor of the interrelation of glaucoma and neurodegenerative processes are presented. The genetic basis for the development of glaucoma and a variety of its conjoined syndromes is considered. Immunological mechanisms that initiate the programmed cell death are analyzed. The processes that influence the increase of trabecular meshwork retention are also described as well as its role in the glaucoma pathogenesis.