Introduction: In the absence of capsular support, anterior chamber intraocular lens (IOL), iris fixated IOL and sutured scleral fixated intraocular lens (SFIOL) implantation have been performed for many years. Recently sutureless glued SFIOL have been used as a primary or secondary procedure to correct aphakia. In this study we have used sutureless and glueless technique of SFIOL implantation. Methodology: An interventional case series was conducted. Aphakic patients without capsular support, sub-luxated lens (>180˚), dislocated lens and dislocated IOL were the inclusion criteria. The patients with hazy cornea, non-dilating pupil, macular scar and glaucoma were not enrolled in the study. Results: Of 62 eyes who completed 1 month followup, 48 were men and 14 women. There was a significant improvement in uncorrected distance visual acuity after surgery (p<0.001). One month postoperative best corrected distance visual acuity was 6/18 or better in 45 eyes (72.6%). The common early postoperative complications were hypotony, corneal edema. No serious complications such as endophthalmitis and retinal detachment were seen. Conclusion: Our technique of sutureless and glueless SFIOL implantation showed good visual outcome in the absence of serious complications. SFIOL will be the only choice in eyes that have anatomic contraindications like non constricting pupil, large sectoral iridectomy and peripheral anterior synechia in which other types of lens are not suitable.
Given the obvious quality of life concerns with medical and surgical lowering of intraocular pressure (IOP), lasers have received considerable attention as a therapeutic modality for glaucoma.Selective laser trabeculoplasty (SLT) is increasingly being used in clinical practice as both the primary procedure and as an adjunct to medical and surgical therapy. Preliminary published evidence suggests that SLT is an effective, compliance-free, repeatable and safe therapeutic modality having only minor, transient, self-limiting or easily controlled side effects with no sequelae.This review attempts a broad overview of the current knowledge of its mechanism, efficacy, indications and limitations, point out the knowledge lacunae that still exist with respect to this highly promising technology which has captured the attention of glaucoma surgeons all over the world.How to cite this articleJha B, Bhartiya S, Sharma R, Arora T, Dada T. Selective Laser Trabeculoplasty: An Overview. J Current Glau Prac 2012;6(2):79-90.
SUMMARY:Opitz syndrome is a rare autosomal recessive disorder of cholesterol metabolism associated with mental retardation and multiple congenital malformations. It is also uncommonly associated with congenital glaucoma. We describe the orbital findings on CT in this rare case of a patient with Opitz syndrome who presented with congenital glaucoma, with a review of the literature. The CT findings of congenital glaucoma, which have not been described before in the literature, are also discussed. It is important for the radiologist to be aware of this rare association. It is also important to be aware of the findings of congenital glaucoma on CT because patients with Opitz syndrome and other syndromes associated with learning difficulties may not present with typical clinical features of glaucoma. A high index of suspicion will lead to a correct diagnosis and earlier intervention.
Objective: To find out the most common referral parameter among the glaucoma suspects patients from general eye clinic and to establish glaucoma diagnosis. Methods: This study is a retrospective cohort hospital based study. Two hundred patients from January to February 2017 sent to glaucoma clinic as glaucoma suspects were re-evaluated meticulously by glaucoma specialist and were diagnosed as glaucoma, non glaucoma, suspects and ocular hypertension. Results: Out of the 200 patients referred to glaucoma clinic as glaucoma suspects only19% were diagnosed to have glaucoma. The mean age at which glaucoma diagnosed was 55.29(14.4) compared to 41.6(15.1) in normal group. One hundred and sixty five patients were referred on the basis of suspicious optic nerve head, among them 14.5% (24/165) had glaucoma. This study showed that, open angle glaucoma (OAG) 28.9% was the most common type of total glaucoma diagnosed. The mean vertical cup discratio in the OAG group was 0.69±0.1 (0.4 -0.9) compared to 0.56 ± 0.11((0.2-0.8)(p=0.00) normal. The mean intra ocular pressure (IOP) in OAG group was 19.73 ±4.95(11-32) mmHg compared to 16.74± 3.36(10-30) mmHg (p=0.00) in normal group. The mean central corneal thickness (CCT) in OAG group was 533.05 ± 31.24μm (467-606) compared to normal was 534.9±33.6 μm (432-696) (p=0.670). Conclusions: Suspicious optic nerve head is the most common referral parameter between the general ophthalmologist and residents, but this study shows only few of them were diagnosed with glaucoma. This gives us a clue that the ophthalmologists and residents are to be trained better to help them identify the signs of glaucoma on the optic nerve head beside its size, which will reduce unnecessary burden to the resources of patients and hospital.
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