No abstract

This review provides some limited evidence that control of IOP is better with trabeculectomy than viscocanalostomy. For deep sclerectomy, we cannot draw any useful conclusions. This may reflect surgical difficulties in performing non-penetrating procedures and the need for surgical experience. This review has highlighted the lack of use of quality of life outcomes and the need for higher methodological quality RCTs to address these issues. Since it is unlikely that better IOP control will be offered by NPFS, but that these techniques offer potential gains for patients in terms of quality of life, we feel that such a trial is likely to be of a non-inferiority design with quality of life measures.

Both trabeculectomy and deep sclerectomy induced considerable postoperative astigmatism. A longer follow-up period is recommended to study the different patterns of astigmatism in either procedure.

Background/aim: To evaluate the economic burden of intraocular pressure (IOP)-lowering medications on Egyptian patients with glaucoma, in addition to studying the social grounds of glaucoma education. Methods: In a cross-sectional observational study, the clinical and socioeconomic data were collected from 68 glaucomatous patients who were attending the outpatient clinics of Cairo University Hospital, through interviews, questionnaires, and clinical examinations. Results: Patients had a mean IOP of 22.9 mm Hg (SD 11.5). Just under half the patients had an IOP of over 30 mmHg although 88% were on medical treatment; average of 2.1 medications (SD 0.8). Patients had been spending 79.5 LE (SD 95.3) on glaucoma medications a month, which equals 30.1% of their monthly income. Forty per cent of patients did not know that glaucoma causes blindness. The primary source of knowledge about glaucoma for 79.4% of patients was the ophthalmologist. Conclusion: The lack of control of IOP is probably related to the economic burden associated with glaucoma medications. 'Glaucoma education' is an important issue to both the treating ophthalmologist and the patient.

Second eye patients tend to present to clinical diagnosis at a better visual acuity than first ones and subsequently have better chances for better posttreatment visual acuity. However, both groups have an equal chance of significant visual improvement.

Purpose. Glaucoma is the second commonest cause of blindness worldwide. Visual fields and intraocular pressures are optimum outcomes to be assessed in developed countries. Visual acuity as an outcome is the key player when assessing blindness in developing countries. The aim of this study is to assess visual impairment and blindness in glaucoma patients and to identify the bulk they represent in comparison to nonglaucoma patients in the same practice setting. Methods. Patients attending outpatient clinics of Cairo University Hospitals were enrolled in this cross-sectional study. Clinical data collected for these patients included their demographic data, best obtained visual acuity, and whether or not they have had an established diagnosis of glaucoma. Results were compared at 95% confidence intervals. Results. 988 eyes of 494 patients were included for this study. Their mean visual acuity was 6/24 (±3 Snellen lines). Legal blindness was found in 5% and 4% of glaucoma and nonglaucoma groups, respectively. There were high odds for finding eyes with total blindness due to glaucoma. That was statistically significant (P < 0.05). Conclusions. A large proportion of glaucoma patients suffered from blindness in at least one eye. Interventional strategies are recommended regarding visual disability among Egyptian glaucoma patients.

The disagreement between disposables and standard Goldmann tips followed different patterns in glaucoma patients when compared with normal subjects. The use of the Goldmann tip is advised with glaucoma patients.

Purpose:To study the relationship between the axial length and personal A-constant for the 1-piece Tecnis (Abbott ZCB00), AcrySof MA60AC (Alcon) and the Quatrix aspheric preloaded (CROMA) intraocular lenses (IOL).Materials and Methods:Patients matching the inclusion criteria were further subdivided according to the implanted IOL in this prospective comparative study. The obtained refractive outcomes were introduced into the formula installed in the biometry machine (Humphrey model 820 ultrasonic biometer) to obtain the personal A-constant for each eye. Polynomial regression analysis was done to study the individualized A-constant for each type of IOL in relation to preoperative axial length measurement.Results:Two hundred and forty five eyes of 186 patients were enrolled into this study, of whom 73 eyes with Tecnis 1-piece, 116 eyes with MA60AC, and 56 eyes with Quatrix. The median of personalized A-constant for Tecnis 1-piece, MA60AC, and Quatrix were 119.21 (SD 1.3, Std. Mean error 0.15), 119 (SD 1.2, Std. Mean error 0.11) and 120.4 (SD 1.2, Std. Mean error 0.16) respectively. Regression plots for the same range of axial length among all the groups showed that the Tecnis1 group followed the same pattern of the Quatrix group in which there was a linear relationship of a trend towards myopia when the axial length had increased and a hyperopic shift when decreased. This relationship changed into a plateau when the axial length became in the range of 23.5 mm to 27 mm in the MA60AC group.Conclusions:Personal A-constant follows different trends with different IOLs even for the same range of axial length.