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.
ABSTRACT.Purpose: The aim of this study was to assess the efficacy of viscotrabeculotomy in the management of congenital glaucoma as compared to conventional trabeculotomy, in Egyptian infants. Methods: This is a prospective interventional randomized comparative study in which patients with primary congenital glaucoma were randomly allocated to either group A or B; viscotrabeculotomy (VT); and trabeculotomy (T), respectively. Patients were followed up regarding intra-ocular pressure (IOP), cup/disc (C/D) ratio and horizontal corneal diameter (HCD) for 6 months. A probability value (p value) <0.05 was considered significant. Results: Twenty-one eyes in group A and 20 eyes in group B were enrolled in the study. The mean preoperative IOP was 23.5 and 24.3 mmHg in the VT and T groups, respectively. Postoperatively, IOP dropped at six months to 14.7 and 17 mmHg in the VT and T groups, respectively. That was significant in either group when compared to preoperative IOP, but not significant between both groups at the same point of comparison. Conclusions: Both techniques were equally effective in the reduction in IOP in the management of congenital glaucoma, but viscotrabeculotomy did not appear to add more benefit to the surgical outcome than classic trabeculotomy.
Background: Ocular emergencies are a worldwide cause of visual impairment. The emergency eye service of Cairo University Hospitals is a tertiary referral center for eye emergencies in Egypt. Researchers pointed out that pattern of casualties on weekends differed from weekdays with higher utilization and less severity of presenting patients during the weekends. However; little, if any, was reported regarding weekend eye emergencies.Aim of Study: Casualty service of Cairo University Hospitals is a tertiary referral center for eye emergencies in Egypt. In this study I analyzed patients admitted through this service including trauma andmedical eye emergencies during weekends. Patients and Methods:In a prospective observational study I enrolled all patients admitted through the casualty eye serviceduring the same time period every weekend for 3 months from September 2021 till December 2021. Data were tabulated and analyzed regarding the patients' demographic data, presenting visual acuity, patient's diagnosis, ocular imaging investigations and management.Results: 563 patients presented to the emergency service of whom 63 were admitted to the hospital for their emergency eye condition. Age of admitted patients ranged from 1.5 to 82 years (mean 28.3 SD 24.4). About 60% of admitted patients were due to trauma while the other 40% were not due to trauma. Corneo-scleral lacerations comprised the highest percentage of all admissions followed by corneal infiltrates then acute glaucoma conditions. Of traumatic globe injuries, 80% were open while remaining were closed globe injuries. Open globe injuries were: 84% lacerations (of whom one fifth with intraocular foreign bodies), 12% rupture globes, and 4% globe perforation. Children (under 12 years old) constitutes about half of all admissions and nearly 80% of these patients were admitted for traumatic eye conditions, odds 3.91 (CI 1.3-11.9), p=0.02. Conclusion:Non-trauma causes comprise a considerable sector of patients needing admissions of whom corneal infiltrates was the leading cause. The factors behind the high rates of ocular trauma in children need to be investigated.
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