Purpose To determine the incidence of glaucomatous progression at mean intraocular pressure (IOP) levels in patients with ocular hypertension (OHT). Methods A retrospective, multicentre, cohort analysis of 230 OHT patients with 5 years of follow-up evaluated for risk factors associated with progressive optic disc and visual field loss to determine the incidence of glaucomatous progression. Results Forty percent of patients with IOPs X24 mmHg, 18% of patients with IOPs of 21-23 mmHg, 11% of patients with IOPs with 18-20 mmHg, and 3% of patients with IOPs of p17 mmHg progressed to glaucoma. The mean IOP was 19.872.4 mmHg in the stable group and 21.772.6 mmHg in the progressed group (P ¼ 0.0004). The highest average peak IOP was 23.474.0 mmHg in the stable group and 25.273.1 mmHg in the progressed group (P ¼ 0.006). Based on the pachymetry values for central corneal thickness, patients with thinner corneas more often progressed to glaucoma (Po0.0001). A multivariant regression analysis to determine risk factors for progression was positive primarily for higher peak IOPs, older age, male gender, argon laser trabeculoplasty, visual acuity X20/50, and no topical medical therapy or b-blocker therapy prior to the study. Conclusions IOP reduction within the normal range over 5 years of follow-up reduces the chance of progression to primary openangle glaucoma in OHT patients.
Phacoemulsification (PHACO) is the gold standard of cataract surgery. Сataract surgery in eyes with pseudoexfoliative (PEX) syndrome is associated with increased risk of intra- and postoperative complications. Zonular laxity is one of the main causes of surgical complications. Purpose. To assess the degree of zonular weakness in patients with PEX. Materials and methods. 1010 eyes (580 eyes with PEX and 430 eyes without it) that underwent consecutive PHACO at the Ophthalmology Department No 5 of the City Multifunctional Hospital No 2 from May 2016 until October 2017 were enrolled in the study. The zonular laxity was assessed preoperatively and intraoperatively. Results. Zonular weakness was observed more often in patients with PEX, both at preoperative and intraoperative evaluation (p < 0.05). However, in both groups, the percentage of zonular weakness estimated intraoperatively, was several times higher, than that estimated preoperatively. Nevertheless there was no difference in the rate of capsular bag related intraoperative complications between two groups. (For citation: Potemkin VV, Ageeva EV. Zonular instability in patients with pseudoexfoliative syndrome: the analysis of 1000 consecutive phacoemulsifications. Ophthalmology Journal. 2018;11(1):41-46. doi: 10.17816/OV11141-46).
Meticulous objective examination of a patient with blepharoptosis allows determining the tactics of surgical treatment. It depends on many factors, but main ones are blepharoptosis etiology, upper eyelids levator function, and ptosis degree. The estimation algorithm of objective examination of a patient with blepharoptosis is presented in this article.
Phacoemulsification is a main method of cataract surgery. The presence of pseudoexfoliation syndrome (PEX) may involve the procedure in difficulty and contribute to development of intra- and postoperative complications.
Purpose. To assess the effect of PEX on phacoemulsification.
Materials and methods. 1010 patients (580 with PEX and 430 without PEX) admitted for cataract surgery, underwent phacoemulsification with implantation of various IOL types. An analysis of main phacoemulsification parameters was carried out: cumulative dissipated energy (CDE), aspirated BSS amount, time of surgery. The prevalence of some possible intraoperative complications was assessed: descemet membrane detachment, posterior capsule rupture, retrolental lens material, and zonular dialysis.
Results. In patients with PEХ, local descemet membrane detachment and retrolental lens material were significantly more common, at the same time CDE was higher.
Conclusion. When planning phacoemulsification, patients with PEX require more thorough preoperative examination, higher alertness during surgery and longer follow-up in the postoperative period.
In this article, using a clinical case as example we report clinical features of keratopathy associated with pseudoexfoliation syndrome, as well as pathological changes found by confocal microscopy.
BACKGROUND:Intraocular lens (IOL) dislocation is a rare but serious complication of surgical treatment of patients with cataract. Among the factors contributing to its development, the main ones are pseudoexfoliation syndrome (PEX), high axial myopia, chronic uveitis, history of eye injury and age. There is no universal IOL dislocation correction technique.
PURPOSE:To evaluate the impact on corneal endothelium of two different methods of IOL dislocation correction: IOL repositioning with transscleral suture fixation or IOL exchange to iris-claw one.
MATERIALS AND METHODS:Within the study, 78 patients were examined and operated. All patients were divided into two groups: in the first group, IOL was repositioned with transscleral suture fixation, and in the second group IOL was exchanged to iris-claw IOL. Groups were equal by gender and age. Key estimated indicators were endothelial cell density and coefficient of variation reflecting the degree of polymegatism.
RESULTS:Endothelial cell density was significantly lower both before surgery and at any term after it, in the group with IOL exchange, and coefficient of variation was significantly higher in the group with IOL exchange throughout this study.
CONCLUSION:The choice of technique for IOL dislocation correction is the basis of success in surgical treatment. Certain preoperative examination data should be definitely considered, including the degree of dislocation, IOL type, IOP level, endothelial cell density and presence of concomitant ocular conditions.
In this article, a clinical case of astrocytoma of optic nerve head in patient with neurofibromatosis type 1 is presented. The main feature of this clinical case is a difficulty in differential diagnosis with amelanotic choroidal melanoma.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.