Effect of Latanoprost 0.005% and Brimonidine 0.2% on Intraocular Pressure After Phacoemulsification and Intraocular Lens Implantation Surgery

Bach‐Holm

et al. 2019

Acta Ophthalmologica

The purpose of this systematic review was to evaluate the literature regarding prophylactic treatment of intraocular pressure (IOP) elevation after uncomplicated cataract surgery to provide an evidence-based guideline for cataract surgeons. The relevant literature was identified in EMBASE and PubMed. The risk of bias was assessed according to the 'Cochrane Handbook for Systematic Reviews of Interventions' and the ROBINS-I tool. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) criteria were used to rate the quality of evidence, and relevant data were systematically extracted to evaluate the pressure-lowering effect of the active substances. The primary outcomes for this systematic review were the absolute and relative pressure-lowering effect of the different drugs after 3-8 hr and 1 day after surgery. In total, 23 randomized controlled trials and one nonrandomized controlled study consisting of 45 treatment arms with 14 different active substances were included in the qualitative synthesis. According to the GRADE criteria, nine trials were graded as 'high' quality of evidence, 12 trials as 'moderate', while three trials were given the grade 'low' quality of evidence. The primary outcomes showed most consistency between the trials, which studied the effect of timolol, and presented a relative effect from 18.6% to 29.6% at 3-8 hr and 9.8% to 23.6% at day 1. This systematic review indicates that timolol, latanoprost and travoprost alone or medications containing timolol as an additive active substance, such as dorzolamide + timolol, brinzolamide + timolol and brimonidine + timolol, are characterized by a good relative IOP-lowering effect, which can be gained by a single dose postoperatively.

Section: Resultsmentioning

confidence: 99%

Prophylactic treatment of intraocular pressure elevation after uncomplicated cataract surgery in nonglaucomatous eyes – a systematic review

Bach‐Holm

et al. 2019

Acta Ophthalmologica

“…Studies show that these medications, alone or in combination, can be effective in reducing IOP. 38,39 One important limitation of our case report is our inability to provide advice on underpinning the genetic or pathological abnormalities that lead to the combination of congenital ocular abnormalities. Furthermore, case reports have inherent difficulties in terms of external generalization.…”

Section: Discussionmentioning

confidence: 99%

“…Studies show that these medications, alone or in combination, can be effective in reducing IOP. 38 , 39 …”

Section: Discussionmentioning

confidence: 99%

Challenges in Surgical Intervention for a Rare Case of Anterior Segment Dysgenesis: A Case Report

Aldawood,

Bakri,

Alotaibi

2023

IMCRJ

Anterior Segment Dysgenesis (ASD) represents a spectrum of rare, congenital disorders that pose significant challenges to ophthalmological management due to their complex and heterogeneous nature. The management of ASD becomes particularly complex when associated with other serious ocular conditions. This report discusses the case of a 4-year-old girl diagnosed with ASD exhibiting a combination of sclerocornea, aphakia, aniridia, and secondary glaucoma. Owing to the complexity of such condition, a multi-disciplinary approach is required. Despite successful initial surgical interventions on the left eye, eye was lost due to subsequent endophthalmitis and retinal detachment, resulting in a decision to adopt a conservative, non-surgical approach for the right eye. Although a series of therapeutic interventions have been performed, the final visual outcome was poor, demonstrating the complexity and seriousness of such cases. This case serves as a reminder of the need for regular follow-up, prompt recognition, and management of potential complications. Further research is necessary to optimize the outcomes in patients with similar presentations.

“…[125] Several studies have shown that the use of these drugs did not change corneal thickness or worsen recovery from oedema after phacoemulsification. [126][127][128][129] On the other hand, there is evidence that preservatives present in hypotensive eye drops, such as benzalkonium chloride, have deleterious and toxic effects on endothelial cells. [130] In addition, there are several case reports demonstrating reversible [131] and irreversible [132] endothelial decompensation with the use of these drugs both in healthy patients and in those with endothelial dysfunction.…”

Section: Iopmentioning

confidence: 99%

Essentials of the corneal endothelium for the cataract surgeon

Fontes

Bandeira

Nosé

et al. 2022

GJCSRO

The human eye is an optical system with two lenses in parallel, with complementary functions essential to vision: the cornea and the lens. There is an intimate relationship between these two structures, especially during cataract surgery when there is inevitably corneal endothelium injury at different severity levels. Every cataract surgeon should be aware of the functioning of the fragile corneal tissue, especially its noblest layer and responsible for corneal transparency: the endothelium. It is of paramount importance to be able to identify the different endothelial pathologies and local conditions associated with greater tissue damage before cataract surgery, as well as to proceed individually in the pre-operative evaluation, during surgery (choice of supplies, technologies and techniques) and prescription of medications or need for additional procedures in the post-operative period. There are several conditions peculiar to cataract surgery and others to the corneal endothelium itself that are described and discussed, as well as information about the physiology, diagnosis and clinical and surgical treatment of diseases that affect it.