Comprehensive treatment of patients with refractory glaucoma complicated by bullous keratopathy
Journal Title: Офтальмологический журнал - Year 2019, Vol 0, Issue 1
Abstract
Introduction. Patients with refractory glaucoma complicated by bullous keratopathy often suffer from insupportable pain and uncomfortable sensations in the eye, and visual acuity loss, which worsens the patients’ quality of life. Purpose. To study the efficacy of a complex treatment of patients with refractory glaucoma complicated by bullous keratopathy through transscleral cyclophotocoagulation (TS CPC ) (λ=1.06 µm) followed by laser stimulation for corneal regeneration (λ=0.63 µm) and in combination with a preservative-free tear substitute bio-protector, containing 3% trehalose and 0.15% sodium hyaluronate. Material and Methods. 23 patients (23 eyes) with refractory glaucoma complicated by bullous keratopathy were treated. TS CPC was performed using neodymium laser (λ=1.06 µm; 3 sessions). On completion of a TS CPC course, each patient underwent a course of helium-neon laser stimulation of the cornea (λ=0.63 µm, t=300 sec, 10 sessions) and a 3-month course of a bio-protective tear substitute, containing 3% trehalose and 0.15% sodium hyaluronate (1 drop thrice a day). Each patient underwent visual acuity assessment, IOP measurement, Ocular Surface Disease Index (OSDI) evaluation before treatment, after a course of TCCSC, and after a three-month follow-up. Results. The TS CPC course resulted in pain management in all patients. The post-treatment IOP level decreased to 26.0 mmHg, by 30%, as compared to pre-treatment IOP level and remained stable at 3 months. Visual acuity improved in 10 of 23 patients (43%). Dry eye severity decreased by 34% (OSDI=59.4 scores). Conclusions. The patients with refractory glaucoma complicated by bullous keratopathy had a significantly decreased IOP level (by 30% in 65% of the patients) after a TS CPC course. The following laser stimulation of the cornea in combination with a course of preservative-free tear substitute, containing 3% trehalose and 0.15% sodium hyaluronate, decreased the severity of dry eye disease and corneal syndrome by 34% and significantly improved the patients’ quality of life.
Authors and Affiliations
O. Guzun, G. Drozhzhyna
Keywords
Related Articles
- EP ID EP490146
- DOI 10.31288/oftalmolzh201911722
- Views 108
- Downloads 0
Genetic susceptibility to the development of primary open angle glaucoma
Background: Primary open angle glaucoma is a multifactorial optic neuropathy and associated with a number of factors such as age, ethnicity, family history, central corneal thickness, and intraocular pressure (IOP). In a...
Improving the technique for controlled cryogenic destruction of conjunctival tumors located in the projection of the ciliary body onto the sclera: a preliminary report
Background: In case of controlled cryogenic destruction of an epibulbar tumor, making direct temperature measurements in the tumor and surrounding tissues during the treatment process is difficult and dangerous. Infrared...
In Memory of Natalia Kovalenko, a Director of the Acad. Filatov Museum and Exhibition Complex
Natalia Borisovna Kovalenko was a Director of the Acad. Filatov Museum and Exhibition Complex, President of the de Ribas Foundation for Renewal of Odesa, Magister of International Cultural Studies Academy, and Member of...
Mathematical substantiation of the method for assessing the risk of progression of diabetic retinopathy with serum leptin determination in patients with metabolic syndrome and diabetes mellitus
Background: Issues of not only the development of methods for treatment of diabetic retinopathy (DR), but also search for criteria reflecting the development and risk for progression of the disease in type 2 diabetes mel...
Spectroscopic analysis of intraocular fluid in patients with cataract and pseudoexfoliation syndrome-associated glaucoma
Background: Pseudoexfoliation syndrome (PES) is a risk factor for the development of primary open angle glaucoma (POAG). Impaired intraocular fluid (as reflected by the chemical composition and physical properties, veloc...