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Focusing on surgical and laser advances in glaucoma management
摘要： Introduction: Lowering the IOP remains the mainstay treatment to stop the progression of glaucoma. Different modalities can be used to achieve this including IOP lowering medications, laser, and surgeries. Nowadays, minimally invasive glaucoma surgeries and newer lasers are becoming more popular due to their safety profile, and their efficacy, allowing the patients to be less dependent on life long medications and substituting more invasive procedures as trabeculectomy, and shunt operations. Areas covered: This review will go through how lasers and surgery are used to lower the IOP, and the newest techniques, and modalities used to achieve this. Expert opinion: the authors of this review believe that in five years’ time lasers and minimally invasive glaucoma procedures will replace eye drops and surgeries like trabeculectomy and shunt procedures.
关键词： cyclophotocoagulation,trabeculectomy,shunt procedures,minimally invasive glaucoma procedures,non-penetrating glaucoma procedures,laser Trabeculoplasty,Intraocular pressure
更新于2025-09-23 15:19:57
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Appraisal of Bleb Using Trio of Intraocular Pressure, Morphology on Slit Lamp, and Gonioscopy
摘要： PurPOsE: The aim of this study was to assess bleb function using Wuerzburg bleb classification score (WBCS) for bleb morphology on slit lamp, intraocular pressure (IOP), and gonioscopy. MEthOds: A total of randomly selected 30 eyes posttrabeculectomy were assessed for bleb function with the trio of bleb morphology, IOP, and gonioscopy. Bleb was assessed using the WBCS of 0–12 on slit lamp, IOP was assessed using applanation tonometry, and visualization of inner ostium and iridectomy were assessed using gonioscopy. Postoperative patients of less than six weeks were excluded from the study. rEsults: The correlation between WBCS and the duration of trabeculectomy was found to be highly significant (P value = 0.029). The correlation of IOP with WBCS was also found to be strongly positive (P = 0.000). IOP was found to be highly associated with peripheral iridectomy (P = 0.000), internal window (P = 0.001), and bleb characteristics.
关键词： gonioscopy,bleb morphology,trabeculectomy,intraocular pressure,WBCS
更新于2025-09-19 17:15:36
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Pulse Waveform Analysis of the Ocular Blood Flow Using Laser Speckle Flowgraphy before and after Glaucoma Treatment
摘要： Although reduction in intraocular pressure (IOP) is the principle of glaucoma treatment, impaired ocular blood ?ow is believed to play a role in the progression of glaucoma. This study evaluated the e?ect of glaucoma treatment on pulse waveforms for optic nerve head (ONH) microcirculation in patients with glaucoma. Fifty-one subjects were included on the basis of the glaucoma treatment administered, which involved instillation of prostaglandin (PG) analogs (PG group; n ? 28) or trabeculectomy (trabeculectomy group; n ? 23). ONH blood ?ow, represented by the mean blur rate (MBRT) and pulse waveforms, was measured using laser speckle ?owgraphy before and 1 and 3 months after treatment. Three months after treatment, IOP exhibited a signi?cant decrease (p < 0.05). Although there was no signi?cant change in MBRT after treatment, the acceleration time index (ATI) signi?cantly decreased (p ? 0.034) in the PG group. In the trabeculectomy group, there was no signi?cant change in the MBRT after treatment, while ?uctuation (p ? 0.019) and blowout score (BOS) (p ? 0.036) exhibited signi?cant decrease and increase, respectively. Multiple regression analysis showed that mean deviation was signi?cantly associated with the rate of change in the BOS (p ? 0.013), age was a signi?cant contributing factor for the rate of change in ?uctuation in the trabeculectomy group, re?ection was signi?cantly associated with the ATI (p ? 0.037) in the in the PG group. Both glaucoma treatments can change the pulse waveforms, with MBRT remaining unchanged, and IOP reduction owing to the treatment may contribute to stable blood ?ow in the tissue area of the ONH. As impaired ocular blood ?ow plays a role in the progression of glaucomatous damage, it would be bene?cial if glaucoma treatment could improve the stability of ONH microcirculation.
关键词： prostaglandin analogs,laser speckle flowgraphy,trabeculectomy,intraocular pressure,glaucoma,ocular blood flow
更新于2025-09-12 10:27:22