Glaucoma research Essay Example | Topics and Well Written Essays - 750 words

Glaucoma research - Essay Example 24 consecutive patients presenting, over seven years, to the emergency department of a tertiary eye hospital in Melbourne, Australia, to identify incident cases of DSCH following glaucoma surgery. Clinical parameters of interest included: indication for glaucoma surgery, clinical risk and prognostic factors, and clinical outcomes. Once cases were identified, controls were selected randomly and matched for type of surgery, age, sex, and interval of time since the initial surgery. Pearson’s chi-square analysis was used to compare cases and controls. Results: There were 24 cases, for a seven-year incidence of DSCH of 1% in patients after glaucoma surgery. The average duration of time from glaucoma surgery to DSCH was 2.88 days. DSCH was most common with glaucoma drainage implants (15.4% 7-year incidence). Significant risk factors included systemic hypertension (OR 5; 95 CI 1.41-17.7; p-value 0.02), diabetes mellitus (4.23; 1.08-16.6; 0.03), ischemic heart disease (5.92; 1.35-26.1; 0.008), chronic obstructive airways disease (8.33; 2.09-33.2; 0.01) and anticoagulant use (13.8; 1.51-125.8; 0.002). Preoperative intraocular pressure (p=0.56), myopia (3.22; 0.88-11.8; 0.09) and hyperlipidemia (1.9; 0.50-7.16; 0.29) were not significant risk factors for DSCH. Visual outcomes of DSCH patients were poorer than controls, with 17 of 24 cases (71%), but only 8 of 24 controls (33%) worse, relative to pre-operative VA, when reassessed at follow-up (p = 0.004). Conclusions: DSCH is a relatively common and potentially serious complication of glaucoma surgery. Patients with known clinical risk factors should be warned of risk of DSCH and should be handled with care. Surgery is the main stay of treatment for those cases of open angle glaucoma uncontrolled by medical treatment. The most widely practiced operation is a trabeculectomy. In recent years a number of alternative non-penetrating glaucoma drainage operations have been developed such as deep sclerectomy and