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Reshaping procedures for the surgical management of corneal ectasia. J Cataract Refract Surg 2015; 41:842-72. [PMID: 25840308 DOI: 10.1016/j.jcrs.2015.03.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/15/2014] [Accepted: 07/23/2014] [Indexed: 12/31/2022]
Abstract
UNLABELLED Corneal ectasia is a progressive, degenerative, and noninflammatory thinning disorder of the cornea. Recently developed corneal reshaping techniques have expanded the treatment armamentarium available to the corneal specialist by offering effective nontransplant options. This review summarizes the current evidence base for corneal collagen crosslinking, topography-guided photorefractive keratectomy, and intrastromal corneal ring segment implantation for the treatment of corneal ectasia by analyzing the data published between the years 2000 and 2014. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Ferreira TB, Güell JL, Manero F. Combined Intracorneal Ring Segments and Iris-Fixated Phakic Intraocular Lens for Keratoconus Refractive and Visual Improvement. J Refract Surg 2014; 30:336-41. [DOI: 10.3928/1081597x-20140319-01] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 12/18/2013] [Indexed: 11/20/2022]
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Comparison of iris-claw and posterior chamber collagen copolymer phakic intraocular lenses in keratoconus. J Cataract Refract Surg 2014; 40:383-94. [DOI: 10.1016/j.jcrs.2013.07.052] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 07/25/2013] [Accepted: 07/30/2013] [Indexed: 02/07/2023]
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Abstract
Pre-2000, the clinical management of keratoconus centred on rigid contact lens fitting when spectacle corrected acuity was no longer adequate, and transplantation where contact lens wear failed. Over the last decade, outcome data have accumulated for new interventions including corneal collagen crosslinking, intracorneal ring implantation, topographic phototherapeutic keratectomy, and phakic intraocular lens implantation. We review the current evidence base for these interventions and their place in new management pathways for keratoconus under two key headings: corneal shape stabilisation and visual rehabilitation.
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Affiliation(s)
- D M Gore
- Moorfields Eye Hospital, London, UK.
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Abstract
Until recently, corneal biomechanical properties could not be measured in vivo. The ocular response analyzer is a new, noninvasive device that analyses corneal biomechanical properties simply and rapidly. The ORA allows cornea compensated IOP measurements and can estimate corneal hysteresis (CH) and corneal resistance factor (CRF). It is designed to improve the accuracy of IOP measurement by using corneal biomechanical data to calculate a biomechanically adjusted estimate of intraocular pressure. This review critically evaluates the technology and its implications in current day glaucoma management.
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Affiliation(s)
- Sushmita Kaushik
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Surinder Singh Pandav
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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He M, Wang D, Jiang Y. Overview of Ultrasound Biomicroscopy. J Curr Glaucoma Pract 2012; 6:25-53. [PMID: 27990069 PMCID: PMC5159457 DOI: 10.5005/jp-journals-10008-1105] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 11/09/2011] [Indexed: 11/23/2022] Open
Abstract
Ultrasound biomicroscopy (UBM) is a high-resolution ultrasound technique that allows noninvasive in vivo imaging of structural details of the anterior ocular segment at near light microscopic resolution and provides detailed assessment of anterior segment structures, including those obscured by normal anatomic and pathologic relations. This review gives an overview regarding the instrument, technique and its applications.
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Affiliation(s)
- Mingguang He
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Dandan Wang
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuzheng Jiang
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Khurana AK, Khurana B, Khurana AK. Drug-induced Angle-Closure Glaucoma. J Curr Glaucoma Pract 2012; 6:6-8. [PMID: 27990064 PMCID: PMC5159452 DOI: 10.5005/jp-journals-10008-1100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Accepted: 11/02/2011] [Indexed: 11/23/2022] Open
Abstract
Drug-induced angle-closure glaucoma is an important entity for the ophthalmologist as well as the general physician as it represents a preventable cause of potential blindness. This brief review highlights the fact that a high index of suspicion, in a susceptible individual followed by confirmation on appropriate imaging modality (UBM, ultrasound or anterior segment OCT) can alleviate the threat to sight and also help to institute appropriate therapy.
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Affiliation(s)
- Aruj K Khurana
- Senior Professor, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Bhawna Khurana
- Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Ashok K Khurana
- Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
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Kaur D, Gupta A, Singh G. Perspectives on Quality of Life in Glaucoma. J Curr Glaucoma Pract 2012; 6:9-12. [PMID: 27990065 PMCID: PMC5159453 DOI: 10.5005/jp-journals-10008-1101] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 10/28/2011] [Indexed: 11/23/2022] Open
Abstract
Chronic diseases are invariably associated with decreased functioning ability of the individual in one form or the other depending upon the system/organ involved. Disability consequent to the disease is the major factor affecting the patient's physical and psychosocial well-being; in other words, the 'Quality of Life (QOL)'. Besides the disease itself, the treatment and its consequences are also major determinants of QOL of the patients. Globally, glaucoma, which is emerging as one of the leading causes of blindness, is one such chronic ophthalmic disease characterized by a progressive loss of visual function and a potential to cause irreversible blindness, if not treated at an early stage. Patients of glaucoma need to take lifelong medications in order to keep their intraocular pressure within limits. It's impact on the daily life of patients cannot be overexpressed and compounded by the fact that it remains asymptomatic for a considerable time after the disease has set in; has led to new imperatives in diagnosis, treatment and epidemiological and outcome studies. Assessment of the debilitating effect of glaucoma and side effects of its treatment on the emotional and physical QOL of the patient is therefore an important criterion for arriving at the treatment regimen. An extensive literature search was done on Pubmed Central, Pubmed and Google Scholar using the keywords 'glaucoma', 'quality of life in glaucoma', 'management in POAG' and 'QOL assessment tools'. Various tools available for the assessment of QOL, and their advantages and limitations have been reviewed in this article.
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Affiliation(s)
- Divjyot Kaur
- Junior Resident, Department of Pharmacology, Government Medical College, Patiala, Punjab, India
| | - Anita Gupta
- Professor and Head, Department of Pharmacology, Government Medical College, Patiala, Punjab, India
| | - Gursatinder Singh
- Associate Professor, Department of Pharmacology, Government Medical College, Patiala, Punjab, India
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Abstract
A large number of glaucoma patients suffer from vision impairments that qualify as low vision. Additional difficulties associated with low vision include problems with glare, lighting, and contrast, which can make daily activities extremely challenging. This article elaborates on how low vision aids can help with various tasks that visually impaired glaucoma patients need to do each day, to take care of themselves and to lead an independent life.
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Affiliation(s)
- Anjani Khanna
- Glaucoma Services, Government Medical College and Hospital, Chandigarh, India
| | - Parul Ichhpujani
- Glaucoma Services, Government Medical College and Hospital, Chandigarh, India
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Sathyan P, Shilpa S, Anitha A. Optical Coherence Tomography in Glaucoma. J Curr Glaucoma Pract 2012; 6:1-5. [PMID: 27990063 PMCID: PMC5159451 DOI: 10.5005/jp-journals-10008-1099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 10/20/2011] [Indexed: 11/30/2022] Open
Abstract
The optic disk and the RNFL are the principal sites of apparent glaucomatous damage which precedes glaucomatous visual field alterations. RNFL defects are known to precede detection of visual field defects by approximately 6 years. Accurate early detection and monitoring of ONH and RNFL defects has become the prime focus of effective management of glaucoma. Optical coherence tomography employs low-coherence interferometry to obtain cross-sectional images of the ocular tissues. This review attempts to critically analyse the applications of both, anterior and posterior segment OCT in glaucoma management.
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Affiliation(s)
- P Sathyan
- Glaucoma Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Shilpa Shilpa
- Glaucoma Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Anitha Anitha
- Glaucoma Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
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Angmo D, Sobti A, Panda A. The Surgical Treatment of Neovascular Glaucoma with Ex-PRESS P-50 Miniature Glaucoma Shunt. J Curr Glaucoma Pract 2012; 6:13-16. [PMID: 27990066 PMCID: PMC5159454 DOI: 10.5005/jp-journals-10008-1102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2011] [Accepted: 10/18/2011] [Indexed: 11/27/2022] Open
Abstract
Surgical treatment for neovascular glaucoma has evolved from cyclodestructive procedures to full-thickness filtration surgery, to trabeculectomy with antifibrosis drugs and glaucoma drainage implant surgery. The choice of a surgical approach may be influenced by several factors, including the stage of the disease. Many surgeons favor drainage implants when the disease is more advanced or when severe inflammation is present, which would be associated with a poorer prognosis if trabeculectomy were chosen. New devices are being developed to allow surgeons increased control with more predictable postoperative results. One such device, the Ex-PRESS™ mini glaucoma shunt, has undergone changes in design and method of insertion making it more appealing for use in patients requiring IOP-lowering surgery. This report highlights the use of Ex-PRESS mini glaucoma shunt in neovascular glaucoma, surgical technique and summarize pertinent literature on the role of this device in glaucoma surgery.
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Affiliation(s)
- Dewang Angmo
- Department of Glaucoma Services, Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Sobti
- Department of Glaucoma Services, Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Panda
- Department of Glaucoma Services, Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Navas A, Ramirez-Miranda A, Graue-Hernandez EO, Gomez-Bastar A, Ramirez-Luquin T. Intracorneal ring segments and phakic intraocular lens. J Refract Surg 2011; 27:555-6; author reply 556. [PMID: 21815594 DOI: 10.3928/1081597x-20110801-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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