Clinical & Experimental Ophthalmology

Biography

Biography: Baswati Prasanth

Abstract

Purpose: To determine the intraocular pressure control and visual outcomes; following combined phacoemulsification with express device, in cases of advanced open angle glaucoma. Design: Retrospective, interventional, consecutive, non-comparative case series. Participants: Patients of advanced glaucoma and cataract not controlled on maximal medication. Methods: Single eye, in 6 patients, with advanced open angle glaucoma, on maximum anti-glaucomatous medical therapy, underwent combined two-site surgery; Phacoemulsification with implantation of acrylic IOL followed by filtrating surgery, Ex-PRESS miniature glaucoma shunt implantation was performed using 0.02% MMC. The standard procedure was performed under peribulbar anaesthesia without complications; implantation was well positioned, whole surgery was performed by the same surgeon, in the Department of Ophthalmology, Ahalia Hospital Abu Dhabi. Post-operatively, we recommended combined antibiotic and steroid drops every four hours in the first week followed by taper. Main Outcome Measures: Evaluated parameters were visual acuity, intraocular pressure control, bleb morphology on 1st, 7th post-operative day, 1, 3 and 6 months after surgery. Surgical success was defined as 5 mm Hg≤intraocular pressure≤18 mm Hg, with or without medications, without further glaucoma surgery. Results: In a case series of six patients, the mean pre-operative intraocular pressure was 30.66±3.59 mm Hg on 3.83±0.37 anti-glaucoma eye drops. The mean day 1, day 7, day 30, 90 and 180 days IOP were 12.83±2.96, 12.67±2.49, 12.0±2.82, 11.0±2.51, 11.34±3.20 mmHg, respectively. Five out of six had IOP<18 mmHg without medication and all had IOP<18 mmHg with anti-glaucoma medication. No intra-operative or post-operative complications were noted. Conclusion: The Express Device demonstrates good IOP control in cases of advanced glaucoma with fewer propensities to hypotony or wipe out.