Our study shows that roughly 50% of the eyes have more than 1 D of astigmatism. The results can help hospitals plan and analyze the amount and costs of using toric IOLs in patients with corneal astigmatism.
To evaluate the gender-related differences in demographic and ocular biometric trends in a defined population presenting for consultation within the Italian public health system and to collect data of several ocular parameters at different stages of life, highlighting the differences between females and males. Patients and Methods: In this retrospective study, keratometry, corneal astigmatism, and axial eye length of 729 patients (729 eyes; mean age: 58±21 years; range: 18-96 years) were evaluated using partial coherence interferometry. Statistical evaluation was performed utilizing a paired t-test and R 2 analysis. Results: In females (396 eyes of 396 patients), mean keratometry ranged between 40.59-47.78 D (44.27±1.36 D), corneal astigmatism ranged between 0-3.82 D (1.13±0.74 D), and axial length ranged between 20.5-31.32 mm (24.07±1.74 mm). In males (333 eyes of 333 patients), mean keratometry ranged between 38.5-46.95 D (43.54±1.35 D; p<0.001), corneal astigmatism ranged between 0.1-3.97 D (1.15±0.79; p=0.75), and axial length ranged between 20.41-31.21 mm (24.57±1.78 mm; p<0.001). Both genders presented a shorter axial length in advanced age. Elderly males presented a higher percentage of against-therule astigmatism. Conclusion: Females may have steeper corneas and shorter eyes. A trend toward axial length reduction with age was observed in both genders. This finding is probably due to the difference in growth between generations, as the new ones have an higher size than the old ones.
Purpose: To test the expanded polytetrafluoroethylene (ePTFE) as a new adju-vant in trabeculectomy. Methods: Consecutive glaucoma surgical inpatients were observed at the Department of Ophthalmology of Palermo University. Sixty patients (60 eyes) were randomly assigned to undergo trabeculectomy (T), trabeculectomy with mitomycin-C (TMMC), with ePTFE (TG) or with mitomycin-C and ePTFE (TGMMC). Postoperative visits were scheduled at 24 hr, 7 days, 1, 3, 6, 12, 18 and 24 months. Complete success and qualified success were assessed at two target intraocular pressure (IOP) levels-£21 and £17 mmHg-by Kaplan-Meier curves. Results: The postoperative IOP reduction was significant (P < 0.01) at the endpoint in all groups, with a mean IOP of 16.9 (±2.9), 16.2 (±2.7), 15.3 (±3.4) and 15.2 (±4.3) mmHg in T, TMMC, TG and TGMMC eyes, respectively. No intergroup difference was found at either IOP targets. The Kaplan-Meier curves relating to either the £21 mmHg or the £17 mmHg target IOP did not show significant intergroup differences for complete and qualified success rate. When ePTFE was used, a trend favouring the medium-term survival rate was noted. No adverse reaction to the ePTFE was present, and no membrane extrusion or conjuctival erosion were noted in any cases. Hypo-tony was significantly more frequent (P = 0.035) in groups without ePTFE. Moreover, the late MMC-related complications were more frequent when MMC was applied. Conclusion: Expanded polytetrafluoroethylene implant in trabeculectomy is well tolerated and could act as a filtration modulating device. Therefore, it is useful in reducing early hypotony-related complications and contributes to attaining medium-term IOP control that is comparable to the low-dosage MMC.
Elevated intraocular pressure (IOP) has been recognized as the major risk factor for the development of glaucoma and a wide range of options are now available to reduce it: medical treatment, laser, filtering, or cyclodestructive surgery (alone or in combination). All these modalities act by decreasing eye pressure and, thereby, protecting the optic nerve head from a mechanic direct and/or vascular indirect insult. Topical medical therapy represents the first-choice treatment and, in most cases, it effectively controls IOP, avoiding the occurrence of further optic nerve damage. All medications lower IOP in two main ways: decreasing the production of aqueous humour or by increasing its outflow from the eye. Consequently, antiglaucoma drugs either suppress aqueous humour formation (beta-adrenergic antagonists, carbonic anhydrase inhibitors, and alpha-2-adrenergic agonists) or raise aqueous humour outflow throughout the conventional (e.g., pilocarpine) or uveoscleral (prostaglandin FP receptor agonists, and prostamides) route. In addition, fixed and unfixed combinations of antiglaucoma compounds have also been available for patients requiring more than one type of medication. This review, which is part one of two (please see Expert Opinion on Pharmacotherapy 10 (17)) briefly considers the characteristics of sympathomimetic, sympatholytics and parasympathomimetic commonly employed in the medical treatment of glaucoma, mainly the primary open-angle form, focusing the discussion on the clinical evidence supporting the use of these three classes of compound.
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