No abstract

This review provides some limited evidence that control of IOP is better with trabeculectomy than viscocanalostomy. For deep sclerectomy, we cannot draw any useful conclusions. This may reflect surgical difficulties in performing non-penetrating procedures and the need for surgical experience. This review has highlighted the lack of use of quality of life outcomes and the need for higher methodological quality RCTs to address these issues. Since it is unlikely that better IOP control will be offered by NPFS, but that these techniques offer potential gains for patients in terms of quality of life, we feel that such a trial is likely to be of a non-inferiority design with quality of life measures.

Both trabeculectomy and deep sclerectomy induced considerable postoperative astigmatism. A longer follow-up period is recommended to study the different patterns of astigmatism in either procedure.

Background/aim: To evaluate the economic burden of intraocular pressure (IOP)-lowering medications on Egyptian patients with glaucoma, in addition to studying the social grounds of glaucoma education. Methods: In a cross-sectional observational study, the clinical and socioeconomic data were collected from 68 glaucomatous patients who were attending the outpatient clinics of Cairo University Hospital, through interviews, questionnaires, and clinical examinations. Results: Patients had a mean IOP of 22.9 mm Hg (SD 11.5). Just under half the patients had an IOP of over 30 mmHg although 88% were on medical treatment; average of 2.1 medications (SD 0.8). Patients had been spending 79.5 LE (SD 95.3) on glaucoma medications a month, which equals 30.1% of their monthly income. Forty per cent of patients did not know that glaucoma causes blindness. The primary source of knowledge about glaucoma for 79.4% of patients was the ophthalmologist. Conclusion: The lack of control of IOP is probably related to the economic burden associated with glaucoma medications. 'Glaucoma education' is an important issue to both the treating ophthalmologist and the patient.

Second eye patients tend to present to clinical diagnosis at a better visual acuity than first ones and subsequently have better chances for better posttreatment visual acuity. However, both groups have an equal chance of significant visual improvement.