Primary angle-closure glaucoma: A retrospective interventional case series in South India

Abstract

Purpose:To report the outcome of surgically managed primary angle-closure glaucoma (PACG) cases in 84 eyes at a tertiary eye hospital in South India.Materials and Methods:Retrospective analysis of medical records of 84 eyes of 81 patients with PACG, who were surgically managed over 4 years at tertiary eye hospital in South India. Data were obtained from medical and surgical records of the patients identified from October 2010 to October 2014. The patients were operated by two surgeons in the Glaucoma Department of the institute.Results:The patients’ mean age at surgery was 56.21 years. Twenty-four eyes with a mean intraocular pressure (IOP) of 45.8 mmHg underwent trabeculectomy, and 60 eyes with a mean IOP of 29.9 mmHg underwent trabeculectomy with cataract extraction with or without intraocular lens implantation with good postoperative IOP control. A statistically significant greater reduction in IOP was noted in 14 patients who underwent augmentation with Mitomycin C (P = 0.0060, Student's t-test).Conclusion:Knowing the risk factors, the diagnostic methods and treatment options for PAC disease is vital to every ophthalmologist as it is potentially treatable yet visually debilitating if untreated. Trabeculectomy or trabeculectomy with cataract extraction preferably with antifibrotics is an excellent treatment modality for PACG, which also effectively halts the disease progression.

Role of 24-Hour Intraocular Pressure Monitoring in Glaucoma Management

“…Mean IOP, which we may also be able to appreciate by averaging spot office IOP measurements, and short-term IOP fluctuations were reported to be higher than normal healthy individuals [6, 19, 32] in patients with POAG [6, 19, 39, 57, 58], secondary open-angle glaucoma (e.g., XFG) [19, 36, 60], PACG [39, 72], and OHT [19, 35, 37, 59, 75, 76], but not in patients with NTG [6, 66]. The circadian IOP rhythm in POAG was generally similar to normal individuals that the IOP level was highest in the morning and gradually decreased over the day [6, 17, 19, 33, 34, 59].…”

“…In a retrospective analysis by Suresh et al, the mean IOP in PACG patients before treatment ranged from 29.9 mmHg to 45.8 mmHg [72]. The circadian IOP rhythm of PACG patients was similar to that of POAG patients, and normal individuals except those with PACG eyes had a consistently higher IOP [39].…”