Comparison between sutureless scleral tunnel phacotrabeculectomy with and without placement of anterior capsule remnant.

PURPOSE: To compare sutureless scleral tunnel phacotrabeculectomy with and without placement of anterior capsule remnant in the tunnel. METHODS: In this comparative interventional case series, 41 eyes of 40 patients having open-angle glaucoma (OAG) underwent sutureless scleral tunnel phacotrabeculectomy (Group A) and 28 eyes of 24 patients underwent the same procedure with placement of anterior capsule remnant in the tunnel (Group B). Baseline intraocular pressure (IOP) and IOP at 1 day, 1 month and 6 months after surgery were recorded. IOP < 21 mmHg and 20% reduction in IOP from baseline without and with antiglaucoma medication(s) were considered as complete and qualified success, respectively. Any further procedures or complications that require returning the patient to the operating room or becoming no light perception (NLP) were defined as failure. RESULTS: Mean preoperative IOP was 26.6 ± 10.08 and 26.64 ± 6.31 mmHg in group A and B, respectively (P-value = 0.984). Mean IOP at 1 month was significantly lower in group B (14.24 ± 4.4 versus. 12.07 ± 3.1, P = 0.027) but at 6 months there was no significant difference between groups (14.38 ± 3.56 versus. 14.8 ± 1.85, P = 0.590). The qualified success rate in group B was higher than group A (78.6 versus. 58.5%) at month 1, while the complete success rate was higher in group A than B (34.1% versus. 17.9%). Neither of any group had complete success at month 6. The qualified success rate was 94.7% and 100% in group A and B, respectively, at 6 months. CONCLUSION: Placement of anterior capsule remnant in the ostomy during combined phacotrabeculectomy may improve the outcome of the procedure.

Eye disorders in old people.

BACKGROUND: Visual impairment is one of a major public health problem among elderly people. OBJECT: Aim of this study was determining the prevalence of visual impairment in median and old peoples in Qazvin (Iran). METHOD: In this cross sectional study, with a simple random sampling, 446 patients older than 5o years who were referred to outpatient ophthalmology clinics at Avecina hospital of Qazvin (a province of Iran) in 2010 were enrolled. Participants first complete a questionnaire with 25 questions toward demographic and past medical history and then were examined by ophthalmologist. These examinations includes direct and indirect ophthalmoscopy, slit lamp examination, measurement of uncorrected visual acuity and visual acuity with current glasses, lensometery of the previous glasses, refraction with and without the use of cycloplegic and determining the best corrected visual acuity. All slit lamp examinations were performed by the same ophthalmologist. Data were analyzed with SPSS16 with use of Chi - Square test with Pvalue <0.05. RESULTS: In this study 446 patients were examined that 54.7% were male. Mean age of study population was 62+-9.3 years old. 96.4% of participants had refractory disorder. Prevalence of myopia, hyperopia and astigmatism were 33.6%, 45.9% and 16.8% respectively. Of patients 17.4% had diabetes. Of participants 28.9% had temporal headache, 37% red eye, 41.2% flashing, 27.3% and 28% had dryness and discharge of eye respectively. 31.1% of participants had eyelide problem, 4.7% Color Vision Deficiency (CVD) and 3.8% had family history of CVD. Of total 4.5% had glaucoma, 3.3% macular degeneration and 21.7% had hypertension. 0.6% of population had macular degeneration, 0.4% of population had glaucoma Of 892 eyes (446 individuals), 36.2% had visual acuity less than 7/10, 1.7% light perception (LP) and 0.22% no light perception (NLP) and 2.7% finger count. CONCLUSION: Refractory errors, cataract and amblyopia were most important eye disorders in older people in Qazvin.