Article

Effects of medications and surgery on intraocular pressure fluctuation.

Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Survey of Ophthalmology (impact factor: 2.35). 11/2008; 53 Suppl1:S45-55. DOI:10.1016/j.survophthal.2008.08.009 pp.S45-55
Source: PubMed

ABSTRACT Intraocular pressure (IOP) varies dynamically throughout the circadian cycle. IOP elevations during the nocturnal period may be particularly important in the pathogenesis of glaucoma, although sleeping IOP cannot be measured at this time. Additionally, IOP fluctuations may be an independent risk factor for glaucoma. However, not all glaucoma therapies are equally effective at lowering IOP throughout the 24-hour period. The prostaglandin analogs have excellent IOP control throughout the 24-hour period, although less at night than during the day. In contrast, some other classes of medications, such as the beta-blockers, have little or no IOP-lowering effect at night. The prostaglandin analogs also have excellent persistency of IOP lowering, lasting at least as long as the 24-hour dosing period, and likely much longer. Glaucoma filtering surgery appears to have even better 24-hour IOP reduction and smaller fluctuations than maximal medical therapy including prostaglandin analogs.

0 0
 · 
0 Bookmarks
 · 
26 Views
  • Source
    Article: Ab externo trabeculectomy performed under topical anesthesia supplemented by conscious sedation.
    Marco Antonio Cortés-Gastélum, José Antonio Paczka-Zapata, Jossué Fernando Mendoza-Barbosa
    [show abstract] [hide abstract]
    ABSTRACT: Ab externo trabeculectomy (AET) is the most common surgical procedure to treat glaucoma; topical anesthesia supplemented by conscious sedation is one of the diverse anesthetic methods to perform such type of surgery. The efficacy and safety of using topical anesthesia supplemented with conscious sedation for performing trabeculectomy were assessed in this prospective study. Twenty-six eyes of 26 consecutive patients underwent trabeculectomy under the effect of topical anesthesia and sedation. All cases were prospectively assessed during five different intra-operative times in which the degree of pain was measured using a visual analog scale (VAS). One patient was excluded from the study due to excessive somnolence. Performing the iridectomy caused less tolerance (p = 0.03) but with acceptable scores according to the VAS (score 2 = minimal and tolerable pain; p = 0.02), followed by conjunctival closure (nonsignificant p values). The entire procedure did not cause either moderate to extreme pain (scores 4 and 5 of the scale, respectively) in any of the patients. Levels of pain, blood pressure, heart rate, and oxygen saturation were compared among the different intra-operative times. No statistically significant (p >0.05) differences were demonstrated. Eighty percent (n = 4) of the patients with green or blue iris had symptoms during the surgery, but this was of borderline statistical significance (p = 0.053). No ocular or systemic side effects appeared related to the reported anesthesia regime. Topical anesthesia associated with conscious sedation seems to be efficacious and safe and can be recommended for performing trabeculectomy.
    Cirugia y cirujanos 05/2011; 79(3):215-9, 233-8. · 0.14 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

24-hour dosing period
 
24-hour period
 
classes
 
glaucoma therapies
 
independent risk factor
 
Intraocular pressure
 
IOP-lowering effect
 
lasting
 
maximal medical therapy
 
medications
 
nocturnal period
 
prostaglandin analogs
 

Arthur J Sit