Posters

Aborting acute angle-closure glaucoma

Poster Details

First Author: M.Idrees PAKISTAN

Co Author(s):                        

Abstract Details

Purpose:

To evaluate the safety and effectiveness of Subconjunctival Peri-Corneal injection of Carbachol,Dorzolamide ,Dexamethasone  with local anesthesia to abort an attack of Acute Angle Closure Glaucoma

Setting:

REDO Eye Hospital Rawalpindi , Pakistan

Methods:

Total of  34 patients , 22 female and 12 male were included in this study having Acute Angle  Closure Glaucoma.Ocular and systemic evaluation was performed .Informed written consent was followed by an injection of a  combination of Cabachol 0.3 ml ,0.3 ml of Dorzolamide 2% , 0.2 ml of Dexamethasone  and 0.2 ml of Lignocain in the subconjunctival  pericorneal  space.IOP was checked after 6 hours 12 hour and after 24 hours.Pupil became miosed ,IOP dropped ,pain was relieved,visual functions improved ,AC became quiet in 6-12 hours.Then patients were advised for  Laser Iridotomy .

Results:

The IOP dropped ,Pupil became miosed, cornea became clear,AC became deep and quiet,Pain and conjunctival congestion was relieved in 6-12 hours in 85% patients.The remaining patients were given oral Acetazolamide and IV Mannitol along with the above combination of injection to manage the acute congestive glaucoma.This was followed by  the Peripheral laser Iridoplasty and Laser Iridotomy which was successful in 92% cases,remaining 8% were treated by surgical iridectomy.Patients were followed up for 1 year and 18% of patients were lost in follow up after 6 months.

Conclusions:

Pericorneal subconjunctival injection of Carbachol,Dorzolamide ,Dexamethasone with 2% Lignocaine appears to be safe and effective for aborting an acute  phase of Primary  Angle  Closure Glaucoma.More over this technique can also be used to treat a very high IOP in cases of POAG and to prepare an eye for  under going  Trabeculectomy in which preoperative IOP is very high.

Financial Disclosure:

... has significant investment interest in a company producing, developing or supplying product or procedure presented, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... is employed by a competing company