Abstract
Purpose: :
In developing African countries the follow–up of patients is very difficult for cultural and logistic reasons. The aim of this study was to evaluate the utility of pneumatic trabeculoplasty (PNT) in the treatment of glaucomatous African patients.
Methods: :
This is a prospective study carried out in Ghana. Eighty three glaucomatous eyes were consecutively included in this study. All the eyes had been diagnosed primary open angle glaucoma based mainly on intraocular pressure by Goldmann tonometer, slit–lamp examination and optic disc evaluation by ophthalmoscopy. Each eye received two drops of oxybuprocaine clorhydrate and a negative pressure suction of 60 mmHg for one minute was applied by using scleral suction. The procedure was repeated after five minutes. IOP was assessed pre–treatment, after 30 minutes, the day–after, and after 1 week. Then a second treatment was performed in the same way, and the IOP was measured after 30 minutes and the day–after. A paired Student’s t test was used to analyze the results. A p value < 0.05 was considered significant.
Results: :
The mean age of the included patients was 60.52 + 13.07 years (mean + standard deviation), and 67 (80.72%) were affected by cataract. The mean pre–PNT IOP was 26.39 + 5.75 mmHg, no significant difference was found after 30 minutes, but after 1 day and 1 week the IOP reduction was significant (P<0.001). When the second PNT treatment was performed, a significant reduction was found after 1 day. No significant side–effects were found except for 16 cases (19.28%) of subconjunctival haemorrhages.
Conclusions: :
In this study PNT showed a potentially good IOP lowering short term effect on glaucoma patients. Even if the mean decrease of IOP was 17.32%, this technique could be useful in developing countries where the compliance of medical therapy is low for logistic and cultural reasons. Moreover the lack of side–effects, except for transient conjunctival hyperemia and subconjunctival haemorrhages, makes PNT safe and easy to perform. and could be carried out even by non–ophthalmologist physicians.
Keywords: outflow: trabecular meshwork • intraocular pressure • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials