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P. Liskova, H. Kraus, N. Ebenezer, S.S. Bhattacharya, M. Filipec; Glaucoma in Patients with Posterior Polymorphous Dystrophy in the Czech Republic . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4363.
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Purpose: To evaluate the prevalence of glaucoma and surgical therapy necessary to control the intraocular pressure (IOP) in patients with posterior polymorphous dystrophy (PPCD). Methods: Clinical records of 96 patients diagnosed to have PPCD in the Department of Ophthalmology in Prague were retrospectively reviewed. Collected data included the following parameters: prevalence of glaucoma and outcome of surgery performed to control IOP between the years 1990-1999. Successful glaucoma control was defined as IOP lower than 21 mmHg without medication at 3 years. Results: Secondary glaucoma occured in 55 eyes of 30 (31,3 %) of the patients with PPCD and lead to amaurosis in 12 eyes (21,8 %) of 9 patients. There were 19 trabeculectomies (TE), 1 glaucoma drainage implant (GDI), and 2 cryocoagulation in 18 eyes of 13 patients performed. The patients were followed for a mean of 84,8 months (range 43 to 141 months). The age at which patients underwent surgery for glaucoma ranged from 21 to 75 years. Simple TE was performed in 10 eyes (3 of these with previous unsuccessful surgery for glaucoma) leading to IOP control in 5 eyes. TE with intraoperative application of Mitomycin C was performed in 9 eyes (4 of these with previous unsuccessful surgery for glaucoma) leading to IOP control in 7 eyes. One GDI implanted after previous unsuccessful surgery for glaucoma failed immediately after surgery. None of the two cryocoagulation was successful. Conclusions: PPCD in the Czech republic is potentially a blinding condition due to secondary glaucoma. Glaucoma occurred in 31,3 % of patients with PPCD. TE was succesful in 12 eyes (66,6 %). Control of the secondary glaucoma in PPCD is often very difficult. The use of antimetabolites in primary surgical antiglaucoma procedure in PPCD does not appear to offer any major benefit.
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