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| Discussion on the Therapeutic Effect of Secondary Glaucoma Characterized by Iris Atrophy |
| Xiaowei Yan, Guangxian Tang, Yulei Geng, Qian Zhang, Kexin Jiao, Yawen Li, Hengli Zhang |
| Department of Ophthalmology, Shijiazhuang People's Hospital (Shijiazhuang No.1 Hospital), Shijiazhuang
050000, China |
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Abstract Objective: To analyze the therapeutic effect of secondary glaucoma characterized by iris atrophy. Methods: In this case retrospective study, a total of 60 patients (70 eyes) with secondary glaucoma characterized by iris atrophy admitted to Shijiazhuang People's Hospital from July 2013 to January 2020 were collected and followed up for 12 months, including 32 males (36 eyes) and 28 females (34 eyes), aged 26-67 (50.0±10.4) years. The clinical classification and therapeutic effect were analyzed, and the changes of best corrected visual acuity, intraocular lens (IOP) and anti-glaucoma drugs were observed. Repeated measures analysis of variance, Wilcoxon signed-rank test were used to analyze the data. Results: Therewere 70 eyes of patients with secondary glaucoma characterized by iris atrophy, including uveitis in 54 eyes, Fuchs syndrome in 10 eyes and corneal endodermatitis in 6 eyes; There were 44 eyes with diffuse iris atrophy and 26 eyes with localized atrophy; In 30 eyes, 10 eyes were positive for IgG antibody of aqueous humor virus, and 20 eyes were elevated for interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and vascular cell adhesion molecule (VCAM). After active treatment with inflammation and antiviral therapy, there were 20 eyes treated with anti-glaucoma medications, 12 eyes were treated with YAG laser peripheral iridectomy, and 38 eyes were treated with anti-glaucoma surgery. After 12 months of follow-up, the best corrected visual acuity of 70 eyes before and after treatment had a statistically significant difference (F=24.04, P<0.001). The best visual acuity was found 1 month after treatment and leveled off 3 months after treatment. The IOP before and after treatment had a statistically significant difference (F=445.16, P<0.001), the IOP was the lowest 1 month after treatment, then rose gradually, and leveled off 3 months after treatment. Anti-glaucoma drugs decreased significantly after treatment, the difference was statistically significant (Z=-7.28, P<0.001). Conclusion: Viral uveitis is still the main cause of secondary glaucoma characterized by iris atrophy. Based on active control of intraocular inflammation and anti-viral therapy, anti-glaucoma medications and YAG peripheral iris laser perforation showed significant efficacy in the first attack, and short iris adhesion time. Glaucoma surgery is necessary for recurrent glaucoma and severe glaucoma damage.
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Received: 21 December 2021
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Corresponding Authors:
Hengli Zhang, Department of Ophthalmology, Shijiazhuang People's Hospital
(Shijiazhuang No. 1 Hospital), Shijiazhuang 050000, China(Email:simoomy@126.com)
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