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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-10202023-140407


Thesis type
Tesi di specializzazione (4 anni)
Author
PALMA, ALESSANDRO
URN
etd-10202023-140407
Thesis title
Has Minimally Invasive Glaucoma Surgery changed the surgical timing for glaucoma?
Department
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Course of study
OFTALMOLOGIA
Supervisors
relatore Prof. Figus, Michele
correlatore Prof.ssa Posarelli, Chiara
Keywords
  • glaucoma
  • minimally invasive glaucoma surgery
  • visual field
  • surgical treatment
Graduation session start date
09/11/2023
Availability
Withheld
Release date
09/11/2093
Summary
Objectives: To compare the baseline features of the glaucoma patients who underwent glaucoma surgery between January and December 2011 and between January and December 2021 to determine if the rise of Minimally Invasive Glaucoma Surgery (MIGS) in the last ten years has changed our approach to glaucoma surgery timing.
Methods: Monocentric, retrospective study. Ophthalmic data of the patients between January and December 2011 (group A) and between January and December 2021 (group B) were collected. Data included: best-corrected visual acuity, Goldmann applanation tonometry, biomicroscopy, gonioscopy with a 3-mirror contact lens, fundus examination, and a 30-2 full-threshold visual field test. All surgical procedures performed were analyzed including traditional surgery and MIGS.
Results: A total of 455 patients were collected, 230 and 225 for group A and B respectively. No significant differences in baseline characteristics were found between the two groups except for age, in which patients of group B were younger than those of group A (p=0.02), and pre-operative intraocular pressure, which was 25.9 ± 6.6mmHg for group A and 24.9 ± 7.8mmHg for group B (p=0.02). Group A included 19 trabeculectomy, 179 Ex-PRESS®, 13 Ahmed® Glaucoma Valve and 18 MIGS, while in Group B there were 17 trabeculectomy, 50 Ex-PRESS®, 7 Ahmed® Glaucoma Valve and 151 MIGS procedures. The mean deviation in the visual field was higher in group A (-16.4 ± 8.8) compared to group B (-13.8 ± 8.7) (p<0.01). Group A had a higher number of patients with severe visual field defects (p<0.01) and the lowest number of individuals with an early defect (p=0.02).
Conclusion: The increase in the number of MIGS procedures has led to perform glaucoma surgery in younger individuals and in patients with less severe stage of the disease compared to ten years ago.
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