For more information check here
Okay let me explain this question regarding systematic review of evidence for surgical treatment of glaucoma which one of the following statements is most likely to be true the viscocanalostomy has an equivalent pressure effect or pressure lowering effect to trapectomy this is not true as the results or the systematic review that compare between the viscocanalostomy
And the trapezoid showed that the trapectomy sure more reduction more reduction of intraocular pressure occurs with trapezoid but or but but unfortunately it comes with a cost as a trapezoid tend to cause more cataract and more infection the randomized controlled trials of tube valve surgery versus trapeztomy alone showed the higher rates of adverse event
Following the traffic colectomy this is the correct answer so uh the these trials that compare the tube versus trapectomy showed that there are the side effects after trapecolectomy such as hypotony and the infection are more with trapiglectomy than with valve however both of them will show the same reduction of intraocular pressure and both of them will show the
Same reduction in the visual field it changes so the c and d here is the wrong answer no here is wrong and no here is wrong because there is a clear pressure lowering effect from the use of 5-fluorouracil in case of trapectomy but this comes with a cause as well as it will cause persistent epithelial defects it can cause blip leakage it can cause infection but
It can decrease the intraocular pressure and the same thing goes with the beta radiation video radiation when it is used with the trapecolectomy it can cause much lower effect but again it comes with a cost as it causes cataract so to review what we have said in the clinical trials lecture according to the trapecolectomy versus canalostomy systemic review the
Trapekelectomy will show more reduction of the intraocular pressure than the vascularostomy but the side effects or the adverse events of the trapecolectomy are more than the viscocanalostomy the trapecolectomy versus cube the study showed that there is no difference or no significant difference in the intraocular pressure reduction between the the the the the
Tube or the tube or the trapectomy but the complications rate or the side effects are higher in case of trapezoid than in case of tube so this was the right answer this is the answer that which is here that the randomized the clinical trial of the tube valve surgery versus trapezoid rate of adverse events followed the trapecolectomy so this is the correct answer
For the fluoride filtering surgery it showed that the iop reduction with the use of five fluorescein is about 75 percent compared to only 50 percent when the when we are not using the five fluorescein but actually we don’t use it on routine basis because it has higher incidence of complications it can cause bleed leakage bleed rupture persistent epithelial defect
Infection and in the thermites and finally the trapecolectomy versus trapectomy and the beta radiation systematic review showed that although in the traffic let me show higher reduction of the introductory pressure it show or show lower iop but it show more incidence of attract and this is the same the same reason why the beta radiation is no longer used with the
Trigem surgery although this was the routine practice like about four years ago for example this is because the beta radiation showed to cause the patient cataract okay another questions about clinical trials um hmm okay so regarding the the evidence of medical treatment of glaucoma which one of the following statements is most likely to be true according to
The clinical evidence that timur which is a beta blocker is stronger than the topical carbonic anhydrase inhibitors such as brainzylamide and dorsal mine so brainzoramide and dorsolamide are weak species specifically the topical uh have a weaker and a weaker effect or weaker lowering effect on the intraocular pressure so both a and b are not true latino prostate
Head has a stronger pressure lowering effect than the pentapro so this is not true again the bimetal prosthetic will be a as equal as antennapros or sometimes it is sometime or some people say that the metapros is a little bit stronger latinoprost is better tolerated than the pimento prost this is the correct answer so as the latino prose is associated with lower
Incidence of conjunctive high premia then the use of bimetoprost or even the travoprost for treatment of ocular hypertension or glaucoma so this will be a if you are giving a patient a pimento prost and you can find he is not tolerating it like is complaining from congenital high premia which is very bothersome for the patient then you can switch it to the latino
Process so as we mentioned that according to the evidence regarding medical treatment of glaucoma prostaglandins they showed uh to be are are you are now are considered the first choice drug unless or other if if they are not contraindicated like the metoprolatinopros travel pros and the latino pros will be the most well tolerated beta then followed by the uh
The standard first choice drug uh like 20 years ago which was the beta blockers so these are stronger then followed by the alpha to agonist and the parasympathetics and the weakest will be the carbonic anhydrase inhibitors
Transcribed from video
Advanced ICO Glaucoma By I-Courses
