Abstract
Objectives: Glaucoma is the most common blinding condition in South Punjab
of Pakistan and its management is a challenge due to illiteracy and lack of financial resources.
Study Design: Randomized Clinical Trial. Setting: Department of Ophthalmology Nishtar
Hospital Multan. Period: June 2016 - June 2018. Material & Methods: We have randomly
selected patients on the basis of Cup to Disc ratio and applied randomized clinical trial of both
medical and surgical modalities of glaucoma management to observe the visual outcomes in
terms of Intraocular pressure and Cup to disc ratio. Results: The vision survival of trabeculectomy
in pseudophakics was 88.77% while only 9.8% was the survival rate of trabeculectomy in
phakics. 90% of 31 phakic patients who underwent trabeculectomy failed. Similarly patients on
3 IOP lowering drugs had 70% vision survival rate out of 260 patients treated. Patients with C-D
ratio 0.8 had maximum failure rate of 69% out of 78 patients in which medical treatment failed.
Conclusion: Trabeculectomy significantly reduced the intraocular pressure in patients in which
pharmacological treatment failed.The success rate of trabeculectomy among pseudophakics is
high. In Phakics, when only Trabeculectomy is done, success rate is low. When trabeculectomy
and clear lens extraction is done simultaneously, the success rate is slightly higher. When
trabeculectomy is done after clear lens extraction, the success rate is highest. In case of
Cataract, cataract extraction and trabeculectomy when done simultaneously, show low success
rate. When trabeculectomy was done after cataract extraction, shows highest success rate.
Rashad Qamar Rao, Wamiq Mehmood, Afifa Batool, Raza Ali, Waseem Sajjad, Akifa Abbas. (2020) Different patterns of glaucoma management in South Punjab., The Professional Medical Journal, Volume 27, Issue 12.
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