[Perioperative prevention of bleeding in glaucoma surgery]

PURPOSE

This study assesses the impact of preoperative administration of Oku-Oku eye drops on the severity of conjunctival hyperemia and the risk of hemorrhagic complications in the early postoperative period following glaucoma surgery.

MATERIAL AND METHODS

The study included a group of 30 patients (30 eyes) with uncontrolled primary open-angle glaucoma who underwent non-penetrating deep sclerectomy. The main group included 15 eyes, in which Oku-Oku drops were administered twice - on the day before surgery (upon hospital admission) and immediately before the operation. The control group consisted of 15 eyes that underwent surgery without additional medications. Intraocular pressure (IOP) and conjunctival hyperemia were measured before and after surgery. The duration of coagulation during surgery was also recorded. The rate of hemorrhagic complications was compared between the groups.

RESULTS

The performed glaucoma surgery significantly reduced IOP in both groups, with no significant differences in postoperative IOP levels. Conjunctival hyperemia increased in both groups postoperatively, though the increase was slightly less in the main group. There was a significant difference in the duration of scleral vessel coagulation in the surgical area, amounting to 3.8±2.6 seconds in the main group and 6.9±3.0 seconds in the control group. Hemorrhagic complications occurred less frequently in the main group.

CONCLUSION

Preoperative use of Oku-Oku eye drops reduced the severity of conjunctival hyperemia and the width of scleral vessels. The reduction in hemorrhagic complications in the early postoperative period may contribute to decreased scarring. Oku-Oku can be included in the comprehensive preoperative preparation for glaucoma surgery and other procedures with a risk of bleeding. Further research is needed to evaluate the effectiveness of Oku-Oku in the perioperative period.

Impact of Topically Administered Steroids, Antibiotics, and Sodium Hyaluronate on Bleb-Related Infection Onset: The Japan Glaucoma Society Survey of Bleb-Related Infection Report 4

Purpose

To investigate the impact of topically administered ophthalmic medications on the onset and severity of bleb-related infections.

Methods

Data obtained from 104 eyes of 104 patients with bleb-related infections were analyzed. We assigned an infection stage to each eye (stage 1-4) and analyzed the onset severity.

Results

Steroids and antibiotics were routinely administered to 13 (12.5%) and 42 (40.4%) eyes, respectively. The median stage of steroid-administered eyes was 3 versus 1 for eyes without steroid administration (P = 0.012). The median duration from surgery to infection for the steroid-administered eyes was 2.0 years versus 5.8 years for eyes without steroid administration (P = 0.030). The median duration from surgery to infection for the antibiotic-administered eyes was 6.4 years versus 3.9 years for eyes without antibiotic administration (P = 0.025). Multiple logistic regression analysis revealed that infections were severe in the steroid-administered eyes (odds ratio: 4.57). No infections developed within 16 weeks postoperatively. No relationship was detected between sodium hyaluronate and the analyzed factors.

Conclusions

Topical steroid administration beyond the immediate postoperative period may affect severe and earlier onset bleb-related infections. Conversely, topical antibiotic administration may be effective in suppressing earlier onset bleb-related infections.