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Combating the pain syndrome in painful glaucoma


Author: Bassam Alhabeebi
Degree:doctor of medicine
Speciality: 14.00.08 - Ophthalmology
Year:2016
Scientific advisers: Eugeniu Bendelic
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Boris Pîrgari (decedat)
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 19 April, 2016
Approved by NCAA on the 3 June, 2016

Abstract

Adobe PDF document – 0.99 Mb / in romanian

Thesis

CZU 617.7-007.681-08-089

Adobe PDF document 2.67 Mb / in romanian
147 pages

Keywords

painful glaucoma, hyperemia, eye hypertension, rubeosis, keratopathy, hyphaema, enucleation.

Summary

The thesis is presented on 147 pages of typed text, includes 30 diagrams, 59 tables, 6 annexes, and has the following structure: introduction, four chapters, conclusions and practical recommendations, summaries in Romanian, Russian and English, bibliographic index with 216 references, a summary of the main results. Essential thesis and study results were presented and discussed at some specialty conferences. Six scientific publications related to the thesis were published and three innovations certificates were developed as well.

Field of Study: Ophthalmology.

Goal and Objectives of the work: Studying modern methods of treatment for pain syndrome in patients with painful glaucoma optimizing complex therapy for preventing and combating eye pain and preserving the eye and visual function if such is present. 1) The assessment of progress of the glaucomatous processes in order to highlight the factors and changes preceding the emergence of pain syndrome in patients included in the study. 2) Assessing the effectiveness of methods of medical treatment, laser, surgical, separately and in complex, in preventing and eliminating the painful syndrome in patients with painful glaucoma. 3) Developing on the basis of this study a treatment algorithm for patients with glaucoma aiming to avoid or mitigate painful syndrome and optimizing the curative measures depending on the progress of the disease.

Scientific novelty and originality: New data were obtained on the occurrence factors of pain in glaucoma, such as the pH level in the painful eye tear. We noticed an interdependence between pain intensity assessed using the Wong Baker scale within painful glaucoma and the obtained topical thermometry data. We developed and proposed a complex treatment algorithm in painful glaucoma, which includes topical hypotensive drugs, NSAIDs and ascorbic acid, which are altering the alkaline environment characteristic for the dolor eye, down to neutral level. The algorithm also included surgeries to decrease intraocular pressure such as fistulising operations, fistulizing transciliary operation, laser endocyclophoto-coagulation and cyclocryopexy to combat pain syndrome and avoid enucleation.

Scientific Problem solved in thesis: It is to identify and analyze the cause of pain syndrome in painful glaucoma with the optimization and elaboration of an algorithm helping to conduct complex medical and surgical treatment.

Theoretical significance: We analyzed complex treatment methods applied in painful glaucoma; Correlations have been established between the IOP, the tear pH level, the topical temperature in the painful eye and the intensity of the pain felt by the patient.

Practical value: Based on the conducted study we propose an algorithm of treatment for patients with painful glaucoma depending on its clinical form in order to avoid or combat pain syndrome and to optimize the curative measures depending on the progress of the disease.

Implementation of the results: Therapeutic and surgical management of patients with painful glaucoma was implemented in the ophthalmology clinic of the IMSP SCR .