Clinical Factors Impacting Outcomes From Failed Trabeculectomy Leading to Glaucoma Drainage Device Implantation and Subsequent Penetrating Keratoplasty.

Prcis: We evaluated the factors that impacted time from glaucoma drainage implant (GDI) surgery to penetrating keratoplasty (PK) in eyes with previously clear corneas (ie, GDI-first sequence), and that specifically underwent a trabeculectomy before GDI surgery for intraocular pressure (IOP) control.

Purpose: To describe through an event-triggered data collection method the clinical course and the long-term outcomes of 2 procedures that are commonly performed sequentially in complex clinical situations: GDI surgery and PK. The study investigates the clinical factors associated with the progression to PK and determines the GDI success rate and graft survival.

Long-term outcomes of modified glued versus flanged intrascleral haptic fixation techniques for secondary intraocular lenses.

Purpose: To report the long-term refractive outcomes and complications of two scleral fixation techniques for secondary intraocular lenses (IOL).

Methods: Consecutive patients who underwent secondary IOL insertion at a tertiary care academic hospital using either modified glued ("glued") or flanged intrascleral haptic fixation (FISHF) techniques with over 12 months of follow-up were retrospectively reviewed. Pre- and postoperative corrected distance visual acuity (CDVA), postoperative complications, and refractive surprises were reported.

Automated Detection of Glaucoma With Interpretable Machine Learning Using Clinical Data and Multimodal Retinal Images.

Purpose: To develop a multimodal model to automate glaucoma detection DESIGN: Development of a machine-learning glaucoma detection model METHODS: We selected a study cohort from the UK Biobank data set with 1193 eyes of 863 healthy subjects and 1283 eyes of 771 subjects with glaucoma. We trained a multimodal model that combines multiple deep neural nets, trained on macular optical coherence tomography volumes and color fundus photographs, with demographic and clinical data. We performed an interpretability analysis to identify features the model relied on to detect glaucoma.

Outcomes of sutureless secondary intraocular lens fixation with haptic flanging in a cohort of surgically complex eyes.

Purpose: To describe clinical outcomes of secondary intraocular lens (IOL) implantation using sutureless trans-scleral techniques in surgically complex eyes.

Methods: Retrospective surgical case series of 45 eyes that underwent secondary IOL implantation using a sutureless haptic flange technique. Demographic data of age, sex, primary diagnosis, best-corrected visual acuity (BCVA), refractive error, intraocular pressure, full ophthalmic exam findings, surgical approach, and any intraoperative complications were noted.

Comparisons of Cornea Cold, a New Corneal Storage Medium, and Optisol-GS.

Purpose: This study compares the quality of donor corneal tissue stored in Optisol-GS and Cornea Cold.

Methods: Seventeen pairs of donor corneas were obtained from an eye bank. One of each pair was stored in Cornea Cold or Optisol-GS.

Quantitative and Qualitative Differences in Endothelial Cell Loss Between Endothelium-In Versus Endothelium-Out Loading in Descemet Membrane Endothelial Keratoplasty.

Purpose: This study compares endothelial cell loss (ECL) between donor grafts loaded in the Geuder Glass Cannula and the Coronet EndoGlide made specifically for Descemet membrane endothelial keratoplasty (DMEK).

Methods: Prestripped tissues using the submerged cornea using backgrounds away (SCUBA) technique were obtained from an eye bank. Donor grafts were loaded with the Geuder Glass Cannula or Coronet DMEK EndoGlide.

Dosimetric effects of bolus and lens shielding in treating ocular lymphomas with low-energy electrons.

Radiation therapy is an effective treatment for primary orbital lymphomas. Lens shielding with electrons can reduce the risk of high-grade cataracts in patients undergoing treatment for superficial tumors. This work evaluates the dosimetric effects of a suspended eye shield, placement of bolus, and varying electron energies.

Scleral Patch Graft With a Suture Reinforcement Technique in Surgical Management of Necrotizing Scleritis With Ectasia.

Purpose: To describe a technique for reducing and reinforcing scleral thinning in cases of necrotizing scleritis with ectasia.

Methods: Descriptive report of a surgical technique in 2 surgical cases with a video.

Results: Successful repair and reduction in uveal prolapse from scleral thinning in 2 cases of necrotizing scleritis with ectasia with a suturing technique using overlapping (weave) compressive suturing over a scleral patch.

Trans-scleral Cyclophotocoagulation Curriculum: Lecture and Skills Practice.

Introduction: Trans-scleral cyclophotocoagulation (TS-CPC) is a laser procedure that is often used in the treatment of end-stage glaucoma and glaucoma that is refractory to medical and surgical treatments. However, formal teaching in proper indications and techniques for TS-CPC can be improved in many institutions. In an effort to standardize TS-CPC teaching, a TS-CPC lecture curriculum and a skills practice session were introduced.

Endophthalmitis Associated With Glaucoma Drainage Implants.

Background And Objective: To identify the clinical features, organisms, and treatment outcomes in patients with endophthalmitis associated with glaucoma drainage implants.

Patients And Methods: A retrospective noncomparative case series.

Results: Of the 13 patients, exposure occurred in eight eyes, including exposure of the tube in four eyes, exposure of the patch graft in three eyes, and exposure of the plate in one eye.

A Retrospective Comparison of Primary Baerveldt Implantation versus Trabeculectomy with Mitomycin C.

Purpose: To compare the safety and efficacy of Baerveldt implantation (Abbott Medical Optics, Santa Ana, CA) and trabeculectomy with mitomycin C (MMC) in patients who have not undergone prior incisional ocular surgery.

Design: Retrospective, comparative case series.

Participants: A total of 125 patients with low-risk glaucoma undergoing primary glaucoma surgery, including 55 patients who received a 350-mm(2) Baerveldt glaucoma implant and 70 patients who underwent trabeculectomy with MMC.

Adverse vitreoretinal outcomes of glaucoma drainage devices based on verified and unverified financial claims data.

Background And Objective: To determine adverse vitreoretinal outcome rates after glaucoma drainage device (GDD) surgery.

Patients And Methods: Medical records from the Anne Bates Leach Eye Hospital with financial claims from 1991 to 2005 for GDD surgery coded for endophthalmitis, choroidal hemorrhage, or retinal detachment were reviewed. Cumulative incidences were calculated before and after verifying claims with chart review.

In vivo effects of femtosecond laser-assisted keratoplasty.

Importance: The femtosecond laser is reported to cut lamellar surfaces with varying degrees of smoothness depending on the depth of the cut, with deeper cuts leaving less smooth surfaces. We attempted to evaluate the smoothness of the deeper lamellar surface as cut by the femtosecond laser after allowing 3 months of in vivo healing.

Observations: Two patients underwent penetrating keratoplasty 3 months after inadequate visual rehabilitation following femtosecond laser-assisted sutureless anterior lamellar keratoplasty for the treatment of anterior stromal scars.

Factors affecting DSAEK graft lenticle adhesion: an in vitro experimental study.

Purpose: The aim of this study was to evaluate different factors that affect Descemet stripping automated endothelial keratoplasty (DSAEK) donor graft lenticle adhesion to the recipient cornea.

Methods: This experimental study included 10 eye bank recipient corneas and 10 donor DSAEK lenticles. Recipient corneas were mounted on an artificial anterior chamber (AC), whereas donor lenticles were placed beneath the host cornea.

Clinical impact of 8 prospective, randomized, multicenter glaucoma trials.

Purpose: To determine the impact of 8 multicenter randomized clinical trials (RCTs) on glaucoma practice.

Methods: An electronic survey was distributed to the members of the American Glaucoma Society (AGS). Each participant was asked 2 study-specific questions and 1 standard question common to all 8 RCTs assessing the study's impact on clinical practice.

Diplopia after glaucoma drainage device implantation.

Purpose: To determine incidence of diplopia after glaucoma drainage device (GDD) surgery and to report treatment outcomes.

Methods: Financial claims data were used to identify patients who underwent GDD surgery (CPT [Current Procedural Terminology] 66180) at the Bascom Palmer Eye Institute from January 2, 1991, through December 31, 2005. After a second claims data search, the medical records of patients diagnosed with diplopia (International Classification of Diseases, 9th Revision code 368.

Progressive loss of retinal ganglion cell function precedes structural loss by several years in glaucoma suspects.

Purpose: We determined the time lag between loss of retinal ganglion cell function and retinal nerve fiber layer (RNFL) thickness.

Methods: Glaucoma suspects were followed for at least four years. Patients underwent pattern electroretinography (PERG), optical coherence tomography (OCT) of the RNFL, and standard automated perimetry testing at 6-month intervals.

The choroid in glaucoma.

Purpose Of Review: Prior studies have not conclusively established a relationship between the choroid and glaucoma. The development of an enhanced imaging technique for spectral domain optical coherence tomography (SD-OCT) has allowed for measurements of choroidal thickness that are more accurate than previously possible. Therefore, the SD-OCT may be capable of documenting the changes in the choroid as they relate to glaucoma.

Evidenced-based comparison of aqueous shunts.

Purpose Of Review: This review provides an evidence-based comparison of aqueous shunts in common use.

Recent Findings: Aqueous shunts are being used with increasing frequency in the surgical management of glaucoma. Recent retrospective studies and prospective clinical trials have compared the outcomes of different shunt designs.

Effect of pupil dilation on macular choroidal thickness measured with spectral domain optical coherence tomography in normal and glaucomatous eyes.

To compare choroidal thickness before and after pupil dilation. Macular subfoveal, nasal, temporal and average choroidal thicknesses were measured in one eye of 17 healthy individuals and 40 glaucoma patients using enhanced depth imaging optical coherence tomography before and after pupil dilation. Comparisons were made between pre- and post-dilation measurements, and between normal and glaucomatous eyes.

Transscleral diode laser cyclophotocoagulation after baerveldt glaucoma implant surgery.

Purpose: To evaluate the safety and efficacy of transscleral cyclophotocoagulation (TSCPC) in patients requiring intraocular pressure (IOP) reduction despite prior Baerveldt glaucoma implant (BGI) surgery.

Participants And Methods: Twenty eyes of 20 patients who had previously undergone BGI placement and subsequently underwent TSCPC with the red (810 nm) diode laser between April 2005 and January 2010 were retrospectively reviewed.

Results: All patients underwent BGI placement an average of 34.