Outcomes of bleb revision with ologen following filtering glaucoma surgery.

Purpose: This study reports long-term outcomes of bleb revision with ologen™ Collagen Matrix (Aeon Astron Europe BV, the Netherlands) for the surgical management of various bleb-related issues including persistent bleb leaks with or without associated hypotony, bleb dysesthesia, overhanging blebs, or hypotony after filtering glaucoma surgery.

Materials And Methods: A retrospective chart review was performed for patients who underwent ologen bleb revision from 2012 to 2019 at Glaucoma Associates of Texas.

Results: The study included 23 eyes of 22 patients undergoing bleb revision with the ologen implant.

Twenty-Four-Month Outcome of Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in Eyes With Prior Corneal Transplant Surgery.

Purpose: Glaucoma is a well-known sequelae of corneal transplant surgery and is a leading cause of visual loss in this patient group. We evaluated the performance and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in this population.

Design: Noncomparative retrospective case series.

Rescue of Failed XEN-45 Gel Implant by Nd:YAG Shock Wave to Anterior Chamber Tip to Dislodge Hidden Intraluminal Occlusion.

Purpose: The purpose of this study was to inform ophthalmic surgeons in a timely manner of the hidden problem of clear intraluminal cellular debris as a cause for XEN-45 failure and to describe low energy neodymium-doped yttrium aluminum garnet (Nd:YAG) laser revision with periluminal anterior chamber tip shockwave treatment to improve flow to the bleb.

Patients And Methods: Six patients with visibly patent stent lumen post XEN-45 surgery. These eyes developed rising intraocular pressure (IOP) with a history of excellent prior bleb formation and were treated successfully with Nd:YAG laser shockwave therapy to disperse assumed intraluminal cellular debris.

Vesicular Release of GABA by Mammalian Horizontal Cells Mediates Inhibitory Output to Photoreceptors.

Feedback inhibition by horizontal cells regulates rod and cone photoreceptor calcium channels that control their release of the neurotransmitter glutamate. This inhibition contributes to synaptic gain control and the formation of the center-surround antagonistic receptive fields passed on to all downstream neurons, which is important for contrast sensitivity and color opponency in vision. In contrast to the plasmalemmal GABA transporter found in non-mammalian horizontal cells, there is evidence that the mechanism by which mammalian horizontal cells inhibit photoreceptors involves the of the inhibitory neurotransmitter GABA.

Visual Field Outcomes in the Tube Versus Trabeculectomy Study.

Purpose: To describe visual field (VF) outcomes in the Tube Versus Trabeculectomy (TVT) Study.

Design: Cohort analysis of patients in a multicenter randomized clinical trial.

Participants: A total of 122 eyes of 122 patients, with 61 eyes in both the tube shunt and trabeculectomy groups.

Historical Considerations and Innovations in the Perioperative Use of Mitomycin C for Glaucoma Filtration Surgery and Bleb Revisions.

Although there is a currently a revolution in angle-based procedures, subconjunctival filtration surgery with mitomycin C (MMC) wound modification remains a vital skill for glaucoma surgeons. MMC is a potent antifibrotic agent that has been an invaluable adjunct for successful glaucoma filtration surgery for over 20 years, but it must be used judiciously to avoid serious complications, including hypotony, corneal decompensation, bleb avascularity, bleb leaks, blebitis, and endophthalmitis. The purpose of this report is to describe the historical lessons learned from MMC use, along with updated methods of MMC delivery during primary trabeculectomy, bleb needling at the slit lamp, bleb revisions in the operating room, and newer and less invasive ab-interno filtering procedures.

Early Results of Goniotomy with the Kahook Dual Blade, a Novel Device for the Treatment of Glaucoma.

Purpose: To report the outcomes of patients who underwent goniotomy with the Kahook Dual Blade (KDB) either as a standalone procedure or in combination with cataract extraction.

Patients And Methods: This retrospective chart review included 111 eyes of 90 patients who underwent KDB goniotomy from January to November 2016 at Glaucoma Associates of Texas. KDB goniotomy was combined with cataract surgery in 100 eyes.

Micropulse Cyclophotocoagulation: Initial Results in Refractory Glaucoma.

Purpose: The purpose of this study is to evaluate the use of micropulse transscleral cyclophotocoagulation (MP-TSCPC), a new and increasingly popular treatment, in patients with uncontrolled glaucoma.

Methods: A retrospective chart review was performed for all patients who underwent a MP-TSCPC at the Glaucoma Associates of Texas.

Results: A total of 84 eyes were treated with MP-TSCPC in this study with a mean follow-up time of 4.

Glaucoma management after vitreoretinal surgeries.

Purpose Of Review: The surgical management of retinal disorders, including scleral buckling procedures, pars plana vitrectomy, and intravitreal injections of gas or silicone oil, can lead to short-term elevations in intraocular pressure (IOP) and ultimately long-term glaucomatous damage if not treated in a timely manner. Glaucoma in these cases is commonly refractory to conventional therapies. This review highlights the treatment strategies for glaucoma in eyes that have previously undergone vitreoretinal surgery.

Glaucoma management after corneal transplantation surgeries.

Purpose Of Review: Intraocular pressure (IOP) elevation and glaucoma progression following corneal transplantation, specifically, penetrating keratoplasty, Descemet's stripping endothelial keratoplasty, and Boston keratoprosthesis, are well described causes of ocular morbidity. Depending on the procedure performed, the incidence of glaucoma is highly variable. Several etiologic factors have been identified, the most common being synechial angle closure and corticosteroid-induced IOP elevation.

Early Aqueous Suppressant Therapy on Hypertensive Phase Following Glaucoma Drainage Device Procedure: A Randomized Prospective Trial.

Purpose: To prospectively evaluate the effect of early aqueous suppression (therapy) on hypertensive phase (HP) and intraocular pressure (IOP) control after implantation of silicone Ahmed glaucoma valve (AGV).

Materials And Methods: Patients who underwent AGV implantation were randomized to initiate therapy (including β-blockers, α-agonists, or carbonic anhydrase inhibitors) when postoperative IOP>10 mm Hg (low-IOP initiation group) or >17 mm Hg (moderate-IOP initiation group). HP was defined as an IOP>21 mm Hg during the first 6 postoperative months, after an initial IOP reduction to <22 mm Hg in the first postoperative week.

Evaluation of the "IS" Rule to Differentiate Glaucomatous Eyes From Normal.

Purpose: To compare the accuracy of the "ISNT" rule [neural rim width of inferior(I)≥superior(S)≥nasal(N)≥temporal(T) regions] and the abbreviated variant, the "IS" rule (inferior≥superior regions) to differentiate normal from glaucomatous eyes.

Materials And Methods: Medical records of patients who were evaluated in 2011, had glaucomatous optic neuropathy and visual field defects, on glaucoma treatment, and had stereoscopic optic disc photographs were reviewed. Optic discs with focal complete loss of neural rim or long axis rotated >30 degrees from vertical meridian, and patients with ≥5 D of myopia or any retinal pathology or nonglaucomatous optic neuropathy were excluded.