Special Commentary: Reporting Clinical Endpoints in Studies of Minimally Invasive Glaucoma Surgery.

Minimally invasive glaucoma surgery (MIGS) refers to a group of procedures generally characterized by an ab interno approach, minimal trauma to ocular tissue, moderate efficacy, an excellent safety profile, and rapid recovery. The number of MIGS procedures continues to increase, and their use has become widespread among glaucoma and cataract specialists. Standardization of the methodology and reporting of clinical endpoints in MIGS investigations enhances interpretation and comparison across different studies.

Addressing Glaucoma in Myopic Eyes: Diagnostic and Surgical Challenges.

Epidemiological and genetic studies provide strong evidence supporting an association between myopia and glaucoma. The accurate detection of glaucoma in myopic eyes, especially those with high myopia, remains clinically challenging due to characteristic morphologic features of the myopic optic nerve in addition to limitations of current optic nerve imaging modalities. Distinguishing glaucoma from myopia is further complicated by overlapping perimetric findings.

Deep Learning for Localized Detection of Optic Disc Hemorrhages.

Purpose: To develop an automated deep learning system for detecting the presence and location of disc hemorrhages in optic disc photographs.

Design: Development and testing of a deep learning algorithm.

Methods: Optic disc photos (597 images with at least 1 disc hemorrhage and 1075 images without any disc hemorrhage from 1562 eyes) from 5 institutions were classified by expert graders based on the presence or absence of disc hemorrhage.

Choroidal Effusions after Glaucoma Drainage Implant Surgery: Risk Factors and Surgical Management.

Objective: To report the incidence of patients who developed choroidal effusions after glaucoma drainage implant (GDI) surgery and determine risk factors for and outcomes of surgical intervention.

Design: Retrospective case series.

Subjects: Medical records of 605 patients who underwent GDI surgery from January 1, 2017 to June 7, 2021 at New York University Langone Health and New York Eye and Ear Infirmary of Mount Sinai were reviewed.

Results from the Primary Tube Versus Trabeculectomy Study and translation to clinical practice.

Purpose Of Review: The Primary Tube Versus Trabeculectomy (PTVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube shunt surgery and trabeculectomy with mitomycin C (MMC) in eyes without previous incisional ocular surgery. This article reviews results from the PTVT Study and suggests how they may be translated to clinical practice.

Recent Findings: Tube shunt surgery had a higher failure rate than trabeculectomy with MMC in the PTVT Study, and the difference was statistically significant at 1 year but not at 3 years and 5 years.

Leadership in Ophthalmology Professional Organizations: A Descriptive Analysis and Trends, 2002-2022.

Purpose: To describe characteristics and trends in appointed leaders of ophthalmology professional organizations between 2002 and 2022.

Design: Trend study.

Methods: This study used a Web-based search and data collection.

Head and Neck Region Dermatological Ultraviolet-Related Cancers are Associated with Exfoliation Syndrome in a Clinic-Based Population.

Objective: We assessed the relationship between ultraviolet (UV)-associated dermatological carcinomas (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) and exfoliation syndrome (XFS) or exfoliation glaucoma (XFG).

Design: Case-control study.

Participants: Between 2019 and 2021, 321 participants and control subjects (XFS or XFG = 98; primary open-angle glaucoma [POAG] = 117; controls = 106; ages 50-90 years) were recruited.

How glaucoma care changed for the better after the pandemic.

Purpose Of Review: The current article reviews enhancements to the delivery of glaucoma care that developed in response to the coronavirus disease 19 (COVID-19) pandemic and are likely to persist beyond its resolution.

Recent Findings: Literature from the review period (2020-2021) includes reports highlighting contributions of the ophthalmology community to global health during the pandemic. Glaucoma practices worldwide have instituted more robust infection control measures to mitigate severe acute respiratory syndrome coronavirus 2 transmission in the outpatient setting, and many of these modifications will endure in the post-COVID era.

The American Glaucoma Society 100: Articles with Significant Impact on Clinical Glaucoma Care.

Purpose: To identify 100 articles with significant impact on the clinical care of patients with glaucoma.

Design: Cross-sectional study.

Participants: A total of 108 members of the American Glaucoma Society (AGS) in the original survey and 63 in the follow-up survey.

Safety profile of minimally invasive glaucoma surgery.

Purpose Of Review: This article reviews the safety profile of trabecular meshwork/Schlemm's canal-based, subconjunctival, and suprachoroidal minimally invasive glaucoma surgery (MIGS).

Recent Findings: Prospective randomized clinical trials and metaanalyses published during the 2019-2020 review period provided important data regarding the safety profile of trabecular meshwork/Schlemm's canal-based MIGS. Transient hyphema and intraocular pressure spikes are among the most common complications associated with this category of MIGS, but more serious adverse events such as cyclodialysis cleft formation may also occur.

Glaucoma care during the coronavirus disease 2019 pandemic.

Purpose Of Review: The current article reviews the impact of the coronavirus disease 2019 (COVID-19) pandemic on the delivery of ophthalmic, and specifically, glaucoma care.

Recent Findings: Literature from the review period includes case series demonstrating the presence of severe acute respiratory syndrome coronavirus 2 RNA in the conjunctival secretions of patients with laboratory-confirmed COVID-19. The global ophthalmology community published reports outlining the enhanced infection control measures undertaken by different institutions around the world to mitigate transmission of the novel coronavirus.

The Effect of Phacoemulsification on Intraocular Pressure in Eyes with Preexisting Glaucoma Drainage Implants.

Purpose: To study the effect of phacoemulsification on intraocular pressure (IOP) control in patients with preexisting glaucoma drainage implants (GDIs).

Design: Retrospective, observational case series.

Participants: A total of 45 patients (51 eyes) with previously placed GDIs who underwent phacoemulsification between January 2013 and March 2018.

Suture Stenting of a Tube Fenestration for Early Intraocular Pressure Control After Baerveldt Glaucoma Implant Surgery.

Purpose: To evaluate the efficacy and safety of a tube fenestration stented with a 10-0 polyglactin suture for controlling early postoperative intraocular pressure (IOP) after Baerveldt glaucoma implant (BGI) surgery.

Methods: The medical records of 110 patients (119 eyes) who underwent BGI surgery with a tube fenestration stented with a 10-0 polyglactin suture anterior to an occlusive tube ligature were retrospectively reviewed. Main outcome measures included IOP and number of glaucoma medications at postoperative day 1, week 1, and weeks 2 to 3 as well as complications occurring before ligature release.

Complications of micro-invasive glaucoma surgery.

Purpose Of Review: Micro-invasive glaucoma surgery (MIGS) is gaining favor with both comprehensive ophthalmologists and glaucoma specialists due in part to its improved safety profile when compared to traditional incisional glaucoma surgery. Despite a micro-invasive approach and minimal induced tissue trauma, each MIGS procedure is associated with unique complications. The present article summarizes evidence from the 2016 to 2017 review period regarding the safety profiles of Schlemm's canal-based, suprachoroidal, and subconjunctival microstents.

Suprachoroidal shunts.

Purpose Of Review: This article reviews recent studies evaluating the efficacy and safety of ab externo and ab interno suprachoroidal shunts designed to augment uveoscleral outflow in patients with open angle glaucoma.

Recent Findings: The Gold Shunt and STARflo are placed into the suprachoroidal space via an ab externo approach, while the CyPass Micro-Stent and iStent Supra are inserted ab interno through a clear corneal incision. A small randomized clinical trial suggested similar efficacy among two different models of the Gold Shunt and the Ahmed glaucoma valve.

Practice Preferences for Glaucoma Surgery: A Survey of the American Glaucoma Society.

Purpose: The purpose of this study is to assess surgical practice patterns among the American Glaucoma Society (AGS) membership.

Methods: An anonymous online survey evaluating the use of glaucoma surgeries in various clinical settings was redistributed to AGS members. Survey responses were compared with prior results from 1996, 2002, and 2008 to determine shifts in surgical practice patterns.

Vitreous Occlusion of a Glaucoma Drainage Implant-Surgical Management.

Vitreous occlusion of a glaucoma drainage implant (GDI) can lead to failure of the device and severely elevated intraocular pressure. The pathophysiology of tube obstruction is related to central and anterior displacement of vitreous that is drawn into and condenses within the proximal lumen of the tube. This can occur from days to years following GDI surgery.

Long-term Outcomes and Complications of Pars Plana Baerveldt Implantation in Children.

Purpose Of The Study: The purpose of the study was to report long-term outcomes and complications of Baerveldt glaucoma implant (BGI) surgery with pars plana tube insertion in children.

Materials And Methods: The medical records of consecutive aphakic and pseudophakic children (<16 y of age) who underwent BGI surgery with pars plana tube insertion between 1990 and 2013 were retrospectively reviewed. Main outcome measures were intraocular pressure and number of glaucoma medications.

Update on pigment dispersion syndrome and pigmentary glaucoma.

Purpose Of Review: The present article reviews the clinical features and pathogenesis of pigment dispersion syndrome and pigmentary glaucoma and provides an update regarding their diagnosis and management.

Recent Findings: Newer imaging modalities including ultrasound biomicroscopy and anterior segment optical coherence tomography facilitate visualization of the iris concavity characteristic of eyes with pigment dispersion syndrome and pigmentary glaucoma. Patients with pigmentary glaucoma may be distinguished from those with other glaucoma types by the presence of typical symptoms, personality type, and patterns of diurnal intraocular pressure fluctuation.