Intraocular Pressure and Medication Changes Associated with Xen Gel Stent: A Systematic Review of the Literature.

The Xen gel stent (Allergan Inc, an AbbVie company; Dublin, Ireland) was conceived as an option for patients requiring modest IOP reduction but for whom trabeculectomy was not yet indicated. As with any glaucoma surgery, establishing criteria for patient selection and identifying factors that contribute to a high likelihood of success are important. To help guide clinical decision-making, a systematic review of published studies on the gel stent was performed, with the goal of understanding postoperative outcomes based on clinical and patient factors.

Early results of micropulse transscleral cyclophotocoagulation for the treatment of glaucoma.

Purpose: To describe our clinical experience with the efficacy and safety of micropulse transscleral cyclophotocoagulation as a treatment for glaucoma.

Methods: In this retrospective case series, we reviewed the charts of 95 consecutive patients with various glaucoma subtypes who underwent micropulse transscleral cyclophotocoagulation. Patients were offered micropulse transscleral cyclophotocoagulation if they had perimetric glaucoma refractory to intraocular pressure-lowering topical medications and who were poor candidates for traditional filtering surgery.

Evaluating objective and subjective quantitative parameters at the initial visit to predict future glaucomatous visual field progression.

Background And Objective: To evaluate the ability of structural assessment to predict glaucomatous visual field progression.

Patients And Methods: A total of 119 healthy eyes with suspected glaucoma and glaucomatous eyes with 5 or more optic nerve stereophotographs, optical coherence tomography (OCT), and confocal scanning laser ophthalmoscopy (CSLO) all acquired within 6 months of each other were enrolled. Odds ratios to predict progression were determined by generalized estimating equation models.

Comparison of retinal nerve fiber layer thickness measurement bias and imprecision across three spectral-domain optical coherence tomography devices.

Purpose: We compared retinal nerve fiber layer (RNFL) bias and imprecision among three spectral-domain optical coherence tomographs (SD-OCT).

Methods: A total of 152 eyes of 83 subjects (96 healthy and 56 glaucomatous eyes) underwent peripapillary RNFL imaging using at least 2 of the following 3 SD-OCT devices on the same day: Cirrus HD-OCT (optic nerve head [ONH]) cube 200 × 200 protocol), RTVue-100 (ONH protocol [12 radial lines and 13 concentric circles]), and 3D OCT-1000 (3D Scan 256 × 256 protocol). Calibration equations, bias and imprecision of RNFL measurements were calculated using structural equation models.

Teleophthalmology assessment of diabetic retinopathy fundus images: smartphone versus standard office computer workstation.

Purpose: To evaluate the diagnostic capability of a smartphone handset compared with a standard office computer workstation for teleophthalmology fundus photo assessments of diabetic retinopathy.

Methods: Eligible, consenting participants' fundus images were acquired using a non-mydriatic camera. These images along with other medical data were transmitted 20 miles away through the Internet (gold standard) and also through an iPhone(®) (Apple, Cupertino, CA) to two ophthalmologists, who independently compared the images.

A comparison of active ingredients and preservatives between brand name and generic topical glaucoma medications using liquid chromatography-tandem mass spectrometry.

Background: This work compares the concentration of active ingredients and preservatives in commonly used brand name versus generic glaucoma medications.

Materials And Methods: Active ingredient and benzalkonium chloride (BAK) concentrations in brand name latanoprost and dorzolamide-timolol were each compared to two generic counterparts using liquid chromatography-mass spectrometry at baseline and after exposure to 25°C and 50°C for 30 days. Micro flow imaging was used to quantify particulate material greater than one micron in diameter.

Variation in optical coherence tomography signal quality as an indicator of retinal nerve fibre layer segmentation error.

Purpose: Commercial optical coherence tomography (OCT) systems use global signal quality indices to quantify scan quality. Signal quality can vary throughout a scan, contributing to local retinal nerve fibre layer segmentation errors (SegE). The purpose of this study was to develop an automated method, using local scan quality, to predict SegE.

Recurrent enterococcal endophthalmitis seeded by an intraocular lens biofilm.

A case of endophthalmitis following uneventful phacoemulsification and posterior chamber intraocular lens (IOL) implantation in a 77-year-old diabetic man was culture-positive for Enterococcus faecalis. After successful treatment with intravitreal, topical, and systemic antibiotic agents, the infection seemed to clear and the patient achieved a corrected visual acuity of 20/25. Four months after the initial presentation, the patient again developed signs and symptoms of endophthalmitis, with regrowth of E faecalis.

Effects of benzalkonium chloride- and polyquad-preserved combination glaucoma medications on cultured human ocular surface cells.

Introduction: The aim of this study is to investigate potential adverse effects of fixed combination glaucoma medications preserved with either benzalkonium chloride (BAK) or Polyquad® (PQ; Alcon Research Ltd., Fort Worth, TX, USA) on cultured ocular epithelial cells.

Methods: Confluent cultures of human cornea and conjunctival cell lines were exposed for 25 minutes to different glaucoma medications as well as a range of concentrations of BAK (0.

Effects of benzalkonium chloride-preserved, polyquad-preserved, and sofZia-preserved topical glaucoma medications on human ocular epithelial cells.

INTRODUCTION|: To investigate potentially adverse effects of different topical glaucoma medications and preservatives on cultured ocular epithelial cells. METHODS|: Confluent cultures of human corneal (10.014 pRSV-T) and conjunctival cells (1-5c-4) were assayed with 100 μL of different glaucoma medications for 25 minutes at 37°C and 5% CO₂.

Corneal thickness and intraocular pressure in edematous corneas before and after Descemet stripping with automated endothelial keratoplasty.

Purpose: It is important to accurately measure intraocular pressure (IOP) in eyes with corneal endothelial dysfunction both before and after Descemet stripping with automated endothelial keratoplasty (DSAEK). Glaucoma is a common comorbidity in this population, and IOP elevation can worsen corneal edema. Additionally, preexisting glaucoma and steroid-responsive ocular hypertension are significant risk factors for graft rejection after DSAEK.

Intracameral dexamethasone reduces inflammation on the first postoperative day after cataract surgery in eyes with and without glaucoma.

Purpose: To evaluate whether dexamethasone injected intracamerally at the conclusion of surgery can safely and effectively reduce postoperative inflammation and improve surgical outcomes in eyes with and without glaucoma.

Methods: Retrospective chart review of 176 consecutive eyes from 146 patients receiving uncomplicated phacoemulsification (PE) (n = 118 total, 82 with glaucoma), glaucoma drainage device (GDD) (n = 35), combined PE/GDD (n = 11) and combined PE/endoscopic cyclophotocoagulation (n = 12). Ninety-one eyes from 76 patients were injected with 0.

Trabeculectomy with intraoperative retrobulbar triamcinolone acetonide.

Use of topical steroids is an important component of postoperative care after filtration surgery. Efficacy of postoperative medications is affected by patient adherence and physical limitations in the elderly population often prohibit proper dosing of ophthalmic drops. We describe a technique for the use of intraoperative retrobulbar triamcinolone acetonide in trabeculectomy surgery and report on postoperative outcomes.

Effects of age on optical coherence tomography measurements of healthy retinal nerve fiber layer, macula, and optic nerve head.

Purpose: To determine the effects of age on global and sectoral peripapillary retinal nerve fiber layer (RNFL), macular thicknesses, and optic nerve head (ONH) parameters in healthy subjects using optical coherence tomography (OCT).

Design: Retrospective, cross-sectional observational study.

Participants: A total of 226 eyes from 124 healthy subjects were included.

Filtering bleb rupture after intravitreal triamcinolone acetonide injection.

Intravitreal triamcinolone acetonide is effective in treating various ocular disorders associated with inflammation and swelling of the retina. Unfortunately, the use of intraocular steroids is also associated with several side effects, including increased intraocular pressure and the development of cataracts. This article describes a case of intravitreal steroid injection resulting in filtering bleb rupture due to an acute rise of intraocular pressure, expands on the mechanism, and provides possible ways to avoid such an occurrence in thin, cystic filtering blebs.

The effect of probe placement and type of viscoelastic material on endoscopic cyclophotocoagulation laser energy transmission.

Background And Objective: Endoscopic cyclophotocoagulation is a laser modality used to treat refractory glaucoma through the ablation of ciliary epithelium on the ciliary processes, which results in reduced aqueous production. The purpose of this study was to investigate the effect of various viscoelastics and optimal probe positioning on endoscopic cyclophotocoagulation treatment.

Materials And Methods: Six different viscoelastic materials and a balanced salt solution, which was used as a control, were evaluated by placing 2 mL of each in a separate 2 mL glass tube.

Comparison of corneal and conjunctival changes after dosing of travoprost preserved with sofZia, latanoprost with 0.02% benzalkonium chloride, and preservative-free artificial tears.

Purpose: To evaluate corneal and conjunctival changes after chronic, once-daily dosing of travoprost preserved with sofZia, latanoprost preserved with 0.02% benzalkonium chloride (BAK), or preservative-free artificial tears.

Methods: Thirty New Zealand white rabbits were randomized to receive once-daily instillation of travoprost with sofZia, latanoprost, or preservative-free artificial tears in 1 eye.

The management of glaucoma and intraocular hypertension: current approaches and recent advances.

In the last decade, numerous novel ocular hypotensive agents have been introduced for the control of intraocular pressure (IOP). Clinicians now have more options than ever in the selection of medical therapy for the treatment of glaucoma and ocular hypertension. When selecting an ocular hypotensive medication for their patients, clinicians should consider not only the IOP-lowering efficacy of an agent, but also the ability of the drug to allow patients to achieve target levels of IOP that are low enough to stop the progression of glaucomatous damage.

A multicentre evaluation of the effect of patient education on acceptance of hyperaemia associated with bimatoprost therapy for glaucoma or ocular hypertension.

Introduction: The aim of this study was to evaluate the incidence of hyperaemia in patients using bimatoprost and to determine if simple interventions result in increased understanding of glaucoma and hyperaemia.

Methods: This was a multicentre, open-label, evaluator-masked clinical trial of 106 patients. Prior to enrolling in the trial, patients were washed out from any ocular hypotensive medications and prescribed bimatoprost daily in the evening for 6 weeks.

Evaluation of circadian control of intraocular pressure after a single drop of bimatoprost 0.03% or travoprost 0.004%.

Purpose: To compare circadian control of intraocular pressure (IOP) after a single drop of bimatoprost 0.03% or travoprost 0.004% in patients with glaucoma or ocular hypertension.

One-site versus two-site endoscopic cyclophotocoagulation.

Purpose: To report the intraocular pressure (IOP) lowering effect of endoscopic cyclophotocoagulation (ECP) treatment through 1 versus 2 corneal incisions.

Methods: This is a retrospective consecutive case review of combined ECP and phacoemulsification (PE). Group 1 included patients undergoing PE-ECP through 1 clear cornea incision and group 2 involved PE followed by ECP through 2 incisions.

Ocular hypotensive efficacy of brimonidine 0.15% as adjunctive therapy with latanoprost 0.005% in patients with open-angle glaucoma or ocular hypertension.

This study was undertaken to evaluate the ocular hypotensive efficacy of brimonidine Purite 0.15% (Alphagan P 0.15%; Allergan, Inc.

Comparison of acute structural and histopathological changes of the porcine ciliary processes after endoscopic cyclophotocoagulation and transscleral cyclophotocoagulation.

Background: The objective of this study is to investigate the acute histological effects of transscleral cyclophotocoagulation and endoscopic cyclophotocoagulation on the ciliary body and other structures of porcine eyes compared with untreated controls.

Methods: Transscleral cyclophotocoagulation and endoscopic cyclophotocoagulation were performed on porcine eyes. Detailed histological evaluations were performed with light and scanning electron microscopy of treated eyes and compared with untreated controls.

Endoscopic cyclophotocoagulation using iris hooks versus viscoelastic devices.

Endoscopic cyclophotocoagulation utilizes a diode laser to ablate ciliary body epithelium, resulting in decreased intraocular pressure. Viscoelastic devices are often used to elevate the iris for improved exposure and efficient treatment of targeted tissue. Occasionally, early postoperative intraocular pressure spikes may occur due to retained viscoelastic material.