Long-term Clinical Outcomes of Pars Plana Versus Anterior Chamber Placement of Glaucoma Implant Tubes.

Purpose: To compare long-term surgical outcomes and complications of pars plana (PP) tube implantation with conventional anterior chamber (AC) tube implantation.

Materials And Methods: Records of patients undergoing glaucoma tube implant surgery at a single institution between 2007 and 2015 were retrospectively reviewed. Eyes were matched for glaucoma diagnosis and patient age.

Effects of crystalloid versus colloid and the α-2 agonist brimonidine versus placebo on intraocular pressure during prone spine surgery: a factorial randomized trial.

Background: Volume replacement with colloid solution and topical α-2 agonists may each moderate the progressive increase in intraocular pressure (IOP) during prone surgery. The authors tested the hypotheses that during prolonged prone surgery, IOP increases less with goal-directed intravenous administration of 5% albumin than with goal-directed administration of lactated Ringer's solution, and with topical α-2 agonist brimonidine than with placebo eye drops.

Methods: Patients having complex prone spine surgery were factorially randomized to albumin and topical placebo (n = 15); albumin and topical brimonidine (n = 16); lactated Ringer's solution and topical placebo (n = 13); and lactated Ringer's solution and topical brimonidine (n = 16).

Oculodentodigital dysplasia: new ocular findings and a novel connexin 43 mutation.

Objectives: To describe new ocular findings associated with oculodentodigital dysplasia (ODDD) and a novel mutation in the connexin 43 transmembrane domain.

Design: Oculodentodigital dysplasia is a rare autosomal dominant disease characterized by multiple systemic abnormalities, most commonly of the ocular, nasal, dental, and limb structures. Herein, we studied 2 patients with ODDD.

Decreased carbohydrate metabolism enzyme activities in the glaucomatous trabecular meshwork.

Purpose: To determine whether activity of carbohydrate metabolism enzymes (aldolase, pyruvate kinase, isocitrate dehydrogenase, and malate dehydrogenase) are altered in the glaucomatous trabecular meshwork (TM) compared to controls.

Methods: Tissue specimens were obtained from trabeculectomy (n=45 open angle glaucoma; Caucasian, average age 61+/-8 years of age of both genders) and from cadaver eyes (n=15 control and n=5 glaucoma; Caucasian, average age 63+/-4 years of both genders). Protein extracts from TM tissue were prepared in a non-denaturing buffer containing 0.

Comparison of silicone and polypropylene Ahmed Glaucoma Valve implants.

Purpose: To compare the efficacy and safety of silicone and polypropylene Ahmed Glaucoma Valves (AGVs) in patients with refractory glaucoma.

Methods: A retrospective chart review of 180 eyes of 166 patients who underwent AGV implantation with a minimum follow-up period of 3 months was performed. All patients who underwent implantation of either the AGV model S-2 (polypropylene) or model FP-7 (silicone) were included, unless previous laser cyclophotocoagulation had been performed.

Cataract extraction in the collaborative initial glaucoma treatment study: incidence, risk factors, and the effect of cataract progression and extraction on clinical and quality-of-life outcomes.

Objectives: To study the incidence of and predictors for cataract extraction (CE) in patients with newly diagnosed glaucoma, the impact of CE on visual function, and changes in the time around CE.

Methods: Patients were randomized to medical or surgical treatments for glaucoma at 14 centers and followed up for a median of 7.7 years.

Proteomics reveal Cochlin deposits associated with glaucomatous trabecular meshwork.

The etiology of primary open angle glaucoma, a leading cause of age-related blindness, remains poorly defined, although elevated intraocular pressure (IOP) contributes to the disease progression. To better understand the mechanisms causing elevated IOP from aqueous humor circulation, we pursued proteomic analyses of trabecular meshwork (TM) from glaucoma and age-matched control donors. These analyses demonstrated that Cochlin, a protein associated with deafness disorder DFNA9, is present in glaucomatous but absent in normal TM.

Outcomes of combined cataract extraction, lens implantation, and trabeculectomy surgeries.

Purpose: To report outcomes and their association with preoperative and intraoperative factors of 456 combined cataract and glaucoma operations.

Methods: A concurrent series (from January 1, 1987, to October 1, 1997) of one surgeon's consecutive 585 (456 patients) combined cataract extraction, intraocular lens implantation, and trabeculectomy surgeries, some with intraoperative mitomycin C and/or postoperative subconjunctival 5-fluorouracil. The study was a retrospective outcomes analysis for the first 191 operations (before June 10, 1992) and, subsequently, concurrent outcomes analysis for the latter 394 operations.

Management of glaucoma implants occluded by vitreous incarceration.

Purpose: To review the authors' experience in the management of aphakic or pseudophakic patients without an intact posterior capsule who had undergone glaucoma implant surgery complicated by vitreous incarceration in the tube, resulting in increased intraocular pressure or combined rhegmatogenous and tractional retinal detachment.

Methods: Retrospective review of the clinical features, treatment, and outcomes of eight patients who had vitreous incarceration in a glaucoma implant drainage tube. In each patient, a model 425 (7 patients) or model 350 (1 patient) Baerveldt glaucoma implant was used.

Glaucoma drainage devices: pros and cons.

Glaucoma drainage devices are an option in the management of complicated glaucomas that carry a high risk of failure from conventional filtering surgery. Examples include the glaucomas associated with aphakia or pseudophakia, neovascular glaucoma, and glaucomas associated with trauma, uveitis, epithelial downgrowth, iridocorneal endothelial syndrome, vitreoretinal disorders, and penetrating keratoplasty. Modifications in the various implant designs have been developed to limit the occurrence of postsurgical complications such as hypotony, serous and hemorrhagic choroidal detachment, tube and plate avulsion, tube exposure, and corneal endothelial damage.

Prospective ultrasonographic evaluation of intraoperative and delayed postoperative suprachoroidal hemorrhage from glaucoma filtering surgery.

Purpose: To determine the incidence of, visual loss from, and perioperative risk factors for suprachoroidal hemorrhage (SCH) occurring during or after glaucoma filtering surgery.

Methods: Contact B-Scan ultrasonography was used to evaluate at a median of 15 days postoperatively, one eye of 158 patients who underwent various glaucoma filtering procedures during an 18 month period.

Results: Ultrasonography detected SCH in 13 patients (8.

Glaucoma filtering surgery with postoperative 5-fluorouracil in patients with intraocular inflammatory disease.

Twenty-one eyes of 18 patients with uncontrolled glaucoma and intraocular inflammatory disease had glaucoma filtering surgery with postoperative subconjunctival 5-fluorouracil (5-FU). Follow-up for eyes in which intraocular pressure was controlled ranged from 6 to 53 months (mean, 34 months; median, 35 months). Fifteen of 21 eyes (71%) had controlled intraocular pressure (21 mmHg or less).

Infectious crystalline keratopathy occurring in an eye subsequent to glaucoma filtering surgery with postoperative subconjunctival 5-fluorouracil.

We present a case of infectious crystalline keratopathy occurring after 5-fluorouracil filtering surgery. The patient had discrete, branching, white crystalline lesions in the anterior corneal stroma. Cultures grew Streptococcus viridans, and gram-positive cocci were demonstrated in corneal tissue biopsy specimens.

Nonarteritic anterior ischemic optic neuropathy and intraocular pressure.

Several reports have suggested that nonarteritic anterior ischemic optic neuropathy (AION) may be related to increased intraocular pressure. We reviewed the records of 45 patients aged 48 through 86 years with nonarteritic AION (10 patients had bilateral AION) for intraocular pressure measurements and the diagnosis of glaucoma or suspected glaucoma. This group was compared with 45 age- and sex-matched patients with normal eye examination results.

The configuration of peripapillary tissue in unilateral glaucoma.

We compared the peripapillary scleral and choroidal halos and crescents in the two eyes of 42 patients with unilateral glaucoma. In most cases, the edge of the three tissue layers (the retinal pigment epithelium [RPE], the choroid, and the sclera) that encircle the optic nerve head of the glaucomatous eye superimposed exactly on the mirror images of the edges in the fellow nonglaucomatous eye. Although the size of the peripapillary crescent or halo was the same in both eyes, it and the scleral rim were often more conspicuous in the eye with glaucomatous damage because the tissue edges were seen more easily through the reduced thickness of nerve fiber layer tissue.

Angiotensin-converting enzyme in bovine, feline, and human ocular tissues.

Angiotensin-converting enzyme was shown to be present in retinal vessels and neural retina of feline, bovine, and human eyes. It was also demonstrated in the other ocular tissues of feline eyes, in especially high concentration in the highly vascular uveal layer. Its role in the physiology of ocular blood flow and neurophysiology is uncertain, especially in the retina where circulating angiotensin and bradykinin are confined to the intravascular space by the blood-retina barrier, and sufficient data are not available to describe these peptides as transmitters or modulator molecules in the retina.

Acquired peripapillary changes and progression in glaucoma.

In a review of fundus photographs, changes in the degree of depigmentation or atrophy of the retinal pigment epithelium (RPE) were observed near the disc over time in 21% of cases with progressive glaucomatous cupping, but they also occurred as a natural phenomenon over time in 4% of eyes with nonprogressive glaucoma and in 3% of nonglaucomatous eyes. Thus, the peripapillary RPE shows some progressive alteration in normal individuals, but also may sometimes suffer along with the axons during glaucomatous damage. The acquired changes observed in the progressive glaucomatous eyes seem too small and too infrequent to account for the high prevalence of large haloes and crescents seen around the optic disc in glaucoma.