Initial Results of the Paul Ahmed Comparison (PAC) Study in Refractory Childhood Glaucoma.

Purpose: To compare the effectiveness and safety of the Paul glaucoma implant (PGI) to the Ahmed glaucoma valve (AGV) in managing refractory childhood glaucoma.

Design: Randomized controlled trial.

Setting: Two clinical centers.

Early Experience with the Paul Glaucoma Implant in Childhood Glaucoma: A Case Series.

Purpose: The Paul glaucoma implant (PGI, Advanced Ophthalmic Innovations, Singapore, Republic of Singapore) is a recently developed novel non-valved glaucoma drainage device (GDD) designed to effectively reduce the intraocular pressure (IOP) in glaucoma patients with a theoretically reduced risk of postoperative complications such as hypotony, endothelial cell loss, strabismus, and diplopia. Limited literature has evaluated its use in adult glaucoma; however, its use in pediatric glaucoma has not been reported to date. We present our early experience with PGI in refractory childhood glaucoma.

Ahmed and Baerveldt Glaucoma Drainage Devices in Childhood Glaucoma: A Meta-Analysis.

Prcis: The effectiveness of Ahmed glaucoma valve (AGV) and Baerveldt glaucoma implant (BGI) was comparable in the management of childhood glaucoma over the long term despite initial better success rate with BGI. There were higher tube block and retraction rates in the BGI group and higher tube exposure rates in the AGV group.

Purpose: To evaluate the outcomes and safety of AGV and BGI in childhood glaucoma.

Safety and Effectiveness of the PRESERFLO® MicroShunt in Primary Open-Angle Glaucoma: Results from a 2-Year Multicenter Study.

Purpose: To assess the safety and effectiveness of the PRESERFLO® MicroShunt (formerly InnFocus MicroShunt) in patients with primary open-angle glaucoma (POAG).

Design: The MicroShunt, a controlled ab externo glaucoma filtration surgery device, was investigated in a 2-year, multicenter, single-arm study.

Participants: Eligible patients were aged 18-85 years with POAG inadequately controlled on maximal tolerated medical therapy with intraocular pressure (IOP) ≥18 and ≤35 mmHg or when glaucoma progression warranted surgery.

Deep Sclerectomy With Intrascleral Versus Suprachoroidal Collagen Implant: A Randomized Control Trial.

Prcis: Deep sclerectomy with intrascleral collagen implant (DSCI) was less effective in lowering intraocular pressure (IOP) than with suprachoroidal implantation. Further studies are needed to establish the potency and safety of deep sclerectomy with suprachoroidal collagen implant (DSSCI).

Purpose: The purpose of this study was to analyze the safety and IOP-lowering effect of DSSCI in comparison with DSCI.

Revisiting Results of Conventional Surgery: Trabeculectomy, Glaucoma Drainage Devices, and Deep Sclerectomy in the Era of MIGS.

Bhartiya S, Dhingra D, Revisiting Results of Conventional Surgery: Trabeculectomy, Glaucoma Drainage Devices, and Deep Sclerectomy in the Era of MIGS. J Curr Glaucoma Pract 2019;13(2):45-49.

The Quest for the Holy Grail of Glaucoma Surgery: Does Cypass Herald the End?

Bhartiya S, Shaarawy T. The Quest for the Holy Grail of Glaucoma Surgery: Does Cypass Herald the End?. J Curr Glaucoma Pract 2018;12(3):99-101.

Comparing pattern scanning laser trabeculoplasty to selective laser trabeculoplasty: A randomized controlled trial.

Purpose: To compare safety, tolerability and intraocular pressure (IOP)-lowering efficacy of pattern scanning laser trabeculoplasty (PSLT) with selective laser trabeculoplasty (SLT) in fellow eyes of untreated patients with glaucoma.

Design: Randomized controlled trial.

Participants: Twenty-nine patients (58 eyes) with primary and secondary open angle glaucoma (OAG) were randomized to undergo PSLT or SLT in each eye.

The Suprachoroidal Route in Glaucoma Surgery.

Glaucoma surgeries targeting the uveoscleral drainage pathways have been drawing more attention lately. Among all the available techniques, procedures focusing on the supra-choroidal space seem particularly promising, by making use of a presumably efficient and secure outflow route and avoiding subconjunctival filtration blebs. The purpose of this review is to assess the efficacy and the security of the different suprachoroidal drainage implants, namely the CyPass Micro-Stent, the iStent Supra, the SOLX Gold Shunt, the Aquashunt, and the STARflo Glaucoma Implant.

Surgery on the Trabecular Meshwork: Histopathological Evidence.

Juxtacanalicular (JXT) trabecular meshwork and endothelial lining of Schlemm's canal have been cited as the loci of aqueous outflow resistance, both in a normal as well as a glaucomatous eye. In this review, we attempt to understand the currently available surgical modalities in light of the available histopathological evidence, regarding localization of outflow resistance. How to cite this article: Bhartiya S, Ichhpujani P, Shaarawy T.

24-h Efficacy of Glaucoma Treatment Options.

Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle.

EX-PRESS glaucoma filtration device: Review of clinical experience and comparison with trabeculectomy.

Glaucoma filtration surgery is performed to reduce intraocular pressure (IOP) in patients for whom maximal tolerable pharmacologic IOP-lowering therapy and/or laser surgery fail to lower IOP sufficiently and/or fail to prevent optic nerve damage or visual field deterioration. For decades, the most widely utilized procedure for glaucoma filtration surgery has been trabeculectomy. Although this approach reliably provides long-term IOP reduction in many patients, the postoperative complication rate is high.

Supraciliary Micro-stent Implantation for Open-Angle Glaucoma Failing Topical Therapy: 1-Year Results of a Multicenter Study.

Purpose: To evaluate the safety and efficacy of a supraciliary micro-stent (CyPass Micro-Stent; Transcend Medical, Menlo Park, California, USA) for surgical treatment of glaucoma in patients refractory to topical medications.

Design: Multicenter, single-arm interventional study.

Methods: Patients with open-angle glaucoma (Shaffer Grade 3 and 4) and uncontrolled medicated intraocular pressure (IOP) >21 mm Hg at baseline and candidates for conventional glaucoma surgery were enrolled.

Determination of bleb capsule porosity with an experimental glaucoma drainage device and measurement system.

Importance: Control of intraocular pressure after implantation of a glaucoma drainage device (GDD) depends on the porosity of the capsule that forms around the plate of the GDD.

Objective: To compare capsular porosity after insertion of 2 different GDDs using a novel implant and measurement system.

Design, Setting, And Subjects: We performed an experimental interventional study at an eye research facility in a tertiary eye care center.

Glaucoma surgery: taking the sub-conjunctival route.

We are currently in the midst of a surge in interest in glaucoma surgery. Novel pathways for reducing intraocular pressure (IOP) have been tried with various levels of success over the last few years. While the trabecular bypass and suprachoroidal approaches have captured much of the attention, filtering aqueous into the sub-conjunctival space remains the gold standard for lowering IOP.

Update on Schlemm's canal based procedures.

Surgical options for glaucoma have expanded in recent years. This article provides an evidence-based update on the novel or emerging surgical techniques for the treatment of open-angle glaucoma that are based on the Schlemm's canal (SC). Canaloplasty is an ab externo approach and was developed as an alternative to traditional filtering surgeries.

New perspectives on target intraocular pressure.

The evidence in support of intraocular pressure (IOP) lowering to reduce risk of glaucoma onset or progression is strong, although the amount and quality of IOP reduction is less well defined. The concept of a target IOP includes a percentage reduction, calculated IOP, or a predetermined IOP figure or range. Yet none of these strategies have been validated.