Ologen versus Mitomycin-C for Trabeculectomy in a Predominantly African American PopulationOlogen versus Mitomycin-C for Trabeculectomy in a Predominantly African American Population

Glaucoma is the most common cause of irreversible blindness worldwide. Treatment of glaucoma begins with medical management but often requires surgical intervention. Since the late 1960s, the most common surgical treatment for glaucoma has been trabeculectomy. AGIS investigators and others have established that race plays a significant role in an individual’s response to trabeculectomy. Specifically, African American patients have been shown to have advanced glaucoma at time of diagnosis and respond less favorably than Caucasian patients to trabeculectomy. Our group wishes to investigate the role of ethnicity in specific surgical treatments for glaucoma.

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Primary Open Angle Glaucoma Poses Threats in the Form of Increased Axial Length

Primary Open Angle Glaucoma (POAG) is one of the most common forms of eye disease that occurs due to high Intraocular Pressure (IOP). If untreated, it would leads to periphery loss of vision that gradually leads to complete blindness.. When a comparative study was initiated to determine the axial length (AL) and K value between two groups of patients consisting patients with POAG and the age matched controls group, Patients with POAG are having longer AL and flatter corneas than the age-matched controls. This would clearly highlights the risks involved for the patients of POAG.

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Un-doing All that Good Work! Glaucoma after Vitrectomy and Silicone Oil Injection for the Treatment of Complicated Retinal Detachment

A fifty-two year old bilaterally pseudophakic Caucasian gentleman having a retinal detachment secondary to two retinal breaks superotemporally in his right eye underwent twenty-three gauge pars plana vitrectomy (PPV), endophotocoagulation and perfluoroethane (C2F6) gas insertion. He presented five weeks later with a total retinal detachment in the same eye presumed consequent to a retinal break infero temporally thought to represent temporal extension of the initial retinal tear beyond the margin of the aforementioned retinopexy. Twenty gauge PPV was performed, cryotherapy was applied to the retinal break, indirect retinal photocoagulation carried out and 16% perfluoropropane (C3F8) inserted into the vitreous cavity.

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General on Glaucoma and Oxidative Stress. Comments on Study Design: “Biomarkers of Lipid Peroxidation in the Aqueous Humor of Primary Open angle Glaucoma Patients”

Glaucoma is an optic neuropathy that causes progressive changes in the visual field and whose main known risk factor is the increased IOP. It is true that the latest acquisitions in image analysis technology (Optical Coherence Tomography -OCT-) have provided objective and quantifiable data of morphological damage, in any way eliminates the subjectivity and variability of the methods previously employed. If we speak from the functional point of view, computerized perimetry remains the method most commonly used scanning glaucomatous damage worldwide. While exploring the optic disc remains the way easier to assess the damage to the optic nerve, the great variability in the interpretation and errors derivatives thereof, the OCT has become critical in monitoring patients with glaucoma.

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Hypotony as a Hazard of Trabeculectomy with Mitomycin C

An eighty two year old Caucasian lady with primary open angle glaucoma attended eye clinic. She was using guttate latanoprost 50 g/ml, Brimonidine 2 mg/ml and combined Dorzolamide 20 g/ml and Timolol 5 mg/ml.

This lady was myopic with right eye manifest refraction spherical equivalent of -2.00 and left eye manifest refraction spherical equivalent of -8.00 dioptres. The left eye was amblyopic as a result of this anisometropia. This lady had had bilateral uncomplicated cataract extractions by phacoemulsification with intraocular lens implantation and subsequently bilateral neodymium yttrium aluminium garnet or Nd: YAG laser posterior capsulotomies.

This patient had a medical history of pulmonary tuberculosis and pulmonary fibrosis. She also had aortic valve regurgitation and osteoarthritis. Her regular medications were Digoxin 125 μg, Bumetanide 1mg and Lisinopril 1mg daily. She utilized supplementary oxygen for 16 hours daily.

Surgical Management of Glaucoma in Sturge-Weber Syndrome

Glaucoma is a common feature, with an incidence of 30%-71% in patients with Sturge-Weber syndrome. Many mechanisms of raised intraocular pressure have been described in the past, the most consistent being congenital trabeculodysgenesis, increased episcleral venous pressure and hypersecretion due to ciliary body angioma.

An increased risk of intra and post-operative complications has been noted with glaucoma filtering procedures in these patients, predominantly due to rupture of the fragile vasculature in the choroidal hemangiomas, leading to expulsive choroidal haemorrhage or exudative choroidal detachment (CD) caused by sudden decompression during or after filtering procedures. Prohylactic sclerotomies have been advocated, to be performed prior to ocular decompression, during filtering procedures in order to avoid these complications. The necessity of prophylactic procedures has been questioned. Eibschitz-Tsimhoni et al., in a retrospective study, have reported that none of their 17 patients with SWS who underwent glaucoma filtering surgery without prophylactic posterior sclerotomy developed intraoperative suprachoroidal haemorrhage or choroidal effusion requiring therapeutic intervention.

Higher Axial Length and Flatter Cornea in Primary Open Angle Glaucoma than in the Age Related Glaucoma Cases

Glaucoma is a leading cause for the blindness globally and 79.6% millions might be affected by Open Angle Glaucoma (OAG) and Angle Closure Glaucoma (ACG) by the year 2020. 74% of these patients may be diagnosed OAG and 47% of the Asian population are affected by it. A study among the 209 patients revealed higher axial length and flatter Cornea among the patients affected by POAG than the age-matched control group.

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Surgical Management of Glaucoma in Sturge-Weber Syndrome

Sturge-Weber syndrome (SWS) or encephalo-trigeminal hemangiomatosis is a sporadic, mesodermal phakomatosis characterised by hemangiomas involving many parts of the body, particularly ocular, intracranial and facial cutaneous structures. Glaucoma is a common feature, with an incidence of 30%-71% in patients with Sturge-Weber syndrome. The aim of study was to evaluate the surgical outcomes in terms of intraocular pressure control, maintenance of visual acuity and complications of glaucoma surgeries, in eyes with Sturge-Weber syndrome and to evaluate risk factors leading to surgical failure.

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Need for the cost-effective techniques to detect and cure open angle glaucoma in Mexico

A transversal study estimated the cost of open angle glaucoma during the first year as $1,144,611,537 USD per annum in Mexico. The study that assessed the socio-economic costs in 30 most populous places of the country suggests the need for cost-effective method that could facilitate the early detection of open angle glaucoma with visual disability.

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Challenges in the Management of Glaucoma in a Patient with Severe Ocular Surface Disease: A Case Report

Ocular surface disease (OSD) is a significant problem for glaucoma patients worldwide, who will require long-term topical treatment. The risk of OSD increases with age, with a reported prevalence of up to 60%. The severity and burden of OSD also increase with the number of topical anti-glaucoma medications used in treatment due to multiple, daily exposures of the ocular surface (OS) to toxic active compounds in the drug itself, other components of the formulation or preservatives. 

The presentation of OSD varies depending on its severity, but usually includes symptoms of dry eyes, allergy and distorted vision, which can be debilitating and affect quality of life. The clinical signs of the diseaseinclude tear-film instability, toxic kerato conjunctivitis, eyelid abnormalities and allergic manifestations. However, the lack of concordance between symptoms and signs often makes the diagnosis of OSD and assessment of its severity challenging.