Journal of GlaucomaPub Date : 2024-09-01Epub Date: 2024-03-07DOI: 10.1097/IJG.0000000000002377
Xianhuai Wang, Tianhui Li, Xinyu Guo, Qing Feng, Xincheng Sun
{"title":"Iris Cerclage To Treat Persistent Mydriasis Following Acute Angle Closure Glaucoma Improves Visual Quality.","authors":"Xianhuai Wang, Tianhui Li, Xinyu Guo, Qing Feng, Xincheng Sun","doi":"10.1097/IJG.0000000000002377","DOIUrl":"10.1097/IJG.0000000000002377","url":null,"abstract":"<p><strong>Prcis: </strong>We developed a modified iris cerclage technique that improves best corrected visual acuity, pupillary parameters, self-assessed photophobia, and visual function index-14 questionnaire scores in patients with acute primary angle closure and permanent mydriasis after cataract surgery.</p><p><strong>Purpose: </strong>To evaluate the efficacy of a modified iris cerclage technique in patients with acute primary angle closure (PAC) and permanent mydriasis after cataract surgery.</p><p><strong>Patients and methods: </strong>Twelve eyes of 12 patients with acute PAC and permanent mydriasis at more than 3 months after phacoemulsification combined with intraocular lens (IOL) implantation underwent modified iris cerclage. Best corrected visual acuity (BCVA), intraocular pressure (IOP), pupil diameter, and visual function index-14 (VF-14) questionnaire and self-assessed photophobia scores before surgery and at 1 week, 1 month, and 3 months postoperatively were compared. Further, the postoperative pupil position morphology and complications were evaluated.</p><p><strong>Results: </strong>BCVA improved from 0.48±0.23 preoperatively to 0.28±0.15, 0.27±0.15, and 0.26±0.14 at 1 week, 1 month, and 3 months postoperatively, respectively ( P =0.008). No significant difference was observed between the preoperative and postoperative IOP ( P =0.974). Pupil diameter improved from 6.34±0.51 mm preoperatively to 3.59±0.33, 3.59±0.34, and 3.58±0.32 mm at 1 week, 1 month, and 3 months postoperatively, respectively ( P <0.001). Self-assessed photophobia scores improved from 3.33±0.78 preoperatively to 0.83±0.72, 0.51±0.15, and 0.45±0.14 at 1 week, 1 month, and 3 months postoperatively, respectively ( P <0.001). VF-14 scores improved from 47.6±6.1 points preoperatively to 67.9±6.2, 72.1±6.1, and 73.5±6.0 points at 1 week, 1 month, and 3 months postoperatively, respectively ( P< 0.001). Postoperatively, all pupils were centered and round. No postoperative complications, such as iris-suture slippage, iridodialysis, or exposure of the IOL's optical zone edge, were observed.</p><p><strong>Conclusion: </strong>Modified iris cerclage creates a centered, precisely sized, round pupil. It improves visual quality in patients with acute PAC and permanent mydriasis after cataract surgery.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"703-708"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of GlaucomaPub Date : 2024-09-01Epub Date: 2024-04-01DOI: 10.1097/IJG.0000000000002380
Alina-Dana Baxant, Martin Pencak, Jana Vranova, Magdalena Netukova, Katarina Urbaniova, Lucie Holubova, Patrik Pluhovsky, Jozef Rosina, Pavel Studeny
{"title":"The Efficacy of Fibrin Sealant in Sutureless Deep Sclerectomy-Preliminary Outcomes.","authors":"Alina-Dana Baxant, Martin Pencak, Jana Vranova, Magdalena Netukova, Katarina Urbaniova, Lucie Holubova, Patrik Pluhovsky, Jozef Rosina, Pavel Studeny","doi":"10.1097/IJG.0000000000002380","DOIUrl":"10.1097/IJG.0000000000002380","url":null,"abstract":"<p><strong>Prcis: </strong>Deep sclerectomy (DS) with fibrin adhesive can constitute a safe alternative to the classic procedure using sutures, providing nonallergenic, nontoxic, and secure adhesion with no sign of aqueous humor outflow obstruction postoperatively.</p><p><strong>Objective: </strong>To evaluate short and medium-term postoperative results of DS with a fibrin sealant.</p><p><strong>Patients and methods: </strong>This prospective, noncomparative, interventional case series involves 12 eyes of 12 patients with uncontrolled open angle glaucoma who underwent DS with Esnoper (Clip or V2000) implant between February 2021 and March 2022. A novel method of wound closure (sclera, Tenon fascia, and conjunctiva) employing fibrin glue was used instead of classic sutures. Surgical outcomes assessed include: intraocular pressure and glaucoma therapy reduction, best-corrected visual acuity changes, and number of complications registered peri and postoperatively. All measurements were performed preoperatively, as well as at 1 day, at 1 and 2 weeks, and at 1, 2, 3, 6, 9, and 12 months after surgery.</p><p><strong>Results: </strong>The mean intraocular pressure decreased from 24.0 ± 9.1 mm Hg to 13.8 ± 6.3 mm Hg at 1 year postoperatively ( P < 0.001). Kaplan-Meier survival analysis revealed complete and qualified success rates of 83.3% and 91.7%. The mean glaucoma therapy decreased from 3.2 ± 1.1 to 0.8 ± 1.3 drugs 12 months after surgery ( P < 0.001). Nd:YAG goniopunture was performed in 2 eyes at 1 and 12 months postoperatively. No significant best-corrected visual acuity changes were registered. Perioperatively, we noted a trabeculo-descemet microperforation in 1 eye, transient hypotony in 5 eyes, and mild hyphema in 2 eyes.</p><p><strong>Conclusions: </strong>Fibrin adhesive provided an effective closure in sutureless DS in the patients included in our study. This modification of classical DS may simplify the surgical technique, ensure secure wound adaptation, optimize healing, and lower the risk of inflammation and fibrosis postoperatively.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"686-695"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correlation of Binocular Perimetry Screening using imo, a Portable Head Mounted Perimeter with 10-2 Standard Automated Perimetry for Early Glaucoma with Central Visual Field Defects.","authors":"Euido Nishijima, Yoshinori Itoh, Takahiko Noro, Shumpei Ogawa, Sachiyo Okude, Tadashi Nakano","doi":"10.1097/IJG.0000000000002492","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002492","url":null,"abstract":"<p><strong>Prcis: </strong>The screening program using imo strongly correlates with 10-2 Standard automated perimetry in detecting central visual field defects in early glaucoma, highlighting its potential as a valuable tool for efficient screening and severity quantification.</p><p><strong>Purpose: </strong>To investigate the correlation between abnormalities within the central 10° of the screening program using imo, a portable head-mounted perimeter, and 10-2 standard automated perimetry in early-stage glaucoma with central visual field defects.</p><p><strong>Methods: </strong>This retrospective study included early glaucoma with (26 eyes) and without (38 eyes) central visual field defects. The correlation between the numbers of abnormal points within the central 10° of the imo screening program and those in the probability plot of 10-2, and mean total deviation and pattern deviation, were analyzed.</p><p><strong>Results: </strong>The imo screening program demonstrated sensitivity (80%) and specificity (98.7%) in detecting abnormalities, with a 91.6% agreement rate of 10-2. The mean number of anomalies in the 10-2 plot (pattern deviation) with P<1% was 0.85, 7.75, and 9.69 (95% confidence interval: 0.18-1.51, 5.38-10.1, and 6.89-12.5, respectively) for no, one, and two anomalies in the imo screening program, respectively. The number of anomalies with P<1% was significantly higher when the imo screening program detected one anomaly versus none (P<0.01), and two versus one (P<0.05). Mean total deviation values were -1.15, -7.5, and -15.2 (95% confidence interval: -2.32 to 0.03, -11.21 to -3.78, and -19.7 to -10.6, respectively), while mean pattern deviation values were -1.57, -9.0, and -16.0 (95% confidence interval: -2.57 to -0.57, -12.5 to -5.49, and -21.4 to -10.7, respectively), for no, one, and two anomalies in the imo screening program, respectively.</p><p><strong>Conclusions: </strong>The imo portable head-mounted perimeter was found to correlate with 10-2 standard automated perimetry in glaucoma patients with central visual field defects and has the potential to shorten visual field testing times.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhannad I Alkhalifah, Ahmed Mousa, Saleh A Al Obeidan
{"title":"Long-term Visual Acuity Outcomes of Deep Sclerectomy in Pediatric Glaucoma.","authors":"Muhannad I Alkhalifah, Ahmed Mousa, Saleh A Al Obeidan","doi":"10.1097/IJG.0000000000002490","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002490","url":null,"abstract":"<p><strong>Prcis: </strong>This study provides evidence of the long-term efficacy and safety of Deep Sclerectomy as a successful surgical intervention option in cases with childhood glaucoma.</p><p><strong>Objectives: </strong>The primary objective was to evaluate the long-term visual acuity outcomes of Deep Sclerectomy in pediatric glaucoma and identify factors predicting poor prognosis. The secondary objective was to evaluate the long-term success rate of Deep Sclerectomy in controlling intraocular pressure.</p><p><strong>Methods: </strong>A retrospective review was conducted of all pediatric patients who underwent deep sclerectomy at King Abdulaziz University Hospital (KAUH) between 2001 and 2016. We included all patients who had valid visual acuity tests. The preoperative findings and long-term visual and intraocular pressure outcomes were analyzed.</p><p><strong>Results: </strong>A total of 83 eyes of 68 patients were included. The mean (SD) age of participants was 11.1 (4.0) years (range: 5-25 years). The mean age at surgery was 5.9 months, and the mean follow-up period was 10.75 years. The majority of cases (83.1%) were primary congenital glaucoma. Visual acuity was ≥ 20/40 in 56.6% of cases, ranged between 20/40 and 20/200 in 18.1%, and was ≤ 20/200 in 25.3% of the operated eyes. Complete success rate (IOP ≤ 21 mmHg without medications) after one surgery was achieved in 53 eyes (63.86%). Qualified success rate (IOP ≤ 21 mmHg with medications) was achieved in 8 eyes (9.6%), while 22 eyes (26.5%) failed to achieve target IOP of ≤ 21 mmHg or needed additional surgery to achieve it. Nine eyes (10.74%) had post-operative complications.</p><p><strong>Conclusion: </strong>Deep sclerectomy is a reasonable option for pediatric glaucoma that can provide good long-term visual outcomes and IOP control with a lower risk of surgical complications.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dilara Aydemir, Sadi Can Sonmez, Zeynep Busra Kisakurek, Merve Gozel, Melisa Zisan Karslıoglu, Umit Yasar Guleser, Afsun Sahin, Murat Hasanreisoglu
{"title":"Evidence of Mitophagy in Lens Capsule Epithelial Cells of Patients with Pseudoexfoliation Syndrome.","authors":"Dilara Aydemir, Sadi Can Sonmez, Zeynep Busra Kisakurek, Merve Gozel, Melisa Zisan Karslıoglu, Umit Yasar Guleser, Afsun Sahin, Murat Hasanreisoglu","doi":"10.1097/IJG.0000000000002484","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002484","url":null,"abstract":"<p><strong>Prcis: </strong>Alterations in the PINK-mediated mitophagy pathway play an important role in PEX disease.</p><p><strong>Purpose: </strong>Pseudoexfoliation Syndrome (PEX) is a condition in which aberrant fibrillary protein builds up in various components of the eye and other extraocular tissues. In this study, we aim to investigate the functionality of intracellular auto-degradative machinery -especially mitophagy- and related genes and proteins in PEX.</p><p><strong>Methods: </strong>Anterior lens capsules were obtained from cataracts patients with and without PEX to constitute the PEX group and age-matched controls during microincision cataracts surgery. PINK1-mediated mitophagy markers were evaluated on the transcriptional and translational level via RT-qPCR and immunohistochemistry analysis, respectively.</p><p><strong>Results: </strong>The lens epithelial cells of PEX patients were characterized by significantly higher PINK1 gene expression compared to that of the controls (P<0.05). In terms of intensity of staining of expressed proteins, PINK1 (P<0.05), Parkin (P<0.01) and LC3B (P<0.01) were all statistically higher in PEX, compared to the controls.</p><p><strong>Conclusion: </strong>Altered auto-degradative response -specifically mitophagy- is a component of increased oxidative stress in PEX patients. The role of this mechanism in emerging complications warrants further research.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica A Wright, Sarah C Xu, Mitchell H Wong, Razan M El Melik, David Hodge, Arthur J Sit
{"title":"\"CYP3A4 Poor and Intermediate Metabolizers Have a Higher Rate of Steroid-Induced Intraocular Pressure Response\".","authors":"Jessica A Wright, Sarah C Xu, Mitchell H Wong, Razan M El Melik, David Hodge, Arthur J Sit","doi":"10.1097/IJG.0000000000002482","DOIUrl":"https://doi.org/10.1097/IJG.0000000000002482","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluate the relationship between CYP3A4 phenotype, the gene encoding the enzyme that metabolizes exogenous steroid, and the rate of steroid-induced intraocular pressure (IOP) response.</p><p><strong>Materials and methods: </strong>Lymphocyte-derived DNA sequencing of CYP3A4 from 10073 patients was completed using the PGRN-Seq assay. Subjects with CYP3A4 intermediate metabolizer or slower phenotypes were identified and compared with controls matched by age, race and sex. All subjects had at least three eye exams with at least an exam while on topical/systemic/local steroid in any body location except the eye. Patients with pre-existing glaucoma or glaucoma suspect were excluded.</p><p><strong>Results: </strong>Of the 10073 patients, there were 63 patients who had CYP3A4 poor or intermediate metabolizer phenotype. Of the 63 patients, 22 had documented steroid use. Fifty-nine percent (13/22) of patients with CYP3A4 poor/intermediate metabolizer had a steroid-induced IOP response of 3 mmHg or more, significantly higher compared to 23% (5/22) of matched controls (P=0.031). Although more poor /intermediate metabolizers were steroid responders, the average IOP elevation in steroid responders in both groups were similar (5.0 ± 2.5 mmHg in CYP3A4 poor/intermediate metabolizers compared to 4.1 ± 2.1mmHg in controls, P=0.327). Family history of glaucoma was similar in both groups (7/22 vs. 8/22, P=1.0).</p><p><strong>Conclusion: </strong>Reduced CYP3A4 phenotypes may help identify patients at a higher risk of steroid-induced IOP elevation.</p><p><strong>Prcis: </strong>This retrospective study examined patients with sequenced CYP3A4, a gene encoding an enzyme that metabolizes exogenous steroids. When compared to normal metabolizers, CYP3A4 poor or intermediate metabolizers have a higher steroid-induced IOP response rate.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of GlaucomaPub Date : 2024-08-01Epub Date: 2024-08-19DOI: 10.1097/IJG.0000000000002439
George A Cioffi, Jeffrey M Liebmann, David Friedman, Louis Pasquale
{"title":"Implementation and Consensus.","authors":"George A Cioffi, Jeffrey M Liebmann, David Friedman, Louis Pasquale","doi":"10.1097/IJG.0000000000002439","DOIUrl":"10.1097/IJG.0000000000002439","url":null,"abstract":"<p><p>■■■.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":"33 Suppl 1","pages":"S66"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of GlaucomaPub Date : 2024-08-01Epub Date: 2024-08-19DOI: 10.1097/IJG.0000000000002426
Panagiota Founti, Kelsey Stuart, Winifred P Nolan, Anthony P Khawaja, Paul J Foster
{"title":"Screening Strategies and Methodologies.","authors":"Panagiota Founti, Kelsey Stuart, Winifred P Nolan, Anthony P Khawaja, Paul J Foster","doi":"10.1097/IJG.0000000000002426","DOIUrl":"10.1097/IJG.0000000000002426","url":null,"abstract":"<p><strong>Prcis: </strong>While glaucoma is a leading cause of irreversible vision loss, it presents technical challenges in the design and implementation of screening. New technologies such as PRS and AI offer potential improvements in our ability to identify people at high risk of sight loss from glaucoma and may improve the viability of screening for this important disease.</p><p><strong>Purpose: </strong>To review the current evidence and concepts around screening for glaucoma.</p><p><strong>Methods/results: </strong>A group of glaucoma-focused clinician scientists drew on knowledge and experience around glaucoma, its etiology, and the options for screening. Glaucoma is a chronic progressive optic neuropathy affecting around 76 million individuals worldwide and is the leading cause of irreversible blindness globally. Early stages of the disease are asymptomatic meaning a substantial proportion of cases remain undiagnosed. Early detection and timely intervention reduce the risk of glaucoma-related visual morbidity. However, imperfect tests and a relatively low prevalence currently limit the viability of population-based screening approaches. The diagnostic yield of opportunistic screening strategies, relying on the identification of disease during unrelated health care encounters, such as cataract clinics and diabetic retinopathy screening programs, focusing on older people and/or those with a family history, are hindered by a large number of false-positive and false-negative results. Polygenic risk scores (PRS) offer personalized risk assessment for adult-onset glaucoma. In addition, artificial intelligence (AI) algorithms have shown impressive performance, comparable to expert humans, in discriminating between potentially glaucomatous and non-glaucomatous eyes. These emerging technologies may offer a meaningful improvement in diagnostic yield in glaucoma screening.</p><p><strong>Conclusions: </strong>While glaucoma is a leading cause of irreversible vision loss, it presents technical challenges in the design and implementation of screening. New technologies such as PRS and AI offer potential improvements in our ability to identify people at high risk of sight loss from glaucoma and may improve the viability of screening for this important disease.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":"33 Suppl 1","pages":"S15-S20"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of GlaucomaPub Date : 2024-08-01Epub Date: 2024-05-21DOI: 10.1097/IJG.0000000000002435
Fengbin Lin, Yingzhe Zhang, Xiaomin Zhu, Ping Yu, Sujie Fan, Aiguo Lv, Xiaoyan Li, Li Tang, Yao Zhang, Guangxian Tang, Xiaowei Yan, Lan Lu, Meichun Xiao, Huiping Yuan, Wulian Song, Minwen Zhou, Xiaohuan Zhao, Xin Nie, Mengfei Liao, Yunhe Song, Zhenyu Wang, Weirong Chen, Keith Barton, Ki Ho Park, Tin Aung, Dennis S C Lam, Robert N Weinreb, Clement C Tham, Liuzhi Zeng, Lin Xie, Ningli Wang, Xiulan Zhang
{"title":"Impact of Peripheral Anterior Synechiae on the Outcome of Combined Phacoemulsification, Goniosynechialysis, and Goniotomy for Primary Angle Closure Glaucoma and Cataract: A Multicenter Observational Study.","authors":"Fengbin Lin, Yingzhe Zhang, Xiaomin Zhu, Ping Yu, Sujie Fan, Aiguo Lv, Xiaoyan Li, Li Tang, Yao Zhang, Guangxian Tang, Xiaowei Yan, Lan Lu, Meichun Xiao, Huiping Yuan, Wulian Song, Minwen Zhou, Xiaohuan Zhao, Xin Nie, Mengfei Liao, Yunhe Song, Zhenyu Wang, Weirong Chen, Keith Barton, Ki Ho Park, Tin Aung, Dennis S C Lam, Robert N Weinreb, Clement C Tham, Liuzhi Zeng, Lin Xie, Ningli Wang, Xiulan Zhang","doi":"10.1097/IJG.0000000000002435","DOIUrl":"10.1097/IJG.0000000000002435","url":null,"abstract":"<p><strong>Prcis: </strong>The combination of phacoemulsification, goniosynechialysis and goniotomy is an effective treatment for primary angle closure glaucoma patients with cataract, and this is not linked to the extent of preoperative peripheral anterior synechiae.</p><p><strong>Purpose: </strong>To evaluate the impact of the extent of peripheral anterior synechiae (PAS) on the effectiveness and safety of combined phacoemulsification (PEI), goniosynechialysis (GSL), and goniotomy (GT) in eyes with primary angle closure glaucoma (PACG) and cataract.</p><p><strong>Patients and methods: </strong>This study included patients diagnosed with PACG and cataracts who underwent combined PEI and 120 degrees GSL plus GT (PEI+GSL+GT) between April 2020 and October 2022 at 10 ophthalmic institutes. Eligible patients were divided into 3 groups based on the extent of PAS: 180°≤PAS<270°, 270°≤PAS<360°, and PAS=360°. Data on intraocular pressure (IOP), the number of ocular hypotensive medications, and complications were collected and compared. The study defined complete success as postoperative IOP within the 6-18 mm Hg range and a 20% reduction from baseline without the use of topical medications. Qualified success was defined in the same way as complete success, but it allowed for the use of ocular hypotensive medications.</p><p><strong>Results: </strong>Three hundred four eyes of 283 patients were included. The mean follow-up was 12.50±1.24 months. All groups experienced a significant reduction in IOP after the surgery ( P <0.05). There were no significant differences in final IOP, number of medications, and cumulative complete and qualified success rates among the 3 groups ( P >0.05). The groups with 270°≤PAS<360°had a higher frequency of hyphema compared with 180°≤PAS<270° ( P = 0.044).</p><p><strong>Conclusions: </strong>PEI+GSL+GT has proven to be an effective treatment for PACG with cataracts over a 1 year period. However, the outcome was not correlated with the preoperative extent of PAS.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"587-593"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of GlaucomaPub Date : 2024-08-01Epub Date: 2024-08-19DOI: 10.1097/IJG.0000000000002416
Rithambara Ramachandran, Joshua R Ehrlich, Joshua D Stein
{"title":"How Do We Pay for Glaucoma Screening?","authors":"Rithambara Ramachandran, Joshua R Ehrlich, Joshua D Stein","doi":"10.1097/IJG.0000000000002416","DOIUrl":"10.1097/IJG.0000000000002416","url":null,"abstract":"","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":"33 Suppl 1","pages":"S67-S70"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}