Journal of Glaucoma最新文献

{"title":"Patients' Acceptance of Glaucoma Therapy in Sub-Saharan Africa.","authors":"Olusola Olawoye, Tarela Sarimiye, Jennifer Washaya, Girum W Gessesse, Komi Balo, Jeremie Agre, Boniface Macheka, Nkiru Kizor-Akaraiwe, Jonathan Pons, Adeyinka Ashaye, Farouk Garba, Richard Chitedze, Affiong Ibanga, Abdull Mahdi, Adunola Ogunro, Patrick Budengeri, Haroun Adetunji Ajibode, Lemlem Tamrat, Adeola Onakoya, Suhanyah Okeke, Abeba T Giorgis, Chimdi Chuka Okosa, Kayode Fowobaje, Stephen Cook, Scott Lawrence, Ving Fai Chan, Augusto Azuara Blanco, Nathan Congdon, Tony Realini","doi":"10.1097/IJG.0000000000002487","DOIUrl":"10.1097/IJG.0000000000002487","url":null,"abstract":"<p><strong>Prcis: </strong>Patients' acceptance of glaucoma therapy was high overall in this study, but lower for surgery than for laser or medical therapy. Fear and cost were the leading reasons why patients declined recommended therapy and they were treatment-specific. Cost was the primary reason for declining medical and laser therapy, while fear was the most common reason for declining surgical therapy.</p><p><strong>Purpose: </strong>To determine the frequency at which patients newly diagnosed with glaucoma in sub-Saharan Africa (SSA) decline recommended therapy and to characterize the reasons for declining therapy.</p><p><strong>Methods: </strong>This was a multicenter, cross-sectional study conducted on adult patients at the time of glaucoma diagnosis at 27 centers in 10 countries in SSA. Data collected from the diagnostic encounter included demographics, clinical glaucoma characteristics, treatment recommendations, patient acceptance of therapy, and reasons for declining therapy.</p><p><strong>Results: </strong>Among 2282 eyes of 1198 patients offered treatment for glaucoma, initially recommended treatment was accepted in 2126 eyes (93.2%). Acceptance of therapy varied with the nature of treatment offered, with medical therapy accepted in 99.2% of eyes, laser therapy in 88.3%, and surgical therapy in 69.3%. The most common reasons cited for declining therapy were fear (42.9%) and cost (41.7%); cost was the primary reason for declining medical and laser therapy, while fear was the most common reason for declining surgical therapy. Most patients declining laser or surgical therapy accepted medical therapy as an alternate therapy (98.1%).</p><p><strong>Conclusions: </strong>Patients' acceptance of glaucoma therapy was high overall, but lower for surgery than for laser or medical therapy. Most patients who declined laser or surgical therapy accepted medical therapy as an alternate therapy when offered. Educational interventions, sustainable incentives, and other approaches are needed to enhance patient acceptance of glaucoma therapy in this setting, particularly surgery, when needed.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"951-956"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975784","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":"Characterization of Gaze Metrics and Visual Search Pattern Among Glaucoma Patients While Viewing Real-World Images.","authors":"Sangeetha Nagarajan, Najiya Sundu K Meethal, Johan J M Pel, Rashima Asokan, Kalpa Negiloni, Ronnie George","doi":"10.1097/IJG.0000000000002493","DOIUrl":"10.1097/IJG.0000000000002493","url":null,"abstract":"<p><strong>Prcis: </strong>We quantified and compared the gaze metrics during target-oriented visual search tasks between glaucoma and healthy controls. On the basis of a mathematical concept we showed that due to glaucoma, focal search becomes prominent over global search.</p><p><strong>Purpose: </strong>Visual search (VS) which is essential for target identification and navigation is significantly impacted by glaucoma. VS metrics can be influenced by differences in cultural exposure or coping strategies, leading to varying VS patterns. This study aimed to explore and label the pattern of VS based on gaze metrics quantified using eye-tracking technology.</p><p><strong>Methods: </strong>Twenty-seven glaucoma subjects and 30 healthy controls [median age 51 (14) and 54 (19) y, respectively] underwent a VS experiment during which they had to identify specific targets from real-world images. Eye movements were recorded using a remote eye-tracker and gaze metrics-fixation count (FC), fixation duration (FD), saccade amplitude (SA), and VS time (VST) were computed and compared between the study groups. A Z -score-based coefficient \" K \" was derived to label the search patterns as global ( K ≤ - 0.1: short FD with long SA), focal ( K ≥+0.1: long FD with short SA), or a combination ( K between ±0.1).</p><p><strong>Results: </strong>Similar to other ethnicities, Indian glaucoma subjects also exhibited statistically significantly increased FC, FD, and VST ( P =0.01). Healthy controls presented a comparable proportion of focal (47%) and global (42%) search patterns while glaucoma subjects exhibited predominantly focal (56%) than global search patterns (26%, P =0.008).</p><p><strong>Conclusions: </strong>This study suggests that glaucoma subjects perform more focal searches during active gaze scanning. This change in viewing behavior reflects underlying compensatory strategies adapted for coping with their visual impairments. These search patterns can be influenced by factors such as saliency which requires further investigation.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"987-996"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132948","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":"Peripapillary and Macular Vessel Density in Unilateral Early Pseudoexfoliation Glaucoma.","authors":"Nilgun Solmaz, Turker Oba","doi":"10.1097/IJG.0000000000002483","DOIUrl":"10.1097/IJG.0000000000002483","url":null,"abstract":"<p><strong>Prcis: </strong>In early pseudoexfoliation glaucoma (PXG), radial peripapillary capillary vessel density (RPC-VD) was reduced nasally, while the retinal nerve fiber layer (RNFL) thinned from the nasal to temporal sectors. Nonglaucomatous fellow eyes demonstrated no RPC-VD or RNFL loss in comparison to the controls.</p><p><strong>Purpose: </strong>To evaluate peripapillary and macular vessel density (VD) in unilateral early PXG and unaffected fellow eyes compared with healthy controls.</p><p><strong>Methods: </strong>This cross-sectional study included 28 eyes with PXG and 28 nonglaucomatous, pseudoexfoliation-free fellow eyes of 28 patients, and 28 eyes of 28 healthy participants. All subjects underwent optical coherence tomography angiography (OCTA) imaging. RPC-VD, macular VD, retinal nerve fiber layer (RNFL) thickness, and ganglion cell complex (GCC) thickness were compared among the groups.</p><p><strong>Results: </strong>The average RPC-VD and RNFL thickness were significantly reduced in PXG eyes compared with both fellow eyes and the control group ( P <0.001-0.002). In fellow eyes, neither RNFL thickness nor RPC-VD parameters differed from controls. In sector-based analysis, RPC-VD loss in the PXG eyes was significant in the nasal-superior, nasal-inferior, superonasal, and inferonasal sectors ( P =0.005-0.031), while RNFL thinning extended from the nasal sectors toward the superotemporal and temporal-superior sectors ( P <0.001-0.014). RPC-VD was strongly correlated with average and all sector RNFL thicknesses ( r =0.402-0.759, P <0.001-0.034). While perifoveal GCC differed from both fellow and control eyes ( P <0.001), there was no significant difference in macular VD parameters among the groups. RPC-VD and RNFL had comparable area under receiver operating curve (AUROC) values in the average and nasal sectors, while RPC-VD had no ability to distinguish PXG from controls in the superotemporal and inferotemporal sectors.</p><p><strong>Conclusion: </strong>In the early stages of PXG, RNFL parameters mostly appear to have better diagnostic ability than RPC-VD parameters. Fellow eyes in the preclinical stage may not exhibit any RPC-VD and RNFL loss detectable by current OCTA technology.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"964-972"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975785","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":"Intermittent Bleeding from the Iridocorneal Angle and Subsequent Ghost Cell Glaucoma Following Gonioscopy-Assisted Transluminal Trabeculotomy: A Case Report.","authors":"Fatma Isil Sozen-Delil, Raziye Donmez Gun, Güzide Akçay, Hatice Selen Kanar, Şaban Şimşek","doi":"10.1097/IJG.0000000000002519","DOIUrl":"10.1097/IJG.0000000000002519","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to present a case involving intermittent bleeding from the iridocorneal angle following gonioscopy-assisted transluminal trabeculotomy (GATT) surgery, followed by the development of ghost cell glaucoma (GCG).</p><p><strong>Methods: </strong>A 25-year-old man with a history of post-traumatic angle recession glaucoma underwent uneventful 360° GATT surgery.</p><p><strong>Results: </strong>Two weeks after the surgery, while the reason for the incomplete resolution of hyphema remained unclear, intermittent bleeding from the iridocorneal angle and hemorrhage in the inferior vitreous were observed during the patient's follow-up examination. Although bleeding was controlled with intravenous tranexamic acid therapy, the patient required pars plana vitrectomy due to the development of GCG. Despite medical treatment, the patient's intraocular pressure (IOP) remained elevated during follow-ups, leading to the decision to perform Ahmed Glaucoma Valve implantation surgery as a final intervention. At the latest evaluation, the patient's IOP was under control without medication.</p><p><strong>Conclusion: </strong>Following GATT surgery, the possibility of intermittent bleeding from the iridocorneal angle should be considered if the hyphema persists beyond the expected duration. Hospitalization and closer patient monitoring may be necessary to detect intermittent bleeding.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828668","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":"Evaluation of the Variability of Ambient Interactive Zippy Estimation of Sequential Rapid Tests on the \"imo\" Perimeter in Patients With Stable Glaucoma.","authors":"Atsuko Kitagawa, Go Horiguchi, Hiroki Nomoto, Michiko Shimizu, Mayumi Hironobu, Akemi Ue, Satoshi Teramukai, Chota Matsumoto","doi":"10.1097/IJG.0000000000002476","DOIUrl":"10.1097/IJG.0000000000002476","url":null,"abstract":"<p><strong>Prcis: </strong>Analysis of Ambient Interactive Zippy Estimation of Sequential Testing (AIZE) Rapid test variability in patients with stable glaucoma showed that the 95% prediction interval of the mean deviation (MD) value, potentially an index for judging progression, was ±1.63 to ±1.78 dB in early-to-moderate-stage patients.</p><p><strong>Objective: </strong>To explore the 95% prediction interval of the MD value using the AIZE Rapid test strategy for glaucoma observation.</p><p><strong>Patients and methods: </strong>This study included 72 patients with stable or suspected glaucoma who underwent the imo AIZE Rapid test 3 times or more within 2 years. Both eyes from each patient were classified as better or worse eyes. They were divided based on baseline MD values into the following 4 groups: MD > -3 dB, -6 dB < MD ≤ -3 dB, -12 dB < MD ≤ -6 dB, and MD ≤ -12 dB. The variability of MD during the observation period and the 95% prediction intervals were analyzed. Pointwise variability of limits at each test location was also calculated.</p><p><strong>Results: </strong>The numbers of better and worse eyes included in the study were 46 and 33. The median follow-up period was 1.3 years (range: 0.5 to 1.9 y). The 95% prediction intervals for MD values were ±1.41 dB for better eyes (n = 46) and ±1.47 dB for worse eyes (n = 33). The 95% prediction intervals in the MD > -3 dB, -6 dB < MD ≤ -3 dB, -12 dB < MD ≤ -6 dB, and MD ≤ -12 dB groups were ±1.63 dB, ±1.34 dB, ±1.78 dB, and ±1.33 dB, respectively. Pointwise variability of worse eyes was larger than that of better eyes, especially between 10 to 15 dB.</p><p><strong>Conclusion: </strong>In the case of a difference in MD greater than the 95% prediction intervals when compared with the previous visual field result, we should pay much attention to the possibility of progression of the glaucomatous visual field in patients with stable glaucoma.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"849-854"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855715","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":"Midterm Survival Results of Preserflo in a Real-World Setting.","authors":"Afonso Lima-Cabrita, Miguel Santos, Patrícia José, Rafael Barão, André Barata, Luís Abegão Pinto","doi":"10.1097/IJG.0000000000002459","DOIUrl":"10.1097/IJG.0000000000002459","url":null,"abstract":"<p><strong>Prcis: </strong>Preserflo surgery is a safe procedure, effective in reducing intraocular pressure into the \"low teens,\" surgical survival is greatest in cases of high baseline intraocular pressure (above 21 mm Hg) and when performed as a standalone procedure.</p><p><strong>Purpose: </strong>To evaluate midterm surgical survival and safety profile of Preserflo filtering surgery.</p><p><strong>Methods: </strong>In this retrospective, cohort study, consecutive patients who underwent standardized Preserflo implantation with mitomycin C from December 2019 to April 2021 were included. Clinical data were retrieved from patient charts. The primary outcome was surgical survival at 24 months in accordance with World Glaucoma Association guidelines. Survival was evaluated using Kaplan-Meier statistics. Analysis was performed at the eye level and as intention to treat.</p><p><strong>Results: </strong>Ninety-five eyes were included in this study (18 cases combined with cataract surgery). More than half of cases (n=51) were primary open angle glaucoma, with over a fifth having a prior filtering glaucoma procedure. Intraocular pressure at 24 months was significantly decreased from baseline (22.4±6.28 vs. 12.0±3.43 mm Hg), as well as the need for IOP-lowering medication [2.88 (±0.92) vs. 0.79 (±1.3), P <0.001 all comparisons]. Standalone Preserflo achieved a qualified survival (irrespective of medication) of 71% (95% CI, 62%-83%) and 44% (95% CI, 27%-75%) in the combined procedure subgroup ( P <0.05 when considering absolute survival). Eyes with baseline intraocular pressure ≥21 mm Hg showed a greater qualified survival when compared with eyes with baseline ≤18 mm Hg [80% (95% CI, 65%-100%) vs. 50% (95% CI, 32%-76%); P <0.05]. Intra and early operative complications were few, self-limited, and did not require surgical management. The reoperation rate was low (18%).</p><p><strong>Conclusions: </strong>Preserflo filtering surgery was effective in reducing intraocular pressure into the \"low teens\" and presents an adequate surgical survival and safety profile. Surgical survival appeared greatest when performed as standalone and when preoperative intraocular pressure was high.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"880-887"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626892","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":"Patient Experience and Barriers to the Visual Field Test for Glaucoma.","authors":"Siyuan J Lu, Shenouda Girgis, Peter Shah, Graham A Lee","doi":"10.1097/IJG.0000000000002477","DOIUrl":"10.1097/IJG.0000000000002477","url":null,"abstract":"<p><strong>Prcis: </strong>There are significant mental, physical, and perceptual challenges in patients undergoing visual field testing, particularly in the elderly population with glaucoma.</p><p><strong>Purpose: </strong>To quantitatively and qualitatively investigate patient experiences of undergoing visual field testing.</p><p><strong>Methods: </strong>This cross-sectional, mixed-methods study involves adult patients attending a private outpatient ophthalmology clinic in Brisbane, Australia. Participant experiences of visual field testing were assessed using a 100 mm visual analog scale (VAS), followed by face-to-face semi-structured interviews. Outcome data comprised of VAS scores (1-100) and thematically analyzed verbatim notes.</p><p><strong>Results: </strong>Of the 152 participants [M:F 79 (52.0%):73 (48.0%)], the age group with the highest proportion of participants was 71-80 years [n=56 (36.8%)], and most had a primary ocular diagnosis of glaucoma [n=107 (70.4%)]. The mean VAS score for visual field testing experience was 60.45 (SD=30.38). The mean VAS score of participants with glaucoma was significantly lower than that of participants without glaucoma [55.34 (31.13) vs. 72.67 (25.04); P <0.05]. Prevalent themes regarding participant experiences of visual field testing consisted of concentration difficulties, intra-test and peri-test anxiety, skepticism in the testing process, and physical discomfort. Age, sex, and mean visual field index did not influence participant experiences of visual field testing.</p><p><strong>Conclusions: </strong>Mental and physical barriers to visual field testing tolerability were identified in a predominantly elderly population with glaucoma. Our findings highlight the importance of addressing patient concerns and apprehensions regarding visual field testing and emphasize the value of patient-initiated breaks, particularly for individuals experiencing concentration difficulties and physical discomfort.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"835-840"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855673","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":"Intraocular Pressure Response to Perceived Stress in Juvenile-Onset Open Angle Glaucoma.","authors":"Samuel Abokyi, Prince Mordi, Michael Ntodie, Benedict Ayobi, Emmanuel Kwasi Abu","doi":"10.1097/IJG.0000000000002478","DOIUrl":"10.1097/IJG.0000000000002478","url":null,"abstract":"<p><strong>Prcis: </strong>High perceived stress from academic pressure is associated with intraocular pressure (IOP) elevation and reduced fluctuation in juvenile-onset open angle glaucoma patients. Personalized stress assessment and relief strategies may serve as an adjunct therapy in glaucoma.</p><p><strong>Objective: </strong>To evaluate the effect of higher perceived stress, resulting from academic pressure, on IOP in juvenile-onset open angle glaucoma (JOAG) patients compared with healthy individuals.</p><p><strong>Methods: </strong>The study included 48 university students aged 18-27 years, comprising 24 JOAG patients on antiglaucoma eyedrops and 24 healthy controls. In an examiner-blind pretest-posttest design, participants' IOP was measured weekly using Goldmann tonometry during three follow-up visits at the beginning and end of the academic semester. Perceived Stress Scale (PSS) scores were also evaluated at these 2-time points to capture the contrast in perceived stress between periods of low and high academic pressure.</p><p><strong>Results: </strong>The baseline PSS score at the semester's start was lower in both groups (14.1±1.9 in glaucoma vs. 13.5±2.4 in control) and significantly increased by the end of the semester (29.2±2.1 vs. 28.5±1.3; P <0.001), indicating increased perceived stress. Concurrently, IOP rose from 22.01±5.87 to 25.08±5.84 mm Hg in the glaucoma group and from 11.36±2.03 to 13.65±2.11 mm Hg in the control group. Factorial analysis revealed a significant interaction between stress and JOAG ( F(1,94) =15.94, P =0.001), partial η 2 =0.08, with stress having a greater increase on IOP in the glaucoma group (+3.10 mm Hg) compared with the control group (+2.23 mm Hg) ( t(94) =4.457, P <0.001).</p><p><strong>Conclusions: </strong>Higher perceived stress significantly increases IOP, especially in JOAG patients, suggesting personalized stress management as a potential adjunct therapy for patients.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"874-879"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860039","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":"Combined Phacoemulsification and Hydrus Microstent Implantation in Asian Eyes With Moderate-to-Severe Normal Tension Glaucoma-12-Month Outcomes.","authors":"Bryan Chin Hou Ang, Elizabeth Jiahui Chen, Wai Kitt Chee, Bjorn Kaijun Betzler, Chun Hau Chua, Vivien Cherng Hui Yip, Leonard Wei Leon Yip","doi":"10.1097/IJG.0000000000002475","DOIUrl":"10.1097/IJG.0000000000002475","url":null,"abstract":"<p><strong>Prcis: </strong>This study reports 12-month outcomes of combined phacoemulsification and Hydrus Microstent implantation in Asian eyes with moderate-to-severe normal tension glaucoma (NTG), demonstrating a significant reduction in glaucoma medications with an excellent intra and postoperative safety profile.</p><p><strong>Objective: </strong>To evaluate the 12-month safety and efficacy outcomes of combined phacoemulsification and Hydrus Microstent (Ivantis Inc.) implantation in Asian eyes with moderate to severe NTG.</p><p><strong>Methods: </strong>Retrospective study of consecutive surgeries performed from August 2019 to August 2021 in a single tertiary eye centre in Singapore. Outcome measures included a reduction in intraocular pressure (IOP), number of glaucoma medications, and intra and postoperative complications.</p><p><strong>Results: </strong>Data from 21 eyes of 21 subjects were analyzed. All subjects were ethnic Chinese, and the majority were males (14, 66.7%). At baseline, the mean IOP was 13.3 (2.3) mm Hg, all eyes had a Humphrey visual field mean deviation of ≥-6 dB [mean: -13.9 (4.3) dB], and all eyes were on at least one glaucoma medication. There was no statistically significant reduction in IOP at all time points compared with baseline (all P > 0.05). However, the median number of medications was reduced from 2 to 0 at all time points, up to postoperative month (POM) 12 (all P < 0.001). There were no intraoperative complications. No eyes underwent secondary glaucoma procedures nor lost any Snellen line of visual acuity by POM12. One (4.8%) eye experienced numerical hypotony at postoperative day 1, which resolved conservatively. Two (9.5%) eyes underwent laser iridoplasty for stent occlusion by iris. There was no deterioration in Humphrey visual field mean deviation at POM12 compared with baseline (n = 20, P > 0.05).</p><p><strong>Conclusion: </strong>Combined phacoemulsification and Hydrus Microstent implantation were effective in reducing medication burden in Asian eyes with moderate to severe NTG, up to 12 months postoperatively.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"855-861"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855714","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":"A Survey of Current Gonioscopy Practice in the United Kingdom.","authors":"Shaheryar Ahmed Khan, Sean Zhou, Nuwan Niyadurupola","doi":"10.1097/IJG.0000000000002468","DOIUrl":"10.1097/IJG.0000000000002468","url":null,"abstract":"<p><strong>Prcis: </strong>This survey highlights a deficiency in gonioscopy practices across the UK, particularly in the utilization of indentation gonioscopy and training of junior ophthalmologists. Recommendations include standardizing practice and enhancing training opportunities to improve patient care.</p><p><strong>Objective: </strong>Gonioscopy is an important general skill learned and practiced by all grades of ophthalmologists. The aim of this study is to discover the general attitude, perception, and practice of gonioscopy among ophthalmologists in the UK.</p><p><strong>Materials and methods: </strong>A National gonioscopy survey was carried out by utilizing an anonymous electronic questionnaire of 18 questions. The questionnaire was electronically distributed online, using the survey tool, Microsoft 2016 \"MS Forms\" to all grades of ophthalmologists in the UK.</p><p><strong>Results: </strong>A total of 146 responses were analyzed. Overall, 89% of the participants felt \"comfortable in performing slit lamp gonioscopy,\" but only 38% of junior trainees (ophthalmic specialist trainees years 1-3) felt comfortable in gonioscopy. Only 13% of the junior trainees felt they had adequate training in performing gonioscopy compared with 68% of the total respondents. Surprisingly, the majority of consultants (58%) did not \"strongly agree\" to be confident in assessing the angle and its configuration on gonioscopy. The most commonly used gonioscopic lens in this survey was the Zeiss four-mirror gonio lens, but only 38% of participants performed indentation gonioscopy routinely. The majority of the participants utilized the modified Shaffer's classification for gonioscopy. Fewer than expected numbers performed gonioscopy routinely for new patients with glaucoma.</p><p><strong>Conclusion: </strong>This survey suggests that gonioscopy is not being performed according to the UK national recommendations, and few ophthalmologists perform indentation gonioscopy. Additional gonioscopy training in the curriculum may be helpful.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"888-893"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633740","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}