Journal of Glaucoma最新文献

{"title":"Transscleral Cyclophotocoagulation for Refractory Intraocular Pressure Elevation After Penetrating Keratoplasty.","authors":"Cristina Martin Lesan, Elias Flockerzi, Ursula Löw, Berthold Seitz","doi":"10.1097/IJG.0000000000002562","DOIUrl":"10.1097/IJG.0000000000002562","url":null,"abstract":"<p><strong>Prcis: </strong>Transscleral cyclophotocoagulation significantly reduces intraocular pressure and anti-glaucomatous medication use post-penetrating keratoplasty, with low hypotony risk, particularly if delayed. Safe reintervention is feasible for intraocular pressure recurrence.</p><p><strong>Purpose: </strong>Transscleral cyclophotocoagulation (TSCPC) is an established procedure for lowering intraocular pressure (IOP). We aimed to evaluate the therapeutic efficacy and the safety of TSCPC in patients with refractory IOP elevation after penetrating keratoplasty (PK), as well as to identify risk factors associated with postoperative hypotony.</p><p><strong>Patients and methods: </strong>TSCPC was performed in 52 eyes with inadequate pressure regulation despite maximal conservative therapy after PK. All the patients were reviewed on day 1, 1 month, 6 months, and 1 year after the TSCPC. A diagnosis of hypotony was considered if the IOP was <6 mm Hg at any time postoperatively. Multivariate analysis was applied to identify risk factors for hypotony and elevated IOP recurrence.</p><p><strong>Results: </strong>The IOP value decreased significantly from the median baseline of 29.1±0.7 mm Hg to 15.1±0.8 mm Hg at 1-year follow-up. The number of anti-glaucomatous medications was significantly reduced 1 year after TSCPC (2.9±0.1 vs. 2.4±0.2; P <0.01). Only 6 (11.5%) patients developed transitory hypotony. The mean time between PK and TSCPC was significantly lower ( P <0.01) in patients who developed hypotony (5.8±2.2 vs. 28.9±5.7 mo). A total of 53.8% of cases had a relapse of IOP increase at any time point during the follow-up. Reintervention with TSCPC was performed in 42.4% of patients.</p><p><strong>Conclusions: </strong>TSCPC after PK significantly reduces IOP and the number of anti-glaucomatous medications. The rate of postoperative hypotony is low. Patients with shorter time intervals between PK and TSCPC are at higher risk of developing hypotony. TSCPC can be safely reperformed in patients after PK.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"604-609"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604881","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":"Anterior Segment Parameters are Associated With Intraocular Pressure Spikes Following Cataract Surgery in Glaucoma Patients.","authors":"Jack P Rees, Thomas H Khuu, Facundo G Sanchez, Stuart K Gardiner, Emily P Jones, Robert M Kinast, Steven L Mansberger","doi":"10.1097/IJG.0000000000002589","DOIUrl":"10.1097/IJG.0000000000002589","url":null,"abstract":"<p><strong>Prcis: </strong>Increasing lens thickness was the anterior segment parameter most associated with IOP spikes in glaucoma patients after cataract surgery.</p><p><strong>Purpose: </strong>To determine whether anterior segment anatomy is associated with intraocular pressure spike on postoperative day 1 (POD1) after cataract surgery in participants with glaucoma.</p><p><strong>Methods: </strong>Optical biometry measured multiple eye parameters before cataract surgery in 48 eyes (39 participants) with glaucoma. Preoperative intraocular pressure (IOP) was the mean of 3 visits before cataract surgery and postoperative IOP on day 1 was defined as the IOP on POD1 after cataract surgery. Change in IOP was the difference between postoperative and preoperative IOP. A \"5 mm Hg IOP spike\" and \"10 mm Hg IOP spike\" were defined as POD1 IOP ≥ 21 mm Hg with IOP ≥5 or ≥10 mm Hg higher than preoperative IOP, respectively.</p><p><strong>Results: </strong>Mean POD1 IOP (22.8±8.8 mm Hg) was significantly higher than mean preoperative IOP (15.3±3.6 mm Hg, P <0.001). A 5 mm Hg IOP spike occurred in 45.8% of eyes (22/48 eyes), and 29.2% of eyes (14/48 eyes) had a 10 mm Hg IOP spike. Multivariable analysis showed that increased lens thickness (LT) and axial length (AL) were associated with a 5 mm Hg IOP spike ( P =0.04 and P =0.09, respectively), and increased LT was associated with a 10 mm Hg IOP spike ( P =0.02). When using change in IOP, increased LT and a lower number of preoperative medications were significant predictors of increased IOP after cataract surgery.</p><p><strong>Conclusions: </strong>IOP spikes were common in glaucoma patients after cataract surgery and were associated with anterior segment anatomy. Future studies may use risk factors to identify and prevent IOP spikes in glaucoma patients after cataract surgery.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"637-643"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988393","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":"Outcomes of Phacogoniotomy for Medically Controlled and Uncontrolled Primary Open Angle Glaucoma With Cataract: A Multicenter Study.","authors":"Yunhe Song, Xiangxiang Ye, Mingmin Yang, Zhihong Zhang, Liuzhi Zeng, Hanying Fan, Lin Xie, Xiaomin Zhu, Hongyang Zhang, Yuhan Feng, Jiangang Xu, Min Ke, Qing Bao, Xiaojing Pan, Qingshu Ge, Fengbin Lin, Zefeng Yang, Zige Fang, Zhixuan Wang, Dilimulati Xiaokaiti, Sujie Fan, Ning Fan, Yongjun Qi, Xiulan Zhang","doi":"10.1097/IJG.0000000000002598","DOIUrl":"10.1097/IJG.0000000000002598","url":null,"abstract":"<p><strong>Prcis: </strong>Phacogoniotomy, a combination of phacoemulsification and intraocular lens implantation (PEI) and 120-degree goniotomy (GT), was an effective and safe surgical treatment for medically controlled or uncontrolled primary open angle glaucoma (POAG) with cataract.</p><p><strong>Purpose: </strong>To evaluate the efficacy and safety of PEI combined with 120-degree GT in the treatment of medically controlled or uncontrolled POAG with cataract.</p><p><strong>Methods: </strong>Multicenter observational study conducted in 9 ophthalmic institutes/general hospitals in China. Patients with medically controlled [baseline intraocular pressure (IOP) ≤21 mmHg] or uncontrolled (baseline IOP > 21 mmHg) POAG with clinically significant cataract were included, who were followed up with at least 12 months. The IOP, topical hypotensive medication, surgery complications, visual acuity, surgery success were recorded and compared between groups at baseline and the final visit. Complete surgical success was defined as postoperative IOP of 5-18 mmHg without additional topical medications, vision-threatening complications or reoperation for glaucoma. Qualified success is same as complete success except allowing use of ocular hypotensive medications.</p><p><strong>Results: </strong>One hundred participants with 132 eyes were included with a mean follow-up time of 17.5±5.2 months ( range:12-32) postoperatively. In general, the mean IOP reduced from 21.2±7.4 mmHg at baseline to 14.7±2.9 mmHg postoperatively ( P <0.05), with an average reduction of 6.4±7.9 mmHg (23.5±25.6%). The mean number of hypotensive medications declined from 1.6±1.2 to 0.3±0.6, with a mean reduction of 1.4±1.2. One hundred eight out of 132 (81.8%) eyes achieved complete success and 118 (89.4%) achieved qualified success of surgery, respectively. The chief complications involved hyphema (15.2%), corneal edema (19.7%), IOP spike (8.3%), or hypotony (1.5%). In subgroup analysis of medically controlled versus medically uncontrolled pariticpants, difference was found neither in IOP at final visit (14.5±0.3 vs. 15.1±0.4 mmHg; P =0.28), medication (1.8±1.1 vs. 1.4±1.3; P =0.54), and complete (85.3% vs. 77.2%; P =0.23) or qualified success rate (95.0% vs. 86.0%; P =0.27), nor in any kind of surgery complications (all P s>0.05), respectively.</p><p><strong>Conclusion: </strong>POAG with cataract could be effectively treated by phacogoniotomy, regardless of medically controlled or medically uncontrolled status at baseline.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"591-597"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132421","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":"Gap Analysis of Standard Automated Perimetry Concept Representation in Medical Terminologies.","authors":"Shahin Hallaj, William Halfpenny, Niloofar Radgoudarzi, Michael V Boland, Swarup S Swaminathan, Sophia Y Wang, Benjamin Y Xu, Dilru C Amarasekera, Brian Stagg, Aiyin Chen, Michelle Hribar, Kaveri A Thakoor, Kerry E Goetz, Jonathan S Myers, Aaron Y Lee, Mark A Christopher, Linda M Zangwill, Robert N Weinreb, Sally L Baxter","doi":"10.1097/IJG.0000000000002575","DOIUrl":"10.1097/IJG.0000000000002575","url":null,"abstract":"<p><strong>Prcis: </strong>In this multi-institutional effort, we identified gaps in SAP data elements within medical terminologies. We proposed new concepts to LOINC to enhance SAP data standards and big data representation and improve interoperability across health care systems.</p><p><strong>Purpose: </strong>To identify gaps in the representation of Standard Automated Perimetry (SAP) data elements in Logical Observation Identifiers Names and Codes (LOINC) and the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) and propose solutions for those gaps.</p><p><strong>Methods: </strong>SAP source data elements and Digital Imaging and Communications in Medicine (DICOM) standard from 2 commonly used perimeter devices were extracted and compared against existing concepts in standardized terminologies using the OMOP CDM Athena browser and LOINC using the LOINC browser. Gap areas were identified and classified following conventions used by Health Level 7 Fast Healthcare Interoperability Resources and discussed within the OHDSI Eye Care and Vision Research Workgroup in iterative rounds aiming to address gaps. New codes were developed upon reaching a consensus and proposed for inclusion in LOINC.</p><p><strong>Results: </strong>Among 107 data elements extracted from the perimeters, 82% (n=88) of SAP data elements lacked representation. Of the 19 remaining elements, 2.8% (n=3) were wider, 1.9% (n=2) were narrower, and 13% (n=14) had equivalent representation. In addition, only 2.6% (n=3) of the 116 DICOM attributes related to SAP had representation in standardized terminologies. Several existing relevant codes were defined ambiguously or erroneously (eg, visual field index, pupil diameter, perimeter format Kowa).</p><p><strong>Conclusion: </strong>There is a lack of representation of some SAP data elements in standardized medical terminologies, hampering interoperability and data sharing. We identified gaps and proposed new concepts for addition to LOINC, aiming to improve SAP data standards and interoperability.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"644-649"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795515","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":"Effect of Postoperative Pilocarpine Eyedrops in the Outcomes of Gonioscopy-Assisted Transluminal Trabeculotomy Surgery.","authors":"Gustavo Espinoza, Luz M Gómez, Ignacio Rodríguez-Una, Laura M Duarte-Bueno, Juan C Parra, Sergio Serrano-Gómez","doi":"10.1097/IJG.0000000000002587","DOIUrl":"10.1097/IJG.0000000000002587","url":null,"abstract":"<p><strong>Prcis: </strong>Postoperative pilocarpine use did not significantly alter IOP reduction or medication burden following GATT in patients with OHT and POAG. Furthermore, it had no effect on reducing IOP spikes or the development of PAS.</p><p><strong>Purpose: </strong>To evaluate the effect of postoperative pilocarpine use on intraocular pressure (IOP), glaucoma medications, and complications in patients undergoing gonioscopy-assisted transluminal trabeculotomy (GATT).</p><p><strong>Methods: </strong>This retrospective study included patients with ocular hypertension or primary open angle glaucoma who underwent stand-alone GATT or combined with cataract extraction between June 2021 and April 2023. Participants were divided into a pilocarpine group (n=28) and a control group (n=25). Pilocarpine 2% was administered twice daily for 4 weeks following surgery in the pilocarpine group. Outcomes, including IOP, visual acuity, glaucoma medication use, and complications were assessed at multiple postoperative intervals up to 12 months.</p><p><strong>Results: </strong>Baseline characteristics were similar between groups. Surgical success rates at 12 months were 80.8% for the pilocarpine group and 79.2% for the control group ( P =0.999). No significant differences in IOP reduction were found at any follow-up visit. Considering pilocarpine as 1 drug, the mean number of medications was higher in the pilocarpine group from day 1 to month 1 after surgery ( P <0.001). However, from the third month through the 12-month follow-up, the study groups were comparable. Although postoperative complications were similar, on the first postoperative day, 5 patients (17.9%) in the pilocarpine group exhibited hyphema ≥25%, whereas none in the control group did ( P =0.053).</p><p><strong>Conclusions: </strong>Routine postoperative pilocarpine use following GATT did not appear to significantly impact surgical outcomes or complication rates. However, given its potential association with greater hyphema extension in the early postoperative period, a rational and selective use, rather than routine administration, might be more appropriate.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"610-615"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025038","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":"Surgical Outcomes of 180-Degree Gonioscopy-Assisted Transluminal Trabeculotomy: Comparison of Nasal Versus Temporal Incisions.","authors":"Yo Okada, Hiroki Mieno, Morio Ueno, Kengo Yoshii, Kazuhiko Mori, Chie Sotozono","doi":"10.1097/IJG.0000000000002604","DOIUrl":"10.1097/IJG.0000000000002604","url":null,"abstract":"<p><strong>Prcis: </strong>Performing 180-degree gonioscopy-assisted transluminal trabeculotomy for primary open angle glaucoma and pseudoexfoliation glaucoma patients can be expected to be equally effective with either a nasal or temporal incision at 12 months postoperative.</p><p><strong>Purpose: </strong>Anatomically, there are more collector channels on the nasal-side (NS) than on the temporal-side (TS) of the eye. This study aimed to clarify the differences in efficacy between NS and TS incisions for lowering intraocular pressure (IOP) in glaucoma patients who underwent 180-degree gonioscopy-assisted transluminal trabeculotomy (hemi-GATT).</p><p><strong>Patients and methods: </strong>This multicenter retrospective cohort study was conducted on 423 consecutive eyes with primary open angle glaucoma and pseudoexfoliation glaucoma that underwent hemi-GATT between April 2016 and March 2022 at Kyoto Prefectural University of Medicine Hospital, Kyoto, Japan and 3 affiliated medical facilities. Only the patients who had the same type of glaucoma in both eyes and underwent the same surgical procedure were included. Hemi-GATT was performed with an NS incision in the right eye (NS group) and a TS incision in the left eye (TS group). IOP and medication scores were retrospectively investigated.</p><p><strong>Results: </strong>This study involved 100 eyes of 50 patients. Median IOP (NS group/TS group) (mm Hg) at before surgery and at 1-day and 1-, 3-, 6-, and 12-months postoperative was 17.0 (interquartile range: 15.0-19.8)/16.0 (15.0-19.8), 11.0 (9.0-12.8)/11.0 (10.0-13.0), 14.0 (11.8-16.0)/13.0 (11.8-15.3), 13.0 (11.0-14.0)/11.0 (11.0-13.0), 13.5 (11.3-15.0)/12.5 (11.3-14.0), and 13.0 (11.0-15.0)/12.0 (11.0-14.0), respectively, thus showing a significant postoperative decrease of IOP. The median medication scores (NS group/TS group) were 3.0 (interquartile range: 2.0-4.0)/3.0 (2.0-4.0) at preoperative and 0.0 (0.0-2.0)/0.0 (0.0-1.0) at 12-months postoperative, thus showing a significant postoperative reduction. No significant differences were observed between the NS and TS groups at any point.</p><p><strong>Conclusions: </strong>Our findings revealed no significant difference in efficacy between NS and TS incisions for lowering IOP in glaucoma patients who underwent hemi-GATT.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"598-603"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317097","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":"Pattern of Long-Term Intraocular Pressure Variation Following Gonioscopy-Assisted Transluminal Trabeculotomy: Two-Year Outcomes.","authors":"Bruno M Faria, Diego T Dias, Mariana A O Reis, Fabio B Daga, Ana L B Scoralick, Leopoldo Magacho, Pedro H E Ribeiro Junior, Fabio N Kanadani, Vital P Costa, Tiago S Prata","doi":"10.1097/IJG.0000000000002565","DOIUrl":"10.1097/IJG.0000000000002565","url":null,"abstract":"<p><strong>Prcis: </strong>Patients with clinically uncontrolled open angle glaucoma submitted to isolated gonioscopy-assisted transluminal trabeculotomy or combined with phacoemulsification not only achieved low mean IOPs, but also demonstrated stable IOP patterns during a 24-month follow-up.</p><p><strong>Purpose: </strong>To assess the impact of gonioscopy-assisted transluminal trabeculotomy (GATT) on long-term intraocular pressure (IOP) variation.</p><p><strong>Patients and methods: </strong>An unicentric retrospective study including 169 consecutive patients who had undergone standalone GATT or combined with phacoemulsification (PHACOGATT) due to clinically uncontrolled open angle glaucoma, with at least 12 months of follow-up was conducted. Long-term mean IOP, long-term IOP peak, long-term IOP fluctuation, coefficient of variation, mean-positive IOP variation, sustained clinically significant positive IOP variation, and number of follow-up visits with IOP ≥15 mm Hg were investigated.</p><p><strong>Results: </strong>One hundred sixty-nine eyes from 169 patients were included (GATT group=101 patients; PHACOGATT group=68 patients). Mean long term IOP (12.0±1.8 vs. 11.2±2.0 mm Hg), mean long-term IOP peak (12.9±2.6 vs. 11.8±3.5 mm Hg), and mean coefficient of variation (0.07±0.08 vs. 0.05±0.09) were lower in the PHACOGATT group, while mean IOP fluctuation (1.0±3.7 vs. 1.2±1.8 mm Hg) was lower in the GATT group. In addition, the overall mean-positive IOP variation was 0.79±1.64 mm Hg. Finally, only 6.5% of the patients presented sustained clinically significant positive IOP variation and IOP was ≥15 mm Hg in 5.9% of the follow-up visits.</p><p><strong>Conclusions: </strong>Patients with clinically uncontrolled open angle glaucoma submitted to GATT or PHACOGATT achieved low mean IOPs and demonstrated stable IOP patterns. Our results provide additional evidence supporting GATT and PHACOGATT as viable options for the treatment of medically uncontrolled glaucoma patients requiring low and stable IOPs.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"630-636"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605176","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":"Malignant Glaucoma Following Gonioscopy-Assisted Transluminal Trabeculotomy.","authors":"Murat Gunay, Adem Turk, Omer Koksal Kurutas, Ugur Yilmaz, Dilek Uzlu, Busra Kose","doi":"10.1097/IJG.0000000000002592","DOIUrl":"10.1097/IJG.0000000000002592","url":null,"abstract":"<p><p>In this observational case-series study, we aimed to report malignant glaucoma (MGL) occurence in 4 consecutive cases (4 women; mean age, 60±11.0 y) after gonioscopy-assisted transluminal trabeculotomy (GATT) between January 2021 and September 2024 and to evaluate clinical characteristics and treatment outcomes. All patients had primary angle closure glaucoma (PACG) before GATT. They were hypermetropic (+1.75 to +2.00 diopters) and had 360-degree peripheral anterior synechia (PAS) on gonioscopy. Axial length and anterior chamber depth values ranged from 20.85 to 21.22 mm and 1.92 to 2.04 mm, respectively. Preoperative plateau iris appearance was confirmed by using ultrasound biomicroscopy and anterior segment optical coherence tomography in all cases. Intraocular pressure (IOP) ranged from 36 to 45 mm Hg before GATT with maximal antiglaucoma therapy. MGL was diagnosed on the first postoperative day after GATT. IOP levels at the time of MGL diagnosis ranged from 19 to 29 mm Hg. Due to no response to initial medical treatment, one case underwent pars plana vitrectomy with subsequent Nd:YAG laser hyaloidotomy for MGL recurrence, and, other 3 cases received irido-zonulo-hyaloido-vitrectomy (IZHV). The incidence of post-GATT MGL development was 1.3% (4/300 eyes). We first describe post-GATT MGL occurrence in 4 consecutive cases that had advanced PACG. They all had preoperative plateau iris appearance. Proper detection and adequate treatment of MGL are necessary to provide good IOP control and to prevent further angle damage after GATT.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"e56-e59"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986094","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":"Association Between Sociodemographic Risk Factors and No-Show Propensity in a Glaucoma Population Before and During COVID-19 Pandemic.","authors":"Amey Kamdar, Gelila B Yohannes, Swarup S Swaminathan","doi":"10.1097/IJG.0000000000002550","DOIUrl":"10.1097/IJG.0000000000002550","url":null,"abstract":"<p><strong>Prcis: </strong>Greater social vulnerability, younger age, nonwhite race, Hispanic ethnicity, non-English speaking, Medicaid insurance, and milder glaucoma were associated with a higher no-show propensity, which worsened during the COVID-19 pandemic among those subjects who were older and more socially vulnerable.</p><p><strong>Purpose: </strong>To identify sociodemographic risk factors for a higher likelihood to no-show among glaucoma subjects before and during the COVID-19 pandemic using the no-show propensity factor (NSPF), a novel attendance metric, which improves upon no-show percentages by adjusting for number of visits.</p><p><strong>Methods: </strong>We analyzed deidentified demographic, visit attendance, and social risk factor data [social vulnerability index (SVI) and area deprivation index (ADI) scores] of deidentified glaucoma subjects from the Bascom Palmer Glaucoma Repository, computed NSPF, and categorized scores as low, intermediate, or high by the 75th and 90th percentiles for the prepandemic and pandemic periods. We identified predictors of NSPF scores using univariable, multivariable, and logistic regression analyses.</p><p><strong>Results: </strong>Of 15,342 subjects, 11,474, 2238, and 1630 subjects had low, intermediate, and high NSPF scores, respectively, with no-show rates of 9.5%, 39.2%, and 57.8%, respectively. Age (β=-0.039 per decade, P <0.001), Black race (β=0.152, P <0.001), Hispanic ethnicity (β=0.115, P <0.001), Medicaid (β=0.073, P <0.001), Spanish primary language (β=0.076, P <0.001), SVI scores (β=0.047 per 25% increase, P <0.001), ADI ranking (β=0.057 for highest quartile, P <0.001), and baseline moderate (β=-0.046, P <0.001) or severe (β=-0.077, P <0.001) glaucomatous disease were significant predictors of NSPF. Older age [odds ratio (OR) 1.15 per decade, P <0.001], higher overall SVI (OR: 1.09 per 25% increase, P <0.001), Medicare/Tricare insurance (OR: 1.13, P =0.044), and non-English/Spanish primary language (OR: 1.43, P =0.020) were associated with worsening NSPF during the pandemic.</p><p><strong>Conclusion: </strong>Younger age, nonwhite race, Hispanic ethnicity, non-English primary language, Medicaid, milder glaucoma, and residence in vulnerable areas are risk factors for greater propensity to no-show.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"e41-e50"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382651","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":"Bleb Complications After XEN Gel Stent Implantation Linked to Mitomycin C.","authors":"Meghan M Brown, Victoria Sattarova, Wassef Chanbour, Joshua Hou, Huda Sheheitli","doi":"10.1097/IJG.0000000000002588","DOIUrl":"10.1097/IJG.0000000000002588","url":null,"abstract":"<p><strong>Prcis: </strong>This series describes 3 cases of complications following XEN gel stent Implantation and mitomycin C use that highlight the need for further studies on alternative antifibrotic agents for use during glaucoma filtration surgery.</p><p><strong>Purpose: </strong>We report the surgical management of 3 cases of postoperative bleb complications following XEN gel stent implantation that are attributed to the use of mitomycin C (MMC).</p><p><strong>Observations: </strong>Case 1: 76-year-old male with primary open angle glaucoma (POAG) underwent XEN gel stent with MMC in the left eye. He presented with neurotrophic keratitis and thin conjunctiva with overlying epithelial defect and underlying avascular sclera consistent with scleromalacia four years following XEN surgery. He underwent scleral patch graft with conjunctival pedicle advancement flap and amniotic membrane transplant. He has progression of scleromalacia and consequently underwent five additional surgeries for scleral patch graft placement with cryopreserved amniotic membrane transplant in addition to conjunctival autograft from the contralateral eye.Case 2: 81-year-old male with POAG underwent XEN gel stent placement with MMC in the right in superotemporal quadrant. Due to persistently elevated intraocular pressures, he subsequently underwent Baerveldt tube shunt implantation in the superotemporal quadrant in the right eye. He presented to our clinic 3 years later with Baerveldt tube erosion and surrounding scleral melt. He underwent tube shunt removal with scleral patch graft.Case 3: 59-year-old male with POAG in both eyes who underwent cataract extraction and XEN gel placement with MMC in both eyes. Two years after XEN surgery, he developed bilateral nonhealing conjunctival epithelial defects over the blebs with minimal improvement on medical therapy. He required removal of the XEN gel stent with bleb revision and placement of inferonasal Baerveldt tube shunt in both eyes.</p><p><strong>Conclusions and importance: </strong>XEN gel stent implantation with mitomycin C was associated with scleral melt and blebitis, similar to reports following trabeculectomy. Adjunctive antimetabolite use should consider individualized patient risk profiles.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"e51-e55"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969605","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}