Solisvinson4350
A change in government policy, allowing Medicare medication prices negotiations, could greatly reduce health expenditure on glaucoma treatment.
Brand glaucoma medication prices vastly increased in the United States over the past 7 years, despite a reduction in eye-care providers' tendency to prescribe brand medications over generics. A change in government policy, allowing Medicare medication prices negotiations, could greatly reduce health expenditure on glaucoma treatment.
To report an infectious cause of congenital pupillary-iris-lens membrane with secondary angle closure glaucoma in an infant.
Case report.
Institutional review board exemption for this report was obtained from Institutional Ethics Committee, Aravind eye hospital, Tirunelveli. Informed consent was obtained.A 3 month old infant female presented to us with congenital pupillary-iris-lens membrane (CPILM), iris bombe and raised intraocular pressure (IOP) in the left eye. She underwent trabeculotomy and trabeculectomy along with membranectomy for the same. #link# An aqueous tap performed a month later and was suggestive of co-existing Toxoplasma Gondii infection detected by polymerase chain reaction (PCR).
Description of the course of management of angle closure glaucoma secondary to CPILM with an associated infection. link2 IOP reduced from 40 to 20▒mm Hg in the left eye.
This condition is a rare entity of unknown aetiology with an increased risk of glaucoma and visual loss. A multidisciplinary approach is needed for the management of these eyes. Infectious associations with these membranes should be ruled out by an aqueous tap with PCR and a close post-operative follow up is mandatory.
This condition is a rare entity of unknown aetiology with an increased risk of glaucoma and visual loss. A multidisciplinary approach is needed for the management of these eyes. Infectious associations with these membranes should be ruled out by an aqueous tap with PCR and a close post-operative follow up is mandatory.
The aim was to determine whether 24-hour recording of intraocular pressure (IOP)-related ocular dimensional changes with a contact lens sensor (CLS, Triggerfish) is associated with the rate of visual field (VF) progression in primary open-angle glaucoma (POAG) patients.
This was a retrospective, observational cohort study.
Patients with POAG were included from the Glaucoma Clinic and Diagnostic Innovations in Glaucoma Study at the Hamilton Glaucoma Center at University of California, San Diego.
selleck kinase inhibitor of 24-hour CLS recording was acquired for 1 eye from each patient. The mean follow-up time was 9.9±4.0 years. The association between CLS variables and rate of change of mean deviation was determined by univariate and multivariate mixed linear regression models.
Thirty-two patients, aged 69.8±13.6 years were included, 50% were female. An average of 11.6±5.6 standard automated perimetry examinations was available with a mean rate of mean deviation progression of -0.2±0.4 dB/year. Mean IOP was 17.8±4.2 mm Hg. The mean number of IOP-lowering medications were 1.2±1.0. Each 10-unit larger nocturnal variability of IOP-related ocular dimensional changes measured by CLS recording was significantly associated with -0.25±0.11 dB faster VF loss in POAG patients (P=0.035).
Twenty-four-hour CLS recording of IOP-related ocular dimensional change was associated with faster VF progression. Such CLS recordings are useful to assess the risk of in progression in POAG patients.
Twenty-four-hour CLS recording of IOP-related ocular dimensional change was associated with faster VF progression. Such CLS recordings are useful to assess the risk of in progression in POAG patients.
Micropulse transscleral cyclophotocoagulation (MPTCP) is only moderately effective in lowering intraocular pressure (IOP) and is useful as an adjunct procedure to other glaucoma surgeries. There was a small risk of loss of vision, prolonged hypotony, and phthisis bulbi.
The aim of this study was to determine the efficacy and safety of a single MPTCP treatment for an Asian population with advanced glaucoma.
This is a retrospective single-center study of 207 eyes (207 patients) with advanced glaucoma which underwent first-time MPTCP between January 1, 2008, and March 31, 2018. Success was defined as IOP of 6 to 21 mm Hg or ≥20% reduction in IOP without an increase in glaucoma medication from baseline, and without glaucoma reoperation. The IOP, best-corrected visual acuity, and number of glaucoma medications were also analyzed.
The mean (SD) age was 64.9±16.9 years. The mean follow-up duration was 18.7±16.2 months. The rate of success at postoperative years 1 and 2 follow-up was 44.1% and 32.6%, respectively. The median survival time of MPTCP was 9.0 months and 85 (40.9%) eyes received reoperation. The mean IOP decreased from 31.5±12.0 mm Hg preoperatively to 22.1±10.3 and 23.8±11.8 mm Hg at postoperative years 1 and 2, respectively (P<0.0001). The mean number of glaucoma medications was reduced from 3.3±1.0 preoperatively to 2.6±1.1 and 2.4±1.1 at postoperative years 1 and 2, respectively (P<0.0001). Significant complications included prolonged hypotony [1 eye (0.5%)], phthisis bulbi [7 eyes (3.4%)], and best-corrected visual acuity reduction [29 eyes (13.9%)].
Single first-time MPTCP for advanced glaucoma eyes was moderately effective in lowering IOP but >50% failed by 1 year.
50% failed by 1 year.
The MicroShunt was implanted in 23 patients with primary open-angle glaucoma (POAG) in a feasibility study. Reductions in intraocular pressure (IOP) and medications were sustained for up to 5 years with no long-term sight-threatening adverse events (AEs).
The purpose of this study was to assess the long-term effectiveness and safety of the PRESERFLO MicroShunt (8.5 mm long, 70 µm lumen surgical device, formerly known as the InnFocus MicroShunt) in POAG.
In a feasibility study (NCT00772330), patients with POAG inadequately controlled on maximum tolerated therapy with IOP ≥18 to ≤40 mm Hg underwent MicroShunt implantation with adjunctive mitomycin C (0.4 mg/mL), alone or in combination with cataract surgery. Years 1 to 3 findings have previously been reported. Endpoints of this extension study included IOP reduction and success at years 4 and 5 (primary), incidence of AEs, medication use, and reoperations.
Mean IOP was reduced from 23.8±5.3 mm Hg at baseline to 12.8±5.6 mm Hg (year 4; n=21) and 12.4±6.5 mm Hg (year 5; n=21). Overall success (with/without medication use) was 87.0% (year 4) and 82.6% (year 5). The mean number of medications reduced from 2.4±1.0 at baseline to 0.8±1.3 (year 5). Common (≥5% of patients) AEs included corneal edema (n=4), transient hypotony (n=4), bleb-related complications (n=3), and device touching the iris (n=3). There were 4 reports of serious AEs and 2 reoperations.
In this extension study, sustained reductions in mean IOP and medications were observed up to 5 years post-MicroShunt implantation. There were no reports of long-term sight-threatening AEs and a low rate of postoperative interventions.
In this extension study, sustained reductions in mean IOP and medications were observed up to 5 years post-MicroShunt implantation. There were no reports of long-term sight-threatening AEs and a low rate of postoperative interventions.
Pseudoexfoliative glaucoma (PEXG) is the most common cause of secondary open-angle glaucoma worldwide. It is more aggressive and often more resistant to conventional treatments than primary open-angle glaucoma, yet there is currently no clear consensus on best management practices. This review explores current literature on PEXG to assess the safety and efficacy of currently available surgical techniques, and discusses clinical considerations on the diagnosis and management of the disease.
A PubMed and Google Scholar search identified 2271 articles. These were reviewed to exclude irrelevant or duplicate data. A total of 47 studies reporting specifically on PEXG were retained and analyzed.
One of the most significant ophthalmic consequences of pseudoexfoliative (PEX) syndrome is the compromising of the blood-aqueous barrier resulting in the leakage of inflammatory cytokines and extracellular matrix material into the anterior chamber. Considering the high risk of developing PEXG and the aggressive nature t the frequent IOP spikes following surgery, and more aggressive anti-inflammatory therapy may reduce the rates of postoperative adverse events in PEXG.
Specific studies of the surgical management of PEXG remain scarce in the medical literature, and more long-term and comparative studies are warranted to define more robust recommendations.
Specific studies of the surgical management of PEXG remain scarce in the medical literature, and more long-term and comparative studies are warranted to define more robust recommendations.
Rates of ocular surface failure and glaucoma reoperation were similar between cyclophotocoagulation (CPC) and glaucoma drainage devices (GDDs). CPC is a safe option in the management of secondary glaucoma after ocular surface stem cell transplantation (OSST).
To assess surgical and ocular surface outcomes in patients requiring glaucoma surgery after OSST.
Retrospective chart review of eyes with previous OSST that underwent either transscleral CPC or implantation of a GDD. Primary outcomes were ocular surface failure (defined as recurrence of corneal conjunctivalization with late fluorescein staining) and glaucoma surgery failure (defined as the need for additional glaucoma surgery, including repeat treatment or revision). Secondary outcomes were changes in intraocular pressure (IOP) and number of glaucoma medications. Additional subgroup analysis was performed for subtypes of CPC and GDD.
Thirty-six glaucoma surgeries (7 Ahmed, 19 Baerveldt, and 10 CPC) were performed in 31 eyes with a history of prio.
Glaucoma is a frequent comorbidity in patients with severe ocular surface disease, and treatment poses unique challenges in those with prior OSST. In this study, ocular surface failure and glaucoma reoperation rates were similar between CPC and GDD groups, suggesting that CPC, including repeat treatment, is a safe option for the management of secondary glaucoma after OSST. A multidisciplinary approach is recommended in the management of these complex eyes.
Ahmed and Baerveldt implants succeed in 90.7% of cases for lowering intraocular pressure (IOP) <21 mm Hg at 1 year when used for the treatment of juvenile open-angle glaucoma.
The purpose of this study was to report the 1-year outcomes of Ahmed and Baerveldt tubes as the treatment for juvenile open-angle glaucoma at an academic institution.
Patients 18 to 40 years of age at the time of juvenile open-angle glaucoma diagnosis, who had inadequately controlled glaucoma with an IOP of 18 mm Hg or more on maximum tolerated antiglaucoma therapy that underwent tube shunt surgery with at least 6 months of follow-up were eligible for the study. link3 Exclusion criteria included evidence of neovascular, uveitic or inflammatory, steroid-induced or primary congenital glaucoma, or if they did not have light perception vision. Postoperative failure was defined as an IOP, with or without antiglaucoma drops, >21 mm Hg for 2 consecutive visits after 3 months from surgery, <20% decrease in IOP at 1 year, no light perception, or revision of an implant due to high IOP.