Comparison of Surgical Outcomes after Phacoemulsification between Trabeculectomized Eyes and Ahmed Valve-implanted Eyes

Purpose@#We compared the outcomes of cataract surgery in patients who underwent trabeculectomy and Ahmed glaucoma valve implantation. @*Methods@#Twenty-nine trabeculectomized eyes of 29 patients (group 1) and 20 Ahmed glaucoma valve-implanted eyes of 20 patients (group 2) were enrolled consecutively. All subjects underwent thorough ophthalmic examinations, including slit-lamp microscopy and Goldmann applanation tonometry preoperatively, on postoperative days 1 and 7, and at postoperative months 1, 3, and 6. The surgical outcomes including intraocular pressure (IOP) and the required number of IOP-lowering medications were compared between the two groups. @*Results@#The mean preoperative IOP in groups 1 and 2 was 15.34 ± 4.34 and 16.35 ± 3.44 mmHg, respectively (p = 0.265). In group 1, the IOP on postoperative day 1 increased significantly (by 3.86 ± 9.69 mmHg, p = 0.038), and the number of IOP-lowering medications rose at both 3 months (0.28 ± 0.70, p = 0.046) and 6 months (0.34 ± 0.94, p = 0.047) postoperatively. Group 2 exhibited no change in the IOP postoperatively or the number of IOP-lowering medications required in the postoperative period. Subconjunctival 5-fluorouracil injections for IOP control were required by two group 1 patients within 1 month postoperatively. @*Conclusions@#In patients with a trabeculectomized eye, the IOP increased immediately after cataract surgery; additional IOP-lowering procedures were required by some patients. The number of IOP-lowering medications increased after 3 months postoperatively. As cataract surgery may compromise filtering bleb function to a greater extent in trabeculectomized than in Ahmed glaucoma valve-implanted eyes, the former eyes require closer observation during the early postoperative period.

Comparison of Surgical Outcomes after Phacoemulsification between Trabeculectomized Eyes and Ahmed Valve-implanted Eyes

Purpose@#We compared the outcomes of cataract surgery in patients who underwent trabeculectomy and Ahmed glaucoma valve implantation. @*Methods@#Twenty-nine trabeculectomized eyes of 29 patients (group 1) and 20 Ahmed glaucoma valve-implanted eyes of 20 patients (group 2) were enrolled consecutively. All subjects underwent thorough ophthalmic examinations, including slit-lamp microscopy and Goldmann applanation tonometry preoperatively, on postoperative days 1 and 7, and at postoperative months 1, 3, and 6. The surgical outcomes including intraocular pressure (IOP) and the required number of IOP-lowering medications were compared between the two groups. @*Results@#The mean preoperative IOP in groups 1 and 2 was 15.34 ± 4.34 and 16.35 ± 3.44 mmHg, respectively (p = 0.265). In group 1, the IOP on postoperative day 1 increased significantly (by 3.86 ± 9.69 mmHg, p = 0.038), and the number of IOP-lowering medications rose at both 3 months (0.28 ± 0.70, p = 0.046) and 6 months (0.34 ± 0.94, p = 0.047) postoperatively. Group 2 exhibited no change in the IOP postoperatively or the number of IOP-lowering medications required in the postoperative period. Subconjunctival 5-fluorouracil injections for IOP control were required by two group 1 patients within 1 month postoperatively. @*Conclusions@#In patients with a trabeculectomized eye, the IOP increased immediately after cataract surgery; additional IOP-lowering procedures were required by some patients. The number of IOP-lowering medications increased after 3 months postoperatively. As cataract surgery may compromise filtering bleb function to a greater extent in trabeculectomized than in Ahmed glaucoma valve-implanted eyes, the former eyes require closer observation during the early postoperative period.

Major concerns regarding food services based on news media reports during the COVID-19 outbreak using the topic modeling approach

BACKGROUND/OBJECTIVES@#Coronavirus disease 2019 (COVID-19) cases were first reported in December 2019, in China, and an increasing number of cases have since been detected all over the world. The purpose of this study was to collect significant news media reports on food services during the COVID-19 crisis and identify public communication and significant concerns regarding COVID-19 for suggesting future directions for the food industry and services. @*SUBJECTS/METHODS@#News articles pertaining to food services were extracted from the home pages of major news media websites such as BBC, CNN, and Fox News between March 2020 and February 2021. The retrieved data was sorted and analyzed using Python software. @*RESULTS@#The results of text analytics were presented in the format of the topic label and category for individual topics. The food and health category presented the effects of the COVID-19 pandemic on food and health, such as an increase in delivery services. The policy category was indicative of a change in government policy. The lifestyle change category addressed topics such as an increase in social media usage. @*CONCLUSIONS@#This study is the first to analyze major news media (i.e., BBC, CNN, and Fox News) data related to food services in the context of the COVID-19 pandemic. Text analytics research on the food services domain revealed different categories such as food and health, policy, and lifestyle change. Therefore, this study contributes to the body of knowledge on food services research, through the use of text analytics to elicit findings from media sources.

Comparison of college students' behavior toward nutrition information communication between Korea and the US

BACKGROUND/OBJECTIVES@#The expansion of menu labeling to restaurants has created a need to study customers' behavior toward nutrition information. Therefore, the purpose of this research was to compare college students' behavior toward nutrition information communication between Korea and the US. This study consisted of three objectives: 1) to compare the frequency of usage as well as degree of trust regarding smartphone-based communication channels in the acquisition of nutrition information among college students between Korea and the US, 2) to compare knowledge-sharing behavior related to nutrition information among college students between Korea and the US, and 3) to identify the role of country in the process of knowledge-sharing behavior. @*SUBJECTS/METHODS@#A survey was distributed via the web to college students in Korea and the US. Data were collected in the 2nd week of March 2017. Completed responses were collected from 423 Koreans and 280 Americans. Differences between Koreans and Americans were evaluated for statistical significance using a t-test. In order to verify the effects of knowledge self-efficacy and transactive memory capability on knowledge-sharing behavior related to nutrition information, a regression analysis was performed. @*RESULTS@#Significant differences were found in the frequency of usage as well as degree of trust in communication channels related to nutrition information between Korean and American college students. While knowledge self-efficacy and tractive memory capability had positive effects on knowledge-sharing behavior related to nutrition information, country had a significant effect on the process. @*CONCLUSIONS@#This study is the first to compare customer behavior toward nutrition information acquisition and sharing between Korea and the US. Comparative research on nutrition information revealed differences among the different countries. Therefore, this study contributes to the body of knowledge on the nutrition information research, in particular, by providing a comparison study between countries.

Profiles and Clinical Characteristics of Newly Diagnosed Glaucoma in Urban Korea: A Multicenter Study

Purpose@#To explore the clinical characteristics and profiles of newly diagnosed glaucoma subtypes in urban Korea. @*Methods@#All newly diagnosed glaucoma patients enrolled in the participating ophthalmology outpatient clinics were in-cluded. A review of medical history including family history of glaucoma was conducted. The patients underwent complete ophthalmologic examinations including visual field test. The diagnosis of glaucoma was based on the International Society of Geographical and Epidemiological Ophthalmology criteria developed by glaucoma specialists. @*Results@#A total of 198,671 patients visited the participating ophthalmology outpatient clinics during the study period (from January 1, 2001 to June 30, 2016), of which 5,530 (2.8%) were diagnosed with glaucoma. The mean age of the newly diag-nosed glaucoma patients was 52.0 ± 17.3 years (range, 6 to 89) and 2,830 patients were male (51.2%). The mean untreated in-traocular pressure and vertical cup-to-disc ratio of the optic nerve head of newly diagnosed glaucoma eyes were 22.1 ± 10.6 mmHg and 0.66 ± 0.22, respectively. The most frequently observed subtypes of glaucoma were: normal tension glaucoma (33.0%) primary open-angle glaucoma (28.4%), ocular hypertension (11.1%), chronic angle-closure glaucoma (6.8%), neovas-cular glaucoma (5.2%), glaucoma associated with inflammation (3.8%), acute angle-closure glaucoma (3.3%), and glaucoma associated with aphakia or pseudophakia (2.2%). @*Conclusions@#Normal tension glaucoma was the most frequently observed glaucoma subtype in urban ophthalmology outpa-tient clinics in Korea.

Urrets-Zavalia Syndrome Following Trabeculectomy

PURPOSE: We report a case of Urrets-Zavalia syndrome with a fixed dilated pupil after an uneventful trabeculectomy.CASE SUMMARY: Trabeculectomy was performed on a 51-year-old male who had a history of recurrent uveitis in the left eye, with uncontrolled intraocular pressure despite maximally-tolerated medial therapy. There was no unexpected event during surgery. Topical 1% atropine was used for only 2 days after surgery. In the early postoperative period, 1% prednisolone and 0.3% ofloxacin were given four times a day, then gradually reduced. One month later, only 1% prednisolone was given once a day. Intraocular pressure in his left eye was well controlled from 8–14 mmHg after surgery. One month after surgery, the pupils remained dilated. There was no reaction to topical 2% pilocarpine and no relative afferent pupillary defect or posterior synechia.CONCLUSIONS: Our case, although rare, suggests that Urrets-Zavalia syndrome should be considered in patients with well-controlled intraocular pressure after uneventful trabeculectomy.

Safety of Active Phacoemulsification Fluidics with Bevel-down Phaco-tip on Corneal Endothelial Cells

Purpose@#To evaluate the safety of active phacoemulsification fluidics with a bevel-down phaco-tip on corneal endothelial cells in patients with various corneal endothelial cell densities (ECDs). @*Methods@#One hundred and seventy-three eyes of 111 patients who underwent cataract surgery using active phacoemulsification fluidics with a bevel-down phaco-tip technique were consecutively enrolled. We analyzed the postoperative changes in corneal parameters including ECD and clinical factors associated with percent change in ECD. @*Results@#Preoperative mean ECD was 2,511.02 ± 463.14 cells/mm2 (range, 540-3,390 cells/mm2). There was a significant change in postoperative ECD (-50.70 cells/mm2, p < 0.017), and no significant change in hexagonality or coefficients of variation. A higher preoperative mean ECD (B = -0.010, p < 0.001), a higher grade of nucleus sclerosis (B = -3.002, p < 0.001), and a younger age (B = 0.167, p = 0.040) were associated with a larger percent change in ECD. @*Conclusions@#There was very low ECD loss after active phacoemulsification fluidics with a bevel-down phaco-tip. The lower preoperative ECD was not a risk factor for postoperative ECD loss. Therefore, we suggest that active phacoemulsification fluidics with a bevel-down phaco-tip technique can be performed safely in patients with low ECD when nuclear sclerosis is not severe.

Secondary Open-angle Glaucoma and Vitreous Opacity as Presenting Manifestations of Familial Amyloid Polyneuropathy

Purpose@#We report a case of familial amyloid polyneuropathy in a patient presenting with open-angle glaucoma and progressive vitreous opacity.Case summary: A 62-year-old female patient presented with uncontrolled intraocular pressure (IOP) in the left eye that did not respond to medical treatment. She had no history of systemic diseases other than hypertension. Trabeculectomy was performed in the left eye. Thirteen months later, as IOP in the right eye suddenly increased to 50 mmHg and was not controlled, trabeculectomy was also performed in the right eye. Anterior chamber angle was wide and open in both eyes and there were no abnormalities. Vitreous opacity increased gradually in both eyes. Neurological examination was conducted as the patient complained of numbness in the feet, and a diagnosis of familial amyloid polyneuropathy was confirmed. @*Conclusions@#Although rare, familial amyloid polyneuropathy and secondary glaucoma should be considered as differential diagnoses in open-angle glaucoma patients showing high intraocular pressure accompanied by progressive vitreous opacity.

Safety of Active Phacoemulsification Fluidics with Bevel-down Phaco-tip on Corneal Endothelial Cells

Purpose@#To evaluate the safety of active phacoemulsification fluidics with a bevel-down phaco-tip on corneal endothelial cells in patients with various corneal endothelial cell densities (ECDs). @*Methods@#One hundred and seventy-three eyes of 111 patients who underwent cataract surgery using active phacoemulsification fluidics with a bevel-down phaco-tip technique were consecutively enrolled. We analyzed the postoperative changes in corneal parameters including ECD and clinical factors associated with percent change in ECD. @*Results@#Preoperative mean ECD was 2,511.02 ± 463.14 cells/mm2 (range, 540-3,390 cells/mm2). There was a significant change in postoperative ECD (-50.70 cells/mm2, p < 0.017), and no significant change in hexagonality or coefficients of variation. A higher preoperative mean ECD (B = -0.010, p < 0.001), a higher grade of nucleus sclerosis (B = -3.002, p < 0.001), and a younger age (B = 0.167, p = 0.040) were associated with a larger percent change in ECD. @*Conclusions@#There was very low ECD loss after active phacoemulsification fluidics with a bevel-down phaco-tip. The lower preoperative ECD was not a risk factor for postoperative ECD loss. Therefore, we suggest that active phacoemulsification fluidics with a bevel-down phaco-tip technique can be performed safely in patients with low ECD when nuclear sclerosis is not severe.

Secondary Open-angle Glaucoma and Vitreous Opacity as Presenting Manifestations of Familial Amyloid Polyneuropathy

Purpose@#We report a case of familial amyloid polyneuropathy in a patient presenting with open-angle glaucoma and progressive vitreous opacity.Case summary: A 62-year-old female patient presented with uncontrolled intraocular pressure (IOP) in the left eye that did not respond to medical treatment. She had no history of systemic diseases other than hypertension. Trabeculectomy was performed in the left eye. Thirteen months later, as IOP in the right eye suddenly increased to 50 mmHg and was not controlled, trabeculectomy was also performed in the right eye. Anterior chamber angle was wide and open in both eyes and there were no abnormalities. Vitreous opacity increased gradually in both eyes. Neurological examination was conducted as the patient complained of numbness in the feet, and a diagnosis of familial amyloid polyneuropathy was confirmed. @*Conclusions@#Although rare, familial amyloid polyneuropathy and secondary glaucoma should be considered as differential diagnoses in open-angle glaucoma patients showing high intraocular pressure accompanied by progressive vitreous opacity.

Influence of Epiretinal Membranes on the Retinal Nerve Fiber Layer Thickness Measured by Spectral Domain Optical Coherence Tomography in Glaucoma

PURPOSE: We investigated changes in the thickness of the peripapillary retinal nerve fiber layer (RNFL) following the onset of an epiretinal membrane (ERM) in glaucoma patients. METHODS: Among regularly monitored glaucoma patients, patients with a newly diagnosed ERM were consecutively enrolled. Before and after the onset of ERM, the RNFL thickness was measured using spectral domain optical coherence tomography, and a visual field examination was performed using a Humphrey field analyzer. Changes in RNFL thickness parameters and global indices of the visual field analyzer were assessed. RESULTS: In a total of 28 eyes from 28 patients, the average RNFL thickness increased by a mean of 4.0 ± 7.4 µm (p = 0.009) after ERM onset. There was an increase in the superior, nasal, and temporal quadrant RNFL thicknesses, and the change in the temporal RNFL thickness was significant (14.4 ± 21.2 µm, p < 0.001). However, the inferior RNFL thickness decreased by −0.6 ± 7.5 µm (p = 0.116). In the visual field examination, the mean deviation decreased significantly by −0.8 ± 1.7 dB (p = 0.038), from −14.6 to −15.4 dB. CONCLUSIONS: A significant increase in average RNFL thickness was detected following ERM onset in glaucoma patients, although there was deterioration of the mean deviation in the visual field. When ERM occurs in glaucoma patients, clinicians should be aware that RNFL thickness measurements obtained with a spectral domain optical coherence tomography may underestimate the status of glaucomatous optic neuropathy.

Effect of Preoperative Factor on Intraocular Pressure after Phacoemulsification in Primary Open-angle Glaucoma and Primary Angle-closure Glaucoma

PURPOSE: To compare the effects of cataract surgery on intraocular pressure (IOP) according to preoperative factor in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). METHODS: The medical records of 75 POAG and 95 PACG patients who underwent cataract surgery were reviewed. We classified POAG patients with a preoperative peak IOP of less than 31 mmHg and less than three medications used before surgery and PACG patients with a peak IOP of less than 42 mmHg, less than three medications used, and peripheral anterior synechiae of less than four clock hours into group 1. Patients with levels exceeding these thresholds were classified into group 2. The IOP, numbers of medications, and success rates were compared between two groups. RESULTS: At 36 months after surgery, IOP reduction in group 1 was significantly greater than that in group 2 among POAG patients (−1.7 ± 2.1 vs. −0.6 ± 2.0 mmHg, p = 0.021); however, there was no significant difference between the two groups for PACG patients (−2.5 ± 2.0 vs. −2.2 ± 3.3 mmHg, p = 0.755). The medication changes were similar between the two groups for both POAG and PACG patients. The success rate at 36 months was significantly higher in group 1 than in group 2 for POAG patients (66.7% vs. 35.7%, p = 0.009), but there was no significant difference between the two groups for PACG patients (79.1% vs. 69.2%, p = 0.264). CONCLUSIONS: For patients with relatively low peak IOP who used fewer medications before surgery, cataract surgery alone was effective for IOP control in both POAG and PACG patients. Conversely, For POAG patients with a history of higher peak IOP and who used more medications, cataract surgery was not effective in lowering IOP, whereas it resulted in relatively good IOP values in PACG patients.

Encapsulated Bleb Excision with Collagen Matrix Implantation Following Failed Ahmed Glaucoma Valve Implantation

PURPOSE: To investigate the clinical features and surgical outcomes of encapsulated bleb excision with collagen matrix implantation performed in patients with failed Ahmed glaucoma valve (AGV) implantation. METHODS: Eighteen eyes of 18 patients underwent encapsulated bleb excision and collagen matrix implantation. Patients were divided into two groups by reference to intraocular pressure (IOP) after preoperative ocular massage: group 1, patients who exhibited substantial IOP reductions; and group 2, patients who did not show substantial changes in IOP. Needling was conducted in group 2. The clinical features of the two groups were compared, including IOP changes after ocular massage and needling, AGV status, and surgical outcomes 6 months after surgery. RESULTS: The mean preoperative IOP among the 18 patients was 30.6 ± 5.7 mmHg. After ocular massage, the IOPs decreased by 22 and 26 mmHg in the two patients in group 1 and the 16 patients in group 2 showed a mean IOP reduction of 1.6 ± 2.2 mmHg (p = 0.013). IOPs decreased after needling in group 2 (range, 6 to 30 mmHg; p < 0.001). Fibrovascular tissue ingrowth into the AGV was observed in the two patients in group 1 and the same ingrowth was observed in 10 of the 16 patients in group 2. Six months after surgery the mean IOP among the 18 patients decreased significantly (19.1 ± 3.2 mmHg, p < 0.001). There was no significant difference in the mean postoperative IOP at 6 months between group 1 (14.0 ± 2.8 mmHg) and group 2 (19.8 ± 2.6 mmHg, p = 0.052). CONCLUSIONS: Encapsulated bleb excision with collagen matrix implantation resulted in a significant IOP-lowering effect 6 months after surgery. Fibrovascular ingrowth into the AGV was common but did not seem to be a major cause of AGV implantation failure.

Conjunctival Necrosis following Ahmed Valve Implantation and Subtenon Triamcinolone Injection

PURPOSE: We report a case of conjunctival necrosis in a glaucoma patient who underwent Ahmed valve implantation and subtenon triamcinolone injection. CASE SUMMARY: subconjunctival injections of mitomycin C in her right eye. Ahmed valve implantation and subtenon triamcinolone injection were performed in the right eye. Four weeks later, conjunctival necrosis was observed. After debridement of necrotic tissue, an additional conjunctival autograft was needed because of recurrence of the conjunctival necrosis. After amniotic membrane transplantation was performed for one more recurrent conjunctival necrosis, conjunctival epithelialization was completed. CONCLUSIONS: Although conjunctival necrosis after periocular injection of triamcinolone is a rare complication, previous multiple usage of antimetabolites such as mitomycin C might be associated with a higher risk of developing conjunctival necrosis. In such cases, aggressive surgical intervention may be helpful in the reconstruction of the conjunctival epithelium.

Comparison of Effects and Complications between Conventional Trabeculectomy and Trabeculectomy with a Collagen Matrix Insertion

PURPOSE: To compare the surgical outcomes between trabeculectomy with a collagen matrix (Ologen®) insertion and conventional trabeculectomy. METHODS: An ophthalmic examination, including tonometry and a slit lamp examination, was performed 1 week, 2 weeks, 1 month, 2 months, 4 months, 6 months, and 12 months postoperatively in glaucoma patients who underwent a trabeculectomy using Ologen® (experimental group) or a conventional trabeculectomy (control group). Clinical features including success rate and complications were compared between the two groups. RESULTS: In 21 eyes of the experimental group and 42 eyes of the control group, the success rates were 76% and 69%, respectively (p = 0.554). Needling with subconjunctival 5-fluorouracil injection or laser suture lysis of the scleral flap was required in three eyes (14.3%) in the experimental group and 18 eyes (42.9%) in the control group (p = 0.023). The types of complications differed, although the total number of complications did not differ between the two groups (23.8% vs. 19.0%, respectively; p = 0.745). The most common complication in the experimental group was an encapsulated bleb, which occurred in three eyes (14.3%), whereas an avascular bleb occurred in three eyes (7.1%) in the control group. CONCLUSIONS: The success rate of trabeculectomy with Ologen® was comparable to that of conventional trabeculectomy. However, postoperative interventions were less commonly required after trabeculectomy with Ologen®, and the complications differed between the groups. When choosing the surgical method and examining the postoperative condition, these differences should be considered.

Standardization of Ingredient Classification and Quality Attributes of at School Foodservices

The purpose of this study was to standardize ingredients used by school foodservices. This study analyzed the current notation of ingredients in used by used in school foodservices through the NEIS system employed by school foodservices of elementary schools through high schools in South Korea. Specifically, this study suggests systemized standardization of ingredient classification and quality attributes of at school foodservices by applying a case study analysis. The findings from the case analysis of the Electronic Procurement System operator are as follows. Classifications for ingredients of the NEIS system used by school food services consisted of included food group, food name, detailed food name, and description. Classification was not clearly divided between the classification scheme and the attribute system. Therefore, food group, food name, and product information of each food should be categorized as the classification scheme, whereas the detailed food name (excluding product information) and description should be standardized as the attribute system, which is composed of required attributes, recommended attributes, and other attributes. This study suggests that system standardization should be carried out in the field of school foodservices, as advancements between distributors and school food service providers could affect food ingredient quality. Thus, standardization can influence purchase and distribution in many ways.

Influence of Biometric Variables on Refractive Outcomes after Cataract Surgery in Angle-closure Glaucoma Patients

PURPOSE: To evaluate the influence of biometric variables on refractive outcomes after cataract surgery in angle-closure glaucoma (ACG) patients. METHODS: In this case-control study, 42 ACG patients, 40 open-angle glaucoma (OAG) patients, and 35 controls without glaucoma who had undergone conventional cataract surgery were enrolled consecutively. Electronic medical records, including preoperative biometric variables (keratometric diopter, axial length, anterior chamber depth, and lens thickness), the refractive change (RC), and the absolute value of refractive change (ARC) were reviewed. RESULTS: In the control and OAG patients, the anterior chamber depth was negatively correlated with the ARC (r = -0.344, p = 0.043 and r = -0.431, p = 0.006, respectively), whereas there was no correlation in the ACG patients. Lens thickness was positively correlated with the RC, but not with the ARC, in the control and OAG groups (r = 0.391, p = 0.020 and r = 0.501, p = 0.001, respectively). In contrast, lens thickness in the ACG group was not correlated with the RC but was positively correlated with the ARC (r = 0.331, p = 0.032). CONCLUSIONS: In contrast with the anterior chamber depth, preoperatively measured lens thickness may be a useful predictor of the direction of the RC after cataract surgery in control and OAG patients. However, in ACG patients, a thicker lens was correlated with a larger RC, regardless of the direction of the shift (hyperopic or myopic).

Performance of and Pressure Elevation Formed by Small-diameter Microtubes Used in Constant-flow Sets

PURPOSE: We explored the performance of and pressure elevation caused by small-diameter microtubes used to reduce overfiltration. METHODS: Using a syringe pump-driven constant-flow setting (2 µL/min), pressures were measured for polytetrafluoroethylene (PTFE) microtubes 5 mm in length with inner diameters of 51, 64, and 76 µm and for polyether block amide (PEBAX) microtubes with an inner diameter of 76 µm. Experiments (using microtubes only) were initially performed in air, water, and enucleated pig eyes and were repeated under the same conditions using intraluminal 9/0 nylon stents. RESULTS: The pressures measured in air in 51-, 64-, and 76-µm-diameter PTFE microtubes differed significantly (22.1, 16.9, and 12.2 mmHg, respectively; p < 0.001), and that of the 76-µm-diameter PEBAX microtube was 15.8 mmHg (p < 0.001 compared to the 12.2 mmHg of the 76-µm-diameter PTFE microtube). The pressures measured in water also differed significantly among the three microtubes at 3.9, 3.0, and 1.4 mmHg, respectively, while that in the PEBAX microtube was 2.6 mmHg (all p < 0.001). Using the intraluminal stent, the pressure in water of the three different PTFE microtubes increased to 22.6, 18.0, and 4.1 mmHg, respectively, and that in the PEBAX microtube increased to 10.5 mmHg (all p < 0.001). Similar trends were evident when measurements were performed in pig eyes. CONCLUSIONS: Although microtubes of smaller diameter experienced higher pressure in air, reduction of the inner diameter to 51 µm did not adequately increase the pressure attained in water or pig eyes. Insertion of an intraluminal stent effectively elevated the latter pressures. PEBAX microtubes created higher pressures than did PTFE microtubes.

Changes in Corneal Endothelial Cell after Ahmed Glaucoma Valve Implantation and Trabeculectomy: 1-Year Follow-up

PURPOSE: To compare changes in corneal endothelial cell density (CECD) after Ahmed glaucoma valve (AGV) implantation and trabeculectomy. METHODS: Changes in corneal endothelium in patients that underwent AGV implantation or trabeculectomy were prospectively evaluated. Corneal specular microscopy was performed at the central cornea using a non-contact specular microscope before surgery and 6 months and 12 months after surgery. The CECD, hexagonality of the endothelial cells, and the coefficient of variation of the cell areas were compared between the two groups. RESULTS: Forty eyes of 40 patients with AGV implantation and 28 eyes of 28 patients with trabeculectomy were studied. Intraocular pressure in the AGV implantation group was significantly higher than that in the trabeculectomy group (p < 0.001), but there was no significant difference in other clinical variables between the two groups. In the AGV implantation group, the mean CECD significantly decreased by 9.4% at 6 months and 12.3% at 12 months compared with baseline values (both, p < 0.001), while it decreased by 1.9% at 6 months and 3.2% at 12 months in the trabeculectomy group (p = 0.027 and p = 0.015, respectively). The changes at 6 months and 12 months in the AGV implantation group were significantly higher than those in the trabeculectomy group (p = 0.030 and p = 0.027, respectively). In the AGV implantation group, there was a significant decrease in the CECD between baseline and 6 months and between 6 months and 12 months (p < 0.001 and p = 0.005, respectively). However, in the trabeculectomy group, a significant decrease was observed only between baseline and 6 months (p = 0.027). CONCLUSIONS: Both the AGV implantation group and the trabeculectomy group showed statistically significant decreases in the CECD 1 year after surgery. The decrease in CECD in the AVG implantation group was greater and persisted longer than that in the trabeculectomy group.

Change in Visual Acuity Following Trans-Scleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma

PURPOSE: To evaluate the effects of trans-scleral diode laser cyclophotocoagulation (TSDLC) on best corrected visual acuity (BCVA) in patients with refractory glaucoma. METHODS: The medical records of 148 eyes of 148 patients with refractory glaucoma who were followed-up for over 6 months after TSDLC were analyzed retrospectively. Among them, 49 eyes of 49 subjects who had BCVA greater than no light perception (NLP) before TSDLC were classified as Group 1 and the other 99 eyes of 99 patients who had NLP vision were classified as Group 2. The outcomes of TSDLC including change in BCVA following surgery were analyzed for all patients and 49 subjects. RESULTS: The mean follow-up period in Group 1 was 19.1 +/- 13.5 months and 16.7 +/- 12.7 months in Group 2. The intraocular pressure (IOP) and the number of IOP lowering medications decreased in both groups (both p or = 0.2 log MAR was found in 31 eyes (63.3%) and light perception was lost in 15 eyes (30.6%). After treatment, corneal edema developed in 5 eyes (3.4%), phthisis bulbi and chronic hypotony occurred in 3 eyes each (2%) and iridocydlitis occurred in 2 eyes (1.4%). CONCLUSIONS: TSDLC in patients with refractory glaucoma showed an efficient reduction in IOP and the number of IOP-lowering medications. However, there was a significant loss in BCVA in many patients and therefore, careful monitoring regarding potential visual loss is necessary when considering TSDLC in glaucoma patients with useful vision.