Effect of yellow-tinted intraocular lens on standard automated perimetry and short wavelength automated perimetry in patients with glaucoma

To investigate the effect of cataract surgery and yellow-tinted intraocular lens [IOLs] implantation on perimetry indices of short-wavelength automated perimetry [SWAP] and standard automated perimetry [SAP] testing in patients with coexisting cataract and glaucoma. In this prospective comparative case series, phacoemulsification with implantation of yellow-tinted Acrysof Natural IOL was performed in 16 eyes of 16 patients with visually significant cataract [best-corrected visual acuity [VA] better than 20/120] and mild to moderate glaucoma. Pre- and postoperative values for VA and for perimetry indices including mean deviation [MD], pattern standard deviation [PSD], and foveal threshold [FT] from both SAP and SWAP testing were compared. Postoperative VA improved significantly after cataract surgery and yellow-tinted IOL implantation [P < 0.001]. After cataract extraction and IOL implantation, MD and FT on SWAP testing improved significantly [P = 0.001]; however, there was no statistically significant change with SAP testing between the pre- and postoperative perimetry indices. There was no statistically significant change in PSD with either SAP or SWAP testing postoperatively. The differences between pre- and postoperative values for all perimetry indices under study were not significant when comparing SAP with SWAP tests, except for MD which had improved statistically significantly in SWAP testing [P = 0.03]. In mild to moderate glaucoma patients with cataracts, the perimetry indices of SWAP testing improved after phacoemulsification and yellow-tinted IOL implantation. This suggests that the yellow-tinted IOLs have less effect on SWAP testing than visually significant cataracts

Dynamic contour tonometry in primary open angle glaucoma and pseudoexfoliation glaucoma: factors associated with intraocular pressure and ocular pulse amplitude

To compare the intraocular pressures [IOP] and ocular pulse amplitudes [OPAs] in patients with primary open-angle glaucoma [POAG] and pseudoexfoliation glaucoma [PXG], and to evaluate ocular and systemic factors associated with the OPA. In this prospective study, on 28 POAG and 30 PXG patients, IOP was measured with the Goldmann applanation tonometry [GAT] and the Pascal dynamic contour tonometry [DCT]. Other measurements included central corneal thickness [CCT], vertical cup-to-disc ratio [CDR], and systolic and diastolic blood pressure. Statistical significance was defined as P< 0.05. In each of the POAG and PXG groups, GAT IOP was correlated with CCT [r = 0.40, P -= 0.03 and r= 0.35, P =0.05, respectively], whereas DOT IOP and CCT were not correlated. In all patients and in the POAG group, OPA was positively correlated with DCT IOP [r= 0.39, P = 0.002]. OPA was not correlated with CCT in the POAG [P= 0.80], nor in the PXG [P = 0.20] group, after adjusting for DCT IOP When corrected for DCT IOP and CCT, there was a significant negative correlation between OPA and vertical CDR in all patients [r= - 0.41, P = 0.002]. There was no significant difference in OPAbetween groups [P= 0.55], even when OPA was adjusted for IOP and systolic and diastolic pressure [P= 0.40], in a linear regression model. DCT IOP and OPA are not correlated with CCT. There is no significant difference between the OPA of PXG and POAG eyes. OPA is correlated with DCT IOP, and is lower in eyes with more advanced glaucomatous cupping

Oscillatory photodynamic therapy for choroidal neovascularization and central serous retinopathy; a pilot study

To report the preliminary results of oscillatory photodynamic therapy [OPDT] for choroidal neovascularization [CNV] and central serous retinopathy [CSR]. This study included 7 eyes of 6 patients with CSR [2 eyes], idiopathic CNV [2 eyes], CNV due to age-related macular degeneration [AMD] [2 eyes], and peripapillary CNV secondary to presumed ocular histoplasmosis syndrome [1 eye]. Intravenous verteporfin [6 mg/m[2] body surface area] was infused over 10 minutes followed by oscillating laser [wavelength 689 nm] covering slightly beyond the entire lesion. An Area Centralis lens was applied and laser was delivered [600 mW/cm[2] fluence rate and 50 J/cm[2] dose]. Intravitreal bevacizumab and dexamethasone combination therapy was used with OPDT in 4 eyes with CNV; intravitreal dexamethasone and triamcinolone acetonide were injected in the other eye with CNV. Clinical examination, funduscopy, fluorescein angiography, and optical coherence tomography [OCT] were performed at baseline and after treatment. After mean follow-up of 7.1 +/- 5.1 months, visual acuity improved from 0.87 +/- 0.69 logMAR [20/160] to 0.60 +/- 0.65 logMAR [20/80] [P = 0.027]; central foveal thickness decreased from 322 +/- 62.1 to 240.7 +/- 34.8 microns as measured by OCT [P = 0.018]. Fluorescein angiography and OCT demonstrated cessation of vascular leakage, and resolution of hemorrhage and subretinal fluid in all eyes. No adverse events or recurrence were noted. OPDT was effective in treating CNV lesions and CSR. OPDT may be an improvement on standard PDT due to reduced side effects, thermal damage and scarring

Ahmed glaucoma valve in children: a review

Pediatric glaucoma is potentially a blinding disease. Although goniotomy and trabeculotomy are associated with good early success rates, eventually 20% of these procedures fail and many children will require additional surgery to control the IOP in the long-term. In this review, we reported that adequate IOP control can be achieved with the placement of Ahmed glaucoma valve and can last 5 or more years. However, most patients will need one or more glaucoma medications at some point after surgery. In addition, the implants may be associated with pupillary irregularities, lenticular opacification as well as tube-related complications, particularly in the first year of life, as the globe is enlarging with age