Long-Term Results of Transscleral Diode Laser Cyclophotocoagulation in Glaucoma: A Real-Life Study.

PRCIS: Transscleral diode laser cyclophotocoagulation (TDLC) is effective and safe in a large population and different types of glaucoma but is least effective in the neovascular glaucoma (NVG) group. OBJECTIVE: We aimed to investigate the clinical outcomes of TDLC in a large cohort of patients with different types of refractory glaucoma. PATIENTS AND METHODS: Using patient charts, we retrospectively analyzed the success and complications of TDLC performed on eyes categorized into 6 groups: primary glaucoma (116 eyes), trauma (41 eyes), NVG (84 eyes), post-vitreoretinal surgery (post-VRS, 79 eyes), penetrating keratoplasty (47 eyes), and miscellaneous (40 eyes). Failure was defined as intraocular pressure (IOP) >22 mm Hg or <5 mm Hg, the need for further glaucoma surgery, and the loss of light perception during follow-up. RESULTS: Overall, the mean follow-up time was 33.4 ± 17.4 months, the mean total energy delivered was 109.2 ± 56.5 J, and the mean IOP reduction rate was 41.8%. Total energy delivered and IOP reduction rates were similar between the groups (all P > 0.05). The probability of success at 36 months was 71.5%, 70.7%, 55.9%, 77.2%, 72.3%, and 72.5% in primary glaucoma, trauma, NVG, post-VRS, penetrating keratoplasty, and miscellaneous groups, respectively. The NVG group showed a significantly lower success rate ( P = 0.009) than the other groups. Significant complications consisted of phthisis bulbi in 1 eye (0.2%) in the NVG group and chronic hypotony in 7 eyes (1.7%) in the NVG (3 eyes), trauma (2 eyes), post-VRS (1 eye), and primary glaucoma (1 eye) groups. CONCLUSIONS: Although TDLC was found to be a safe, effective method in the long term, it was least effective in eyes with NVG.

Lamellar corneal patch grafts in the management of corneal thinning and perforations without using extra corneas.

OBJECTIVES: To report the tectonic role of circular and square-shaped lamellar grafts without using extra corneas. MATERIALS AND METHODS: We retrospectively reviewed 23 lamellar patch grafts performed over a six-year period for various tectonic indications in corneal thinning and perforations. The anterior stroma of corneal endothelium peeled for Descemet Membrane Endothelial Keratoplasty were used to prepare circular lamellar corneal grafts. After punch trepanation of donor corneas for penetrating keratoplasty, the remaining rim of the cornea was used to prepare square-shaped grafts. RESULTS: Circular lamellar grafts were used in 13 eyes that had paracentral or central corneal thinning or perforations. Square-shaped grafts were used in 10 eyes, nine of which had peripheral corneal thinning or perforations, and one, limbal. Anatomical success after tectonic grafts was achieved in 22 of 23 eyes (95.6%) at a mean follow-up of 9.83 ± 6.27 months. The mean of the best-corrected visual acuity improved from logMAR 2.29 ± 0.23 preoperatively to logMAR 1.35 ± 0.2 postoperatively, at the final follow-up. CONCLUSIONS: The main disadvantage of patch grafts is the shortage in corneal supply due to insufficient cornea donation in developing countries like Turkey. By evaluating unused corneal rims, extra corneas will not be required.

Who can get the next Nobel Prize in infectious diseases?

The aim of this paper is to deliver a perspective on future Nobel prizes by reviewing the features of Nobel prizes awarded in the infectious diseases-related (IDR) field over the last 115 years. Thirty-three out of 106 Nobel prizes (31%) in Physiology or Medicine have been awarded for IDR topics. Out of 58 Nobel laureates for IDR topics, two have been female; 67% have been medical doctors. The median age of Nobel laureates in Physiology or Medicine was found to be lower than the median age of laureates in Literature (p<0.001). Since the Second World War, US-affiliated scientists have dominated the Nobel prizes (53%); however before 1945, German scientists did so (p=0.005). The new antimicrobials received Nobel prizes until 1960; however no treatment study was awarded the Prize until the discovery of artemisinin and ivermectin, for which the Nobel Prize was awarded in 2015. Collaborative works have increasingly been appreciated. In the future, more female laureates would be expected in the IDR field. Medical graduates and scientists involved in multi-institutional and multidisciplinary collaborative efforts seem to have an advantage.