Hypotony in the early postoperative period after MicroShunt implantation versus trabeculectomy: A registry study.

PURPOSE: A comparison of the safety and efficacy of the MicroShunt versus trabeculectomy in the early postoperative period, with a particular focus on hypotony. METHODS: In this registry study, we evaluated 200 eyes of 200 glaucoma patients who underwent filtration surgery at Oslo University Hospital between 2017 and 2021. Of these patients, 100 had a Preserflo MicroShunt (Santen) implantation and 100 had a trabeculectomy procedure. The patients were examined per standard hospital protocol after filtration surgery. Data were extracted from the 4- and 8-week visits. We defined hypotony as intraocular pressure (IOP) < 6 mmHg. RESULTS: The mean preoperative IOP was 20.6 ± 7.1 mmHg in the MicroShunt group and 21.6 ± 7.1 mmHg in the trabeculectomy group, and the patients used a mean of 3.0 ± 0.9 and 3.1 ± 0.9 glaucoma medications, respectively. After 8 weeks, IOP was reduced to 10.4 ± 5.4 mmHg and 11.3 ± 4.6 mmHg, respectively (p = 0.23). During the early postoperative period, hypotony was registered in 63% of the MicroShunt patients and in 21% of the patients in the trabeculectomy group (p < 0.001); and 11% and 1%, respectively, of the patients developed choroidal detachments (p < 0.003). One patient in the MicroShunt group required reoperation due to hypotony. CONCLUSIONS: In this registry study, we found that the Preserflo MicroShunt and trabeculectomy had equally satisfactory IOP-lowering effects during the early postoperative period. In this same period, a high number of patients in the MicroShunt group developed hypotony.

The prevalence and incidence of glaucoma in Norway 2004-2018: A nationwide population-based study.

PURPOSE: To describe prevalence, life-time prevalence and incidence of glaucoma in Norway over a 15-year period. MATERIALS AND METHODS: Data from The Norwegian Prescription Database was used to identify all prescriptions for glaucoma medication during the period 2004 to 2018. Population figures and lifespan data were obtained from The National Bureau of Statistics. RESULTS: Of a population of 5.3 million, a total of 75733 patients using glaucoma eye drops were identified in 2018. The national prevalence was thus 1.4%, whilst in those over 70 years of age, 8.0%. When divided into counties, the prevalence varied between 1.1 and 1.9%. Overall, the prevalence was stable in the period 2004-2018. Life time prevalence was found to be 9.4% for men and 10.2% for women. National one-year incidence proportion per 10000 was 17.0 for the total population and a peak incidence of 93.8/10000 in the 80-89 year age group was identified. CONCLUSIONS: Glaucoma prevalence remained stable during the period 2004-2018, while incidence decreased slightly in the elderly population.

[Medical management of glaucoma and interaction between glaucoma and systemic medications].

INTRODUCTION: Glaucoma used to be the most common cause for blindness in Iceland. As the incidence of glaucoma increases with age, the patients often have numerous comorbidities and use various medications. It is important to keep in mind interactions and side effects of glaucoma medications when deciding systemic medical treatment for these patients to ensure their safety and comfort. The goal of the study was to gather information about drug use of patients with severe glaucoma. METHODS: A retrospective study where data were collected from 100 consecutive patients who underwent a trabeculectomy as first glaucoma surgery at Landspitali National University Hospital of Iceland during 2013-2017. All systemic and ophthalmic medications during 6 months before and after the surgery, medical diagnoses, age and gender of the patients were registered. RESULTS: Of all 100 patients, 87 used systemic medication, averaging 5.3 drugs/patient. Mean number of glaucoma medication used was 3.0. Mean age at surgery was 75 years and 53 were women. The most common systemic drug class was anti-hypertensives, used by 57 patients where beta-blockers were the most common, used by 30 patients. Zopiclone was the most common single drug, used by 29 patients. CONCLUSION: It is evident that patients with glaucoma take various drugs for systemic illness that can affect their glaucoma and have interactions with glaucoma drugs. It is urgent that healthcare providers keep this in mind when deciding on systemic treatment for patients with glaucoma, with regards to possible interactions with glaucoma drugs and the effect on patient's overall health.

Retinal oxygen metabolism in patients with mild cognitive impairment.

INTRODUCTION: We have previously reported that retinal vessel oxygen saturation is increased in mild-to-moderate dementia of Alzheimer's type when compared with healthy individuals. Mild cognitive impairment (MCI) is the predementia stage of the disease. The main purpose was to investigate if these changes are seen in MCI. METHODS: Retinal vessel oxygen saturation was measured in 42 patients with MCI and 42 healthy individuals with a noninvasive retinal oximeter, Oxymap T1. The groups were paired according to age. RESULTS: Arteriolar and venular oxygen saturation was increased in MCI patients compared to healthy individuals (arterioles: 93.1 ± 3.7% vs. 91.1 ± 3.4%, P = .01; venules: 59.6 ± 6.1% vs. 54.9 ± 6.4%, P = .001). Arteriovenous difference was decreased in MCI compared to healthy individuals (33.5 ± 4.5% vs. 36.2 ± 5.2%, P = .01). DISCUSSION: Increased retinal vessel oxygen saturation and decreased arteriovenous difference in MCI could reflect less oxygen extraction by retinal tissue. This indicates that retinal oxygen metabolism may be affected in patients with MCI.