Trabeculectomy with OloGen versus trabeculectomy for the treatment of glaucoma: a pilot study.

PURPOSE: To present the preliminary results of our study comparing the outcomes of trabeculectomy with or without OloGen implant in patients requiring glaucoma surgery for uncontrolled intraocular pressure (IOP). METHODS: Forty eyes of 40 patients were assigned randomly to undergo trabeculectomy either with OloGen implant (study group) or without implant (control group). Preoperative data included age, gender, type of glaucoma, IOP and number of preoperative glaucoma medications. Postoperative IOP, number of postoperative glaucoma medications and postoperative complications were recorded. Each patient was followed up for at least 6 months. RESULTS: There were no significant differences between the groups in terms of age, gender, type of glaucoma, preoperative IOP and number of antiglaucoma medications. Mean IOPs for both groups were significantly lower than preoperative levels at all intervals (P < 0.05) The number of glaucoma medications used dropped from a preoperative mean of 3.5 +/- 0.7 to a 6-month postoperative mean of 0.3 +/- 0.7 (P < 0.001) in the study group and from 3.7 +/- 0.4 to 0.5 +/- 1.1 (P < 0.001) in the control group. No statistically significant differences between the two groups were observed in terms of postoperative complications. CONCLUSION: In this pilot study it appears that trabeculectomy with OloGen does not seem to offer any significant advantages compared with trabeculectomy alone. Additionally, even though there were no statistical differences between the two groups as far as complications were concerned, one eye from the study group developed endophthalmitis 10 days after surgery and two eyes presented with positive Seidel test and flat anterior chamber and required additional suturing. Studies with larger numbers of patients and longer follow-ups are required to confirm these findings and to examine the safety and long-term outcomes of trabeculectomy with OloGen.

Preliminary results following the use of a fixed combination of timolol-brimonidine in patients with ocular hypertension and primary open-angle glaucoma.

PURPOSE: The purpose of this prospective study was to evaluate the efficacy in intraocular pressure (IOP) control and the tolerance of a topically administered fixed combination of timolol-brimonidine in 50 patients with ocular hypertension and primary open-angle glaucoma. METHODS: After determining a baseline IOP, the fixed combination timolol-brimonidine was used twice daily for two months, while IOP, ophthalmic signs, and/or symptoms were monitored. RESULTS: The mean IOP value was decreased from 23.09 mm Hg (+/-1.98 SD) to 17.46 mm Hg (+/-1.47 SD) during the 1st month (paired Student's t test = 9.88 kappaalphaiota p < 0.001), and to 17.51 mm Hg (+/-1.43 SD) in the 2nd month. Between the 1st and 2nd month, no statistical difference was observed (paired Student's t test = 0.02 kappaalphaiota p > 0.1). In 8% of the patients during the 1st month and 10% of patients in the 2nd month, some ophthalmic signs were observed, while only mild ophthalmic symptoms were reported in 6% and 8% of the patients, respectively. CONCLUSIONS: In conclusion, the fixed combination of timolol-brimonidine has a satisfactory IOP-lowering effect without any serious side effects due to the topical use.

Acquired color vision and visual field defects in patients with ocular hypertension and early glaucoma.

PURPOSE: To study acquired color vision and visual field defects in patients with ocular hypertension (OH) and early glaucoma. METHODS: In a prospective study we evaluated 99 eyes of 56 patients with OH without visual field defects and no hereditary color deficiencies, followed up for 4 to 6 years (mean = 4.7 +/- 0.6 years). Color vision defects were studied using a special computer program for Farnsworth-Munsell 100 hue test and visual field tests were performed with Humphrey analyzer using program 30-2. Both tests were repeated every six months. RESULTS: In fifty-six eyes, glaucomatous defects were observed during the follow-up period. There was a statistically significant difference in total error score (TES) between eyes that eventually developed glaucoma (157.89 +/- 31.79) and OH eyes (75.51 +/- 31.57) at the first examination (t value 12.816, p < 0.001). At the same time visual field indices were within normal limits in both groups. In the glaucomatous eyes the earliest statistical significant change in TES was identified at the first year of follow-up and was -20.62 +/- 2.75 (t value 9.08, p < 0.001) while in OH eyes was -2.11 +/- 4.36 (t value 1.1, p = 0.276). Pearson's coefficient was high in all examinations and showed a direct correlation between TES and mean deviation and corrected pattern standard deviation in both groups. CONCLUSION: Quantitative analysis of color vision defects provides the possibility of follow-up and can prove a useful means for detecting early glaucomatous changes in patients with normal visual fields.