Combined Viscodilation of Schlemm's Canal and Collector Channels and 360° Ab-Interno Trabeculotomy for Congenital Glaucoma Associated with Sturge-Weber Syndrome.

PURPOSE: This case report demonstrates the potential role of the OMNI surgical system in the surgical management of congenital glaucoma. PATIENTS AND METHODS: The case was a 4-month-old full-term, otherwise healthy female infant with cutaneous hemangiomas of both upper lids, corneal edema in the right eye (RE) and IOP > 30 mmHg. Sturge-Weber syndrome (SWS) was diagnosed. The RE was surgically treated with ab-interno circumferential viscodilation and trabeculotomy. RESULTS: Through 10 months of follow-up, intraocular pressure was adequately controlled without the need for adjunctive medical therapy. CONCLUSION: Given its advantages over other angle surgery techniques, this procedure's role in treating glaucomas of childhood warrants further evaluation.

Relationships between central corneal thickness and optic disc topography in eyes with glaucoma, suspicion of glaucoma, or ocular hypertension.

PURPOSE: To identify relationships between central corneal thickness (CCT) and optic disc topography, as determined by scanning laser ophthalmoscopy (SLO), for patients seen in a specialist glaucoma service. METHODS: 272 eyes of 144 patients with primary open angle glaucoma (POAG; n = 71), normal tension glaucoma (NTG; n = 50), ocular hypertension (OH; n = 48) and those considered to be suspicious for glaucoma (GS; n = 103) underwent ultrasonic pachymetry and optic disc topography by SLO. Correlations between CCT and SLO parameter values were identified. A Bonferroni correction for multiple comparisons was performed and a p value of <0.0042 was considered significant. RESULTS: Mean CCT values were 533 mum (POAG), 530 mum (NTG), 550 mum (GS), and 565 mum (OH). As a group the GS and OH eyes had significantly thicker CCT values than eyes with POAG. In addition, the NTG eyes had significantly thinner CCT values than GS and OH eyes. Overall multiple SLO parameters correlated with CCT even after accounting for co-variance with age, refraction and inclusion of both eyes. Sub-group analysis indicated that 'optic disc rim area' positively correlated with CCT (r = 0.378) and 'cup to disc area ratio' negatively correlated with CCT (r = -0.370) in the POAG group. In the GS group the parameter 'area below reference' (a measure of cup volume) and 'mean cup depth' had negative correlations with CCT (r = -0.297 and -0.323) indicating that eyes with thinner than average corneal thickness measurements had larger and deeper cups. CONCLUSION: Thinner corneas appear to be associated with larger and deeper optic disc cups in the eyes of patients seen in a specialist glaucoma service.