Anterior Segment Optical Coherence Tomography Changes to the Anterior Chamber Angle in the Short-term following Laser Peripheral Iridoplasty.

PURPOSE: To evaluate, by anterior segment optical coherence tomography (AS-OCT), the changes in the anterior chamber angle during the short-term postoperative period after diode laser peripheral iridoplasty (LPI). METHODS: Retrospective, observational study of consecutive primary angle closure suspect, primary angle closure, or primary angle closure glaucoma patients who underwent LPI. These patients had persistent iridotrabecular contact despite the presence of a patent peripheral iridotomy. The AS-OCT images of the temporal and nasal anterior chamber angles in dark conditions before and after LPI were ana lyzed. The main outcome measures were changed in AS-OCT parameters such as trabecular-iris angle (TIA), angle opening distance (AOD), trabecular-iris space area (TISA), trabecular-iris contact length (TICL), iris thickness (IT), and maximum iris bow height (MIBH). Secondary outcome para meters included intraocular pressure (IOP) and postlaser complications. RESULTS: Images of 14 eyes of 14 patients were assessed. The mean time from LPI to the follow-up AS-OCT scan was 6 ± 3 weeks. The IT did not alter significantly after LPI, but there were significant increases in the TIA, AOD and TISA, as well as a significant decrease in TICL and MIBH. There were no significant postlaser complications. There was a small decrease in mean IOP from 17.1 ± 4.0 mm Hg to 14.8 ± 4.6 mm Hg (p = 0.014). CONCLUSION: Based on AS-OCT imaging, LPI resulted in significant angle widening and iris profile fattening during the short-term postoperative period in eyes with persistent angle closure despite the presence of a patent peripheral iridotomy. How to cite this article: Leong JCY, O'Connor J, Ang GS, Wells AP. Anterior Segment Optical Coherence Tomography Changes to the Anterior Chamber Angle in the Short-term following Laser Peripheral Iridoplasty. J Current Glau Prac 2014;8(1):1-6.

Wound Healing Modulation in Glaucoma Filtration Surgery- Conventional Practices and New Perspectives: Antivascular Endothelial Growth Factor and Novel Agents (Part II).

Glaucoma filtration surgery is regularly performed for the treatment of glaucoma and trabeculectomy is often regarded as the 'gold standard' glaucoma operation. The biggest risk of failure of the operation is bleb scarring. The advent of antifibrotic agents, such as mitomycin C (MMC) and 5-fluorouracil (5FU) has vastly prolonged the longevity of the bleb, but concerns remain regarding the potential increase in postoperative complications. More selective therapeutic targets have therefore been explored. One of these is vascular endothelial growth factor (VEGF) inhibition. VEGF inhibition has a role not only in subconjunctival angiogenesis inhibition but also it has direct anti-fibrotic properties. Newer pharmacological compounds and materials have also been developed in recent years in attempt to modulate the wound healing in different ways after glaucoma surgery. These include physical barriers to scarring and vehicles for sustained release of pharmacological agents, and early promising results have been demonstrated. This two-part review will provide a discussion of the application of anti-fibrotic agents in glaucoma filtration surgery and evaluate the newer agents that have been developed. How to cite this article: Fan Gaskin JC, Nguyen DQ, Ang GS, O'Connor J, Crowston JG. Wound Healing Modulation in Glau coma Filtration Surgery-Conventional Practices and New Pers pectives: Antivascular Endothelial Growth Factor and Novel Agents (Part II). J Curr Glaucoma Pract 2014;8(2):46-53.

Wound Healing Modulation in Glaucoma Filtration Surgery-Conventional Practices and New Perspectives: The Role of Antifibrotic Agents (Part I).

Glaucoma filtration surgery is regularly performed for the treatment of glaucoma and trabeculectomy is often regarded as the 'gold standard' glaucoma operation. The biggest risk of failure of the operation is bleb scarring. The advent of anti-fibrotic agents, such as mitomycin C (MMC) and 5-fluorouracil (5FU) has vastly prolonged the longevity of the bleb, but concerns remain regarding the potential increase in postoperative complications. More selective therapeutic targets have therefore been explored. One of these is vascular endothelial growth factor (VEGF) inhibition. Vascular endothelial growth factor inhi bition has a role not only in sub conjunctival angiogenesis inhi bition but also it has direct anti-fibrotic properties. Newer phar macological compounds and materials have also been developed in recent years in attempt to modulate the wound healing in different ways after glaucoma surgery. These include physical barriers to scarring and vehicles for sustained release of pharmacological agents, and early promising results have been demonstrated. This two-part review will provide a discussion of the application of anti-fibrotic agents in glaucoma filtration surgery and evaluate the newer agents that have been developed. How to cite this article: Fan Gaskin JC, Nguyen DQ, Ang GS, O'Connor J, Crowston JG. Wound Healing Modulation in Glaucoma Filtration Surgery-Conventional Practices and New Pers pectives: The Role of Antifibrotic Agents (Part I). J Curr Glaucoma Pract 2014;8(2):37-45.