Subconjunctival implantation of ologen Collagen Matrix to treat ocular hypotony after filtration glaucoma surgery.

PurposeTo report the results of subconjunctival ologen Collagen Matrix implantation to manage ocular hypotony after filtration glaucoma surgery.Patients and methodsThis retrospective observational case series included 12 consecutive implantations of ologen in nine eyes of nine Japanese subjects (five men, four women; mean age±SD, 72.1±12.7 years) who underwent subconjunctival implantation of the device to treat hypotony after glaucoma filtration surgery. Demographic data and surgical results were collected by chart review.ResultsThe subjects included six patients who underwent trabeculectomy and three who underwent an EX-PRESS shunt surgery. The duration between the last glaucoma surgery and the initial ologen implantation was longer than 2 years in seven (78%) eyes. Bleb leakage in five (56%) eyes preoperatively stopped in all cases by 8 days after the device implantation. After the initial implantation, three (33.3%) eyes required a second implantation of ologen because of insufficient efficacy. After a mean follow-up of 12.6±6.8 months, the mean preoperative intraocular pressure (IOP) of 3.8±2.7 mmHg increased significantly (P=0.0001) to 9.0±3.2 mmHg; no eye required glaucoma medication to control the IOP. No vision-threatening complications developed in association with the treatment.ConclusionWhen conservative management failed, subconjunctival implantation of ologen Collagen Matrix in combination with bleb revision can be a useful therapeutic option for ocular hypotony after glaucoma filtration surgery.

The preoperative intraocular pressure level predicts the amount of underestimated intraocular pressure after LASIK for myopia.

AIMS: To evaluate the statistical significance of the parameters that affect underestimation of intraocular pressure (IOP) after laser in situ keratomileusis (LASIK) for myopia. METHODS: In this prospective case series study, patient age, axial length, preoperative corneal curvature, preoperative central corneal thickness (CCT), preoperative IOP, and ablation depth were studied to determine whether they affect the underestimation of IOP in the right eyes of 100 consecutive patients who underwent LASIK. RESULTS: The preoperative IOP was the most important parameter for an amount of underestimated Goldmann applanation tonometric IOP (GAT) and non-contact tonometric IOP (ncIOP) at 1 month (r = 0.654, p<0.0001, R(2) = 0.427, and r = 0.694, p<0.0001, R(2) = 0.481, respectively) and 3 months (r = 0.637, p<0.0001, R(2) = 0.406, and r = 0.726, p<0.0001, R(2) = 0.527, respectively). Patient age was statistically significant for underestimating the GAT at 1 month, and both the ablation depth and CCT were statistically significant parameters for underestimating the ncIOP at 1 month and at 3 months by stepwise multiple regression analysis (F>4.000). However, these parameters had small bivariate correlation coefficients, and were considered as minor parameters. CONCLUSION: Preoperative IOP is the most important parameter that affects an underestimation of IOP after LASIK for myopia. Eyes with a higher true IOP have a larger underestimation of the IOP after LASIK for myopia. From these results, the importance of the modulus of elasticity on IOP measurements was discussed.

Geranylgeranylacetone promotes induction and secretion of thioredoxin in gastric mucosal cells and peripheral blood lymphocytes.

Thioredoxin (TRX) is a redox-active protein which is induced by oxidative stresses and shows a variety of biological activities including cytoprotection against oxidative stress. We recently reported that geranylgeranylacetone (GGA), an anti-ulcer drug, induces TRX in rat hepatocytes. In this study, we demonstrate that GGA promotes induction and secretion of TRX in rat gastric mucosal cells and human peripheral blood lymphocytes (PBLs). Western blotting and a sensitive sandwich ELISA showed that TRX was induced by GGA in the cell lysates and culture supernatants of rat gastric mucosal RGM-1 cells and human PBLs. LDH releasing assay showed that GGA protected rat gastric mucosal RGM-1 cells from ethanol-induced cytotoxicity. Moreover, exogenous recombinant wild type TRX decreased 51Cr release from primary cultured rat gastric mucosal cells incubated with ethanol or hydrogen peroxide in a dose-dependent manner, whereas recombinant mutant TRX (C32S/C35S), in which the two cysteines were replaced with serines in its active site, did not. These results indicate that GGA promotes the induction and secretion of TRX in a variety of types of cells and suggest that induced or secreted TRX may play an important role in the cytoprotective action of GGA on gastric mucosal cells.

Surgical outcome of combined trabeculotomy and cataract surgery.

PURPOSE: To evaluate the efficacy of combined trabeculotomy and cataract surgery in lowering intraocular pressure and improving visual acuity in adults with primary open-angle glaucoma. PATIENTS AND METHODS: A consecutive series of 141 eyes with primary open-angle glaucoma or ocular hypertension was prospectively recruited. One hundred five eyes with visual field defects were treated by trabeculotomy combined with phacoemulsification and intraocular lens implantation (TPI group), and 36 eyes without visual field defects underwent cataract surgery (PI group). Patients in the TPI and PI groups were followed for more than 6 months after surgery (578.1 +/- 35.8 days and 616.0 +/- 58.5 days, respectively). The intraocular pressure reductions after surgery were compared between the groups to evaluate the effect of combined trabeculotomy and cataract surgery. Visual acuity and the complication rate in the two groups were secondary outcomes. The success probabilities of both groups were evaluated by Kaplan-Meier life table analysis with log rank test. RESULTS: A significant intraocular pressure reduction was observed in the TPI and PI groups up to 3 years and up to 1 year and 6 months after surgery, respectively; the magnitude of the reduction was significantly larger in the TPI group up to 3 years after surgery. The success probabilities of TPI group for intraocular pressure control under 21, 17, and 15 mm Hg were 95.8%, 58.7%, and 30.0%, respectively, 1 year after surgery, and 84.9%, 29.5%, and 13.5%, respectively, 3 years after surgery; the success probabilities were significantly higher than those of the PI group. Of 105 eyes, 104 (99.0%) had visual acuity equal to or better than the baseline acuity 3 months after combined trabeculotomy and cataract surgery. CONCLUSION: Combined trabeculotomy and cataract surgery normalizes intraocular pressure and improves visual acuity in adults with glaucoma and coexisting cataract.