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<p>Intraocular Pressure Calculation in Myopic Patients After Laser-Assisted In Situ Keratomileusis</p>
摘要： Background: Corneal refractive surgery is widely used worldwide. Myopia is the most common reason for laser-assisted corneal refractive surgery (LASIK) and one of the risk factors for glaucoma. Intraocular pressure (IOP) measurement becomes variable postoperatively as the results are affected by the decrease in corneal thickness and biomechanics. This prospective clinical case study attempted to establish a simple correction formula for the calculation of IOP in post-LASIK myopic patients. Methods: This study included 300 eyes of 150 patients with myopia and myopic astigmatism as a refractive error who underwent LASIK. IOP was measured preoperatively and 6 months postoperatively. Preoperative and postoperative corneal thickness as well as ablation depth were measured. Statistical analysis was performed to detect the relationship between ablation depth and change in IOP. An attempt was made to construct a correction formula for the calculation of post-LASIK IOP. Results: The age of the patients ranged between 18 and 50 (mean ± SD 34.78±8.8) years. The spherical equivalent of refractive error ranged between ?1.5 and ?10 diopters. The mean IOP decreased signi?cantly from 15.72±2.37 mmHg preoperatively to 11.71±2.24 mmHg postoperatively, with a mean difference of 4±1.75 mmHg (p?0.001). A positive correlation was detected between corneal thickness and IOP difference among patients both preoperatively and postoperatively (p?0.001). A positive correlation was identi?ed between ablation depth and IOP change (p?0.001). The correction formula for IOP was established: Real IOP=4+0.7(preoperative IOP)?0.3(ablation depth). Conclusion: IOP measurements change after corneal refractive surgery with LASIK. A corrected formula may be a good option for the proper calculation of post-LASIK IOP.
关键词： intraocular pressure calculation,Goldmann applanation tonometry,laser in situ keratomileusis,glaucoma,post-LASIK glaucoma
更新于2025-09-16 10:30:52
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Evaluation of the effects of selective laser trabeculoplasty on anterior segment parameters by anterior segment optical coherence tomography
摘要： To prospectively examine the effects of selective laser trabeculoplasty (SLT) on the anterior chamber angle (ACA) and its related parameters using anterior segment-optic coherence tomography (AS-OCT). Fifty eyes of 50 patients with primary open angle glaucoma (POAG) and ocular hypertension were included in the study. AS-OCT was performed before SLT application, immediately after and at 1 day and 1 month. Intraocular pressure (IOP), central corneal thickness (CCT) and anterior chamber depth (ACD) were also recorded and evaluated. No statistically significant difference was determined in ACA and other AS-OCT parameters (AOD, angle opening distance at 500 and 750 mm; TISA, trabecular-iris space area at 500 and 750 mm) before and 1 day after SLT application (p > 0.05). However, a statistically significant increase was determined in both the temporal and nasal ACA, AOD and TISA values between the baseline and day 30 (p < 0.001). No statistically significant change was observed in the CCT or ACD values (p > 0.05). SLT resulted in an increase in ACA, AOD and TISA when evaluated using AS-OCT. We think that this study provides a different perspective concerning the effects of SLT in the angle region and the involved mechanism.
关键词： Selective laser trabeculoplasty,Glaucoma,Anterior segment optical tomography
更新于2025-09-16 10:30:52
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Inner Retinal Changes in Primary Open-Angle Glaucoma Revealed Through Adaptive Optics-Optical Coherence Tomography
摘要： To examine the microstructural changes in the inner nuclear layer (INL) and ganglion cell layer (GCL) in a primary open-angle glaucoma (POAG) subject at 2 timepoints, 4 months apart. This case-control study (1 POAG subject and 1 normal control) used the single cell, 3-dimensional volumetric imaging capability of an adaptive optics-optical coherence tomography-scanning laser ophthalmoscopy system to examine the inner retina. At the area of greatest glaucomatous change in the POAG subject [3-degrees temporal (T), 3-degrees inferior (I), right eye], the GCL was greatly thinned at both timepoints, yet retinal ganglion cell soma remained visible amid a meshwork of capillaries. Microcystic lesions in the INL were visible at both timepoints, ranging in diameter from 8 to 43 μm on day 1 to 11 to 64 μm at 4 months, with an average diameter increase of ～124%. Small hyperre?ective features (not seen in the contralateral eye or control subject) at a depth midway through the INL seemed correlated to the development of microcysts. We demonstrate the ability to image microcystic lesions early in their development and have quanti?ed longitudinal changes. The presence of small hyperre?ective structures at a layer midway through the INL seems to be a precursor to their formation and is a potential biomarker for assessing POAG severity and progression. The adaptive optics imaging system is also able to visualize retinal ganglion cells in this subject, despite severe thinning of the GCL.
关键词： optical coherence tomography,adaptive optics,retinal ganglion cells,microcysts,primary open-angle glaucoma
更新于2025-09-16 10:30:52
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West Indies Glaucoma Laser Study (WIGLS)—2
摘要： To identify factors associated with intraocular pressure (IOP) reduction following selective laser trabeculoplasty (SLT) in Afro-Caribbean people with primary open-angle glaucoma (POAG). Design: This was a prospective stepped-wedge study. Methods: Data were drawn from 72 Afro-Caribbean subjects with POAG participating in the ongoing West Indies Glaucoma Laser Study. Multivariable mixed-model analysis was utilized to develop a predictive model for percent IOP reduction 12 months following SLT. Putative factors (age, sex, site, baseline IOP, prior use of prostaglandin therapy, number of prewashout IOP-lowering medications, central corneal thickness, severity of glaucoma, duration of follow-up, and signs of acute postoperative inflammation) were evaluated in bivariate analysis. Factors significant at P ≤ 0.2 were included in the final model. Right and left eye data were modeled separately. Results: At month 12 following SLT, mean IOP reductions in the West Indies Glaucoma Laser Study were 6.2 to 6.5 mm Hg (29.7% to 31.0%) in right and left eyes. The only factor significant in both eyes (P = 0.0005 in right eyes and P < 0.0001 in left eyes) was time, with IOP reductions being greatest at month 3 and declining slightly over time through month 12. Vertical cup-disc ratio (P = 0.006) and prior prostaglandin therapy (P = 0.004) were significant only in right eyes, and central corneal thickness (P = 0.014) was significant only in left eyes. Factors significant only unilaterally did not approach significance in fellow eyes, suggesting the possibility that these represent type 1 errors. Site (St. Lucia vs. Dominica) was not a significant factor, establishing generalizability of these treatment outcomes to a broader population of African-derived people. Conclusions: This analysis did not identify any subject-specific factors consistently predictive of therapeutic response to SLT. Of note, no factors predicted a suboptimal response. These findings favorably position SLT for broad application as primary therapy in African-derived people with POAG.
关键词： selective laser trabeculoplasty,intraocular pressure,glaucoma,low-income and middle-income countries
更新于2025-09-16 10:30:52
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CO2 Laser-assisted Deep Sclerectomy Combined With Phacoemulsification in Patients With Primary Open-angle Glaucoma and Cataract
摘要： To assess the safety and efficacy of CO2 laser-assisted sclerectomy surgery (CLASS) combined with phacoemulsification in patients with primary open-angle glaucoma (POAG) and visually significant cataracts. This was a prospective, uncontrolled, interventional case series. Seventeen patients (17 eyes) diagnosed with POAG and cataracts were enrolled starting from November 2015. All subjects underwent CLASS combined with phacoemulsification surgery by the same surgeon. After the surgery, all patients were followed for 12 months. The preoperative to postoperative changes in intraocular pressure (IOP), glaucoma medication requirements, best-corrected visual acuity and adverse events were recorded. The results of 17 eyes of 17 patients were included in the statistical analysis. The baseline mean IOP was 23.94 ± 8.57 mm Hg (mean ± SD), and patients used 2.18 ± 0.88 types of antiglaucoma medication. At 12 months postsurgery, the mean IOP was 14.67 ± 2.97 mm Hg, and patients used 0.59 ± 0.87 types of antiglaucoma medication (both P < 0.001). The logarithm of the minimal angle of resolution of the best-corrected visual acuity improved from 0.77 ± 0.42 preoperatively to 0.33 ± 0.47 postoperatively (P < 0.05). Two patients experienced intraoperative perforation accompanied by iris prolapse. One patient exhibited postoperative choroidal detachment. CLASS with phacoemulsification may become a safe and effective intervention for patients with POAG and visually significant cataracts.
关键词： cataract,primary open-angle glaucoma,phacoemulsification,CLASS,laser surgery
更新于2025-09-16 10:30:52
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Neodymium Laser Treatment of IOP Rise Following Ex-press Glaucoma Device Implantation
摘要： To report on the use neodymium laser for treatment of eyes with IOP rise following Ex-Press glaucoma filtration device implantation. We retrospectively examined the medical records of 73 patients who underwent Ex-Press device implantation at four medical institutions between 2007 and 2015 and subsequently developed an IOP rise. Enrollment criteria included patients with POAG on whom post treatment IOP data is available. Indications for treatment with neodymium laser were an IOP above target and a flat bleb. In order to disrupt the presumed micro-blockage, the neodymium laser was aimed at the axial and relief ports of the Ex-Press device. Applanation tonometry measurements were followed up after neodymium treatment for variable time intervals. Success was defined as an IOP < 18 mm Hg at 6 months without further surgical or laser-based glaucoma interventions. 73 charts were reviewed. 20 patients were excluded due to insufficient data or a diagnosis other than POAG. Data from 53 eyes of the remaining 53 patients was analyzed. The mean duration between Ex-Press implantation and rise in IOP requiring neodymium intervention was 34.2 months (range, 1.1 – 67.2). We found a statistically significant immediate IOP lowering effect in all eyes, with a mean IOP drop of 13.34 +/- 8.99 mm Hg, and a mean post treatment IOP of 14.30 ± 8.57 mm Hg (P<0.0001). Of a subset of 43 eyes on which 6 months follow up IOP data was available, 11 eyes required further glaucoma intervention (surgery or laser based); four eyes had an IOP of 18 or greater at 6 months. In the remaining 28 successful eyes, a sustained IOP below 18 mm Hg was observed at 6 months, with a mean pressure of 11.39 ± 4.03 mm Hg (P < 0.0001). Hypotony (IOP < 5) occurred in 3 eyes immediately following treatment and self-resolved by 1 week. Our retrospective case series suggests that neodymium laser is a potential consideration in eyes with sustained IOP rise after Ex-Press device implantation.
关键词： intraocular pressure,neodymium laser,Ex-Press glaucoma filtration device,glaucoma
更新于2025-09-12 10:27:22
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Selective laser trabeculoplasty in enhancing glaucoma care
摘要： Background/Aim There is increasing evidence for using selective laser trabeculoplasty as a first line treatment for chronic open angle glaucoma. The current first-line treatment is pharmacological therapy using eye drops. This study aims to assess the outcomes of selective laser trabeculoplasty in patients with glaucoma and ocular hypertension at a district general hospital and consider its role in reducing cost and treatment burden when treating patients with these conditions. Methods A single centre, retrospective case-note audit involving 58 eyes from 31 patients with a minimum follow-up of 4 months. Results Post selective laser trabeculoplasty, 62% had intraocular pressure <20 mmHg on latest follow up (36/58 eyes). Post selective laser trabeculoplasty, 10 patients (32%) were prescribed one fewer topical medication, while 20 patients (65%) were prescribed the same number of topical medications. Only 1 patient (3%) was prescribed one additional topical medication. Conclusion Selective laser trabeculoplasty is a safe and effective option for managing glaucoma and ocular hypertension. Selective laser trabeculoplasty may represent a cost-effective solution for healthcare providers as compared to pharmacological treatment.
关键词： Patient centred care,Glaucoma,SLT,Cost-effectiveness
更新于2025-09-12 10:27:22
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Transscleral Diode Laser Cyclophotocoagulation
摘要： To compare the outcomes of standard pop-titrated transscleral cyclophotocoagulation (TSCPC) and slow-coagulation TSCPC in the treatment of glaucoma. Design: Retrospective case series. Participants: Seventy-eight eyes with glaucoma of any type or stage that underwent TSCPC as part of their treatment course. Methods: This study compared 52 eyes treated with slow-coagulation TSCPC with 26 eyes treated with standard pop-titrated TSCPC. Patient demographics, treatment course, surgical techniques, settings, and outcomes were assessed. Main Outcome Measures: Visual acuity (VA), intraocular pressure (IOP), and postsurgical complications. Results: The initial mean VA was 1.94 logarithm of the minimum angle of resolution (logMAR; standard deviation [SD], 0.73 logMAR) in the slow-coagulation TSCPC group and 1.71 logMAR (SD, 0.90 logMAR) in the standard TSCPC group (P ? 0.507). Initial IOP was 37 mmHg (SD, 13 mmHg) in the slow-coagulation group and 39 mmHg (SD, 13 mmHg) in the standard group (P ? 0.297). The follow-up periods were 16.36 and 24.68 months for the slow-coagulation and standard groups, respectively (P ? 0.124). Visual acuity remained better than light perception in 71.1% of slow-coagulation TSCPC patients and 65.0% of standard TSCPC patients (P ? 0.599). Intraocular pressure remained less than 20 mmHg in 46% of slow-coagulation TSCPC patients and 44% of standard TSCPC patients (P ? 0.870). The mean number of complications was higher in the standard group (1.46; SD, 1.24) versus the slow-coagulation group (0.62; SD, 0.75; P ? 0.002). The incidence of the need for a second procedure (slow-coagulation group, 28.8%; standard group, 23.1%; P ? 0.588) and maximum number of medications needed to control IOP after surgery (P ? 0.771) were similar between the 2 groups. Conclusions: In this case series, slow-coagulation TSCPC and standard pop-titrated TSCPC resulted in similar VA and IOP outcomes in the treatment of glaucomatous eyes. The complication profiles of the techniques also were comparable, although standard TSCPC showed a higher incidence of prolonged inflammation after surgery. This study suggests that slow-coagulation TSCPC may achieve equivalent control of IOP while reducing the incidence of prolonged postoperative inflammation—a feared complication of TSCPC—when compared with standard pop-titrated TSCPC.
关键词： intraocular pressure,visual acuity,glaucoma,complications,slow-coagulation,transscleral cyclophotocoagulation,standard pop-titrated
更新于2025-09-12 10:27:22
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Crystalline lens changes after selective laser trabeculoplasty in Afro-Caribbean patients with open-angle glaucoma; report 4 of the West Indies Glaucoma Laser Study (WIGLS)
摘要： To characterize changes in nuclear, cortical, and posterior subcapsular lens opacities after selective laser trabeculoplasty (SLT) in Afro-Caribbean eyes with primary open-angle glaucoma (POAG).
关键词： SLT,lens opacities,Afro-Caribbean,open-angle glaucoma,selective laser trabeculoplasty
更新于2025-09-12 10:27:22
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Effect of Anticoagulants and Surgeon-Related Factors on Short-term Outcomes of Laser Peripheral Iridotomy
摘要： To assess the effects of surgeon-related factors on laser peripheral iridotomy (LPI) outcomes by comparing residents and glaucoma specialists, and to look for demographic and clinical predictive factors associated with LPI complications.
关键词： surgeon-related factors,complications,LPI,glaucoma,laser peripheral iridotomy
更新于2025-09-12 10:27:22