0000000000010430
AUTHOR
Hagen Thieme
Optical coherence tomography of macular thickness after biaxial vs coaxial microincision clear corneal cataract surgery
PURPOSE To evaluate macular thickness changes after biaxial microincision versus coaxial small incision cataract surgery using optical coherence tomography (OCT). METHODS This prospective, randomized, marked study comprised 70 patients (70 eyes) undergoing biaxial microincision surgery or conventional coaxial phacoemulsification. Patients were evaluated by Stratus OCT preoperatively and 1 day, 4 weeks, and 8 weeks postoperatively. Best-corrected visual acuity (BCVA), phacoemulsification power, and effective phacoemulsification time (EPT) were evaluated. RESULTS In the biaxial group, median foveal thickness changed from 160 microm preoperatively to 168 microm 8 weeks postoperatively (p=0.018…
Histopathologic Findings in Early Encapsulated Blebs of Young Patients Treated With the Ahmed Glaucoma Valve
Objective/aim Uncontrolled glaucoma presents a challenge for the ophthalmic surgeon especially in children and juvenile patients. For many patients who have undergone failed surgical procedures before, episcleral implants remain the last choice. Encapsulated blebs forming over antiglaucoma devices present a complication leading to malfunctioning or even failure with reincrease in intraocular pressure. We report our histopathologic findings of such blebs developing around the Ahmed glaucoma valve (AGV) after a short time period in young patients. Materials and methods Nine young patients (2 to 17 y of age) with otherwise uncontrollable glaucoma were treated with AGV (models FP-7 and FP-8, si…
Endothelin Antagonism: Effects of FP Receptor Agonists Prostaglandin F2αand Fluprostenol on Trabecular Meshwork Contractility
Purpose This study analyzes additional mechanisms behind the ocular hypotensive effect of prostaglandin F (PGF) receptor (FP receptor) agonists PGF2alpha and fluprostenol (fluprostenol-isopropyl ester [travoprost]), which reduce intraocular pressure (IOP) in patients with glaucoma probably by enhancing uveoscleral flow. The trabecular meshwork (TM) is actively involved in IOP regulation through contractile mechanisms. Contractility of TM is induced by endothelin (ET)-1, a possible pathogenic factor in glaucoma. The involvement of FP receptor agonists in the ET-1 effects on TM function was studied. Methods The effects of FP receptor agonists on contractility of bovine TM (BTM) were investiga…
Efficacy and tolerability of preservative-free eye drops containing a fixed combination of dorzolamide and timolol in glaucoma patients.
To evaluate the efficacy and tolerability of preservative-free eye drops (dorzolamide/timolol) in routine management of preservative-sensitive glaucoma patients.Data from 2,298 glaucoma patients requiring intraocular pressure (IOP) reduction and suffering from intolerance to benzalkonium chloride or active agents of previously used eye drops were valid for baseline and safety analysis in this prospective, open, noncomparative, multicenter, noninterventional study. Patients were treated with preservative-free dorzolamide/timolol eye drops for 12 weeks. Main efficacy endpoint was IOP reduction after 12 weeks of treatment. Two thousand forty-nine patients were considered for efficacy analysis.…
Surface Topographies of Glaucoma Drainage Devices and Their Influence on Human Tenon Fibroblast Adhesion
PURPOSE. This study was performed to investigate the surface topography of different glaucoma drainage devices and to determine the effects of surface roughness on cell adhesion of cultured human tenon fibroblasts.METHODS. The surface topography of four widely used devices (Ahmed FP7 and Ahmed S-2; New World Medical, Inc., Rancho Cucamonga, CA; Baerveldt BG101-350; Advanced Medical Optics, Irvine, CA; and Molteno S1; Molteno Ophthalmic Ltd., Dunedin, New Zealand) was investigated by scanning electron microscopy, and roughness was quantified by white-light confocal microscopy. Cells were grown for 72 hours on the surfaces of implants affixed to standard culture dishes. The cells were labeled…
Endothelin receptor B in trabecular meshwork
Abstract Endothelin-1 (ET-1), the most potent vasoconstrictor known to date, seems to be involved in the pathogenesis of primary open angle glaucoma. ET-1 was found in different tissues of the eye and in high concentrations in the aqueous humour. The effects of ET-1 are mediated by two receptors, ET-A receptor (ET-AR) and ET-B receptor (ET-BR), which are both expressed in bovine trabecular meshwork (TM). ET-1 induced contraction of TM predominantly by activation of ET-AR. This study analyzes the role of ET-BR in TM function and investigates the synthesis of ET-1 by human TM (HTM) cells. The effect of IRL-1620, a specific ET-BR agonist, on contractility of bovine TM (BTM) was investigated wi…
Current Status of Epibulbar Anti-glaucoma Drainage Devices in Glaucoma Surgery
SUMMARY Background: The term “glaucoma” covers a hetero geneous group of progressive optic neuropathies that are accompanied by characteristic visual-field defects. Primary open-angle glaucoma, the most common type, progresses insidiously and causes blindness if untreated. All current forms of treatment aim at lowering the intraocular pressure (IOP) in patients whose IOP is elevated. The implantation of anti-glaucoma drainage systems is one of the available options for surgical treatment. Methods: This review is based on pertinent literature retrieved by a selective search, including glaucoma treatment guidelines from Germany and abroad. Results: A paradigm shift is currently underway regar…
Efficacy and safety of preoperative IOP reduction using a preservative-free fixed combination of dorzolamide/timolol eye drops versus oral acetazolamide and dexamethasone eye drops and assessment of the clinical outcome of trabeculectomy in glaucoma
Introduction To demonstrate that preoperative treatment for 28 days with topical dorzolamide/timolol is non-inferior (Δ = 4 mm Hg) to oral acetazolamide and topical dexamethasone (standard therapy) in terms of intraocular pressure (IOP) reduction 3 and 6 months after trabeculectomy in glaucoma patients. Materials and methods Sixty-two eyes undergoing trabeculectomy with mitomycin C were included in this monocentric prospective randomized controlled study. IOP change between baseline and 3 months post-op was defined as the primary efficacy variable. Secondary efficacy variables included the number of 5-fluorouracil (5-FU) injections, needlings, suture lyses, preoperative IOP change, hyperten…
Contrast sensitivity after implantation of a spherical versus an aspherical intraocular lens in biaxial microincision cataract surgery.
Purpose To determine whether implantation of a microincision intraocular lens (IOL) with a modified anterior surface, designed to compensate for the positive spherical aberration of the cornea in eyes of cataract patients, results in improved pseudophakic quality of vision in pseudophakic eyes after biaxial microincision phacoemulsification. Setting Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. Methods In a nonrandomized parallel cohort investigation, the visual performance of 52 eyes of 52 patients unilaterally implanted with the aspherical Acri.Smart 36 A IOL (Acri.Tec) were compared with those of 25 eyes of 25 age-matched patients unilaterally implanted with…
Sulcus implantation of a single-piece foldable acrylic intraocular lens after posterior capsular rupture in cataract surgery.
Purpose. To evaluate the safety of a foldable acrylic single-piece intraocular lens (IOL) in cases of complicated cataract surgery and sulcus implantation. The setting was University and private anterior segment surgery practices. Methods. In this observational case series study, 13 eyes of 13 patients were included after complicated phacoemulsification with extensive posterior capsule rupture with or without vitreous loss. A foldable acrylic single-piece IOL (Rayner Superflex 620H; Rayner Intraocular Lenses Limited, Hove, East Sussex, UK) was implanted in the ciliary sulcus in each eye. Postoperative follow-up included best-corrected visual acuity, anterior segment biomicroscopy, IOL centr…