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Glaucoma: HELP
Articles from Minnesota
Based on 98 articles published since 2009

These are the 98 published articles about Glaucoma that originated from Minnesota during 2009-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial Editor's Comment. 2018

Samuelson, Thomas W. ·Minneapolis, Minnesota, USA. ·J Cataract Refract Surg · Pubmed #29502606.

ABSTRACT: -- No abstract --

2 Editorial Glaucoma: Today and Tomorrow. 2016

Lam, Dennis / Lee, Jacky / Jonas, Jost / Leung, Christopher / Park, Ki-Ho / Sit, Arthur / Ritch, Robert. ·From the *Dennis Lam and Partners Eye Center, Hong Kong, China; †C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, China; ‡Zhongshan Ophthalmic Center, Guangzhou, China; §Department of Ophthalmology, Mannheim, Germany; ¶Department of Ophthalmology and Visual Sciences, The Chinese University of Hong; Kong, Hong Kong, China; ∥Seoul National University Hospital, Seoul, South Korea; #Mayo Clinic College of Medicine, Rochester, MN; and **New York Eye and Ear Infirmary of Mount Sinai, New York, NY. ·Asia Pac J Ophthalmol (Phila) · Pubmed #26886113.

ABSTRACT: -- No abstract --

3 Editorial Evaluation and adoption of new technology in glaucoma surgery. 2014

Sit, Arthur J. ·Mayo Clinic, Rochester, Minnesota. Electronic address: sit.arthur@mayo.edu. ·Am J Ophthalmol · Pubmed #24439437.

ABSTRACT: -- No abstract --

4 Review Glaucoma secondary to intraocular tumors: mechanisms and management. 2019

Camp, David A / Yadav, Prashant / Dalvin, Lauren A / Shields, Carol L. ·Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania. · Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA. ·Curr Opin Ophthalmol · Pubmed #30562240.

ABSTRACT: PURPOSE OF REVIEW: Glaucoma secondary to intraocular tumors is important to consider in eyes with a known tumor and those with unilateral or refractory glaucoma. The purpose of this review is to discuss the mechanisms and management of intraocular tumors with related secondary glaucoma. RECENT FINDINGS: Several intraocular tumors can lead to glaucoma, including iris melanoma, iris metastasis, iris lymphoma, trabecular meshwork melanoma, choroidal melanoma, choroidal metastasis, retinoblastoma, and medulloepithelioma. The mechanisms for glaucoma include solid tumor invasion into the angle, tumor seeding into the angle, angle closure, and iris neovascularization. Management of the tumor can lead to resolution of glaucoma. Management of the secondary glaucoma may involve medical therapy, transscleral cyclophotocoagulation, laser trabeculoplasty, and potentially antivascular endothelial growth factor therapy. Minimally invasive glaucoma surgery (MIGS) can be considered for eyes with treated, regressed posterior segment malignancies if there is no iris or ciliary body involvement. Importantly, avoidance of MIGS, filtering, or shunting surgery in eyes with active malignancies is emphasized. SUMMARY: Intraocular tumors can produce secondary glaucoma. Treatment of the primary tumor can sometimes resolve the glaucoma. Topical, oral, or laser therapies can be considered. Avoidance of MIGS, filtering, or shunting surgery is advised until the malignancy is completely regressed.

5 Review The Rationale for Selective Laser Trabeculoplasty in Africa. 2018

Realini, Tony / Olawoye, Olusola / Kizor-Akaraiwe, Nkiru / Manji, Selina / Sit, Arthur. ·West Virginia University Eye Institute, Morgantown, WV. · Department of Ophthalmology, College of Medicine, University of Ibadan, Nigeria. · Enugu State University Teaching Hospital, Enugu, Nigeria. · Global Health Program, McMaster University, Hamilton, Ontario, Canada. · Mayo Clinic, Rochester, MN. ·Asia Pac J Ophthalmol (Phila) · Pubmed #30484574.

ABSTRACT: Glaucoma is the leading cause of irreversible blindness in Africa. The condition is treatable but not curable. There are numerous obstacles to glaucoma care in Africa, including availability, accessibility and affordability of treatments, as well as medication nonadherence among patients. Medical therapy is costly relative to the average income in Africa and it requires daily self-dosing by patients. Surgery is of limited availability in many regions in Africa, and a high proportion of patients refuse surgery because it is expensive. Selective laser trabeculoplasty (SLT) proves to be a favorable alternative to medical or surgical care, as it is highly effective and safe in people of African descent, more cost-effective than medical therapy, quick and easy to perform, and portable. The procedure also requires no postoperative care, thus obviates the issue of nonadherence. In uncontrolled studies, SLT has a high response rate and it lowers intraocular pressure by 30% to 40%, which exceeds the goal in international guidelines for initial therapies. The African Glaucoma Consortium (AGC), a member-driven stakeholder collective, has been formed in part to develop the infrastructure for continent-wide improvements in glaucoma care. It embraces SLT as a potential key tool in their development plans. The mission of AGC includes improving clinical care by educating existing and new health care professionals to expand the provider network, by conducting trials to identify optimal care strategies for glaucoma in Africa, and by facilitating the development of an integrated network of Centers of Excellence to bring SLT and other crucial glaucoma therapies to communities throughout Africa.

6 Review Managing coexistent cataract and glaucoma with iStent. 2017

Larsen, Christine L / Samuelson, Thomas W. ·Minnesota Eye Consultants, P.A., Bloomington, Minnesota, USA. Electronic address: cllarsen@mneye.com. · Minnesota Eye Consultants, P.A., Bloomington, Minnesota, USA. ·Surv Ophthalmol · Pubmed #27217122.

ABSTRACT: The iStent is an intraocular implant that resides within Schlemm canal and allows for direct bypass of the trabecular meshwork by aqueous fluid. It is one of several procedures termed microinvasive glaucoma surgery. The prominence of microinvasive glaucoma surgery is growing because of its role in lowering intraocular pressure in mild to moderate glaucoma combined with its favorable safety profile. With transcleral glaucoma filtering surgery, there is an increased potential for significant complications including hypotony, suprachoroidal hemorrhage, and long-term risk of endophthalmitis. In comparison, the iStent minimizes this risk and has been shown to be similar to cataract surgery in terms of associated complications. As will be discussed, multiple publications have addressed both the safety and efficacy of the implant. This review additionally presents an overview of implantation technique as well as what to expect postoperatively. Looking forward, the second-generation models may ease implantation and the use of multiple stents may potentially play a role in more advanced disease.

7 Review ATP sensitive potassium channel openers: A new class of ocular hypotensive agents. 2017

Roy Chowdhury, Uttio / Dosa, Peter I / Fautsch, Michael P. ·Dept. of Ophthalmology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. Electronic address: roychowdhury.uttio@mayo.edu. · Institute for Therapeutics Discovery and Development, Department of Medicinal Chemistry, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, United States. Electronic address: pidosa@umn.edu. · Dept. of Ophthalmology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. Electronic address: fautsch.michael@mayo.edu. ·Exp Eye Res · Pubmed #27130546.

ABSTRACT: ATP sensitive potassium (K

8 Review Allergic Contact Dermatitis to Ophthalmic Medications: Relevant Allergens and Alternative Testing Methods. 2016

Grey, Katherine R / Warshaw, Erin M. ·From the *University of Minnesota Medical School; †HCMC Parkside Occupational and Contact Dermatitis Clinic; ‡Department of Dermatology, Minneapolis Veterans Affairs Medical Center; and §Department of Dermatology, University of Minnesota Medical School, Minneapolis. ·Dermatitis · Pubmed #27775976.

ABSTRACT: Allergic contact dermatitis is an important cause of periorbital dermatitis. Topical ophthalmic agents are relevant sensitizers. Contact dermatitis to ophthalmic medications can be challenging to diagnose and manage given the numerous possible offending agents, including both active and inactive ingredients. Furthermore, a substantial body of literature reports false-negative patch test results to ophthalmic agents. Subsequently, numerous alternative testing methods have been described. This review outlines the periorbital manifestations, causative agents, and alternative testing methods of allergic contact dermatitis to ophthalmic medications.

9 Review Personalizing Intraocular Pressure: Target Intraocular Pressure in the Setting of 24-Hour Intraocular Pressure Monitoring. 2016

Sit, Arthur J / Pruet, Christopher M. ·From the Department of Ophthalmology, Mayo Clinic, Rochester, MN. ·Asia Pac J Ophthalmol (Phila) · Pubmed #26886115.

ABSTRACT: Determining target intraocular pressure (IOP) in glaucoma patients is multifaceted, requiring attention to many different factors such as glaucoma type, severity of disease, age, race, family history, corneal thickness and hysteresis, and initial IOP. Even with all these variables accounted for, there are still patients who have progression of the disease despite achieving target IOP. Intraocular pressure variability has been identified as a potential independent risk factor for glaucoma progression but is currently difficult to quantify in individual patients. New technologies enabling measurement of both diurnal and nocturnal IOP may necessitate modifying our concept of target pressure.

10 Review Aqueous humor outflow: dynamics and disease. 2015

Roy Chowdhury, Uttio / Hann, Cheryl R / Stamer, W Daniel / Fautsch, Michael P. ·Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States. · Department of Ophthalmology, Duke University, Durham, North Carolina, United States. ·Invest Ophthalmol Vis Sci · Pubmed #26024085.

ABSTRACT: -- No abstract --

11 Review Intraocular pressure variations: causes and clinical significance. 2014

Sit, Arthur J. ·Department of Ophthalmology, Mayo Clinic, Rochester, Minn.. Electronic address: sit.arthur@mayo.edu. ·Can J Ophthalmol · Pubmed #25433736.

ABSTRACT: Reduction of intraocular pressure (IOP) is the only known effective treatment for glaucoma. However, IOP is a highly variable and dynamic parameter, undergoing virtually constant changes from numerous factors, including body position and circadian rhythms. Despite this variability, evidence for the efficacy of IOP reduction in glaucoma is based on studies designed to assess mean IOP and not IOP variations. Post hoc analysis of data from major clinical trials has suggested that IOP variations may be an independent risk factor for the development of glaucoma or glaucomatous progression, at least in some patients, but the evidence is incomplete and further studies are required. In the interim, judicious selection of existing therapies can help to minimize IOP variations. In general, therapies that improve outflow instead of suppressing aqueous humor production result in more stable IOP. However, new technology to allow better monitoring of IOP, ideally in a continuous 24-hour manner, is required to fully understand the role of IOP variations in glaucoma.

12 Review Effects of prostaglandin analogues on aqueous humor outflow pathways. 2014

Winkler, Nelson S / Fautsch, Michael P. ·1 Mayo Clinic College of Medicine , Rochester, Minnesota. ·J Ocul Pharmacol Ther · Pubmed #24359106.

ABSTRACT: Elevated intraocular pressure (IOP) is the most prevalent risk factor for glaucoma. All treatments, whether surgical or pharmaceutical, are aimed at lowering IOP. Prostaglandin analogues are a first line therapy for glaucoma due to their ability to reduce IOP, once-daily dosing, efficacy, and minimal side-effect profile. Whereas prostaglandin analogues have been known to alter aqueous humor outflow through the unconventional (uveoscleral) pathway, more recent evidence suggests their action also occurs through the conventional (trabecular) pathway. Understanding how prostaglandin analogues successfully lower IOP is important, as this information may lead to the discovery of new molecular targets for future therapeutic intervention. This review explores the current understanding of prostaglandin analogue biology as it pertains to IOP reduction and improved aqueous humor outflow facility.

13 Review Control of outflow resistance by soluble adenylyl cyclase. 2014

Lee, Yong Suk / Marmorstein, Alan D. ·Department of Ophthalmology, Mayo Clinic , Rochester, Minnesota. ·J Ocul Pharmacol Ther · Pubmed #24320087.

ABSTRACT: Abstract Glaucoma is a leading cause of blindness in the United States affecting as many as 2.2 million Americans. All current glaucoma treatment strategies aim to reduce intraocular pressure, even in patients with normal tension glaucoma. Typically, this is accomplished by reducing the rate of aqueous flow by limiting aqueous production or enhancing drainage using drugs and surgery. Whereas these strategies are effective in diminishing vision loss, some patients continue to lose vision and many discontinue use of their medications because of undesirable side effects. Drugs known to be effective in altering conventional outflow have for the most part been abandoned from modern clinical practice due to undesirable side effects. Identification of new drugs that could enhance conventional outflow, would offer additional options in the treatment of glaucoma and ocular hypertension. To this end, our laboratory has recently uncovered a novel pathway for regulation of conventional outflow by the ciliary body. This pathway is dependent on soluble adenylyl cyclase, an enzyme that catalyzes the generation of cyclic adenosine 3',5' monophosphate (cAMP) in response to bicarbonate.

14 Review Endoscopic ophthalmic surgery of the anterior segment. 2014

Francis, Brian A / Kwon, Julie / Fellman, Ronald / Noecker, Robert / Samuelson, Thomas / Uram, Martin / Jampel, Henry. ·Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California. Electronic address: bfrancis@usc.edu. · University of Medicine and Dentistry New Jersey-Robert Wood Johnson Medical School, Piscataway, New Jersey. · Glaucoma Associates of Texas, Dallas, Texas. · Ophthalmic Consultants of Connecticut, Fairfield, Connecticut. · Minnesota Eye Consultants, Minneapolis, Minnesota. · Retina Consultants of New Jersey, Attending Surgeon, Manhattan Eye, Ear and Throat Hospital, New York, New York. · Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland. ·Surv Ophthalmol · Pubmed #23931901.

ABSTRACT: We summarize the uses of anterior segment endoscopic techniques and the basic science and technology of endoscopic cyclophotocoagulation (ECP) as compared with transscleral cyclophotocoagulation. This is followed by an analysis of patient selection for ECP, a description of surgical techniques, and clinical results. In addition, the ophthalmic endoscope has other uses in anterior segment surgeries. We discuss the techniques for these endoscope-assisted surgeries.

15 Review Measurement of episcleral venous pressure. 2011

Sit, Arthur J / McLaren, Jay W. ·Department of Ophthalmology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, United States. sit.arthur@mayo.edu ·Exp Eye Res · Pubmed #21621536.

ABSTRACT: Episcleral venous pressure (EVP) is an important determinant of intraocular pressure (IOP) and can be measured by using various techniques. It has been measured non-invasively by estimating the pressure required to compress an episcleral vein to a predetermined endpoint. However, the lack of objective endpoints makes EVP measurement in humans uncertain, and a wide range of mean EVP has been reported in the literature. We review the evidence for physiologic regulation of EVP and its role in glaucoma therapy, techniques that have been used to measure EVP and the need for objective measurements, and reported values for EVP. We also review recent progress toward developing an objective technique for EVP measurement.

16 Review Pathophysiology of glaucoma and continuous measurements of intraocular pressure. 2009

Sit, Arthur J / Liu, John H K. ·Department of Ophthalmology, Mayo Clinic, Rochester, USA. ·Mol Cell Biomech · Pubmed #19382536.

ABSTRACT: Glaucoma is a leading cause of visual impairment and blindness worldwide. The main risk factor for glaucoma is an elevated intraocular pressure (IOP), which is also the only currently treatable risk factor. Despite its importance, our understanding of IOP is incomplete and our ability to measure IOP is limited. IOP is known to undergo both random fluctuations as well as variations following a circadian pattern. In humans, IOP is highest at night and lower during the daytime, largely due to changes in body position, although other factors appear to contribute. In rabbits, IOP is also highest at night and lower during the day, likely due to circadian variations in sympathetic nervous system activity. Random and circadian IOP variations may be important to glaucoma pathogenesis, independent of the diurnal IOP level. However, due to limitations with current IOP measurement technology, clinical practice typically involves only a few IOP measurements per year. As well, current technology does not allow 24-hour monitoring of pressure without the use of sleep laboratories or hospital admission. Two strategies for automating IOP measurement are temporary (non-invasive) monitoring and permanent (implantable) monitoring. Efforts at developing devices to allow continuous IOP monitoring have occurred for over 40 years without producing a clinical device. Current technological progress would seem to suggest that such devices are possible at this time, and a review of previous attempts provides guidelines for their development.

17 Clinical Trial Implantation of two second-generation trabecular micro-bypass stents and topical travoprost in open-angle glaucoma not controlled on two preoperative medications: 18-month follow-up. 2017

Berdahl, John / Voskanyan, Lilit / Myers, Jonathan S / Hornbeak, Dana M / Giamporcaro, Jane Ellen / Katz, L Jay / Samuelson, Thomas W. ·Vance Thompson Vision, Sioux Falls, South Dakota, USA. · S.V. Malayan Ophthalmology Centre, Yerevan, Armenia. · Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania, USA. · Glaukos Corporation, San Clemente, California, USA. · Minnesota Eye Consultants, Minneapolis, Minnesota, USA. ·Clin Exp Ophthalmol · Pubmed #28384377.

ABSTRACT: IMPORTANCE: Additional data are sought regarding treatment options for glaucoma, a major cause of global blindness. BACKGROUND: The study assessed outcomes following standalone implantation of two second-generation trabecular micro-bypass stents and postoperative topical prostaglandin in eyes with open-angle glaucoma not controlled on two preoperative medications. DESIGN: The study design is a prospective, nonrandomized, open-label study at a tertiary-care ophthalmology centre. PARTICIPANTS: Subjects had open-angle glaucoma with preoperative intraocular pressure of 18-30 mmHg on two medications, a medication washout phase, and post-washout intraocular pressure of 22-38 mmHg. All subjects (N = 53) have been followed for 18 months. METHODS: One day following implantation of two second-generation trabecular micro-bypass stents, subjects started topical travoprost. Medication washout was repeated at month 12. MAIN OUTCOME MEASURES: The main outcome measure was the proportion of eyes with intraocular pressure reduction ≥ 20% versus medicated baseline intraocular pressure with reduction of one medication at 12 months. RESULTS: At 12 months, 91% of eyes achieved intraocular pressure reduction ≥ 20% with reduction of one medication. All eyes had intraocular pressure ≤ 18 mmHg with reduction of one medication, and 87% had intraocular pressure ≤ 15 mmHg. Mean intraocular pressure on one medication was ≤ 13.0 mmHg (≥ 34% reduction) through 18 months. Mean post-washout intraocular pressure at month 13 was 33% lower than preoperative unmedicated intraocular pressure. No adverse events occurred through 18 months. CONCLUSIONS AND RELEVANCE: In open-angle glaucoma eyes on two preoperative medications, treatment with two second-generation trabecular stents and one postoperative prostaglandin resulted in mean intraocular pressure ≤ 13 mmHg with reduction of one medication, with favourable safety. These findings show the utility of second-generation trabecular bypass with postoperative prostaglandin in patients with open-angle glaucoma.

18 Clinical Trial Outcomes Following Implantation of Two Second-Generation Trabecular Micro-Bypass Stents in Patients with Open-Angle Glaucoma on One Medication: 18-Month Follow-Up. 2016

Lindstrom, Richard / Lewis, Richard / Hornbeak, Dana M / Voskanyan, Lilit / Giamporcaro, Jane Ellen / Hovanesian, John / Sarkisian, Steven. ·Minnesota Eye Consultants, Minneapolis, MN, USA. rllindstrom@mneye.com. · Sacramento Eye Consultants, Sacramento, CA, USA. · Glaukos Corporation, San Clemente, CA, USA. · S.V. Malayan Ophthalmology Centre, Yerevan, Armenia. · Harvard Eye Associates, Laguna Hills, CA, USA. · Dean A. McGee Eye Institute, University of Oklahoma Health Science Center, Oklahoma City, OK, USA. ·Adv Ther · Pubmed #27739003.

ABSTRACT: INTRODUCTION: The study objective was to evaluate the intraocular pressure (IOP) and medication-lowering effect of 2 second-generation trabecular micro-bypass stents in eyes with open-angle glaucoma (OAG) on one preoperative medication. METHODS: Fifty-seven qualified phakic eyes with OAG on 1 medication, preoperative medicated IOP of 18-30 mmHg, and preoperative unmedicated (post-washout) IOP of 22-38 mmHg underwent implantation of 2 second-generation trabecular micro-bypass stents in a standalone procedure. Evaluations included IOP, best-corrected visual acuity, medication use, fundus and slit lamp examinations, visual field, cup to disc ratio, pachymetry, and complications and interventions. Subjects have been followed for 18 months, and follow-up is ongoing. RESULTS: At Month 12 postoperative, 100% of eyes had achieved an IOP reduction ≥20% (100% had IOP ≤18 mmHg and 67% had IOP ≤15 mmHg) without medication versus preoperative unmedicated IOP, and 75% had IOP reduction ≥20% without medication versus preoperative medicated IOP. The Month 12 mean unmedicated IOP had decreased by 42%, to 14.2 ± 1.9 mmHg vs 24.4 ± 1.3 mmHg preoperatively, and this reduction was maintained through 18 months (14.4 ± 2.1 mmHg). A high safety profile was observed. CONCLUSION: In this prospective, open-label, single-arm study, the standalone implantation of two second-generation trabecular micro-bypass stents in OAG patients on 1 preoperative medication resulted in IOP reduction to ≤15 mmHg and elimination of medication through 18 months, with favorable safety. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT02868190. FUNDING: Glaukos Corporation, San Clemente, CA.

19 Clinical Trial Intraocular pressure in eyes receiving monthly ranibizumab in 2 pivotal age-related macular degeneration clinical trials. 2014

Bakri, Sophie J / Moshfeghi, Darius M / Francom, Steve / Rundle, Amy Chen / Reshef, Daniel S / Lee, Paul P / Schaeffer, Carol / Rubio, Roman G / Lai, Phillip. ·Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota. Electronic address: bakri.sophie@mayo.edu. · Horngren Family Vitreoretinal Center, Department of Ophthalmology, Byers Eye Institute at Stanford University, Stanford University School of Medicine, Palo Alto, California. · Genentech, Inc., South San Francisco, California. · Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan. ·Ophthalmology · Pubmed #24393349.

ABSTRACT: PURPOSE: To characterize preinjection intraocular pressure (IOP) in eyes receiving monthly ranibizumab versus sham or verteporfin photodynamic therapy (PDT) for age-related macular degeneration (AMD). DESIGN: Post hoc analysis of IOP data from 2 phase 3 clinical trials, the Minimally Classic/Occult Trial of the Anti-VEGF Antibody Ranibizumab in the Treatment of Neovascular AMD (MARINA) and the Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal Neovascularization in AMD (ANCHOR) trial. PARTICIPANTS: All safety-evaluable patients who received 1 or more injections of sham or PDT or of ranibizumab and had 1 or more postbaseline IOP measurements recorded for the study eye. METHODS: Preinjection IOP measurements for study eyes (n = 1125) and fellow eyes in MARINA and ANCHOR at baseline and at each monthly visit through month 24 were analyzed. MAIN OUTCOME MEASURES: End points evaluated were maximum preinjection IOP during the 24-month treatment period; any occurrence of absolute preinjection IOP of 21 mmHg or more, 25 mmHg or more, or 30 mmHg or more; any occurrence of IOP increase of 6 mmHg or more, 8 mmHg or more, or 10 mmHg or more from baseline; any combination of IOP increase of 6 mmHg or more or 8 mmHg or more from baseline with concurrent absolute preinjection IOP of 21 mmHg or more or 25 mmHg or more; glaucoma-related adverse events; new glaucoma medications used for 45 days or more; and glaucoma filtration or laser surgeries. RESULTS: Across treatment groups, 60.1% to 70.9% of study eyes had a maximum preinjection IOP of less than 21 mmHg. Comparing ranibizumab 0.5 mg versus sham or PTD treatment, respectively: 39.9% versus 29.1% and 10.9% versus 5.1% had maximum preinjection IOPs of 21 mmHg or more or 25 mmHg or more, respectively; 44.1% versus 29.9% and 24.2% versus 13.6% had IOP increases from baseline of 6 mmHg or more or 8 mmHg or more, respectively; 26.1% versus 13.6% and 16.8% versus 9.0% had 1 or more IOP increase from baseline of 6 mmHg or more or 8 mmHg or more, respectively, with a concurrent IOP of 21 mmHg or more; 9.6% versus 3.7% and 7.5% versus 2.4% had 1 or more IOP increase from baseline of 6 mmHg or more or 8 mmHg or more, respectively, with a concurrent IOP of 25 mmHg or more. No differences were observed in fellow eyes. CONCLUSIONS: Most ranibizumab-treated eyes did not experience sustained preinjection IOP of 21 mmHg or more (>2 consecutive visits) over 24 months. When evaluating the combined IOP end point, more ranibizumab-treated eyes had 1 or more IOP increase from baseline of 6 mmHg or more or 8 mmHg or more, with concurrent highest IOPs of 21 mmHg or more and 25 mmHg or more versus sham or PDT. Intraocular pressure should be monitored in eyes receiving ranibizumab.

20 Article Corneal Endothelial Cell Density and Morphology After Phacoemulsification in Patients With Primary Open-Angle Glaucoma and Cataracts: 2-Year Results of a Randomized Multicenter Trial. 2019

Ianchulev, Tsontcho / Lane, Stephen / Masis, Marisse / Lass, Jonathan H / Benetz, Beth Ann / Menegay, Harry J / Price, Francis W / Lin, Shan. ·New York Eye and Ear Infirmary of Mount Sinai, New York, NY. · Alcon, Fort Worth, TX. · Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota. · University of California San Francisco, San Francisco, CA. · Cornea Image Analysis Reading Center, University Hospitals Eye Institute, Cleveland, OH. · Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH. · Cornea Research Foundation of America, Indianapolis, IN. ·Cornea · Pubmed #30614901.

ABSTRACT: PURPOSE: To evaluate corneal endothelial cell density (ECD) and morphology 2 years after phacoemulsification in subjects from the COMPASS trial (ClinicalTrials.gov, NCT01085357) who had mild-to-moderate primary open-angle glaucoma and visually significant cataracts. METHODS: The central corneal endothelium was evaluated by serial specular microscopy at 0 to 24 months. ECD, coefficient of variation, and percentage of hexagonal cells were evaluated by a central image analysis reading center and central corneal thickness (CCT) was evaluated by ultrasound pachymetry. RESULTS: Of 131 subjects who underwent routine phacoemulsification, analyzable endothelial images at 24 months were available for 126 subjects (96.2%). Mean ± SD central ECD at baseline was 2453 ± 359 cells/mm, decreasing by 10% ± 14% to 2195 ± 517 cells/mm at 3 months (P < 0.001) but stabilizing thereafter with mean endothelial cell loss (ECL) from baseline to 24 months of 9% ± 13% (P < 0.001). Twelve (9.5%) and 10 (7.9%) subjects experienced >30% ECL at 12 and 24 months, respectively. Neither coefficient of variation nor percentage of hexagonal cells changed significantly from baseline at any time point. Mean CCT was similar at baseline (550 ± 35 μm) and at 12 months (551 ± 37 μm) and 24 months (555 ± 35 μm). Age was significantly associated with ECL after cataract surgery (P = 0.02), but baseline intraocular pressure, number of glaucoma medications, and CCT were not. Similar results were observed in patients who underwent CyPass micro-stent implantation accompanying phacoemulsification. CONCLUSIONS: Phacoemulsification in eyes with mild-to-moderate primary open-angle glaucoma results in early ECL, with ECD stabilizing after 3 months and no effect on other endothelial stress markers up to 2 years postoperatively.

21 Article A Schlemm Canal Microstent for Intraocular Pressure Reduction in Primary Open-Angle Glaucoma and Cataract: The HORIZON Study. 2019

Samuelson, Thomas W / Chang, David F / Marquis, Robert / Flowers, Brian / Lim, K Sheng / Ahmed, Iqbal Ike K / Jampel, Henry D / Aung, Tin / Crandall, Alan S / Singh, Kuldev / Anonymous971526. ·University of Minnesota, Minnesota Eye Consultants, Minneapolis, Minnesota. Electronic address: twsamuelson@mneye.com. · Altos Eye Physicians, Los Altos, California. · Texan Eye and Keystone Research, Austin, Texas. · Ophthalmology Associates, Fort Worth, Texas. · Department of Ophthalmology, St. Thomas Hospital, London, United Kingdom. · Department of Ophthalmology, University of Toronto, Toronto, Canada. · Wilmer Eye Institute, Baltimore, Maryland. · Singapore National Eye Center, Singapore. · Moran Eye Center, University of Utah, Salt Lake City, Utah. · Stanford University, Stanford, California. ·Ophthalmology · Pubmed #29945799.

ABSTRACT: OBJECTIVE: To compare cataract surgery with implantation of a Schlemm canal microstent with cataract surgery alone for the reduction of intraocular pressure (IOP) and medication use after 24 months. DESIGN: Prospective, multicenter, single-masked, randomized controlled trial. PARTICIPANTS: Subjects with concomitant primary open-angle glaucoma (POAG), visually significant cataract, and washed-out modified diurnal IOP (MDIOP) between 22 and 34 mmHg. METHODS: Subjects were randomized 2:1 to receive a single Hydrus Microstent (Ivantis, Inc, Irvine, CA) in the Schlemm canal or no stent after uncomplicated phacoemulsification. Comprehensive eye examinations were conducted 1 day, 1 week, and 1, 3, 6, 12, 18, and 24 months postoperatively. Medication washout and MDIOP measurement were repeated at 12 and 24 months. MAIN OUTCOME MEASURES: The primary and secondary effectiveness end points were the proportion of subjects demonstrating a 20% or greater reduction in unmedicated MDIOP and change in mean MDIOP from baseline at 24 months, respectively. Hypotensive medication use was tracked throughout the course of follow-up. Safety measures included the frequency of surgical complications and adverse events. RESULTS: A total of 369 eyes were randomized after phacoemulsification to Hydrus Microstent (HMS) and 187 to no microstent (NMS). At 24 months, unmedicated MDIOP was reduced by ≥20% in 77.3% of HMS group eyes and in 57.8% of NMS group eyes (difference = 19.5%, 95% confidence interval [CI] 11.2%-27.8%, P < 0.001). The mean reduction in 24-month unmedicated MDIOP was -7.6±4.1 mmHg (mean ± standard deviation) in the HMS group and -5.3±3.9 mmHg in the NMS group (difference = -2.3 mmHg; 95% CI, -3.0 to -1.6; P < 0.001). The mean number of medications was reduced from 1.7±0.9 at baseline to 0.3±0.8 at 24 months in the HMS group and from 1.7±0.9 to 0.7±0.9 in the NMS group (difference = -0.4 medications; P < 0.001). There were no serious ocular adverse events related to the microstent, and no significant differences in safety parameters between the 2 groups. CONCLUSIONS: This 24-month multicenter randomized controlled trial demonstrated superior reduction in MDIOP and medication use among subjects with mild-to-moderate POAG who received a Schlemm canal microstent combined with phacoemulsification compared with phacoemulsification alone.

22 Article Efficacy and safety of ab interno trabeculectomy in juvenile open-angle glaucoma. 2018

Arora, Sourabh / Maeda, Masahiro / Francis, Brian / Maeda, Mariko / Sit, Arthur J / Mosaed, Sameh / Nazarali, Samir / Damji, Karim F. ·Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta. · Yasuma Eye Clinic, Nagoya, Japan. · Department of Ophthalmology, University of Southern California, Los Angeles, CA. · Maeda Eye Clinic, Osaka, Japan. · Department of Ophthalmology, Mayo Clinic, Rochester, MN. · Department of Ophthalmology University of California Irvine, Irvine, CA. · Faculty of Medicine, University of Ottawa, Ottawa, Ont. · Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta.. Electronic address: kdamji@ualberta.ca. ·Can J Ophthalmol · Pubmed #30340716.

ABSTRACT: OBJECTIVE: To determine the efficacy and safety of ab interno trabeculectomy with Trabectome in juvenile open-angle glaucoma (JOAG) patients. DESIGN: Prospective cohort study. METHODS: Evaluation of the 12-month results of 2 patient groups receiving ab interno trabeculectomy: group 1, eyes with no prior incisional surgery; group 2, eyes that had prior incisional cataract or glaucoma surgery. RESULTS: Group 1, 40 eyes (average age 31 ± 7 years), had a significant reduction in intraocular pressure (IOP) of 10.6 mm Hg at 12 months from a baseline of 27.4 mm Hg (p = 0.01), and the number of glaucoma medications reduced by 0.4 (p = 0.80). Four eyes (10%) within the study period required a secondary glaucoma surgery. Group 2, 20 eyes (average age 27 ± 8 years), had a significant reduction in IOP of 8.8 mm Hg from a baseline of 27.1 mm Hg (p = 0.06), and the number of glaucoma medications reduced by 1.4 (p = 0.36). Five eyes (25%) from this group underwent a secondary glaucoma surgery within 12 months. CONCLUSION: After 1 year of follow-up, ab interno trabeculectomy appears to be an effective and safe intervention for patients with JOAG; however, a reduction in use of topical medications may not be observed in those receiving ab interno trabeculectomy as a primary procedure.

23 Article Ex-PRESS Shunt Extrusion upon Globe Palpation. 2018

Starr, Matthew R / Shah, Saumya M / Balasubramaniam, Saranya C. ·Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota. · Mayo Clinic School of Medicine, Rochester, Minnesota. ·Ophthalmology · Pubmed #30318039.

ABSTRACT: -- No abstract --

24 Article Healthcare Utilization by Glaucoma Patients in a Team Care Model. 2018

Damento, Gena M / Winkler, Nelson S / Hodge, David O / Khanna, Sunil S / Khanna, Cheryl L. ·a Department of Ophthalmology , Mayo Clinic , Rochester , MN , USA. · b Mayo Clinic , Jacksonville , FL , USA. ·Semin Ophthalmol · Pubmed #30240281.

ABSTRACT: PURPOSE: To determine the effect of a glaucoma team care model on resource utilization and efficiency in glaucoma management. METHODS: Retrospective cohort study of 358 patients diagnosed and treated for glaucoma. Analysis included number of patient visits, diagnostic tests, and glaucoma procedures performed before (2005-2007) and after (2008-2010) implementation of a team care model in 2008. Patients not involved in the model served as controls. RESULTS: Number of patient visits did not change significantly after model implementation (p > .05). Diagnostic tests significantly increased in comprehensive ophthalmologist and glaucoma subspecialist groups 25 months after diagnosis (p = .03 and p = .001). Procedures increased for glaucoma subspecialists but was not statistically significant (p = .06). Optometrists used billing codes with significantly lower reimbursement than other providers (p < .001). CONCLUSIONS: Team care model had neutral effect on patient visits and increased testing. Continued evaluation of this model is required to determine its effect on disease progression and outcomes.

25 Article July consultation #2. 2018

Samuelson, Thomas W. ·Minneapolis, Minnesota, USA. ·J Cataract Refract Surg · Pubmed #30055696.

ABSTRACT: -- No abstract --