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Purpose: We investigated the effect of enhanced monofocal intraocular lenses (IOL) (TECNIS Eyhance DIB00V) on retinal sensitivity in glaucoma patients after cataract surgery by comparing results with of such patients implanted with non-enhanced monofocal intraocular lenses (TECNIS ZCB00V). Patients and methods: This was a multi-facility retrospective study of glaucoma patients who had undergone cataract surgery. We measured the value of the foveal threshold with a Humphrey visual field analyzer before and after cataract surgery and considered this value to represent the sensitivity of the retina. As a sub-analysis, we also compared the mean deviation (MD), pattern standard deviation (PSD), thickness of ganglion cell complex (GCC), and best corrected visual acuity (BCVA) before and after surgery. We used t-tests to determine statistical differences between lens groups. Results: We included 60 glaucoma patients (104 eyes) who underwent cataract surgery: enhanced group, n = 58 eyes; non-enhanced group, n = 46 eyes. In both groups, cataract surgery improved the retinal sensitivity (p < 0.001), MD (p < 0.001) and BCVA (p < 0.001). The postoperative foveal thresholds did not significantly differ by lens type (p = 0.673), at 34.41 ± 2.44 dB in the enhanced group and 34.61 ± 2.19 dB in the non-enhanced group. Likewise, there was no significant difference (p = 0.942) among advanced glaucoma patients, with postoperative foveal thresholds of 33.08 ± 2.35 dB and 33.17 ± 3.45 dB in the enhanced and non-enhanced, respectively. Conclusions: Implantation of enhanced monofocal IOLs in glaucoma patients did not result in any apparent loss of sensitivity compared with non-enhanced monofocal lens implantation. [ABSTRACT FROM AUTHOR]

Purpose: We compared corneal endothelial cell (CED) loss after Ex-Press (EXP) surgery between patients with primary open-angle glaucoma (POAG) and pseudo-exfoliation glaucoma (PEX). Patients and methods: This was a single-facility retrospective study. We included glaucoma patients who had undergone EXP surgery and were followed up > 3 years. We measured the CED before and after (at 12, 24, and 36 months) EXP surgery by noncontact specular microscopy and compared the means of the CED values and CED survival ratios after EXP surgery by paired t-test. Results: We included 119 eyes that underwent EXP surgery, including 60 POAG eyes and 59 PEX eyes. In the POAG group, the mean CED decreased from 2389 ± 321 at baseline to 2230 ± 424 cells/mm2 after 3 years. In the PEX group, the mean CED decreased from 2111 ± 510 at baseline to 1845 ± 628 cells/mm2 after 3 years. At the 3-year follow-up, the CED survival ratio was 93.3 ± 12.5% in the POAG group and significantly lower, at 85.0 ± 19.5%, in the PEX group (p = 0.0064). Two cases in the PEX group developed bullous keratopathy. Conclusions: EXP surgery decreased the corneal endothelial cell populations in PEX patients faster than POAG patients. [ABSTRACT FROM AUTHOR]

Purpose: We treated two patients with ciliary detachment due to an ab interno trabeculotomy. The ciliary detachment was improved by the use of sulfur hexafluoride (SF6) gas or octafluoro propane (C3F8) tamponade. Patients and Methods: Patient 1 was a 52-year-old Brazilian man with primary open angle glaucoma (POAG). His preoperative intraocular pressure (IOP) was 29 mmHg. Patient 2 was a 57-year-old Japanese woman with POAG. Her preoperative IOP was 35 mmHg. Both patients underwent an ab interno trabeculotomy with a microhook. They caused ciliary detachment as a postoperative complication. We could observe their ciliary detachment with anterior segment optical coherence tomography (AS-OCT). Hypotony persisted for 2 months and the patients' ciliary detachment had not improved. They each underwent a pars plana vitrectomy (PPV) with simultaneous 20% SF6 filling. Results: In Patient 1, the use of the SF6 gas tamponade successfully attached the ciliary body. His IOP was increased to 30 mmHg after this resolution of the ciliary detachment. He underwent additional tube shunt surgery. For Patient 2, the SF6 gas tamponade improved the ciliary detachment but the ciliary body could not be attached. We injected 0.6 cc of 100% C3F8 gas into the vitreous cavity, and this gas tamponade was able to attach the ciliary body. Conclusion: AS-OCT is very useful to evaluate ciliary detachment. PPV+Gas tamponade can be a treatment option for ciliary detachment. [ABSTRACT FROM AUTHOR]

Purpose: To compare surgical outcomes of Ex-PRESS® (EXP) surgery for primary open-angle glaucoma (POAG) between low preoperative intraocular pressure (IOP) and high preoperative IOP. Methods: This was a retrospective non-randomized study. Seventy-nine POAG patients who underwent EXP surgery and were followed for > 3 years were included. Patients with a preoperative IOP of ≦ 16 mmHg and > 16 mmHg with tolerant glaucoma medications were defined as the low IOP group and the high IOP group, respectively. We compared the surgical outcomes, postoperative IOP and number of glaucoma medications. Success was defined as a postoperative IOP of ≦ 15 mmHg and a reduction of > 20% from the preoperative IOP to the postoperative IOP. Results: EXP surgeries significantly decreased IOPs from 13.2 ± 2.0 to 9.1 ± 2.9 mmHg in the low IOP group (p < 0.001), and from 22.5 ± 4.8 to 12.5 ± 4.0 mmHg in the high IOP group (p < 0.001). The mean postoperative IOP was significantly low in the low IOP group at 3 years (p = 0.0008). Success rates compared using the Kaplan–Meier survival curve were not significantly different (p = 0.449). Conclusions: EXP surgery was useful for POAG patients with a low preoperative IOP. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the risk factors for Ex-Press® (EXP) surgery failure. Patients and methods: This was a retrospective non-randomized study of 98 patients who had undergone EXP and were followed up ≥ 5 years. We investigated the following nine risk factors: age, gender, hypertension, diabetes mellitus (DM), previous glaucoma surgery, type of glaucoma (primary open-angle glaucoma vs. pseudo-exfoliation glaucoma), surgical methods (EXP alone vs. EXP + cataract surgery simultaneously), central corneal thickness (CCT), and preoperative intraocular pressure (IOP). We defined a successful surgery as a postoperative reduction in the IOP ≥ 20% from the preoperative IOP and ≤ 18 mmHg. We determined the risk factors using multivariate cox regression models. Results: Performing EXP significantly decreased the IOP (preoperative: 25.2 ± 8.7, at 5 years: 11.1 ± 4.1). The success ratio of EXP was 67.4% at 5 years. We found no significant risk factors for EXP surgery failure. The p values of the factors were age (p = 0.936), gender (p = 0.0587), hypertension (p = 0.409), DM (p = 0.967), previous glaucoma surgery (p = 0.940), type of glaucoma (p = 0.435) surgical methods (p = 0.521), CCT (p = 0.091), and preoperative IOP (p = 0.082). Conclusions: No preoperative factors that could be used to predict the failure of EXP surgery were identified. EXP can be safely performed for primary open-angle glaucoma and pseudo-exfoliation glaucoma. [ABSTRACT FROM AUTHOR]

Purpose: We compared the corneal endothelial cell loss between trabeculectomy (Trab) and Ex-Press ® surgery (EXP) for low-intraocular pressure (IOP) glaucoma patients., Patients and Methods: This was a single-facility retrospective study. We analyzed the cases of patients with primary open-angle glaucoma (POAG) and pre-operative IOP ≤ 21 mmHg who had undergone Trab or EXP surgery and were followed for >3 years. Noncontact specular microscopy was used to determine the corneal endothelial cell density (CED) before and after Trab or EXP surgery. We measured the CED at 12, 24, and 36 months post-surgery. We compared the CED values and CED survival ratio after both surgeries using paired t-tests., Results: We included 39 eyes that underwent Trab and 36 eyes that underwent EXP surgery. In the Trab group, the mean CED value had decreased from 2333 ± 399 at baseline to 2066 ± 587 cells/mm2 after 3 years. In the EXP group, the mean CED value had decreased from 2320 ± 393 at baseline to 2229 ± 460 cells/mm 2 after 3 years. The survival ratio of CED at >3 years was 89.3 ± 14.2% (Trab group) and 95.6 ± 11.1% (EXP group); compared to the Trab surgery, the EXP surgery thus significantly decreased the CED loss (p = 0.037). No case resulted in bullous keratopathy., Conclusion: Compared to trabeculectomy, Ex-Press ® surgery appears to be a safer surgical method with regard to the endothelial cell loss risk., Competing Interests: No potential conflict of interest was reported by the authors., (© 2024 Otsuka et al.)