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The study compares the efficacy and safety of PreserFlo™ MicroShunt (Santen, Osaka, Japan) and trabeculectomy in eyes with moderate to advanced open-angle glaucoma.In this prospective study, 300 patients (300 eyes) with moderate to advanced open-angle glaucoma were treated with either PreserFlo MicroShunt or trabeculectomy. The implantation of the PreserFlo MicroShunt was performed in 150 eyes (group A) and trabeculectomy was performed in 150 eyes (group B). The efficacy was evaluated by estimating the absolute and qualified success rates using the Kaplan-Meier survival analysis. Results: During the 12-month follow-up period, 81.33% of eyes in group A and 94% in group B reduced intraocular pressure (IOP)20% without glaucoma eye drops. The average IOP 12 months after surgery was 12.89±3.4 mmHg in group A and 11.39±4.5 mmHg in group B, which was significantly lower than the baseline intraocular pressure (group A: 23.47±8.36 mmHg, p=0.00053; group B: 22.03±5.2 mmHg, p= 0.0006). The number of topical medications administered 12 months after ocular surgery was 0.4±0.8 in group A and 0 in group B, compared to 2.5±1.2 in group A and 2.7±0.9 in group B at baseline (group A: p= 0.00091; group B: p= 0.00072). Ten eyes (6.67%) in group A and four eyes (2.67%) in group B were referred for bleb revision due to bleb fibrosis and consequent acute postoperative rise in IOP. Four eyes of group A and two eyes of group B were treated with transscleral cyclophotocoagulation. Five eyes in group B received re-trabeculectomy because of dysfunction of the primary bleb.PreserFlo MicroShunt reduced the number of antiglaucoma agents compared to baseline, but was inferior to trabeculectomy at reducing IOP after 12 months. Additionally, trabeculectomy produced better absolute success rates after 12 months than PreserFlo MicroShunt in the treatment of moderate to advanced open-angle glaucoma.

Background The aim of this study is to review the outcomes of canaloplasty versus canaloplasty combined with phacoemulsification in a retrospective cohort study and to evaluate the efficacy of these methods in terms of intraocular pressure (IOP) lowering effect, postoperative complications and additional glaucoma surgery or reintroduction of medical therapy over a 12-month follow-up. Methods In a retrospective cohort study, 602 eyes with primary open angle glaucoma (POAG) were treated with canaloplasty or canaloplasty combined with phacoemulsification. The results were evaluated separately in two main groups; group A canaloplasty (262 eyes) and group B canaloplasty combined with phaco (322 eyes). Each group was then subdivided into three additional groups according to the severity of glaucoma. The criteria for successful treatment were evaluated between three IOP ranges; IOP ≤ 16 mmHg, 18 mmHg and 21 mmHg. Complete success was considered the percentage of eyes reaching target IOP with no medication and partial success with medication. Groups A and B subgroups were compared using the Kaplan Meier test. Mean IOP, reduction of antiglaucoma agents and additional IOP lowering methods were also evaluated. The follow-up time was 12 months. Statistical significance was set at p

Purpose: To compare the efficacy and safety of PreserFlo (TM) MicroShunt (Santen, Osaka, Japan) combined with phacoemulsification to PreserFlo (TM) MicroShunt as a standalone procedure in eyes with moderate to advanced open-angle glaucoma. Methods: In an observatory, prospective, clinical study, 30 patients (30 eyes) with moderate to advanced angle glaucoma were allocated to either PreserFlo (TM) MicroShunt combined with phacoemulsification (15 eyes; Group A) or PreserFlo (TM) MicroShunt as a standalone procedure (15 eyes; Group B). The follow-up time of the study was 12 months. Results: Average intraocular pressure (IOP) at 12 months was 11.62 +/- 1.6 mmHg in Group A and 13.8 +/- 3.6 mmHg in Group B, which was significantly lower than baseline IOP (Group A: 23.47 +/- 8.99 mmHg, P < 0.001; Group B: 23.4 +/- 8.68 mmHg, P < 0.001). The absolute reduction of IOP within the 12 postoperative months was not significantly different between the two groups (P = 0.056). The number of the topical medications that were administered 12 months after ocular surgery was 0 in Group A and 0.6 +/- 0.8 in Group B, compared to 3.13 +/- 1.02 in Group A (P < 0.001) and 2.4 +/- 1.45 in Group B (P = 0.004) at baseline. Phacoemulsification combined with PreserFlo (TM) MicroShunt significantly reduced the number of antiglaucoma agents after 12 months compared to the standalone procedure (P = 0.026). One eye in Group A was referred for bleb revision due to bleb fibrosis and a consequent acute postoperative rise in IOP. One eye in Group A required transscleral cyclophotocoagulation with MicroPulse (R) laser. One bleb revision was also necessary in Group B at the 4th postoperative week. Endothelial cell density did not significantly change over 12 months in either group (Group A: baseline, 2017.3 +/- 346.8 cells/mm(2); 12 months, 1968.5 +/- 385.6 cells/mm(2); P = 0.38; Group B: baseline, 2134.1 +/- 382.6 cells/mm(2); 12 months, 2094.4 +/- 373.3 cells/mm(2), P = 0.42). The PreserFlo (TM) MicroShunt combined with phacoemulsification produced higher absolute success rates after 12 months in patients with moderate to advanced open-angle glaucoma than the PreserFlo (TM) MicroShunt as standalone procedure (Group A: 80% and Group B: 60%, P = 0.022). Conclusions: In eyes with moderate to advanced open-angle glaucoma, PreserFlo (TM) MicroShunt with or without phacoemulsification is effective in reducing IOP and the number of the antiglaucoma agents with a very small incidence of complications and subsequent glaucoma surgeries. However, adding phacoemulsification to PreserFlo (TM) MicroShunt successfully reduces IOP without the need for ongoing topical medications as are needed after the standalone procedure.

BACKGROUND: Keratoconus is a slowly progressive ectatic deformity of the cornea with a prevalence of 200 to 400 cases per 100 000 persons. The cornea is thinner than normal and irregularly warped; irregular astigmatism and myopia result. Riboflavin-UVA crosslinking (collagen cross-linking) makes corneal tissue more rigid through a photochemical effect and can stop the progression of the disease. METHODS: This review is based on relevant publications retrieved by a selective search in Medline, as well as on meta-analyses, Cochrane Reviews, and reports of national and international health care institutions. RESULTS: Pertinent randomized controlled trials (RCTs) have shown that cross-linking prevents the progression of keratoconus to a statistically significant extent, as determined by measurement of topographic parameters. In the largest RCT to date (follow-up of 100 eyes for three years), the maximal corneal refractive power increased by 1.75 ± 0.38 diopters in the control group and decreased by -1.03 ± 0.19 diopters in the cross-linking group (p

Zielsetzung: Das Ologen-Implantat (AeonAstron Europe B.V., Leiden, Niederlande) besteht aus einem biodegradierbaren Kollagen und Glycosaminoglykan und soll eine postoperative Filterkissenvernarbung oder Abkapselung vermeiden. Methode: In einer retrospektiven klinischen Studie wurden 806 mit fortgeschrittenem[zum vollständigen Text gelangen Sie über die oben angegebene URL], 31. Internationaler Kongress der Deutschen Ophthalmochirurgen

Der natürliche Verlauf des Keratokonus und seine Auswirkungen auf das visuelle System des Patienten sind klar von der großen prospektiven „Collaborative Longitudinal Evaluation of Keratoconus Study“ dokumentiert worden. Diese Studie konnte zum ersten Mal signifikant nachweisen,[zum vollständigen Text gelangen Sie über die oben angegebene URL], 178. Versammlung des Vereins Rheinisch-Westfälischer Augenärzte

Backgrounds: To report 2 cases of multidrug-resistant fungal keratitis caused by Fusarium solani. The patients underwent a different conservative and surgical therapy including in both of them a keratoplasty a chaud. Methods and findings: A 21-years-old male and a 26- years-old female patient, who both used soft contact lenses developed corneal infiltrates. In the first case the diagnosis was delayed because multiple microbiological examinations of corneal scrapings were initially negative for fungi. A combined empirical therapy against Acanthamoeba and bacteria resulted in no improvement of the clinical findings. The patient underwent a keratoplasty a chaud and the histopathologic analysis of the corneal button yielded Fusarium solani multiresistant to all antifungal agents. In the second case, Fusarium solani was detected in the initial microbiological examination of the corneal scrapings. Although the fungus was multiresistant to all antifungal agents, an aggressive multiple topical antifungal therapy as well as lyposomal Amphotericin B i.v was applied successfully after the keratoplasty a chaud combined with application of Polyvidon-Iodine on the infected cornea and cryocoagulation circular at limbus. Results: Although a therapy with topical Amphotericin B and systemic lyposomal Amphotericin B was applied by the first case the infection progressed to an endophthalmitis. Unfortunately an enucleation was unavoidable. The multiple conservative antifungal therapy in the second case was successful, and the corneal transplant remained free from new infiltrations. Conclusion: We consider the fast diagnosis of multidrug resistance of great importance. Secondly, a penetrating keratoplasty early on the course of the disease increases the chances of a successful outcome.

To evaluate the effect of central corneal thickness (CCT), corneal curvature, and axial length on applanation tonometry in an in vivo study.In a masked, prospective clinical trial, we examined 125 eyes of 125 patients scheduled for cataract surgery. Corneal curvature was measured by means of keratometry and axial length by A-scan ultrasonography. By cannulating the anterior chamber before surgery, intraocular pressure (IOP) was set to 20, 35, and 50 mm Hg in a closed system by means of a water column. After measuring thickness, the IOP was measured with an applanation tonometer. Pearson product moment correlations and multiple linear regression analyses were performed, and significance levels were evaluated by the paired, 2-tailed t test.The difference between measured and real IOP was significantly dependent (P.001) on CCT. The associations between IOP and corneal curvature or IOP and axial length were not statistically significant (P = .31). The association between IOP reading and CCT is shown in the "Dresdner correction table," which illustrates an approximately 1-mm Hg correction for every 25-microm deviation from a CCT of 550 microm. The correction values were positive as thickness decreased and negative as thickness increased.Central corneal thickness significantly affects IOP readings obtained by applanation tonometry according to the Goldmann principle. A correction of IOP readings by considering CCT according to the Dresdner correction table might be helpful for determining an accurate IOP value.