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Purpose: To assess the course of intraocular pressure (IOP), visual field progression, and adverse effects of antiglaucoma medication used during pregnancy. Methods: Thirteen eyes of eight patients with glaucoma were examined. Their clinical records were reviewed to compare IOP, number of medications, and visual field indices (VFI) before, during, and after pregnancy using a two-tailed paired t-test. Results: In seven (87.5%) of the eight patients, no disease progression was observed. IOP (mmHg) remained stable (baseline 17.3 ± 3.6; first trimester 17.4 ± 5.2, P = 0.930; second trimester 18.1 ± 4.7, P = 0.519; third trimester 20.2 ± 8.7, P = 0.344; and postpartum 21.5 ± 7.6, P = 0.136). The mean number of glaucoma treatments fell from 1.7 ± 0.52 before pregnancy to 0.83 ± 0.75 (P = 0.04) in the second and third trimesters. In one patient, IOP increased during pregnancy and there was further visual field loss. In the only patient kept on fixed combination timolol-dorzolamide therapy throughout pregnancy, labor was induced because of delayed intrauterine growth. Conclusions: No changes in IOP and VFI were detected in most patients despite a reduction in the number of hypotensive agents required. Delayed intrauterine growth in one patient under fixed combination timolol-dorzolamide treatment was observed whereas no other adverse effects were detected. [ABSTRACT FROM AUTHOR]

Thygeson's superficial punctate keratitis (Thygeson's SPK) is a distinct clinical entity, characterized by round conglomerates of discrete, granular, white-gray, fine intraepithelial dots without conjuctival involvement. The only effective treatment with regard to relieving symptoms and diminishing lesions has been topical corticosteroids, but their prolonged use can be associated with severe side-effects. The purpose of this study is to present the long-term results of the use of 2% topical cyclosporin A in olive oil in Thygeson's SPK. Eight patients diagnosed as having Thygeson's SPK were included. All the patients were treated with 2% cyclosporin dissolved in olive oil four times a day for three months, and two times a day for one month before withdrawing therapy. The follow-up period ranged from twelve to twenty-five months. The number of corneal lesions varied between 5 and 15 before treatment. After cyclosporin treatment, no corneal lesion was observed and the cornea remained clear after the follow-up period. In conclusion, 2% cyclosporin in olive oil is a safe alternative to corticosteroids in the treatment of Thygeson's SPK, and resulted in satisfactory control of the condition. [ABSTRACT FROM AUTHOR]

Aim: To determine the effects of peripheral corneal thickness (PCT) on dynamic contour tonometry(DCT) and Goldmann applanation tonometry (GAT)., Methods: A cross-sectional study. We created a software which calculates the corneal contour (CC) as a function of the radius from the corneal apex to each pixel of the contour. The software generates a central circumference with a radius of 1 mm and the remainder of the cornea is segmented in 5 rings concentric with corneal apex being its diameter not constant around the corneal circumference as a consequence of the irregular CC but keeping constant the diameter of each ring in each direction of the contour. PCT was determined as the mean thickness of the most eccentric ring. Locally weighted scatterplot smoothing (LOWESS) regression was used to determine the pattern of the relationship between PCT and both DCT and GAT respectively. Thereafter, two multivariable linear regression models were constructed. In each of them, the dependant variable was intraocular pressure (IOP) as determined using GAT and DCT respectively. In both of the models the predictive variable was PCT though LOWESS regression pattern was used to model the relationship between the dependant variables and the predictor one. Age and sex were also introduced control variables along with their first-degree interactions with PCT. Main outcome measures include amount of IOP variation explained through regression models (R 2 ) and regression coefficients (B)., Results: Subjects included 109 eyes of 109 healthy individuals. LOWESS regression suggested that a 2 nd -degree polynomial would be suitable to model the relationship between both DCT and GAT with PCT. Hence PCT was introduced in both models as a linear and quadratic term. Neither age nor sex nor interactions were statistically significant in both models. For GAT model, R 2 was 17.14% ( F =9.02; P =0.0002), PCT linear term B was -1.163 (95% CI: -1.163, -0.617). PCT quadratic term B was 0.00081 (95% CI: 0.00043, 0.00118). For DCT model R 2 was 14.28% ( F =9.29; P =0.0002), PCT linear term B was -0.712 (95% CI: -1.052, -0.372), PCT quadratic term was B=0.0005 (95% CI: 0.0003, 0.0007)., Conclusion: DCT and GAT measurements are conditioned by PCT though this effect, rather than linear, follows a 2 nd -degree polynomial pattern.

Purpose: To evaluate the safety and efficacy of the iStent Trabecular Micro-bypass Stent in patients undergoing concurrent cataract and glaucoma surgery., Methods: Prospective, 24-month, uncontrolled, multicenter, multicountry evaluation of 58 patients with uncontrolled primary open-angle glaucoma (including pseudoexfoliation and pigmentary) and cataract. Patients underwent clear cornea phacoemulsification followed by ab interno gonioscopically guided implantation of the iStent. Of the 48 per protocol population, 42 patients completed 12 months of the 24-month study, and their data are included in this interim analysis., Results: At baseline, mean (+/-SD) intraocular pressure (IOP) was 21.7+/-3.98 mmHg. At 12 months, mean IOP was reduced to 17.4+/-2.99 mmHg, a mean IOP reduction of 4.4+/-4.54 mmHg (p<0.001, 18.3%). At baseline, patients were taking a mean 1.6+/-0.8 medications. By 12 months, the mean number of medications was reduced to 0.4+/-0.62 (p<0.001). Half the patients achieved an IOP < or =18 mmHg and were able to discontinue hypotensive medication by the 12-month visit. The most commonly reported device-related adverse events were the appearance of stent lumen obstruction (7 eyes) and stent malposition (6 eyes). None of the adverse events were deemed serious., Conclusions: In patients undergoing concurrent cataract and glaucoma surgery, the iStent was safe and efficacious for the reduction of IOP and medication therapy.

Purpose: The objective of the present study was to determine whether dry eye (DE) associated with primary Sjögren's syndrome (PSDE) and DE not associated with Sjögren's syndrome (NSDE) are related to an alteration of corneal innervation., Methods: Eleven healthy volunteers younger than 60 years (normal [N] < 60 group), 10 healthy volunteers 60 years of age or older (N > or = 60 group), 11 patients with PSDE, and 10 patients with NSDE were studied. Epithelial and stromal density and subbasal and stromal nerves were investigated by confocal microscopy., Results: The density of the superficial epithelial cells was 741 +/- 306 cells/mm2 in the PSDE group; 1022 +/- 331 cells/mm2 in the NSDE group; 1523 +/- 294 cells/mm2 in the N > or = 60 group, and 1529 +/- 341 cells/mm2 in the N < 60 group (P < 0.0001, ANOVA). The number of subbasal nerves was 2.8 +/- 1.2 in the PSDE group, 3.3 +/- 0.7 in the NSDE group, 3.1 +/- 0.9 in the N > or = 60 group, and 4.6 +/- 0.8 in the N < 60 group (P < 0.0001, ANOVA). The number of beadlike formations observed in the different groups was 387 +/- 62/mm in the PSDE group, 323 +/- 64/mm in the NSDE group, 182 +/- 63/mm in the N > or = 60 group, and 198 +/- 66/mm in the N < 60 group (P < 0.0001, ANOVA). A correlation was found between the number of subbasal nerves and age (P < 0.01) and between the number of subbasal nerves and Schirmer's test (P < 0.001, Spearman rho)., Conclusions: Patients with DE show alteration in the corneal innervations. The demonstration of such alterations introduces new strategies for treatment of this frequent disease., (Copyright Association for Research in Vision and Ophthalmology)