Average Intraocular Pressure Research Articles

Modified technique for reconstruction of large cyclodialysis cleft with capsular tension ring and continuous and cerclage sutures without scleral flaps.

To present a modified technique for the reconstruction of a large cyclodialysis cleft with capsular tension ring (CTR) and continuous and cerclage sutures without scleral flaps in 12 cases. The mean visual acuity was 0.75 ± 0.47 logarithm of the minimal angle of resolution (logMAR), and the average intraocular pressure (IOP) was 3.35 ± 0.41 mmHg before surgery. Ultrasound biomicroscopy (UBM) revealed a ciliary cleft of 4.3 ± 3.5 clock hours. We performed the modified technique for the reconstruction of a large cyclodialysis cleft. Postoperative visual acuity improved to 0.48 ± 0.26 logMAR, and the IOP improved to 15.88 ± 3.81 mmHg. Postoperative UBM showed that cyclodialysis disappeared in the whole circumference of 12 eyes. The postoperative complications included 42% (5 eyes) with a temporary elevation of IOP and 16% (2 eyes) with a posterior shift of the ciliary body. No other complications were detected during the follow-up. Based on the results, our modified technique might be useful for most cyclodialysis clefts.

Ab Externo Choroidal Fluid Drainage, Pars Plana Vitrectomy, and Endotamponade for the Management of Persistent Hypotony following Glaucoma Surgery.

Persistent severe serous choroidal detachment is a rare complication after glaucoma surgery. Surgical treatment with choroidal fluid drainage through a scleral incision is an option in these cases. Combining this procedure with pars plana vitrectomy and gas endotamponade has potential advantages. In the following, the perioperative course of this surgical option in a small cohort will be presented. This is a retrospective cohort study of the postoperative course of ab externo drainage of persistent serous choroidal detachment (≥4 weeks) in combination with pars plana vitrectomy and gas endotamponade in six eyes of six patients after exhausting all conservative treatment options. Inclusion criterion was persistent hypotony with severe serous choroidal detachment after intraocular pressure (IOP) lowering surgery due to medically uncontrolled glaucoma. Eyes were evaluated according to resolution of choroidal detachment, change in IOP and visual acuity (VA), postdrainage complications, and need for further surgeries. Before surgery, all patients presented with flat anterior chamber, decreased vision, and persistent choroidal detachment. The surgery itself was uneventful, but due to the complexity of the cases, tailoring the procedure to each patient's needs was required. Complete resolution of choroidal effusion was achieved by one month in 5 eyes and in 1 eye by month 3. There was an increase in average IOP from 5 (±2.1) mmHg before surgery to 11.3 (±3.7) mmHg and in VA from 1.7 (±0.8) to 1.2 (±0.6) logMAR. Five out of six patients required additional surgery, mainly to further increase the IOP even though choroidal detachment had already resolved. Ab externo choroidal fluid drainage combined with pars plana vitrectomy and gas endotamponade seems to be an effective and safe treatment option in persistent ocular hypotony. Although repeated surgeries might be necessary, large-scale prospective studies must be undertaken to provide corroborative evidence.

Determination of intraocular pressure and Schirmer tear test and the comparison between the applanation tonometer (Tono-Pen AVIA®) and the rebound tonometer (TonoVet Plus®) in mini lionhead rabbits.

To determine intraocular pressure (IOP) and tear production, as well as to compare the IOP obtained with the TonoVet Plus® (rebound) with the Tono-Pen Avia® (applanation) tonometers. Twenty-five Mini Lionhead rabbits (n = 50 eyes). Tear production was measured at 6:00 a.m. and 6:00 p.m. by using the STT. The IOP reading was performed with the rebound tonometer, followed by the applanation tonometer, at 6:00 a.m., 9:00 a.m., 12:00 p.m., 3:00 p.m., and 6:00 p.m. Regression analysis, analysis of variance (anova) and Bland-Altman statistics were used. Daily tear production was 10.25 ± 3.75 mm/min, with no differences among the moments evaluated. Average daily IOP was 17.7 ± 3.08 mmHg with the TonoVet Plus® and 11.5 ± 4.56 mmHg with the Tono-Pen Avia®. IOP values were higher at the beginning and end of the day with both tonometers. The IOP values are higher with the TonoVet Plus® tonometer. The reference values of IOP and tear production obtained in this work may support the diagnosis, treatment, and monitoring of ocular disorders in pet Mini Lionhead rabbits.

Intraocular pressure and central corneal thickness in a healthy student population

Introduction/Objective. Intraocular pressure is an important parameter of eye health, especially when glaucoma is suspected. So far, few studies have been published that aimed to determine the average value of intraocular pressure and central corneal thickness in a healthy population aged 20?30 years. The aim of this study was to determine the distribution of the values of intraocular pressure and central corneal thickness in healthy student population. Methods. In a cross-sectional study, intraocular pressure and central corneal thickness were measured on a sample of a healthy population, aged 22?37 years. Intraocular pressure was measured using the Goldmann applanation tonometry method, while central corneal thickness was measured using ultrasound pachymetry. The analysis of numerical values was done using the methods of descriptive statistics. Results. By measuring intraocular pressure and central corneal thickness in 641 subjects (1282 eyes), the average value of intraocular pressure was determined to be 14.79 ? 2.31 mmHg, and central corneal thickness was 553.92 ? 25.56 ?m. By comparing two groups of subjects, one male group and the other one female, we determined that there was no statistically significant difference in the average value of intraocular pressure (t-test, p > 0.05), and the average value of central corneal thickness (t-test, p > 0.05) between the sexes. Conclusion. The determined average value of intraocular pressure and central corneal thickness is similar to those determined in other cross-sectional studies of this type. No statistically significant difference was found in the intraocular pressure values and the central thickness of the cornea by sex.

Surgical Outcomes of Ab Interno Trabeculotomy Without Phacoemulsification.

The aim of this study was to evaluate ab interno trabeculotomy outcomes without phacoemulsification. This retrospective study evaluated 118 eyes of patients aged 18 and above who underwent ab interno trabeculotomy between December 2017 and August 2022. When surgeries were performed in both eyes, only the eye undergoing the initial surgery was evaluated. Prior to and after surgery, the intraocular pressure (IOP) and mean number of IOP-lowering medications were compared. An IOP of ≤21 mmHg (A) and ≤18 mmHg (B) along with a ≥20% reduction in the preoperative IOP was defined as survival. Cases that required reoperation for glaucoma were defined as surgical failure. The Kaplan-Meier method was used to evaluate the survival rates. A Cox proportional hazards model was used to analyze the preoperative factors that influenced survival rates. At 36 months postoperatively, the 13.4 ± 2.8 mmHg average IOP was significantly decreased from the preoperative 23.5 ± 9.8 mmHg value (P < 0.0001). Moreover, a significant decrease in the mean number of the IOP-lowering medications to 2.3 ± 1.4 at 36 months was found versus the initial 3.9 ± 1.1 preoperative value (P < 0.0001). The survival rates for criteria A and B at 36 months postoperatively were 28% and 25%, respectively. Only the preoperative IOP was identified by multivariate analysis as a factor influencing survival rates (P < 0.0001). Hyphema in 36 eyes (30.5%) and an IOP spike in 20 eyes (16.9%) were the only observed complications. Additional glaucoma surgery was required in 27 eyes (22.9%) during the follow-up period. Utilization of ab interno trabeculotomy effectively lowered the IOP and reduced the number of IOP-lowering medications. Patients with higher preoperative IOP exhibited better postoperative outcomes.

Results of XEN45 Gel Stent Implantation in the Treatment of Primary Open‐Angle Glaucoma Using 5, 10 or 20 μg Mitomycin C: A Pilot Study

Background: No consensus has been reached on the adequate dose of mitomycin C (MMC) in XEN45 gel stent implantation. Lower doses have the potential to reduce MMC‐linked side effects. This study aimed to evaluate treatment efficacy of ab interno XEN45 gel stent in primary open‐angle glaucoma (POAG) with three different MMC doses.Methods: This retrospective single‐centre nonrandomised trail included 54 patients (56 eyes) who underwent XEN45 gel stent implantation for POAG with above‐target intraocular pressure (IOP) under medical therapy. Eyes were grouped according to the received MMC dose: Group 1 (20 μg; n = 21), Group 2 (10 μg; n = 14) and Group 3 (5 μg; n = 21). The primary endpoint was the mean IOP change in the three MMC dose groups after 6, 12 and 24 months. Secondary endpoints included the success rate defined as lowering of baseline IOP ≥ 20% and below a cut‐off IOP set at three different levels: ≤ 18, ≤ 16 and ≤ 14 mmHg (Criteriums 1, 2 and 3), the mean number of ocular hypotensive medications and the frequency of needling procedures.Results: After 24 months, the overall mean (standard error) IOP was significantly reduced from 24.7 (0.9) mmHg to 15.2 (0.7) mmHg (p &lt; 0.0001). The average IOP change (standard error) in MMC dose groups 1, 2 and 3 was −8.6 (2) mmHg, −10.1 (2.1) mmHg and −10.4 (2.8) mmHg. Complete success (Criterium 1) was achieved in 50%, 62% and 43% of the eyes in groups 1, 2 and 3. No statistically significant difference was found within the first 24 months between the three MMC dose groups for IOP change, success rate, number of ocular hypotensive medications and the frequency of needling procedures.Conclusions: XE45 was effective in all three dose groups. As the success rate did not significantly differ between the MMC doses, these results may support the use of the lowest dose.Trial Registration: ClinicalTrials.gov identifier: 559/2016BO2

Evaluation of agreement of IOP measurements by Tono-Vera tonometer to Goldmann applanation tonometry.

To evaluate the accuracy of the new Tono-Vera rebound tonometer (Reichert Inc, Buffalo, NY) compared to Goldmann Applanation Tonometry. This prospective, observational, cross-sectional study was designed in accordance with ANSI Z80.10-2014 and ISO 8612-2009 guidelines for tonometer comparison. Intraocular Pressure (IOP) was measured by Goldmann Applanation and Tono-Vera on 160 eyes of 160 subjects. Corneal Astigmatism and Central Corneal Thickness were also measured. A single investigator (CN) conducted all measurements. The average of two measurements from each tonometer was used in the analysis. Bland-Altman plots, total least squares regression analysis, and simple linear regression were used to evaluate agreement between the tonometers. Average IOP values from Goldmann Applanation and Tono-Vera were not significantly different (19.17 and 19.03 respectively, p=0.40, paired t-test). The total least squares regression analysis indicated strong agreement between the two tonometers (slope +0.97, offset +0.49 mmHg, standard deviation 2.11 mmHg). There were 2 IOP measurement pairs that exceeded the ± 5 mmHg limits of agreement required in ANSI Z80.10-2014 and ISO 8612-2009, which is within the range of acceptability specified in the standards. We evaluated IOP measurements by Tono-Vera Rebound Tonometer vs Goldmann Applanation Tonometry for eyes with a wide range of IOP values and found no statistically significant differences in the results. Tono-Vera meets the requirements of ANSI Z80.10-2014 and ISO 8612-2009, demonstrating accuracy comparable to Goldmann tonometry.

A A Retrospective Non-Randomized Case Study Analysis of Mitomycin-C Efficacy in Patients Undergoing Combined Phacotrabeculectomy at a Tertiary Care Hospital in Salem, India

Glaucoma and cataracts, which are major contributors to worldwide blindness, frequently occur together, requiring phacotrabeculectomy as the primary therapeutic approach. This study conducted a retrospective analysis of cases to evaluate the efficacy of Mitomycin-C (0.2mg/ml for 3 min) in phacotrabeculectomy, which is a combination surgical treatment that involves trabeculectomy and phacoemulsification. The study was conducted over six months, from January 2022 to June 2022, in a tertiary care hospital in Salem. An analysis was conducted on the records of 60 patients who underwent phacotrabeculectomy and met the inclusion criteria. The study included 60 patients, with 28 (47%) being men and 32 (53%) being females; of these, 22 (37%) underwent surgery on their right eye, while 38 (63%) underwent surgery on their left. Most patients belonged to the age bracket of 51-65 years. The grading of cataracts identified many forms, such as Nuclear Sclerosis (NS-1: 3%, NS-1 and PSC: 10%, NS-2: 17%, NS-2 and PSC: 23%, NS-3: 7%, PSC: 13%). The most prevalent type, affecting the majority (27%) of the population, was Senile Immature Cataract (SIMC). The average preoperative intraocular pressure was 22.4 ± 1.52 mmHg, and after the surgery, the pressure reduced dramatically to 13.20 ± 1.42 mmHg. The difficulties associated with blebs are resolved on their own. After the operation, there was an improvement in visual acuity. The average values increased from 0.86 ± 0.15 before the surgery to 0.22 ± 0.26 on day 1, 0.20 ± 0.23 on day 7, 0.19 ± 0.23 on day 14, 0.18 ± 0.19 on day 30, and 0.18 ± 0.19 on day 45. A paired t-test demonstrated a statistically significant difference (p=0.02) in postoperative visual acuity between day 1 and day 45. The study's findings indicate that Mitomycin-C is efficacious in phacotrabeculectomy, resulting in decreased intraocular pressure and enhanced visual acuity, with no notable problems. The findings provide valuable insights into managing concurrent glaucoma and cataracts, presenting a viable strategy in tertiary care settings.

A comparative study of ultrasound cycloplasty and endoscopic cyclophotocoagulation in the treatment of secondary glaucoma

To compare the clinical efficacy of ultrasound cycloplasty (UCP) and endoscopic cyclophotocoagulation (ECP) in the treatment of secondary glaucoma. In a 12-month prospective single-center study, 22 patients with secondary glaucoma were treated by high-intensity focused ultrasound (HIFU), and 23 patients with secondary glaucoma were treated by a semiconductor laser. At the final follow-up, the two groups’ surgical outcomes were compared. A complete success was defined as an intraocular pressure (IOP) reduction of at least 20% from baseline and an IOP of > 5 mmHg and ≦ 21 mmHg, while a qualified success was defined as an IOP reduction of at least 20% from baseline and an IOP of > 5 mmHg. The secondary outcome was the average IOP, number of drugs, and complications at each follow-up compared with the baseline. The average preoperative IOPs in the UCP and ECP groups were 36.4 ± 9.5 mmHg (n = 2.3 drops, n = 0.2 tablets) and 34.5 ± 11.7 mmHg (n = 2.0 drops, n = 0.3 tablets), respectively. In the last follow-up, the success rate of UCP was 54% (with a decrease of 32%) and that of ECP was 65% (with a decrease of 35%), and the P-value between the two groups was > 0.05. However, there was a difference in the average IOP between these two groups 1 day and 1 week after the operation, and the IOP reduction efficiency in the ECP group was better. However, the amount of drug used after these two surgeries was significantly reduced. There were fewer postoperative complications in the UCP group (18 cases) than in the ECP group (35 cases). Both UCP and ECP can effectively reduce IOP in secondary glaucoma, and ECP has a better effect at the early stages. However, UCP has higher safety and tolerance for patients.

Selective Laser Trabeculoplasty as a Substitute for Medications in Patients with Mild-to-moderate Glaucoma in the Brazilian Public Health System.

Selective laser trabeculoplasty can be used as a substitute for medications in patients with mild-to-moderate glaucoma, reducing the cost of eye drop distribution in the Brazilian public health system. To observe the effectiveness of selective laser trabeculoplasty (SLT) as a substitute for eye drops in patients with open angle glaucoma in the Brazilian Public Health System. SLT was performed bilaterally after medication washout. This is a prospective interventional study comparing intraocular pressure (IOP) when using eye drops at baseline (post-washout), and at 12-month follow-up after SLT. Medication was added if the target IOP was not achieved, following the Brazilian Public Health System eye drops protocol, based on medication costs. Absolute (without eye drops) and qualified (with eye drops) success were measured with IOP ≤ 21, IOP ≤ 18, IOP ≤ 15 and IOP ≤ 12 mm Hg. Besides IOP evolution, the ability to reduce IOP (in %), and eye drops reduction were evaluated. Ninety-two eyes of 46 patients were included, 70 eyes with mild glaucoma and 22 with moderate glaucoma; the mean number of eye drops was 2.26±1.06 (82.6% were using a prostaglandin analogue), and post-washout IOP of 21.10±5.24 mm Hg. There was relative success at IOP ≤18 mm Hg, where the mild group had greater success than the moderate group (88.1% vs. 71.4%, P =0.824). The average IOP reductions were 23.04% and 25.74% at 6 and 12 months, respectively. The average number of eye drops was 1.02, with 1.1% using a prostaglandin analogue. Furthermore, 68.19% of the patients had a decrease in the quantity of eye drops used. SLT is effective in reducing IOP and replacing eye drops in patients in the Brazilian Public Health System. Moreover, there was a significant reduction in the use of prostaglandin analogues.

Posture-Induced Changes in Intraocular, Orbital, Cranial, Jugular Vein, and Arterial Pressures in a Porcine Model.

The purpose of this study was to determine posture-induced changes in arterial blood pressure (ABP), intraocular pressure (IOP), orbital pressure (Porb), intracranial pressure (ICP), and jugular vein pressure (JVP) at various tilt angles in an in vivo pig. Anesthetized and ventilated pigs (n = 8) were placed prone on a tiltable operating table. ABP, IOP, Porb, ICP, and JVP were monitored while the table was tilted at various angles between 15degrees head up tilt (HUT) and 25degrees head down tilt (HDT) either in stepwise changes (5 degrees per step) or continuously. The mean pressure was calculated from digitized pressure waveforms from each compartment. For stepwise changes in tilt angle the pressures were plotted as a function of tilt angle. For continuous tilt changes, the pressures were plotted as a function of time. In the case of stepwise changes, ABP remained relatively stable whilst IOP, Porb, ICP, and JVP demonstrated significant differences between most angles (typically P < 0.0001). The difference was greatest for IOP (P < 0.0001) where the average IOP increased from 13.1 ± 1.23mm Hg at 15degrees HUT to 46.3 ± 2.03mm Hg at 25 degrees HDT. The relationship between pressure and tilt angle was almost linear for ICP and JVP, and sigmoidal for IOP and Porb. Interestingly, the effect of changes in tilt angle occurred very rapidly, within a few seconds. Our results in a pig model demonstrate that changes in posture (tilt angle) induce rapid changes in IOP, Porb, ICP, and JVP, with IOP affected most severely.

Trabeculectomy with collagen implant for the treatment of glaucoma

The goal is to assess the effectiveness and safety of trabeculectomy with collagen implants for glaucoma patients who cannot be managed medically. This research is a case series that intervenes without randomization and focuses on potential outcomes. The study consisted of 76 treated eyes of 76 patients with uncontrollable glaucoma. A thorough examination of the eyes was performed on all patients, and the results were documented. Each patient underwent conventional trabeculectomy surgery using the fornix-based approach. Additionally, a subconjunctival collagen implant known as Ologen was also utilized. We recorded preoperative data such as age, gender, best-corrected visual acuity, intraocular pressure, glaucoma type, and a few preoperative antiglaucoma medications. We recorded the intraocular pressure after surgery, the number of glaucoma medications given after surgery, and any complications that occurred during the postoperative period. Each patient was monitored for a minimum of six months. Before the operation, the average intraocular pressure (IOP) was 34.21 ± 12.5, and the patient took at least two IOP-lowering medications (average 2.3). The postoperative IOP was measured after three months and found to be 13.85±5.42mm Hg, with a p-value of 0.060. On average, the blood pressure decreased by 16.42±6.42 mmHg after six months, with a p-value of 0.056. After six months, it was observed that the medication significantly reduced 1.22 in intraocular pressure (P=&amp;#60;0.001), leading to a notable decrease of 17.79 mmHg. The success rate stood at a commendable 97.36% at the three-month mark, but it reduced to an alarming 88.15% by the last visit. Within just one month after the operation, several complications arose, including three cases of hyphaema, one case of the shallow anterior chamber, and two cases of wound leak. All patients showed gradual improvement with conservative management. However, three of them developed cataracts within three months. For patients who have not responded to topical antiglaucoma medications, to manage intraocular pressure is a dependable and safe surgical procedure that offers an efficient treatment option.

NCX 470 Reduces Intraocular Pressure More Effectively Than Lumigan in Dogs and Enhances Conventional and Uveoscleral Outflow in Non-Human Primates and Human Trabecular Meshwork/Schlemm's Canal Constructs.

Purpose: To determine NCX 470 (0.1%) and Lumigan® (bimatoprost ophthalmic solution, 0.01%-LUM) intraocular pressure (IOP)-lowering activity after single or repeated (5 days) dosing along with changes in aqueous humor (AH) dynamics. Methods: Ocular hypotensive activity of NCX 470 and LUM was compared with vehicle (VEH) in Beagle dogs using TonoVet®. Non-human primates (NHP) and bioengineered three-dimensional (3D) human Trabecular Meshwork/Schlemm's Canal (HTM/HSC™) constructs exposed to transforming growth factor-β2 (TGFβ2) were used to monitor NCX 470 and LUM-induced changes in AH dynamics. Results: NCX 470 (30 μL/eye) showed greater IOP reduction compared with LUM (30 μL/eye) following single AM dosing [maximum change from baseline (CFBmax) = -1.39 ± 0.52, -6.33 ± 0.73, and -3.89 ± 0.66 mmHg (mean ± standard error of the mean) for VEH, NCX 470, and LUM, respectively]. Likewise, repeated 5 days daily dosing of NCX 470 resulted in lower IOP than LUM across the duration of the study (average IOP decrease across tests was -0.45 ± 0.22, -6.06 ± 0.15, and -3.60 ± 0.22 mmHg for VEH, NCX 470, and LUM, respectively). NCX 470 increased outflow facility (Cfl) in vivo in NHP (CflVEH = 0.37 ± 0.09 μL/min/mmHg and CflNCX470 = 0.64 ± 0.17 μL/min/mmHg) as well as in vitro (CHTM/HSC) in HTM/HSC constructs (CHTM/HSC_VEH = 0.47 ± 0.02 μL/min/mm2/mmHg and CHTM/HSC_NCX470 = 0.76 ± 0.03 μL/min/mm2/mmHg). In addition, NCX 470 increased uveoscleral outflow (FuVEH = 0.62 ± 0.26 μL/min and FuNCX470 = 1.53 ± 0.39 μL/min with episcleral venous pressure of 15 mmHg) leaving unaltered aqueous flow (AHFVEH = 2.03 ± 0.22 μL/min and AHFNCX470 = 1.93 ± 0.31 μL/min) in NHP. Conclusions: NCX 470 elicits greater IOP reduction than LUM following single or repeated dosing. Data in NHP and 3D-HTM/HSC constructs suggest that changes in Cfl and Fu account for the robust IOP-lowering effect of NCX 470.

Tonometry and pachymetry to evaluate fluctuations of intraocular pressure in the context of SCUBA diving

It is currently still not clarified whether diving using aself-contained breathing apparatus (SCUBA) is associated with intraocular pressure (IOP) fluctuations of clinical relevance and whether intensive diving could exacerbate the damage in glaucoma patients. This study aimed to evaluate the effect of SCUBA diving on IOP in healthy volunteers without prior eye injuries or surgery. recreational diving does not lead to significant increases or fluctuations of the IOP. The study included 16divers (5female) who performed atotal of 96dives with air or nitrox32 to adepth of 20-30 m for an average of 50 min. The central cornea thickness was measured using ultrasonic pachymetry Pocket IITM (Quantel Medical Pocket II™, Quantel Medical, Clermont-Ferrand, France), and the IOP was measured using an Icare® PRO (Icare® PRO, Icare Finland Oy, Espoo, Finland) directly before the dive and 10 min after surfacing. All data refer to the right eye. Average IOP values ranged from 15.6 to 19.2 mm Hg pre-dive and 16.8 to 18.2 mm Hg post-dive. The range of IOP values was 2.2-11.5 mm Hg pre-dive (∆ = 9.3 mm Hg) and 2.7-14.8 mm Hg post-dive (∆ = 12.1 mm Hg). Of the divers 11.5% vs. 18.8% had increased IOP values > 21 mm Hg (pre-dive vs. post-dive). This study found no significant differences in IOP values between pre-dive and post-dive measurements in healthy SCUBA divers. Therefore, recreational SCUBA diving is unlikely to affect the IOP in healthy individuals.

Comparing Outcomes of 45 Xen Implantation Ab Interno With Closed Conjunctiva to Ab Externo With Open Conjunctiva Approaches.

Ab externo with open conjunctiva placement may lead to improved gelatin stent (XEN Gel Stent; Allergan) success rate compared with ab interno with closed conjunctiva because it conferred more favorable intraocular pressure (IOP) and medication burden reduction based on our complete and qualified success criteria. To compare outcomes of a gelatin stent (XEN 45 Gel Stent; Allergan) placed either ab interno with closed conjunctiva (AIC) or ab externo with open conjunctiva (AEO) with or without cataract surgery in patients with glaucoma. Retrospective, nonrandomized comparative study of 85 eyes from 85 glaucoma patients who received XEN 45 Gel Stent placed either AIC (N=32) or AEO (N=53) with or without cataract surgery between July 2018 and January 2022 at Massachusetts Eye and Ear. Patients were included if they were 18 years of age or above and had at least 30 days of follow-up without any disqualifying event. Baseline demographics were similar between both groups, except for the glaucoma type. Both AIC and AEO procedures resulted in significant patterns of IOP and medication reduction from baseline up to 1 year. At postoperative year (POY)1, mean IOP was reduced to 11.34±4mmHg on 1.29±1.34 medications after AEO and 13.70±3.32mmHg on 2±1.81 medications after AIC. The average IOP reduction was significantly greater in the AEO group at all postoperative time points beyond postoperative week 2. There were significant differences in the survival curves of AEO and AIC groups under both the complete success criteria and the qualified success criteria. Under the complete success criteria, the cumulative probability of survival at POY1 was 28.5% in the AEO group and 3.8% in the AIC group. Under the qualified success criteria, the cumulative probability of survival at POY1 was 60.3% in the AEO group and 21.9% in the AIC group. In our study, we demonstrate that both placements reduce IOP and medication from baseline, with AEO placement having more favorable success rates compared with AIC placement.

Intraocular pressure measurement using ICare rebound tonometer in different positions of eye and different locations on cornea.

Intraocular pressure (IOP) is one of the most crucial aspects for diagnosis and treatment plan among patients with glaucoma. Although the gold standard for IOP measurement is Goldmann applanation tonometer (GAT)[1], it must be mounted to a slit lamp biomicroscope. However, rebound tonometer has become popular due to its ease of operation and portable design, does not require topical anesthesia, and results do not differ significantly from those of GAT[2]. The purpose of this cross-sectional study is to investigate the difference in IOP measurement with iCare IC200 in different angles of the eye and different corneal locations. All participants underwent IOP measurement by GAT twice. Then, IOP was measured with iCare by a single physician. IOP was measured in a straight manner in the upright patient position; then participants were asked to look at fixation targets, which located in four different points. IOP was measured in upgaze, downgaze, medial gaze, and lateral gaze. Then, IOP was measured at 2 mm from limbus in superior, inferior, nasal, and temporal cornea. All methods were measured twice, and the mean was used for calculation. The physician who measured IOP by iCare was masked from GAT results. A total of 168 eyes were tested with a mean age of 62.15 ± 12.34 years. Mean IOP measured by GAT and iCare at the central cornea was 15.53 ± 5.57 and 14.78 ± 6.14 mmHg, respectively. The standardized mean difference (SMD) between iCare and GAT was 0.13 (-0.09-0.34), which is insignificant. The average IOP was 0.6, 0.47, 0.91, and 0.44 mmHg lower than the primary position in upgaze, downgaze, medial gaze, and lateral gaze 15 degrees angulated positions respectively (p<.01). IOPs at 2 mm from limbus in the inferior, nasal, and temporal cornea were 0.5, 0.69, and 0.57 mmHg lower than IOP measured at the central cornea (p=<.01). IOP measurements with iCare in different angles of eye were statistically significantly lower than in the primary position. Similarly, IOPs at different locations on cornea were lower than at the central cornea. However, the difference in IOP measurements with iCare in different angles of the eye and different corneal locations was in the trivial range and might be clinically insignificant.

Analysis of intraocular pressure in healthy individuals and type 2 diabetes patients with and without diabetic retinopathy: A comparative study.

Objective: To compare intraocular pressure between normal subjects and Type 2 diabetics with and without diabetic retinopathy. Study Design: Comparative study. Setting: Sindh Institute of Ophthalmology &amp; Visual Sciences Hyderabad Sindh Pakistan. Period: June 2021 to December 2021. Material &amp; Methods: The ages ranged from 45 to 75 years old. The blood glucose level, intraocular pressure, and indirect ophthalmoscopy were measured between 9:00 am and 11:00 am with an iCare tonometer and an ophthalmoscope. The data were analyzed in SPSS 23.0. Results: A total of 112 participants were included. The average intraocular pressure (IOP) in both eyes of individuals with type 2 diabetes and no diabetic retinopathy is slightly higher than in the non-diabetic population, but the difference is not statistically significant (p&gt;0.05). Group A was composed of 16 males (50.0%) and 16 females (50.0%), while group B had 13 males (40.6%) and 19 females (59.3%). In group C, there were 19 males (59.3%) and 13 females (40.6%), and in group D, 7 males (43.7%) and 9 females (56.2%). All female participants were in the post-menopausal phase. Conclusion: In the study, researchers found that the intraocular pressure of diabetics was higher than non-diabetics. Diabetes progression reduced intraocular pressure in non-proliferative diabetic retinopathy and increased it in proliferative diabetic retinopathy relative to the former, but the difference was not statistically significant.

Clinical characteristics of open-angle glaucoma progression with peripapillary microvasculature dropout in different locations.

The study attempted to identify clinical characteristics associated with structural progression in open-angle glaucoma (OAG) in the presence of MvD in different locations. A total of 181 consecutive OAG eyes (follow-up 7.3 ± 4.0 years), which demonstrated peripapillary choroidal MvD (defined as a focal capillary loss with no visible microvascular network in choroidal layer) on optical coherence tomography (OCT) angiography (OCTA), were divided based on the location of MvD. Structural progression was determined using trend-based analysis of the Guided Progression Analysis software of Cirrus OCT. MvD was identified in the temporal quadrant in 110 eyes (temporal MvD; 60.5 ± 12.6 years), and in the inferior quadrant in 71 eyes (inferior MvD; 60.3 ± 11.1 years). After adjusting for age, average intraocular pressure (IOP) and baseline retinal nerve fibre layer (RNFL) thickness and visual field mean deviation, inferior MvD eyes showed faster rates of thinning in the inferior RNFL (mean (95% CI); -0.833 (-1.298 to -0.367)) compared to temporal MvD eyes (-0.144 (-0.496 to 0.207)) when long-term IOP fluctuation was larger than the median value (1.7 mmHg; P = 0.022). Long-term IOP fluctuations were independently associated with inferior RNFL thinning in eyes with inferior MvD (P = 0.002) but not in eyes with temporal MvD. In OAG eyes, the rates of RNFL and GCIPL thinning were comparable regardless of MvD locations. However, inferior MvD is associated with faster RNFL and GCIPL thinning in the same quadrant when long-term IOP fluctuation is present. Structural progression in the presence of temporal MvD was less associated with IOP fluctuation.

Intraocular Pressure Values using IcareⓇ Rebound Tonometer and Correlation with Postconceptional Age in Premature Infants.

This study aimedto determine a normative range of intraocular pressure (IOP) values measured with Icare rebound tonometer in premature infants and evaluate IOP variation over time and its correlation with the progression of postconceptional age (PCA). By doing so, we also evaluated advantages of this IOP-measuring method in this population when compared to more traditional methods. We conducted a single-center prospective study that included premature infants (gestational age 32 weeks) who were admitted to the neonatal intensive care unit (NICU) in Hospital Professor Doutor Fernando Fonseca. The study took place between January and December 2021. IOP was measured using Icare tonometer on the occasion of the first retinopathy of prematurity (ROP) screening requested by the NICU and again after a two-week interval if PCA was still 37 weeks. IOP measurements were stopped at 37 weeks or if the infant was discharged. The evaluated outcomes were mean IOP values and their correlation with PCA. Thirty-four eyes of 17 preterm infants with a mean gestational age of 29.4 2.3 weeks and a mean birth weight of 1222.9 361.9 gr were evaluated. The mean IOP registered was 16.1 6.4 mmHg, with a median value of 15.3 mmHg. The top 90 percentile was 22.1 mmHg and the bottom 10 percentile was 9.0 mmHg. The average IOP reduction was 4.8 6.7 mmHg (P = 0.0019) within the two-week interval of PCA. The mean IOP in premature infants was 16.1 6.4 mmHg and this value significantly decreased by 4.8 6.7 mmHg every two weeks of PCA.

Changes in Intraocular Pressure and Dry Eye Signs after Botulinum Toxin Injections to Treat Patients with Essential Blepharospasm

Purpose: This study investigates the intraocular pressures and dry eye signs before and after botulinum toxin (botox) injections for patients with essential blepharospasm.Methods: From November 2021 to July 2022, a prospective study examined 78 eyes of 39 patients diagnosed with essential blepharospasm. Before injection and 1 and 3 months after injection, intraocular pressures (IOPs) were measured using a Goldmann applanation tonometer. The noninvasive breakup time (NIBUT), lipid layer thickness (LLT), tear meniscus height (TMH), and meibomian gland clearance were assessed with the aid of the IDRA platform (SBM Sistemi, Turin, Italy).Results: The average IOPs were 14.33 ± 3.47 (7-21), 13.45 ± 3.54 (9-21), and 13.28 ± 2.98 (7-20) mmHg before, and 1 and 3 months after, botox injection respectively (p = 0.002 , p = 0.004). Twenty-four eyes of 12 patients with dry eye symptoms evidenced a significant difference in the NIBUT 1 month after Botox injection, but no significant difference in any of the LLT, TMH, or meibomian gland areal loss percentage (p = 0.007, 0.201, 0.586, and 0.435 respectively). After 3 months, no dry eye parameter change, including the NIBUT, was significant (p = 0.202, 0.542, 0.240, and 0.721 respectively).Conclusions: Botulinum toxin A injection temporarily relieved dry eye symptoms and reduced the IOP in patients with essential blepharospasm.