Incidence Of Glaucoma Research Articles

A Comprehensive Map of Disease Networks and Molecular Drug Discovery for Glaucoma

Background: Glaucoma is the leading cause of irreversible blindness worldwide. The molecular etiology of glaucoma is complex and unclear. At present, there are few drugs available for glaucoma treatment. The aim of the present study was to perform a systematic analysis of glaucoma candidate drugs/chemicals based on glaucoma genes including genetic factors and differentially expressed (DE) genes. Methods and Findings: Online Mendelian Inheritance in Man (OMIM), Genome-wide association study (GWAS) Catalog and Phenolyzer databases were used to identify genetic factors associated with glaucoma. GEO was used to identify glaucomarelated RNA datasets. DE genes were identified using the WGCNA R package. The Database for Annotation, Visualization and Integrated Discovery (DAVID), a functional annotation bioinformatics resource, was used to analyze possible signaling pathways for glaucoma genes. The Phenome-wide Association Studies (PheWAS) database was employed to identify the disease spectrum of glaucoma genes. DGIdb, CLUE, and KEGG databases were used to mine drugs targeting glaucoma genes. In total, 401 genes from the genetic databases and 2,068 genes from the DE gene analysis were included in further analysis. In terms of glaucoma-related genetic factors, 54 pathways were significantly enriched (FDR < 0.05) and 96 pathways for DE genes were significantly enriched (FDR < 0.05). A search of the PheWAS database for diseases associated with glaucoma-related gene returned 1,289 diseases, and a search for diseases associated with DE glaucomarelated genes returned 1,356 diseases. Cardiovascular diseases, neurodegenerative diseases, cancer, and ophthalmic diseases were highly related to glaucoma genes. A search of the DGIdb, KEGG, and CLUE databases revealed a set of drugs/chemicals targeting glaucoma genes. A subsequent analysis of the electronic medical records (EMRs) of 136,128 patients treated in Sichuan Provincial People's Hospital for candidate drug usage and the onset of glaucoma revealed nine candidate drugs. Among these drugs, individuals treated with nicardipine had the lowest incidence of glaucoma. Taken together with the information from the drug databases, 40 most likely candidate drugs for glaucoma treatment were highlighted. Conclusions: Based on the findings, we concluded that the molecular mechanism of glaucoma is complex and it may be a reflection of systemic diseases. A set of ready-for-use candidate drugs targeted glaucoma genes, which may be developed for glaucoma clinical treatment drugs. Our results provide a systematic interpretation of glaucoma genes, interactions with other systemic diseases, and candidate drugs/chemicals. Funding Statement: This research project was supported by: the National Natural Science Foundation of China (81670895 (L.H.) and 81300802 (L.H.); the Department of Science and Technology of Sichuan Province, China (2017JQ0024 (L.H.), 2016HH0072 (L.H.), 2015JQO057 (L.H.) and 2013JY0195 (L.H.) Declaration of Interests: The authors declare no competing financial interests. Ethics Approval Statement: The study was approved by the institutional ethics committee of Sichuan Provincial People’s Hospital and was conducted according to the Declaration of Helsinki principles.

A comparative study of complications and its management following phaco- trabeculectomy in primary open angle glaucoma, primary angle closure glaucoma and pseudo-exfoliative glaucoma with cataract

Introduction: Glaucoma is a progressive optic neuropathy with characteristic optic disc and visual field changes. Major types include primary open angle and primary closed angle glaucoma. Cataract is a progressive degeneration of crystalline lens resulting in its opacification. Incidence of concurrent cataract and glaucoma is increasing. Combined cataract and glaucoma surgery i.e Phacotrabeculectomy can be considered in these cases. Intraoperative and postoperative complications are known in combined surgeries. Comparision of complications and its management in 3 different types of glaucoma undergoing phacotrabeculectomy will be done. Materials and Methods: In this study, 90 eyes with cataract were divided into three groups, group A with POAG, group B with PACG, and group C with PXFG. All patients underwent phacotrabeculectomy by a single surgeon. Intraoperative and post-operative complications at 1 day, 1 week, 1 month, 3 months and 6 months were documented. Management of the complications were also noted. Results: No significant difference was seen in the three groups with respect to complications except at 1 month when high IOP was noted in POAG and PACG, which was statistically significant (p All these cases underwent Argon suturolysis. One case of bleb failure due to late fibrosis was noted each in angle closure and pseudo-exfoliation group at 6 months follow up, which was not statistically significant. Conclusion: No significant difference was noted in the rate of intraoperative and post-operative complications between 3 types of glaucoma following pahcotrabeculectomy. This study shows that phacotrabeculectomy might be used as safe surgery in patients having co-existent cataract and glaucoma. Keywords: Cataract, Complications, Glaucoma, Phacotrabeculectomy.

Medical management of glaucoma and interaction between glaucoma and systemic medications

Glaucoma used to be the most common cause for blindness in Iceland. As the incidence of glaucoma increases with age, the patients often have numerous comorbidities and use various medications. It is important to keep in mind interactions and side effects of glaucoma medications when deciding systemic medical treatment for these patients to ensure their safety and comfort. The goal of the study was to gather information about drug use of patients with severe glaucoma. A retrospective study where data were collected from 100 consecutive patients who underwent a trabeculectomy as first glaucoma surgery at Landspitali National University Hospital of Iceland during 2013-2017. All systemic and ophthalmic medications during 6 months before and after the surgery, medical diagnoses, age and gender of the patients were registered. Of all 100 patients, 87 used systemic medication, averaging 5.3 drugs/patient. Mean number of glaucoma medication used was 3.0. Mean age at surgery was 75 years and 53 were women. The most common systemic drug class was anti-hypertensives, used by 57 patients where beta-blockers were the most common, used by 30 patients. Zopiclone was the most common single drug, used by 29 patients. It is evident that patients with glaucoma take various drugs for systemic illness that can affect their glaucoma and have interactions with glaucoma drugs. It is urgent that healthcare providers keep this in mind when deciding on systemic treatment for patients with glaucoma, with regards to possible interactions with glaucoma drugs and the effect on patient's overall health.

The role of primary intraocular lens implantation in the risk of secondary glaucoma following congenital cataract surgery: A systematic review and meta-analysis.

ObjectiveThis meta-analysis aims to evaluate the incidence of secondary glaucoma in patients under the age of 2 years who underwent congenital cataract surgery with or without primary intraocular lens (IOL) implantation.MethodsAn electronic literature search was performed in Medline, EMBASE, and Web of Science databases to retrieve studies between January 2011 and November 2018. Patients with congenital cataract who did primary IOL implantation, aphakia, or secondary IOL implantation followed by receiving extraction surgery were included in this study. Relevant studies meeting defined eligibility criteria were selected and reviewed systematically by meta-analysis. Long-term incidences of secondary glaucoma, which developed at least one year after cataract surgery, were considered and discussed as clinical outcomes in each cohort. The pooled data were analyzed according to a random effects model.ResultsEight publications involving 892 eyes were included in the current meta-analysis. In the general population of eyes with congenital cataract, the long-term incidence of secondary glaucoma was lower (P = 0.06) in eyes with primary IOL (9.5%) than in eyes without primary IOL (15.1%), including aphakia and secondary IOL. The pooled risk ratio (RR) favors primary IOL implantation in all patients (RR = 0.63). For bilateral congenital cataract, the incidence was 6.7% in eyes with primary IOL implantation, which is significantly lower than the 16.7% in eyes with aphakia and secondary IOL implantation (P<0.05, RR = 0.44). However, for unilateral congenital cataract surgery, the incidence was very similar in eyes with and without primary IOL (12.4% vs 12.0%, P = 0.61, RR = 0.87).ConclusionsIn patients under 2 years of age, primary IOL implantation for bilateral congenital cataract surgery is associated with a lower risk of secondary glaucoma.

Outcomes of Unilateral Cataracts in Infants and Toddlers 7 to 24 Months of Age: Toddler Aphakia and Pseudophakia Study (TAPS)

To evaluate outcomes of unilateral cataract surgery in children 7 to 24 months of age. Retrospective case series at 10 Infant Aphakia Treatment Study (IATS) sites. The Toddler Aphakia and Pseudophakia Study is a registry of children treated by surgeons who participated in the IATS. Children underwent unilateral cataract surgery with or without intraocular lens (IOL) placement during the IATS enrollment years of 2004 and2010. Intraoperative complications, adverse events (AEs), visual acuity, and strabismus. Fifty-six children were included with a mean postoperative follow-up of 47.6 months. Median age at cataract surgery was 13.9 months (range, 7.2-22.9). Ninety-two percent received a primary IOL. Intraoperative complications occurred in 4 patients (7%). At 5 years of age, visual acuity of treated eyes was very good (≥20/40) in 11% and poor (≤20/200) in 44%. Adverse events were identified in 24%, with a 4% incidence of glaucoma suspect. An additional unplanned intraocular surgery occurred in 14% of children. Neither AEs nor intraocular reoperations were more common for children with surgery at 7 to 12 months of age than for those who underwent surgery at 13 to 24 months of age (AE rate, 21% vs. 25% [P= 0.60]; reoperation rate, 13% vs. 16% [P= 1.00]). Although most children underwent IOL implantation concurrent with unilateral cataract removal, the incidence of complications, reoperations, and glaucoma was low when surgery was performed between 7 and 24 months of age and compared favorably with same-site IATS data for infants undergoing surgery before 7 months of age. Our study showed that IOL implantation is relatively safe in children older than 6months and younger than 2 years.

Incidence of Open-angle Glaucoma in Newly Diagnosed Retinal Vein Occlusion: A Nationwide Population-based Study.

The purpose of this study was to compare the incidence of open-angle glaucoma (OAG) in patients with newly diagnosed retinal vein occlusion (RVO) with that in the general population in order to determine the association between OAG and RVO. The Korean Health Insurance Review and Assessment (HIRA) data from 2011 through 2015 was analyzed in order to determine the incidence rates of OAG in the general population and in patients with newly diagnosed RVO based on the diagnostic code. The standardized incidence ratios (SIRs) of OAG in patients with RVO were determined with respect to the age- and sex-matched general population. The incidence rate of OAG in the general population during the 3 years (2013 to 2015) was 233.98 per 100,000 person-years (95% CI, 233.21-234.76). A total of 31,722 patients with newly diagnosed RVO were identified in 2012 as the population at risk. The incidence rate of OAG in patients with RVO during the 3-year follow-up period was 1829.43 per 100,000 person-years (95% CI, 1745.49-1917.42). The expected incidence of OAG in patients with RVO was 433.69 during the 3-year follow-up period. On the other hand, the observed incidence of OAG was 1,741. The SIR of OAG in patients with RVO with reference to the general population was 4.01 (95% CI, 3.83-4.20). The incidence rate of OAG in patients with RVO is significantly higher than that in the general population.

Short-term incidence and management of glaucoma after successful surgery for stage 4 retinopathy of prematurity.

Purpose:The purpose of this study is to describe the short-term incidence, clinical features, and management of glaucoma in children after successful surgery for stage 4 retinopathy of prematurity (ROP).Methods:The retrospective study included all eyes undergoing successful surgery for stage 4 ROP with good outcomes at a tertiary eye care center between June 2014 and June 2016. Cases developing postoperative glaucoma underwent examination under anesthesia for measurement of intraocular pressures (IOP), corneal diameters, Retcam-assisted fundus imaging, and gonioscopy. Outcomes of glaucoma management were evaluated.Results:Hundred eyes of 70 babies underwent successful surgery for stage 4 ROP (with postoperative attached retina, and minimal sequelae) with minimum follow-up of 15 months. Six eyes (6%) developed postoperative glaucoma. Of these, four eyes had undergone lens-sparing vitrectomy and two were managed with lensectomy and vitrectomy (LV). Median time duration for development of glaucoma after primary vitreous surgery was 17.5 weeks. Two cases could be managed with topical IOP-lowering agents alone, whereas four required filtering surgeries (trabeculotomy with trabeculectomy and 0.04% mitomycin C [MMC] application). Average IOP decreased from 25 ± 2.36 to 12.2 ± 2.05 mmHg at 12 months from glaucoma diagnosis.Conclusion:Glaucoma is a potential adverse event following successful vitreous surgery for stage 4 ROP. A combined trabeculotomy–trabeculectomy along with MMC gives favorable outcome.

Nationwide Incidence of Acute Angle Closure Glaucoma in Korea from 2011 to 2015.

BackgroundDespite the significant disease burden, there is a paucity of data addressing the population-based incidence of acute angle closure glaucoma (AACG). Therefore, we estimated the nationwide, population-based standardized incidence rate of AACG in Korea.MethodsWe conducted a nationwide, population-based, retrospective study using the database of National Health Insurance (NHI) system, which includes the entire Korean population (approximately 50 million people) from 2009 to 2015. We identified patients with incident AACG during the 5-year study period from 2011 to 2015 based on their diagnosis and AACG-related treatments (laser iridotomy and cataract surgery), and estimated age- and gender-standardized incidence rate of AACG during the study period.ResultsWe identified 11,049 patients (8,022 women, 72.6%) with incident AACG during the 5-year study period. Of these, after excluding 6 patients under 20 years old, 11,043 patients (8,020 women, 72.6%) aged ≥ 20 years were included in the analysis. The average standardized incidence rate during the 5-year study period was 59.95 (95% confidence interval [CI], 58.87–61.03) per 1,000,000 person-years. The incidence rates increased sharply with age and peaked at individuals aged 75–79 years; in men, those peaked at the same age group, however, in women, those peaked at individuals aged 70–74 years. Women has a 2.56 folds higher incidence rate (85.84 [95% CI, 84.03–87.66] per 1,000,000 person-years) than men (33.48 [95% CI, 32.33–34.62] per 1,000,000 person-years).ConclusionThe present study provides detailed estimates for AACG incidence according to all age groups and gender through the 5-year study period.

Seasonal Variation in the Incidence of Malignant Glaucoma after Cataract Surgery.

Purpose:To investigate a potential link between the incidence of malignant glaucoma after cataract surgery and seasonal variations in daylight.Methods:In total, 18,374 uncomplicated cataract surgeries were performed between June 2008 and June 2013 at an ambulatory surgery center in Toronto. Toronto's average monthly daylight over that time period—in hours per day for each month—was determined. The number of malignant glaucoma cases that developed after cataract surgery performed in months with above average daylight was compared to the number of cases that developed after cataract surgery performed in months with below average daylight. Fisher's exact test was used to analyze the relationship between the development of malignant glaucoma and variation in daylight during the month of cataract surgery.Results:Malignant glaucoma developed in 16 eyes. Thirteen cases of malignant glaucoma developed in months with above average daylight and three cases developed in months with below average daylight (P = 0.01). Eyes that developed malignant glaucoma in months with more daylight were slightly longer (21.95 ± 1.23 mm) than those that developed malignant glaucoma in months with less daylight (21.55 ± 0.88 mm).Conclusion:Light-induced choroidal expansion may play a major role in the development of malignant glaucoma following cataract surgery.

Twenty-three-gauge pars plana approach versus limbal approach for removal of congenital cataracts

Purpose To compare the 23-G vitrectomy system via pars plana approach with the limbal approach for the management of congenital cataract in Egyptian infants attending Mansoura Ophthalmic Center, Delta, Egypt. Patients and methods A total of 30 eyes of 21 infants with congenital cataract who attended Mansoura Ophthalmic Center, Egypt, were included. They were sorted out into two groups; each included 15 eyes. Group I underwent pars plana approach and group II underwent anterior limbal approach for phacoaspiration, posterior capsulorhexis, and anterior vitrectomy. Postoperative examination and follow-up results were recorded. Results There was significant statistical increase in mean duration of surgery in group I (59.27±12.69) than group II (39.93±9.04), with P value less than or equal to 0.001. There was no significant statistical difference in intraocular pressure values at preoperative period, at 1 week, 2 weeks, 1 month, 3 months, and 6 months postoperatively in the studied groups .There was no significant statistical difference in the incidence of visual axis opacification, secondary glaucoma, anterior chamber reaction, capsular phimosis, and wound leak between the two groups. However, there was a significant statistical increase in the incidence of preretinal hemorrhage in group I (26.7%, n=4) when compared with group II (0%, n=0), with P value of 0.032. There was no significant statistical difference in the incidence of secondary glaucoma during a 6-month follow-up period. Conclusion Posterior approach and anterior approach can be used safely for infantile cataract, and the application of the technique depends on surgeon experience and skills.

Subcortical visual pathway may be a new way for early diagnosis of glaucoma

Glaucoma is the leading cause of irreversible blindness worldwide, which is now viewed as a disease of brain with pathogenesis not fully understood. The main diagnostic methods are examining the retinal nerve fiber layer through optical coherence tomography and investigating visual field defect, but these methods present disadvantages in clinical practice. Studies have shown that patients with glaucoma often suffer negative emotion like anxiety and depression which is related to abnormal or reduced amygdala. Moreover, selective reduction of fMRI responses to transient achromatic stimuli in the superficial layer of the superior colliculus was found in the early glaucoma patients. By summarizing previous studies, we developed a hypothesis: superior colliculus-pulvinar-amygdala subcortical visual pathway may be involved in the incidence or progression of glaucoma. Validating this hypothesis would further clarify the mechanism of glaucoma and lead to the development of a more sensitive method for making an early diagnosis of glaucoma.

Prospective analysis of the predictors of glaucoma following surgery for congenital and infantile cataract.

A prospective longitudinal cohort study was performed to assess the incidence of and risk factors for the development of glaucoma following surgery for congenital/infantile cataract. One hundred and one eyes of one hundred and one children, ≤12 years of age who had follow-up of ≥24 months were included. Group I included those who underwent surgery using an anterior approach, group II included those who underwent surgery using a posterior approach, and group III included those who underwent surgery using an anterior approach along with foldable intraocular lens implantation. Standard definitions for glaucoma and glaucoma suspect were used. The Cox proportional hazard model was used to analyze risk factors for glaucoma. Group I: 30 eyes (29.7%); group II: 11 eyes (10.9%); group III 60 eyes (59.4%). The incidence of glaucoma + glaucoma suspect was 7.9% (95% CL: 2.6, 13.2%) in the entire group. The incidence in group I was 16.7% (95% CL 3%, 30%), in group II was 18.2% (95% CL: 0, 41%) and in group III was 1.7% (95% CL: 0, 4.9%). Gonioscopy revealed high iris insertion with grade I (modified Shaffer grading) in one eye each in the glaucoma and glaucoma suspect group and open angles in the rest. Age at surgery of ≤3 months (HR: 6.6, 95% CL: 1.4, 30.6, p = 0.01) was found to be a significant risk factor within the aphakic group. Younger age at the time of surgery was the only identifiable risk factor for glaucoma.

Incidence and prevalence of glaucoma in native and immigrant groups living in Denmark

Incidence and prevalence of glaucoma in native and immigrant groups living in Denmark

Eight-Year Incidence of Open-Angle Glaucoma in the Tema Eye Survey

To determine the incidence of open-angle glaucoma (OAG) and its risk factors in the Tema Eye Survey in Ghana, West Africa. Longitudinal, observational population-based study. One thousand two hundred five of 1500 participants 40 years of age or older selected randomly from 5603 participants originally drawn from the population and who had undergone a baseline examination. All participants underwent baseline and follow-up ophthalmologic examinations 8 years apart. Glaucoma diagnosis was determined based on the International Society for Geographical and Epidemiologic Ophthalmology criteria. Incidence and odds ratio (OR). The response rate was 80.3%. Of 1101 nonglaucomatous participants at baseline who had complete follow-up data, 4.6% (95% confidence interval [CI], 3.7%-5.2%) demonstrated OAG over the 8-year period, or 0.58% (95% CI, 0.4%-0.8%) per year. The 8-year incidence increased with age from 3.1% in those 40 to 49 years old to 7.0% in those 60 to 69 years old. Baseline risk factors for incident OAG were male gender (OR, 2.1; 95% CI, 1.1-4.0; P= 0.025), older age relative to those 40 to 49 years old (those 50-50 years old: OR, 2.6; 95% CI, 1.2-5.7; those 60-69 years old: OR, 4.3; 95% CI, 2.0-8.8; and for those 70 years of age andolder: OR, 6.3; 95% CI, 2.6-15.4; all P < 0.001), higher intraocular pressure (IOP; OR, 1.4; 95% CI, 1.1-1.8; P< 0.001), larger vertical cup-to-disc ratio (OR, 5.8; 95% CI, 5.2-6.6; P < 0.001), and thinner central cornea (OR, 1.2; 95% CI, 1.03-1.5; P= 0.013). A separate analysis performed with central corneal thickness-based IOP correction did not change the outcome of the associative model of incident glaucoma. The incidence of OAG is higher in this population than reported in nonblack populations outside Africa. This is important not only in Ghana and probably other West African countries but also wherever people of the West African diaspora reside. These data enhance our understanding of the epidemiologic factors of OAG in this setting and may serve as reference for public health policy and planning.

Long-Term Dynamics and Medium-Term Prognosis for Glaucoma Incidence in the Amur Region

Long-Term Dynamics and Medium-Term Prognosis for Glaucoma Incidence in the Amur Region

PMD16 - Comparing the Long-Term Impact on Healthcare Resources and Costs Due to Single-Piece Acrylic Intraocular Lens (IOL) Implantation During Cataract Surgery: A Cost-Consequence Analysis From Italian Healthcare System Perspective

Posterior Capsular Opacification (PCO) is a key secondary complication of IOL implant following cataract surgery and clinically significant PCO requires Nd: YAG laser capsulotomy treatment which in turn could lead to further complications. The objective of this analysis was to develop a cost-consequence model to estimate the healthcare resource utilization and cost impact of YAG procedures due to different single-piece acrylic IOLs. A cost-consequence model from Italian national healthcare system perspective was developed. For input parameters, three year incidence of Nd:YAG laser capsulotomy for five single-piece acrylic IOL s (2.4% for AcrySof, 5.1% for Tecnis, 9.2% for Akreos, 12.3% for Lenstec and 12.6% for Rayner) were derived from a retrospective electronic medical records database study. Weighted average calculations were performed to derive 3 year post-YAG incidence of retinal detachment (4.4%), glaucoma (8.8%), and cystoid macular edema (16.9%) using published data. National average of published YAG (€95.4) and Vitrectomy (€1641) DRG tariffs were used, and glaucoma (€522) and CME treatment costs (€79.8) were sourced from the literature. Number of cataract procedures per annum was derived from Eurostat statistics. For 526,966 cataract procedures carried out in a year, in 3-years post cataract surgery, single-piece hydrophobic AcrySof IOLs could result in substantially fewer Nd:YAG procedures compared to Tecnis (n=14,228), B&L Akreos (n=35,834), Lenstec (n=52,170) and Rayner (n=53,751) IOLs with subsequent reductions in vitrectomy, glaucoma and CME treatments. Total cost savings for the Italian healthcare system due to AcrySof IOLs could be in the range of €3.2 to €12.2 million. These results suggest that single-piece hydrophobic AcrySof IOLs are associated with significantly lower incidence of Nd:YAG capsulotomy compared to comparator IOLs resulting in significant reduction in healthcare resource utilization for facilities and cost savings for budget owners.

FREQUENCY OF CONGENITAL GLAUCOMA

Objectives: To compare the incidence of congenital glaucoma of childrenin Pakistan with the world incidence. Study Type, Setting and Period: Comparative study,conducted at Al Shifa eye hospital Rawalpindi from August 2010 to September 2014. Materialand Method: The record was analyzed of congenital eye anomalies of the children comingto hospital, focusing on congenital glaucoma. Results: There were total five hundreds andfourteen congenital anomalies of eyes (225 females, 289 males). The main bulk of patients werebetween births to two years. The frequency of congenital glaucoma was17 (3.3%) with variablevisual standards. Conclusion: Although the frequency of congenital glaucoma is not alarmingin this study but early management will prevent from permanent blindness.

CONGENITAL GLAUCOMA;

Objectives: To compare the incidence of congenital glaucoma of childrenin Pakistan with the world incidence. Study Type, Setting and Period: Comparative study,conducted at Al Shifa eye hospital Rawalpindi from August 2010 to September 2014. Materialand Method: The record was analyzed of congenital eye anomalies of the children comingto hospital, focusing on congenital glaucoma. Results: There were total five hundreds andfourteen congenital anomalies of eyes (225 females, 289 males). The main bulk of patients werebetween births to two years. The frequency of congenital glaucoma was17 (3.3%) with variablevisual standards. Conclusion: Although the frequency of congenital glaucoma is not alarmingin this study but early management will prevent from permanent blindness.

Five-Year Postoperative Outcomes of Bilateral Aphakia and Pseudophakia in Children up to 2 Years of Age: A Randomized Clinical Trial

Comparative evaluation of complications and visual outcomes following bilateral congenital cataract surgery in children up to 2 years of age with and without primary intraocular lens (IOL) implantation at 5 years follow-up. Randomized controlled clinical trial. Sixty children (120 eyes) up to 2 years of age undergoing bilateral congenital cataract surgery were randomized to Group 1, primary aphakia (n=30), or Group 2, primary IOL implantation (pseudophakia) (n= 30). A single surgeon performed surgeries with identical surgical technique. All patients were followed up regularly until 5 years postoperatively. At each follow-up, glaucoma, visual axis obscuration (VAO) requiring surgery, and inflammation (cell deposits, posterior synechiae) were assessed. Visual acuity was assessed until 5 years follow-up. The first operated eye was selected for statistical analysis. Median age of the patients at time of surgery was 5.11months (aphakia group) and 6.01months (pseudophakia group) (P= .56). Five years postoperatively, incidence of glaucoma was 16% and 13.8% in Groups 1 and 2 (P= .82). Incidence of posterior synechiae was significantly higher in the pseudophakia group (27.6%) compared to the aphakia group (8%) (P= .004). VAO requiring surgery was seen in 8% and 10.3% of eyes in Groups 1 and 2 (P= .76). Mean logMAR visual acuity at 5 years follow-up was 0.59 ± 0.33 and 0.5 ± 0.23 in Groups 1 and 2, respectively (P= .79). However, more eyes in the pseudophakic group started giving documentable vision earlier in their postoperative follow-ups. Incidence of postoperative complications was comparable between the groups, except for a higher incidence of posterior synechiae in pseudophakic eyes. Visual rehabilitation was faster in the pseudophakic group.

Increased risk of open-angle glaucoma among patients with diabetes mellitus: a 10-year follow-up nationwide cohort study.

To evaluate the risk of open-angle glaucoma among patients with diabetes. This retrospective propensity score-matched cohort study included patients with diabetes and a matched comparison group from the Korean National Health Insurance Service National Health Screening Cohort, which includes approximately 500000 adults aged ≥40years. Nondiabetes group was matched to diabetes group in a 1:1 ratio using a propensity score based on age, sex, comorbidities, antihypertensive medication use and medical care visits. Each group was followed from January 1, 2004 to either the date of developing open-angle glaucoma or the date of last follow-up in 2013. Incidence of open-angle glaucoma was 20.0/10000 person-years in diabetes group (n=58358) and 17.0/10000 person-years in nondiabetes group (n=58358). Age- and sex- adjusted hazard ratio (HR) was 1.19 (95% confidence interval [CI], 1.09-1.30). In the subgroup analyses, diabetes was associated with an increased risk of open-angle glaucoma in both younger and older age groups (HR=1.20 for those aged 40-59years and HR=1.18 for those aged 60-79years) and in both sexes (men, HR=1.13; women, HR=1.27). Patients diagnosed with diabetes were more likely to develop open-angle glaucoma compared with patients without diabetes.