Secondary Angle Research Articles

Intraocular pressure elevation precedes a phagocytosis decline in a model of pigmentary glaucoma.

Background: Outflow regulation and phagocytosis are key functions of the trabecular meshwork (TM), but it is not clear how the two are related in secondary open angle glaucomas characterized by an increased particle load. We hypothesized that diminished TM phagocytosis is not the primary cause of early ocular hypertension and recreated pigment dispersion in a porcine ex vivo model. Methods: Sixteen porcine anterior chamber cultures received a continuous infusion of pigment granules (Pg), while 16 additional anterior chambers served as controls (C). Pressure transducers recorded the intraocular pressure (IOP). The phagocytic capacity of the trabecular meshwork was determined by fluorescent microspheres. Results: The baseline IOPs in Pg and C were similar ( P=0.82). A significant IOP elevation occurred in Pg at 48, 120, and 180 hours (all P<0.01, compared to baseline). The pigment did not cause a reduction in TM phagocytosis at 48 hours, when the earliest IOP elevation occurred, but at 120 hours onward ( P=0.001 compared to C). This reduction did not result in an additional IOP increase at 120 or 180 hours compared to the first IOP elevation at 48 hours ( P>0.05). Conclusions: In this porcine model of pigmentary glaucoma, an IOP elevation occurs much earlier than when phagocytosis fails, suggesting that two separate mechanisms might be at work.

Autotaxin-Lysophosphatidic Acid Pathway in Intraocular Pressure Regulation and Glaucoma Subtypes.

To compare the levels of autotaxin (ATX), lysophosphatidic acid (LPA), and lysophosphatidylcholine (LPC) in the aqueous humor (AH) of healthy control subjects with those of patients with different subtypes of glaucoma, and also to investigate the relationship of the ATX-LPA pathway with IOP and subtype of glaucoma. This study included 164 eyes of 164 consecutive cases of cataract and glaucoma surgery (37 healthy, 31 normal tension glaucoma, 49 primary open angle glaucoma, 28 secondary open angle glaucoma, and 19 exfoliation glaucoma). Aqueous levels of LPA, LPC, and ATX were quantified using liquid chromatography-tandem mass spectrometry and a two-site immunoenzymetric assay. The association between aqueous levels of ATX/LPA/LPC and IOP elevation in different glaucoma subtypes was investigated. The diagnostic values of indices of the ATX-LPA pathway were compared using receiver operating characteristic curve analysis. Notable increases in ATX/LPA/LPC levels in glaucoma patients were observed. The ATX-LPA pathway was significantly related to IOP elevation and the subtype of glaucoma, especially in SOAG and XFG patients, and the area under the curve was significant for discriminating glaucoma eyes from healthy eyes. Bioactive ATX/LPA/LPC concentrations were present in aqueous humor, and higher ATX and LPA concentrations were significantly correlated with IOP in all study subjects. Furthermore, the ATX-LPA pathway was significantly related to glaucoma subtype. These results reveal the potentially important role of the ATX-LPA pathway for IOP regulation in healthy subjects and glaucoma patients.

Ocena szczelności bariery krew-ciecz wodnista metodą flarymetrii u chorych z jaskrą wtórną otwartego kąta po zabiegu kanaloplastyki z fakoemulsyfikacją w porównaniu do chorych po zabiegu fakoemulsyfikacji

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Szymor J, Jurowski P. Flarymetry measurement of blood-aqueous barrier breakdown after canaloplasty combined with phacoemulsification versus phacoemulsification in patients with secondary open angle glaucoma. Klinika Oczna / Acta Ophthalmologica Polonica. 2018;120(3):133-138. doi:10.5114/ko.2018.81093. APA Szymor, J., & Jurowski, P. (2018). Flarymetry measurement of blood-aqueous barrier breakdown after canaloplasty combined with phacoemulsification versus phacoemulsification in patients with secondary open angle glaucoma. Klinika Oczna / Acta Ophthalmologica Polonica, 120(3), 133-138. https://doi.org/10.5114/ko.2018.81093 Chicago Szymor, Joanna, and Piotr Jurowski. 2018. "Flarymetry measurement of blood-aqueous barrier breakdown after canaloplasty combined with phacoemulsification versus phacoemulsification in patients with secondary open angle glaucoma". Klinika Oczna / Acta Ophthalmologica Polonica 120 (3): 133-138. doi:10.5114/ko.2018.81093. Harvard Szymor, J., and Jurowski, P. (2018). Flarymetry measurement of blood-aqueous barrier breakdown after canaloplasty combined with phacoemulsification versus phacoemulsification in patients with secondary open angle glaucoma. Klinika Oczna / Acta Ophthalmologica Polonica, 120(3), pp.133-138. https://doi.org/10.5114/ko.2018.81093 MLA Szymor, Joanna et al. "Flarymetry measurement of blood-aqueous barrier breakdown after canaloplasty combined with phacoemulsification versus phacoemulsification in patients with secondary open angle glaucoma." Klinika Oczna / Acta Ophthalmologica Polonica, vol. 120, no. 3, 2018, pp. 133-138. doi:10.5114/ko.2018.81093. Vancouver Szymor J, Jurowski P. Flarymetry measurement of blood-aqueous barrier breakdown after canaloplasty combined with phacoemulsification versus phacoemulsification in patients with secondary open angle glaucoma. Klinika Oczna / Acta Ophthalmologica Polonica. 2018;120(3):133-138. doi:10.5114/ko.2018.81093.

Chronic and Intermittent Angle Closure Caused by In-The-Bag Capsular Tension Ring and Intraocular Lens Dislocation in Patients With Pseudoexfoliation Syndrome

A subluxation or dislocation of the intraocular lens (IOL) is a well-known complication after cataract surgery in patients with pseudoexfoliation syndrome (PEX). Capsular tension rings (CTR) are frequently used to prevent postoperative complications caused by zonular weakness. Here we present a series of 7 cases, 2 with intermittent and 5 with acute angle closure caused by a combination of PEX-associated zonular weakness and a resulting unstable capsular bag-CTR-IOL complex. We describe the typical clinical course with elevated intraocular pressure, myopic shift, and shallowing of the anterior chamber in 7 patients with a new type of secondary angle closure. The diagnostic challenges and treatment options are discussed in detail. In all cases, the mechanism of angle closure identified by ultrasound biomicroscopy was an anterior dislocation of the peripheral iris by the capsular bag-CTR-IOL complex. The IOL was removed together with the capsular bag and the CTR and replaced by an iris-fixated IOL in all cases. We present a new type of secondary angle closure caused by an anterior dislocated capsular bag-CTR-IOL complex. The cause of both, this atypical presentation and the ineffectiveness of the laser peripheral iridotomy is the large diameter CTR. Therefore CTR implantation might also be the source of late postoperative complications. If a secondary angle closure associated with PEX and unstable capsular bag-CTR-IOL complex is encountered, IOL explantation and replacement by an iris-fixated IOL is a simple and effective treatment option.

Root Phenotyping of Two Soybean (Glycine max L.) Cultivars in a Vertisol of Central India

The root system architecture (RSA) is a highly plastic trait and in evitable for plant growth because of its role in water and nutrient acquisition. Soybean, an important economic leguminous crop of India, but its RSA is largely unknown. The RSA of two popular soybean cultivars grown in central India viz., JS-335 and JS-9560 was investigated to compare their root phenotype in a clay soil under laboratory condition. It has been observed that root length, root surface area and root volume of JS-9560 were significantly higher than that of JS-355; whereas root diameter of JS-9560 was significantly lower compared to JS-335. Further, in JS-9560, number of nodes, primary roots, secondary roots, length of primary roots and secondary roots were 17, 8, 20, 24 and 16% higher than JS-335. Primary and secondary root insertion angle was observed to be 33 and 11% narrower in JS-9560 than in JS-335. Based on the findings, JS-9560 showed superior RSA over JS-335 and thus, the cultivar may be consider for further physiological and molecular studies for its adaptability to moisture stress condition.

Parametric investigation of secondary injection in post-chamber on combustion performance for hybrid rocket motor

The objective of this effort is to study the combustion performance of a hybrid rocket motor with the help of 3D steady-state numerical simulation, which applies 90% hydrogen peroxide as the oxidizer and hydroxyl-terminated polybutadiene as the fuel. A method of secondary oxidizer injection in post-chamber is introduced to investigate the flow field characteristics and combustion efficiency. The secondary injection medium is the mixed gas coming from liquid hydrogen peroxide catalytic decomposition. The secondary injectors are uniformly set along the circumferential direction of the post-chamber. The simulation results obtained by above model are verified by experimental data. Three influencing parameters are considered: secondary injection diameter, secondary injection angle and secondary injection numbers. Simulation results reveals that this design could improve the combustion efficiency with respect to the same motor without secondary injection. Besides, the secondary injection almost has no effect on the regression rate and fuel sueface temperature distribution. It is also presented that the oxidizer is injected by 8 secondary injectors with a diameter of 7–8 mm in the direction of 120°in post-chamber is identified as the optimized secondary injection pattern, through which combustion efficiency, specific impulse efficiency as well as utilization of propellants are all improved obviously.

Research on the numerical simulation of secondary air diffusion angle to the swirl burners combustion process

In this paper, the combustion process of swirl burners during 660 MW unit power plant is simulated. The influence of secondary air diffusion angle on the furnace temperature and furnace slagging is studied. In detail the temperature field and the carbon concentration field and velocity field inside the furnace are analysed when the secondary air diffusion angle is set as 30 °, 45 ° and 60 ° respectively. The simulation results show that when the secondary air diffusion angle is set as 30°, the center temperature of the furnace is highest, and at this time the pulverized coal combustion is sufficient, the carbon concentration near the water wall is the lowest, moreover, it is not easy to slag in the furnace. With the increase of secondary air diffusion angle, the center temperature of boiler burning zone gradually decline, carbon concentration near the water wall increase, it is the more prone to coking inside the furnace. The numerical simulation results not only provide a reference basis for the boiler operation, but also provide an important reference value for exquisite combustion research of the boiler.

Ultrasound ciliary plasty to treat glaucoma: efficacy and safety results on 152 patients

PurposeTo evaluate the efficacy and safety of the Ultrasound Ciliary Plasty (UCP) procedure using Focused ultrasound with second generation probe on a consecutive series of 152 glaucoma patients.MethodsProspective clinical series of 169 eyes of 152 patients with primary and secondary open angle or angle closure glaucoma treated between April 2015 and September 2016 in 2 University Hospitals. Procedures were conducted with second generation therapy probe comprising 6 piezoelectric transducers, with 8 seconds exposure time per transducer (standard protocol). Complete ophthalmic examinations were performed before the procedure, and at 1 day, 1 week, 1, 3, 6 and 12 months after. Primary outcome was IOP reduction compared to baseline. Secondary outcomes were success rate (defined as IOP reduction from baseline ≥20% and IOP &gt;5 mmHg without adding medication compared to baseline), vision‐threatening complications, hypotensive medication use, complications, and re‐interventions.ResultsNo major intra‐ or post‐operative complications occurred. Ocular exam did not reveal lesions of ocular structures other than ciliary body and no or few signs of anterior chamber inflammation. Semi‐mydriasis was observed on fifteen eyes, reduced or resolved in a few weeks/months. Intraocular pressure was significantly reduced from a mean preoperative value of 27.1 ± 9.3 mmHg (3.1 hypotensive medications) to a mean value of 19.1 ± 7.6 mmHg (3.2 hypotensive medications) at last follow‐up, corresponding of a mean IOP reduction of 27%. Nineteen patients were re‐treated using focused ultrasound, 7 patients were considered as failure and treated by filtering surgery, and 8 patients with Diode laser cyclo‐destructive procedure.ConclusionsUltrasound Ciliary Plasty using High Intensity Focused Ultrasound is an effective method to reduce intraocular pressure in patients with glaucoma.

Optical Coherence Tomography Analysis Based Prediction of Humphrey 24-2 Visual Field Thresholds in Patients With Glaucoma.

PurposeA pilot study showed that prediction of individual Humphrey 24-2 visual field (HVF 24-2) sensitivity thresholds from optical coherence tomography (OCT) image analysis is possible. We evaluate performance of an improved approach as well as 3 other predictive algorithms on a new, fully independent set of glaucoma subjects.MethodsSubjects underwent HVF 24-2 and 9-field OCT (Heidelberg Spectralis) testing. Nerve fiber (NFL), and ganglion cell and inner plexiform (GCL+IPL) layers were cosegmented and partitioned into 52 sectors matching HVF 24-2 test locations. The Wilcoxon rank sum test was applied to test correlation R, root mean square error (RMSE), and limits of agreement (LoA) between actual and predicted thresholds for four prediction models. The training data consisted of the 9-field OCT and HVF 24-2 thresholds of 111 glaucoma patients from our pilot study.ResultsWe studied 112 subjects (112 eyes) with early, moderate, or advanced primary and secondary open angle glaucoma. Subjects with less than 9 scans (15/112) or insufficient quality segmentations (11/97) were excluded. Retinal ganglion cell axonal complex (RGC-AC) optimized had superior average R = 0.74 (95% confidence interval [CI], 0.67–0.76) and RMSE = 5.42 (95% CI, 5.1–5.7) dB, which was significantly better (P < 0.05/3) than the other three models: Naïve (R = 0.49; 95% CI, 0.44–0.54; RMSE = 7.24 dB; 95% CI, 6.6–7.8 dB), Garway-Heath (R = 0.66; 95% CI, 0.60–0.68; RMSE = 6.07 dB; 95% CI, 5.7–6.5 dB), and Donut (R = 0.67; 95% CI, 0.61–0.69; RMSE = 6.08 dB, 95% CI, 5.8–6.4 dB).ConclusionsThe proposed RGC-AC optimized predictive algorithm based on 9-field OCT image analysis and the RGC-AC concept is superior to previous methods and its performance is close to the reproducibility of HVF 24-2.

Heat transfer enhancement in microchannel heat sink using hybrid technique of ribs and secondary channels

The flow and heat transfer characteristics of microchannel heat sink with secondary oblique channels in alternating direction and rectangular ribs (MC-SOCRR) are studied numerically for Reynolds number (Re) ranging from 100 to 500. The effects of secondary channels and ribs on the Nusselt number and friction factor are investigated. A comparative analysis has been conducted to the performance of the proposed design with related geometries such as microchannel with rectangular ribs (MC-RR) and microchannel with secondary oblique channels (MC-SOC). The results emphasized the superiority of overall performance of MC-SOCRR over both MC-RR and MC-SOC. The strategy which pursued by new design is the exploitation of larger flow area which provided by secondary channel to reduce pressure drop caused by ribs. Besides, the existence of the ribs in central portion of the channel is utilized to inject more flow through secondary channels for further enhancement in flow mixing. The effect of three geometrical parameters; relative width of secondary channel (λ) relative rib width (β) and angle of secondary channel (θ) on the convective heat transfer and pressure drop have been investigated. The MC-SOCRR with parameters; λ=0.666, β=0.5 and angle=45° yields the best overall performance with Pf=1.98 at Re=500.

Transition temperature of poly(methyl methacrylate) determined by time-of-flight secondary ion mass spectrometry and contact angle measurements

The surface chain conformations of poly(methyl methacrylate) (PMMA) at different temperatures were extensively studied by time-of-flight secondary ion mass spectrometry (ToF-SIMS). Similar to our previous experimental studies on polystyrene (PS) and poly(2, 3, 4, 5, 6-pentafluorostyrene) (5FPS), a transition temperature (TT) could be identified through the principal component analysis (PCA) of the ToF-SIMS spectra obtained from the PMMA samples annealed at different temperatures. Interestingly, our results show that the TT depended on molecular weight and was about 50–60˚C below the bulk glass transition temperature (Tg) and therefore could possibly be related to the surface glass transition temperature (TgS). These results were confirmed by contact angle measurements. ToF-SIMS results showed higher peak intensities of several low-mass oxygen-containing positive ions, hydrocarbon positive ions and OCH3− negative ion at higher temperatures, which can be interpreted by a higher surface concentration of methoxy groups at the surface.

Effect of outer secondary air vane angles on combustion characteristics and NOx emissions for centrally fuel rich swirl burner in a 600-MWe wall-fired pulverized-coal utility boiler

To solve the high NOx emissions associated with a 600 MWe utility boiler with enhanced-ignition axial control low NOx (EI–XCL) burners, continuous improvement of the previously proposed centrally fuel-rich (CFR) burner technology lies on three aspects: (1) the 36 EI–XCL burners in the original furnace were retrofitted with CFR burners; (2) the 26 over fire air (OFA) ports in two layers have been added above the burners along the top row of the furnace; (3) the designed OFA ratio was 25%. Industrial-size measurements (i.e., adjusting outer secondary air vane angle of 20–30°) uncovered that, compared with the prior EI–XCL burners, the CFR burner exhibited the same good ignition performance and the O2 concentrations near the side walls were found to be above 6% when the secondary air mass flow rate of the burner decreases about 37% for all three outer secondary air vane angles. The NOx emissions decrease from 316 to 237mg/m3 (O2=6%) when outer secondary air vane angle varies from 20° to 30°. Under the optimal outer secondary air vane angle, NOx emissions were found to decrease by 60.50% at a load of 600MWe subsequent to retrofitting of the boiler.

Biomimetic composites inspired by venous leaf

A typical plant leaf can be idealized as a composite having three principal fibers: the central mid-fiber corresponding to the mid-rib, straight parallel secondary fibers attached to the mid-fiber representing the secondary veins, and then another set of parallel fibers emanating from the secondary fibers mimicking the tertiary fibers embedded in a matrix material. This paper introduces a biomimetic composite design inspired by the morphology of venous leafs and investigates the effects of venation morphologies on the in-plane mechanical properties of the biomimetic composites using finite element method. The mechanical properties such as Young’s moduli, Poisson’s ratio, and yield stress under uniaxial loading of the resultant composite structures was studied and the effect of different fiber architectures on these properties was investigated. To this end, two broad types of architectures were used both having similar central main fiber but differing in either having only secondary fibers or additional tertiary fibers. The fiber and matrix volume fractions were kept constant and a comparative parametric study was carried out by varying the inclination of the secondary fibers. The results show that the elastic modulus of composite in the direction of main fiber increases linearly with increasing the angle of the secondary fibers. Furthermore, the elastic modulus is enhanced if the secondary fibers are closed, which mimics composites with closed cellular fibers. In contrast, the elastic modulus of composites normal to the main fiber ( x direction) exponentially decreases with the increase of the angle of the secondary fibers and it is little affected by having secondary fibers closed. Similar results were obtained for the yield stress of the composites. The results also indicate that Poisson’s ratio linearly increases with the secondary fiber angle. The results also show that for a constant fiber volume fraction, addition of various tertiary fibers may not significantly enhance the mechanical properties of the composites. The mechanical properties of the composites are mainly dominated by the secondary fibers. Finally, a simple model was proposed to predict these behaviors.

Medical and surgical management has a role in control of intraocular pressure in early detected iridocorneal endothelial syndrome: case series

Iridocorneal endothelial syndrome is a rare ocular disorder characterized by abnormal endothelization of angle structure and iris producing characteristic manifestation including secondary angle closure glaucoma. The purpose is to present four cases of iridocorneal endothelial syndrome with glaucoma and discuss clinical presentation and management strategies. Out of four cases, two cases of Cogan-Reese syndrome who present early have well controlled IOP with trabeculectomy with mitomycin-C. One case who presented late with progressive iris atrophy and secondary angle closure glaucoma went to absolute stage in spite of trabeculectomy with mitomycin-C. One case with Chandler’s syndrome has well controlled IOP with topical anti-glaucoma medication.

Survey of Traumatic Glaucoma in a Tertiary Hospital

Background: Traumatic eye injury is one of the most common causes of unilateral blindness worldwide and it remains a core root of avoidable blindness worldwide. Traumatic glaucoma can result in severe visual impairment. Recognition of factors related to poor visual outcome, appropriate medical therapy, surgical intervention when indicated and careful follow up will help in preserving vision in these patients. This study is aimed at determining the frequency, clinical forms and types of therapy of traumatic glaucomas as seen in our hospital. Methods: All consecutive patients with ocular injury who received treatment at the eye clinic of Ekiti state university teaching hospital, Ado Ekiti, from January 2012 to December 2014 were selected for the study. All subjects had thorough ophthalmic examinations. The patients with ocular injury and subsequently developed glaucoma were selected extracting from the medical records the demographic data, visual acuity at presentation, clinical form of glaucoma and various therapies for management. The data were analysed using SPSS version 18 (Illinois, Chicago, USA) and presented as tables, and figures, in frequencies, percentage. Result: A total of 5568 patients were seen during this study at the ophthalmology clinic, 365 of them had ocular trauma out of which 31(8.5%) was traumatic glaucoma. Peripheral anterior synerchae (29%), adherent leucoma (16.1%) and Hyphema (16.1%) were the common clinical manifestations (anatomic changes) of traumatic glaucoma. The clinical types of traumatic glaucoma are secondary open angle glaucoma (54.8%) which is higher than the secondary closed angle type (45.2%). 22 (71%) of these patients had medical interventions with antiglaucoma drugs. Conclusion: The prevalence of traumatic glaucoma is 8.5%, this glaucoma may result in severe visual impairment if treatment is not instituted early.

The Influence of Tool Geometry towards Cutting Performance in Machining Aluminium 7075

Aerospace industries often use Computer Numerical Control (CNC) machining in manufacturing aerospace parts. Aluminium 7075 is the most common material used as aircraft components. This research aims to produce end mill with optimum geometry in terms of the helix angle, primary radial relief angle and secondary relief angle. End mills with different geometry parameters are tested on Aluminium 7075 and data on surface roughness and tool wear were collected. The results were then analysed to determine which parameters brought the optimum result with regards to surface roughness and tool wear.

Comparing pattern scanning laser trabeculoplasty to selective laser trabeculoplasty: A randomized controlled trial.

To compare safety, tolerability and intraocular pressure (IOP)-lowering efficacy of pattern scanning laser trabeculoplasty (PSLT) with selective laser trabeculoplasty (SLT) in fellow eyes of untreated patients with glaucoma. Randomized controlled trial. Twenty-nine patients (58 eyes) with primary and secondary open angle glaucoma (OAG) were randomized to undergo PSLT or SLT in each eye. Pattern scanning laser trabeculoplasty was performed using the Pascal laser (Pascal Streamline 577; Topcon Inc., Tokyo, Japan). Patients' comfort level to treatment was assessed using a visual analogue scale (VAS). Follow-up visits were at week 1, month 1, 3 and 6. Success was defined as IOP reduction ≥20%. Safety, tolerability and IOP reduction. The mean age of patients was 54.1±15.5years. Baseline IOP was similar between both groups (PSLT, 17.3±4.0mmHg; SLT, 16.8±3.6mmHg, p>0.05). In the PSLT group, the mean IOP at 1, 3 and 6months was 14.2±3.5, 13.9±2.6 and 14.0±2.7mmHg, respectively. In the SLT group, the mean IOP at 1, 3 and 6months was 14.4±4.1, 13.7±3.2 and 13.7±3.1mmHg, respectively. The IOP reduction in the PSLT group was greater than the SLT group at 1month (p<0.01) and 3months (p<0.01). VAS score was better in PSLT eyes: 23.9±20.5 (range, 0-82) than in SLT eyes: 50.4±25.3 (range, 0-98) (p<0.001). No serious adverse events were recorded. Both laser modalities had similar safety and efficacy profiles while PSLT was better tolerated by patients.

Experimental study on the characteristics of axisymmetric cavity actuated supersonic flow

The effective means of air fuel mixing and flame holding can be achieved by incorporating cavity in supersonic combustor. Understanding the complex flow field of cavity flow is essential for the design of supersonic combustor. An attempt is made to understand the characteristics of supersonic flow past axisymmetric cavity, and a series of nonreacting experiments are carried out in a blow-down type supersonic flow facility. The facility consists of a supersonic nozzle, issues a flow Mach number of 1.80 into a circular cross sectional supersonic combustor in which axisymmetric cavity is placed. Cavity of two consecutive aft wall angles is the key parameter for the study. The performance of the cavity is investigated based on the static pressure measurement, momentum flux distribution at the exit plane of the combustor, and the stagnation pressure loss of the flow. Wall static pressure distribution revealed that pressure increases with decrease in the secondary aft wall angle below 45° due to stronger recompression of shear layers. Moreover, decreasing primary aft wall angle provides a uniform mixing profile along with decrease in stagnation pressure loss across the combustor.

Anterior chamber lenses

SummaryThe anterior chamber intraocular lens (ACIOL) is the ideal intraocular lens (IOL) both for implantation during intracapsular cataract extraction and for secondary implantation. It is also useful during extracapsular cataract surgery, being especially indicated if there is a total absence of capsular support.ACIOLs are preferred over sulcus‐sutured IOLs because they are technically easier to implant, are reasonably well‐tolerated, and have a low rate of postoperative IOL decentration or tilt. However ACIOLs have also become one of the causes of IOL exchange and explantation.Implant‐related problems such as discrepancies between anterior chamber biometry and IOL size may cause pseudophakodonesis in the aqueous, resulting in progressive endothelial cell loss. Because of endothelial complications, they must be reserved for elderly patients.Infrequently, ACIOL‐iris contact may lead to pigment dispersion with subsequent inflammation. Occasionally, secondary angle closure and glaucoma with corneal decompensation due to haptic displacement may develop. Due to these reasons, eyes with shallow anterior chambers or early corneal guttata have been treated as relative contraindications for ACIOLs.

Controversies between how to handle uveitis and glaucoma. The point of view of the uveitis specialist

SummaryUveitic glaucoma is often associated with high pressures and may damage the optic nerve faster than other forms of glaucoma. Therefore, early diagnosis and adequate treatment are essential. The key to successful treatment is an understanding of the pathogenetic mechanisms (secondary open‐angle, secondary angle closure, forward rotation of the ciliary body, etc.) Moreover, one should realize that combined mechanisms are more common in uveitic glaucoma than in other forms of glaucoma.Steroid‐induced pressure rise is common in uveitis patients and should be dealt with in a proper way: do not cut on steroids, but treat the glaucoma agressively. In those patients who have chronic uveitis and are steroid responders, surgery is a better option than medical treatment. Tubes are preferred over trabeculectomy with mitomycin in eyes with chronic inflammation.Contrary to some recommendations, prostaglandins should not be avoided in uveitis patients for fear of cystoid mcular oedema. They should be avoided however in uveitis of herpetic origin.