Interventional Glaucoma

The results of a questionnaire sent out to consultant ophthalmologists in the UK, has discovered that there is no one strategy in place for the management of glaucoma in pregnant women.

Nitric oxide-donating derivatives of latanoprost for the treatment of glaucoma have been shown to successfully lower intraocular pressure (IOP) in preclinical studies.

Results of a Phase III trial of the once-daily formulation of Xibrom (ISTA Pharmaceuticals) has found it to be both safe and efficacious.

Glaucoma medication timolol exerts a direct antioxidant effect, protecting human endothelial cells from oxidative stress.

GDx variable cornea compensation with scanning laser polarimetry (SLP-VCC), Heidelberg retina tomography (HRT) confocal scanning laser ophthalmoscopy (CSLO) and stereoscopic optic nerve head (ONH) photographs may all be useful in assisting clinicians to diagnose glaucoma.

Trabeculectomy is in danger of becoming a technique performed only by sub-specialists with glaucoma fellowship training unless it becomes a mandatory feature in training programmes.

Phaco-trabeculotomy in addition to deep sclerectomy can offer significant reductions in intraocular pressure (IOP).

Manual small incision cataract surgery (MSCIS) with trypan blue staining of the anterior capsule is a safe and effective method of cataract extraction for patients with phacolytic glaucoma.

The Ahmed glaucoma valve (AGV) and the Molteno single plate implant (MSPI) may provide good early and intermediate-term control of intraocular pressure (IOP) in patients with neovascular glaucoma (NVG), but do not achieve the same success when implanted for long periods.

Selective laser trabeculoplasty (SLT) is comparable to medical treatment as the initial therapy for open-angle glaucoma (OAG) or ocular hypertension, according to results of a study presented at the American Academy of Ophthalmology annual meeting, last year in Las Vegas.

Intraocular pressure (IOP) measurements with the Pascal dynamic contour tonometer (PDCT) are relatively immune to changes in corneal biomechanics and pachymetry.

The UK Royal National Institute of the Blind (RNIB) is launching a campaign encouraging glaucoma patients to follow their medical advice more thoroughly, in order to prevent needless loss of sight.

Neuroprotection, a strategy to slow or prevent the death of retinal ganglion cells, offers the possibility of slowing the rate of glaucomatous progression and preventing blindness. But although the underlying theory appears to be sound, much still needs to be learned through basic and clinical research before neuroprotection could become an integral part of glaucoma therapy.

There is some evidence that compliance and persistence are better with prostaglandins than with other drug classes

Its almost time to close the door on 2006 and welcome another new year. But, before we do that we wanted to take you on a journey through the highs and lows of the past twelve months by reflecting on some of the most significant events to shape your industry this year.

Many doctors using ECP undertreat patients, which leads to unnecessary retreatments. This is understandable, as there is a fear of the consequences of over-treatment with ECP, but I have rarely, if ever, seen this

The significant relationship [between cost and stage of disease] demonstrates the important economic repercussions in health care systems world wide, if glaucoma is not dealt with quickly

Phacoemulsification with IOL implantation, in eyes with PACG, allows us to achieve not only high visual acuity, but also to create favourable conditions for aqueous humour outflow.

Combined surgical management of coexisting cataract and glaucoma has recently gained popularity because of the several advantages that it presents. These advantages include, decreased risk, easier management of early and long-term postoperative intraocular pressure (IOP) and performing just one surgical procedure to manage both problems.

The management of paediatric glaucoma is primarily surgical. In the literature, goniotomy and trabeculotomy, despite success rates of only 40-90%, are still the initial surgical procedures of choice for most cases of primary congenital glaucoma. In the case of secondary glaucomas associated with conditions such as aphakia, aniridia, anterior segment dysgenesis and Sturge-Weber syndrome, the success rates of goniotomy or trabeculotomy are much lower.

Open angle glaucoma can be considered as a pathology, which predominantly requires surgical treatment. In light of this, John Cairns, in 1968, introduced a "protect filtering" surgical technique that would improve aqueous outflow and reduce intraocular pressure (IOP) in glaucomatous eyes. That technique was called trabeculectomy.

Deep sclerectomy is not the holy grail of glaucoma surgery, but available evidence indicates that it is definitively safer than trabeculectomy, according to Tarek M. Shaarawy, MD.

The challenge of glaucoma surgery is not only to create a canal within the anterior chamber that acts as a pressure alleviator, it is to ensure that the canal is stable, will not close and, preferably, will alleviate intraocular pressure (IOP) to such an extent that medication is either no longer necessary or the frequency of dosing is minimized. This is the goal of every glaucoma surgeon and one that, unfortunately, is often not achieved, for a number of reasons.

Ophthalmology is a branch of medicine that we, as ophthalmologists, regard as an elite branch of medicine and others, such as general surgeons and physicians, often consider as a minor and sometimes easy discipline. As a result of this misdirected preconception, a general practitioner, consultant or physician may not feel it necessary to fully inform us of a patient's health record because they do not consider that ophthalmic medications could, potentially, carry with them serious, sometimes life threatening side effects, if used inappropriately.

Many ophthalmic disorders give rise to neovascularization of the iris and neovascular glaucoma. Almost all of these disorders are characterized by retinal hypoxia and retinal capillary nonperfusion, the same factors involved in the development of retinal neovascularization. One of the most common causes is central retinal vein occlusion (CRVO), which is a visually disabling disease that is second in prevalence only to diabetic retinopathy.