The effect of axial length on the short-term outcomes of cataract surgery combined with ab interno trabeculotomy.

PURPOSE: Minimally invasive glaucoma surgery is safer and effective surgical modality for patients with glaucoma. To compare the effect of axial length (AL) on the surgical outcomes of combined cataract surgery and ab interno trabeculotomy (phaco-LOT), a retrospective, non-randomized comparative study was performed. METHODS: In total, 458 eyes of 458 open-angle glaucoma patients who underwent phaco-LOT and were followed-up without any intervention for at least 6 months were enrolled. All were divided into a long-AL group (AL ≥ 26.0 mm, 123 eyes) and a not-long-AL group (AL < 26.0 mm, 335 eyes). The principal outcomes were the changes in intraocular pressure (IOP) and medication scores. We also sought a correlation between postoperative IOP spike and hyphema. RESULTS: Significant postoperative reductions in IOP and medication scores were apparent in all subjects. The IOP reductions were significant at all timepoints in the not-long-AL group, but not until 1 month postoperatively in the long-AL group, and the IOP change was significantly lower in the long-AL group from postoperative day 1 to 3 months. On subanalysis of subjects by age, the microhook used, the pre-operative IOP, and the medication score, a significantly higher incidence of IOP spike was observed in the long-AL group in weeks 1 and 2 (both p < 0.05), but this did not correlate with hyphema status, implying that a different mechanism was in play. CONCLUSION: Phaco-LOT was effective regardless of AL, but the postoperative IOP decrease was lower and the early postoperative incidence of IOP spike was higher in long-AL eyes.

Hyphema and vitreous hemorrhage after micropulse cyclophotocoagulation a case report.

INTRODUCTION: We present two cases of vitreous hemorrhage after micropulse cyclophotocoagulation one of which had concurrent hyphema. To the best of our knowledge, these are the first cases of vitreous hemorrhage due to micropulse CPC in the United States. CASE DESCRIPTION: The first case is an 82-year-old woman with bilateral severe primary open angle glaucoma. BCVA in the right eye was 20/25, and 10-2 Humphrey visual field showed severe peripheral defects. The patient underwent MPCPC of the right eye and at one week, a settled 2 mm hyphema and vitreous hemorrhage confirmed by B-scan were noted. At three months, the patient had a BCVA of 20/80 with an IOP of 12 and retina consultation deferred a PPV. The second case is of a patient with bilateral moderate stage POAG who underwent MPCPC in both eyes. His original VA was 20/200 bilaterally. At 2 weeks, RE VA was count fingers at one foot and LE was 20/150-1. At two months, a RE B scan revealed dense vitreous opacities. Retina consultation revealed vitreous hemorrhage but a PPV was deferred. CONCLUSION: Clinicians should be aware of the risks of bleeding and the potential need for additional surgical interventions after MPCPC.

La iridectomía, una alternativa en el tratamiento del hipema total / Iridectomy, an alternative in the treatment of total hyphema

Iridectomy as a therapeutic alternative for total hyphema. Complete resorption of blood in eyes with posttraumatic total hyphema and high intraocular pressure not amenable to medical therapy was accomplished by means of peripheral iridectomy. No postoperative complications were noted in any of the six patients studied and intraocular pressure remained normal without medications for at least one year after the surgical procedure. Pupillary block and obstruction of the drainage pathway by the clot could account for the secondary glaucoma in these patients

Vitreófago: um instrumento útil no tratamento do hifema traumático / Vitreousphago: an useful instrument in treatment for traumatic hyphema

O Hifema Traumático é uma condiçäo bastante comum e cujas maiores complicaçöes estäo relacionadas ao aumento da pressäo intra-ocular dele resultante (ceratochema e atrofia óptica). A recidiva da hemorragia é uma situaçäo freqüente e aumenta a chance de termos glaucoma. A conduta para esses casos é ainda assunto controvertido. Drogas antiglaucomatosas säo utilizadas para o controle da PIO, e o tratamento cirúrgico se impöe quando este objetivo näo é alcançado. Vários métodos cirúrgicos têm sido adotados como a paracentese clássica, a remoçäo com pinça, a remoçäo através de infusäo e aspiraçäo. Acreditamos que a utilizaçäo do vitreófago nesses casos apresenta inúmeras vantagens em relaçäo aos métodos anteriores: preserva a câmara anterior formada durante o ato operatório; permite a retirada, com segurança, de coágulos densos e possibilita o tratamento de hemorragias recidivantes. Os autores apresentam a técnica operatória por eles empregada para o tratamento o hifema traumático