Intraoperative iStent versus postoperative selective laser trabeculoplasty in early glaucoma patients undergoing cataract surgery: A retrospective comparative study.

PURPOSE: To compare the efficacy and safety of iStent inject® versus 360° selective laser trabeculoplasty (SLT) in patients with early glaucoma undergoing cataract surgery. METHODS: A retrospective non-randomized study was conducted in 73 eyes divided into two groups: cataract surgery+intraoperative iStent (n=40) versus cataract surgery+postoperative SLT at one month (n=33). The primary endpoint was intraocular pressure (IOP) lowering≥20% between baseline and 6 months postoperatively. The secondary endpoints were IOP lowering at 1, 6 and 12 months, and the mean number of IOP-lowering medications at 6 and 12 months. RESULTS: The mean baseline IOP was 19.1 mmHg with no significant difference between groups. The mean baseline number of IOP-lowering medications was higher in the iStent group (n=1.95) compared to the SLT group (n=1.53; P=0.04). At 6 months, 18 (60%) patients in the SLT group and 20 (51%) patients in the iStent group achieved IOP lowering≥20% with no significant difference between groups (P=0.431). At 6 months, no difference in the mean number of IOP-lowering medications was found between groups (-0.92 and -0.89 in the iStent and SLT groups, respectively). Similar results were found at 12 months. CONCLUSION: These results suggest similar safety and efficacy of intraoperative iStent and postoperative 360° SLT in lowering IOP and reducing glaucoma eye drops in early glaucoma patients undergoing cataract surgery. Treatment choice should be based on the ophthalmologist's experience and on the cost-benefit ratio.

Long-term results of Ahmed glaucoma valve implantation with/without intravitreal anti-VEGF injection in neovascular glaucoma patients.

PURPOSE: This study aimed to evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation with or without anti-VEGF injections in neovascular glaucoma patients. MATERIALS AND METHODS: This single-center retrospective study assessed NVG patients who underwent AGV implantation with or without anti-VEGF injections. Demographic and clinical data, including ocular findings, intraocular pressure (IOP), visual acuity, and glaucoma medication count, were recorded preoperatively and postoperatively at one day, one month, and one year. The study included 35 patients. Group 1 consisted of 23 patients who received anti-VEGF injections before AGV surgery. Group 2, with 12 patients, had no anti-VEGF injections prior to surgery. Successful surgery was defined as IOP values between 6 and 21mmHg. The primary outcome was a 30% or more reduction in IOP. RESULTS: The groups displayed no significant difference in their demographic or clinical profiles (P>0.05). The visual acuity before and one year after surgery did not differ significantly between the groups. However, IOP values significantly decreased by the end of the one-year follow-up for both groups. No significant differences were found between the groups regarding visual acuity, IOP, or the number of medications during the one-year follow-up (P>0.05). Success rates were 95.7% for Group 1 and 91.7% for Group 2. No significant difference in complications between the groups was observed (P>0.05). CONCLUSION: Anti-VEGF injections prior to AGV implantation did not significantly impact visual acuity, IOP values, or medication count during the one-year follow-up.

Gelatin implant in the treatment of open-angle glaucoma: Safety and efficacy in real-life conditions.

OBJECTIVE: To evaluate the safety and efficacy of the Xen® implant for the treatment of open-angle glaucoma. MATERIAL AND METHOD: Retrospective study including patients who received the Xen® implant between January 2019 and December 2020 in a university hospital. Demographic and medical data were collected using DxCare® software. The primary endpoint was a 20% reduction in intraocular pressure (IOP) at 12 months according to Société Française du Glaucome (SFG) recommendations. The secondary endpoints were decrease in glaucoma medications and incidence of adverse events. RESULTS: Fifty-three patients (65 eyes) were included (sex ratio 0.65, age 75.38±7.31 years). IOP decreased by 18.51% from 17.86±4.22mmHg to 14.55±2.66mmHg (P<0.05). The number of glaucoma medications was 2.16±1.01 preoperatively vs 0.49±0.94 postoperatively (P<0.05). Adverse events included 8 malpositionings, 3 of which required reoperation, 1 case of increased IOP resolved by trabeculectomy, 1 case of venous ischemia treated by photocoagulation, 3 choroidal detachments and 3 corneal ulcers. Needling was required for 18 eyes. CONCLUSION: At 12 months, the IOP was lower than previously reported in the literature (14.55 vs 15.90mmHg, P<0.05), probably due to a lower preoperative IOP. The number of postoperative medications was similar to the literature (0.49 vs 0.40, P=0.51), as was the frequency of needling (27.69% vs 32.00%, P=0.36). The frequency of malpositioning was higher (12.31% vs 7.70%, P<0.05), probably due to the management of complicated patients. The efficacy of Xen® was in line with recommendations. It would be interesting to compare the efficacy of Xen® with trabeculectomy.

[Biomechanics of the lamina cribrosa: A determining factor in glaucomatous neuropathy. A review of the literature]. / Biomécanique de la lame criblée : un facteur déterminant de la neuropathie glaucomateuse. Une revue de la littérature.

Glaucoma is a chronic optic neuropathy characterized by progressive sclero-laminar remodeling. The main factor at the origin of these deformations is the intraocular pressure (IOP), the effect of which varies according to the biomechanical properties of the individual lamina cribrosa (LC). In this environment, the LC represents a malleable zone of weakness within a rigid corneoscleral shell. It is a dynamic structure whose movements play a key role in the pathogenesis of glaucoma: displacing it posteriorly, in addition to contributing to the characteristic appearance of glaucomatous cupping, would increase constriction on the nerve fibers and the laminar capillaries. Often incorrectly considered permanent in adults, these deformations have a certain degree of reversibility, which is currently better characterized thanks to progress in imaging techniques. The occurrence of anterior displacement and laminar thickening following a reduction in IOP could thus constitute a good prognostic factor by reducing mechanical stress on this region. These changes would tend to reduce laminar pore tortuosity and shear forces, which are probably key mechanisms of axonal loss in glaucoma.

Comparison of the iCare rebound tonometer and the Perkins applanation tonometer in children under general anesthesia.

INTRODUCTION: The goal of the study was to compare Perkins applanation tonometry and iCare rebound tonometry, evaluating their correlation and agreement in a diverse pediatric population under general anaesthesia (GA). MATERIALS AND METHODS: Children undergoing an eye examination under GA between November 2019 and March 2020 were included. Intraocular pressure (IOP) was measured successively using the Perkins applanation tonometer and the iCare IC200 rebound tonometer. Ultrasonic central pachymetry and axial length were measured. RESULTS: One hundred and thirty-eight eyes of 72 children were included. The mean age was 2.87years. IOP measurements obtained with the two tonometers were statistically and significantly highly correlated (r=0.8, P<0.001), although the iCare overestimated IOP by an average of 3.37mmHg (SD±4.48). The agreement between the two methods was moderate; the 95% agreement limits ranged from -5.41 to +12.15mmHg (r=0.5, P<0.001). The IOP difference between the two tonometers was weakly but significantly correlated with mean IOP (r=0.52; P=0.006). No correlation was found with axial length and pachymetry. CONCLUSION: In this study, the IOP values obtained using the Perkins applanation tonometer and the iCare IC200 rebound tonometer were well correlated. The iCare tended to overestimate the IOP, especially for high IOP values. However, no underestimation of IOP was found with this device, hence its potential for glaucoma screening in children.

Can hemifacial spasm lead to glaucomatous changes?

PURPOSE: To evaluate the association between hemifacial spasm (HFS) patients and glaucoma as a function of the Botox dosage required. METHODS: A retrospective review of clinical documents and procedure records. RESULTS: Information of 76 consecutive patients (58 females) with HFS who received Botox treatment were reviewed. The age at onset of HFS was 66±11 (32-85) years, and all manifested unilaterally. Ten (13%, 95% confidence interval: 6.5-22.9%) patients were diagnosed with glaucoma, including 8 primary open-angle glaucoma (POAG) (4 unilateral and ipsilateral to the HFS), and 2 bilateral chronic angle-closure glaucoma (CACG). Nine of the 10 patients developed glaucoma after the onset of the HFS. The Botox dosage was significantly higher among those diagnosed with glaucoma (31+/8 vs. 26+/7units, P<0.05). There was a positive relationship between the presenting intraocular pressure (IOP) and the Botox dosage required (R=0.31, P=0.0116). However, there was a weak relationship between the Botox dosage required and the vertical cup to disc ratio (R=0.076, P=0.525). The presenting IOP of the HFS-affected eyes in those diagnosed with glaucoma was higher than those without glaucoma (19±3.5 vs. 13±3.2mmHg, P=<0.05). The presenting IOP between the HFS-affected and unaffected eyes was similar (16±4.8 vs. 15+/4.6mmHg, P=0.430). Smoking status, history of diabetes mellitus, hypertension, hyperlipidemia and obstructive sleep apnea were not different between HFS patients with or without glaucoma. CONCLUSIONS: Hemifacial spasm patients with glaucoma were associated with a higher Botox dosage. We found a positive relationship between the Botox dosage required and the presenting IOP. Whether hemifacial spasm can result in fluctuation of IOP, eventually causing glaucomatous damage, remains to be studied further.

Combining spectral domain optical coherence tomography of retinal nerve fiber layer and noncontact tonometry in mass glaucoma screening during the World Glaucoma Week.

PURPOSE: This study reports the combination of noncontact tonometry and spectral domain optical coherence tomography (SD-OCT) in mass glaucoma screening in the Lebanese population. METHODS: This cross-sectional study included Lebanese individuals who participated in a glaucoma screening campaign in March 2018 and March 2019 for World Glaucoma Week. Intraocular pressure (IOP) was measured by noncontact tonometry. Optic nerve head (ONH) and retinal nerve fiber layer (RNFL) scans were obtained using SD-OCT. Glaucoma suspects were defined as individuals having an IOP above 21mmHg in at least one eye and/or RNFL thinning in either the superior or the inferior quadrant. RESULTS: Among the 1116 individuals who were examined, 15.5% were found to be glaucoma suspects based upon their IOP readings, 15.5% based on OCT, and 3.0% based on both criteria combined. The mean vertical and horizontal disc diameter was 1.75±0.23mm and 1.57±0.22mm, respectively. Eyes that were suspects by OCT with normal IOP had thinner corneas when compared to eyes with normal OCT and high IOP (512.25µm vs. 559.12µm, P<0.0001). CONCLUSION: SD-OCT can be an easy and relatively fast component of mass glaucoma screening in addition to IOP measurement. Further studies are needed to establish this combination as a valid glaucoma screening method.

Tono-pen and Schiotz tonometer measurements in gas-filled eyes.

PURPOSE: This study aims to assess the difference between Tono-Pen and Schiotz tonometer measurements in gas-filled eyes and to create a nomogram and equation which can be used to estimate actual intraocular pressure in order to provide a safe IOP level at the end of the surgery. METHODS: Twenty-two eyes that underwent pars plana vitrectomy were included in the study. Perioperative Tono-Pen and Schiotz tonometer measurements were performed when the eyes were filled with air in the setting of certain vitrectomy infusion pressure levels. Measurements were performed when the eyes were filled with fluid to test the accuracy of the systems. The mean value of the Tono-Pen and Schiotz readings in air-filled eyes corresponding to certain actual intraocular pressure levels were analyzed to create nomograms. RESULTS: Both Tono-Pen and Schiotz tonometers underestimated the actual intraocular pressure set on the screen of the vitrectomy system in the air-filled eyes. The Tono-Pen deviation was 4.5mmHg at a level of 15mmHg actual intraocular pressure, and 16.9mmHg at a level of 55mmHg actual intraocular pressure. The Schiotz tonometer deviation was 10mmHg at a level of 15mmHg actual intraocular pressure, and 8.9mmHg at a level of 55mmHg actual intraocular pressure. All the mean differences between tonometer readings and actual intraocular pressure were statistically significant. (P<0.001) CONCLUSION: To achieve an adequate and safe tamponade at an actual IOP range of 20 - 25mmHg, one should adjust the IOP with Schiotz readings to a level of 9-12mmHg, or Tono-Pen readings to 12-18mmHg.

[XEN 45® gel stent implantation in glaucoma surgery: Dual-center comparative study between steroid-induced glaucoma and primary open angle glaucoma]. / Implantation du dispositif XEN 45® dans la chirurgie du glaucome : étude bicentrique bispective s'intéressant au glaucome cortisonique par rapport au glaucome primitif à angle ouvert.

INTRODUCTION: XEN 45® gel stent is an ab interno aqueous humor drainage device indicated for moderate glaucoma refractory to medical management. Its efficacy has been demonstrated in primary open-angle glaucoma (POAG). However, there are few studies on secondary glaucoma, including steroid-induced glaucoma (CG), defined as optic neuropathy induced by using local or systemic corticosteroids without increased flare. METHODS: We conducted a dual-center comparative cohort study between April 2019 and January 2021. 66 operated eyes were included, divided into two groups: POAG (56 eyes) and GC (10 eyes). The primary endpoint was the relative reduction in intraocular pressure (IOP) at three months postoperatively in the GC group. Three outcomes were defined: total success, partial success and failure. RESULTS: The total success rate was 100% in the GC group and 42.6% in the POAG group. Preoperative IOP was 36.1±9.1mmHg and 19.0±7.3mmHg respectively. IOP reduction was 69.1±11.7% in the GC group and 21.8±30.3% in the POAG group. Patients were younger in the GC group (49.3±21.2 versus 71.1±8.4 years), and preoperative conjunctival preparation was longer in this group (12 versus 5 weeks). The needling rate was 17.9% in the POAG group and 10% in the GC group. CONCLUSION: The XEN 45® gel stent is effective in the treatment of steroid-induced glaucoma. Further studies will be required to identify predictive factors for success and to establish criteria for good candidacy.

[Role of the lamina cribrosa in the pathogenesis of glaucoma. A review of the literature]. / Rôle de la lame criblée dans la pathogenèse du glaucome. Une revue de la littérature.

Located within the scleral canal, the lamina cribrosa is a sieve-like structure separating the intraocular and retrobulbar portions of the optic nerve. Identified as the main site of axonal damage in glaucomatous optic neuropathy, the study of the lamina cribrosa has been of great interest for many years. Numerous studies have explored the histological and morphological characteristics of the laminar region in healthy subjects as well as glaucoma patients. More recently, the development of adaptive optics systems and new generations of OCT has allowed great progress in the understanding of the pathogenesis of glaucoma and has opened new perspectives for the improvement of diagnostic procedures.

[Preliminary selective laser trabeculoplasty (SLT) intraocular pressure results in glaucoma patients in Burkina Faso]. / Résultats tonométriques préliminaires de la trabéculoplastie sélective au laser (SLT) chez les glaucomateux au Burkina Faso.

INTRODUCTION: Glaucoma is the leading cause of irreversible blindness in the world. The purpose of our study was to evaluate the tonometric results of SLT treatment in patients with glaucoma. MATERIALS AND METHODS: This was a prospective study of patients with glaucoma who were seen from October 1, 2017 to July 31, 2018. All patients underwent SLT of the inferior 180°. Intraocular pressure (IOP) was measured before and then at 1, 15, 30, 60, 90 and 120days after treatment. RESULTS: We studied 35 eyes of 31 patients. The mean age was 59.3 (±8.4years), range 43-77years. The mean IOP prior to SLT was 20.1mmHg (±7mmHg). One day after the laser, this decreased to 17.6mmHg (±8.4), for a percentage of drop of 12.4%. At 30days, it was 15.3mmHg (±5.4mmHg), i.e. a 23.9% decrease. After 60 and 90days, there was a drop of 13.9% and 15.4%, respectively. At 120days, 43.3% of treated eyes had a decrease of at least 20%. The main complication was increased IOP in 14.2% of cases. CONCLUSION: SLT reduces IOP and the number of glaucoma medications in patients. It appears to be a viable alternative in our countries. These results should be confirmed with a larger cohort and longer follow-up.

Rate of hypotony and intraocular pressure fluctuation immediately after intravitreal dexamethasone implantation in vitrectomized eyes.

PURPOSE: To observe the rate of hypotony and intraocular pressure (IOP) fluctuations immediately following intravitreal dexamethasone implantation in vitrectomized eyes. METHODS: The study included previously vitrectomized eyes scheduled to receive intravitreal dexamethasone implants. IOP measurements were performed at minute 1, minute 10, hour 1, hour 2, hour 3 and day 1. The primary outcome measure of the study was the rate of hypotony at the various time points, while the secondary outcome measure was the IOP profile over time. RESULTS: A total of 26 eyes were enrolled in the study. Immediately following the injection, 11 (42.3%) of the eyes exhibited an IOP<6mm Hg. Hypotony was observed in one eye (3.8%) at hour 3 and day 1. After the immediate IOP reduction, IOP recovered rapidly and showed a peak at hour 1, with 5 eyes (19.2%) exhibiting IOP levels ≥25mmHg and 1 eye (3.8%) ≥30mm Hg. Aside from the eye with persistent hypotony resulting in a choroidal effusion, no other complication was observed. CONCLUSIONS: Injection of dexamethasone implants in vitrectomized eyes resulted in immediate IOP reduction. Hypotony showed a short, self-limited course in the majority of eyes. In the presence of additional risk factors for wound incompetency, regular follow-up in the early post-injection period appears to be needed.

[The trabecular meshwork: Structure, function and clinical implications. A review of the littérature (French translation of the article)]. / Le trabéculum : structure, fonction et implications cliniques. Une revue de la littérature.

Glaucoma is a blinding optic neuropathy, the main risk factor for which is increased intraocular pressure (IOP). The trabecular meshwork, located within the iridocorneal angle, is the main pathway for drainage of aqueous humor (AH) out of the eye, and its dysfunction is responsible for the IOP elevation. The trabecular meshwork is a complex, fenestrated, three-dimensional structure composed of trabecular meshwork cells (TMC) interdigitated into a multilayered organization within the extracellular matrix (ECM). The purpose of this literature review is to provide an overview of current understanding of the trabecular meshwork and its pathophysiology in glaucoma. Thus, we will present the main anatomical and cellular bases for the regulation of aqueous humor outflow resistance, the pathophysiological mechanisms involved in trabecular dysfunction in the various types of glaucoma, as well as current and future therapeutic strategies targeting the trabecular meshwork.

Prospective randomized clinical trial on the effects of latanoprost, travoprost and bimatoprost on latanoprost non-responders.

PURPOSE: To determine whether a patient who is non-responder to latanoprost after one month of use should continue using latanoprost or switch to either bimatoprost or travoprost. PATIENTS AND METHODS: Prospective randomized clinical trial. We recruited new patients who were felt to require intraocular pressure reduction. Patients who had≤20% intraocular pressure reduction after one month of latanoprost treatment were randomly assigned to another month of treatment with latanoprost or a switch to bimatoprost or travoprost for an additional month. RESULTS: Overall, 83 non-responders to latanoprost after one month of treatment were included in the study. Before latanoprost treatment, the mean intraocular pressure was 23.7±4.7mmHg. At randomization on latanoprost, mean intraocular pressure was 21.5±4.5mmHg. One month after the switch of medication, the mean reduction in intraocular pressure was not significantly different between the groups (P=0.148) and was -0.9mmHg, -2.10mmHg and -2.5mmHg, for latanoprost, bimatoprost and travoprost respectively. One month after randomization, 32 (38.5%) of the patients had become responders, with IOP reduction>20%. Of those patients, 9 (31%) were using latanoprost, 13 (41.9%) bimatoprost and 10 (43.5%) travoprost. The number of new responders was similar between the three groups (P=0.584). CONCLUSION: There is no added benefit of switching latanoprost to another topical prostaglandin for patients who are initially non-responders. Regression towards the mean and the Hawthorne effect are probably important factors explaining the additional IOP reduction obtained after randomization and explain the result of most switch studies.

Effect of glucosamine sulfate on intraocular pressure in patients with knee osteoarthritis: A prospective randomized controlled trial.

PURPOSE: Glucosamine sulfate is one of the treatment options for patients with osteoarthritis of the knee. It has been postulated that glucosamine sulfate affects intraocular pressure (IOP). This study aimed to evaluate the effect of crystalline glucosamine sulfate on IOP in patients with osteoarthritis of the knee. METHODS: Forty-two patients with osteoarthritis of the knee were randomized into two groups. The first group of patients received 1500mg of crystalline glucosamine sulfate once daily for 6 months and the conventional treatment protocol. The second group of patients received only the conventional treatment protocol. IOP was recorded at the start of the study and at 6 weeks, 3 months, 6 months, and 9 months. RESULTS: The patient demographic data were not different between the two groups. There were no differences in the IOPs between the groups (P>0.05) nor differences in baseline IOPs within each group compared with each follow-up visit (P>0.05). CONCLUSIONS: Glucosamine sulfate is still an option without significant concern over elevated IOP in patients with osteoarthritis of the knee and normal ocular pressure.

[The effects of corneal cross-linking on intraocular pressure measurement in keratoconus]. / Les effets du cross-linking cornéen sur la mesure de pression intra-oculaire dans le kératocône.

Cross-linking (CXL) is a technique whose design aims to achieve a specific goal: to harden the corneal tissue of eyes with a progressive form of keratoconus. Other indications are being investigated, such as treatment of infectious keratitis and prevention of corneal ectasia post corneal ablative refractive surgery. Hardening the cornea means changing its biomechanical properties. The existence of true corneal hardening after CXL would inevitably result in an increase in measured intraocular pressure (IOP). This would have a considerable impact in the screening and follow-up of glaucoma patients who have undergone cross-linking because of the central role of IOP measurement in glaucomatous pathology.

Evaluation of the 24-hour intraocular pressure and systemic blood pressure at the same time.

PURPOSE: To obtain simultaneous 24-hour contact lens voltage and systemic arterial blood pressure values with the Sensimed Triggerfish system and Holter monitoring device. METHODS: Ten primary open-angle glaucoma (POAG) and 8 pseudoexfoliation glaucoma (PXG) patients were included in the study. The Sensimed Triggerfish contact lens device was used to calculate the 24-hour IOP, and a Holter sphygmomanometer device was used for simultaneous 24-hour blood pressure measurements. We define the 8:00 am-11:00 pm period measurements as diurnal values and the other measurements as nocturnal values. RESULTS: The mean nocturnal systolic values (nocturnal SBP 120.5±3.4 for POAG and 122.8±5.3mmHg for PXG) and diastolic BP (nocturnal DBP 70.2±1.9 for POAG and 68.1±1.2mmHg for PXG) were lower than the diurnal (diurnal SBP 134.6±5.3 for POAG, 145.9±41.7mmHg for PXG, diurnal DBP 79.4±5.8 for POAG and 78.6±5.1mmHg for PXG) values, and these differences were statistically significant in both groups (P=0.001 in DBP in PXG and P<0.001 for other values). In addition, nocturnal CL voltage values (228.8±41.1 for POAG and 214.3±47.0mVEq for PXG) were higher than the diurnal values (55.8±77.2 for POAG and 145.9±41.7mVEq for PXG) in the POAG and PXG groups, and these were statistically significant as well (P<0.001 for all). In the POAG and PXG groups, CL voltage had a statistically significant negative correlation with systolic (respectively, r: -0.248, P=0.001 and r: -0.272, P˂0.001) and diastolic (respectively, r: -0.115, P=0.036 and r: -0.160, P=0.028) BP values. CONCLUSION: We observed that CL voltage values rose during the nocturnal period, with a concomitant decrease in systolic and diastolic BP.

[XEN® Gel Stent for management of chronic open angle glaucoma: A review of the literature (French translation of the article)]. / L'implant XEN® pour la prise en charge du glaucome chronique à angle ouvert : une revue de la littérature.

PURPOSE: The purpose of this study was to analyze the change in intraocular pressure (IOP) and glaucoma medications using the XEN® Gel Stent as a solo procedure or in association with phacoemulsification in patients with chronic open angle glaucoma (OAG). METHODS: We included cohort studies with at least one year of follow-up in patients with primary open angle glaucoma (POAG), pseudo-exfoliative glaucoma (PXG) or pigmentary glaucoma (PG) who received a XEN® gel stent. The main outcome measure was IOP reduction at 12 months follow-up. Secondary outcomes were the decrease in glaucoma medications 12 months after surgery, frequency and type of postoperative interventions and complication rate. RESULTS: A total of 8 case series published between 2016 and 2018 were included; six were prospective studies, and two were retrospective. There was no randomized controlled trial. The data concerned a total of 958 eyes of 777 patients. The various studies showed a mean IOP at 12 months between 13 and 16mmHg, which represented an IOP reduction between 25 and 56% (mean: 42%). This decrease was associated with a reduction in glaucoma medications in all studies. The decrease in IOP was significantly greater in XEN® implantation as a stand-alone procedure (44%) than in combined surgery (32%) (P<0.05). Transient hypotony (<1 month) (3%), choroidal detachment or choroidal folds (1.5%), hyphema (1.9%), bleb leak (1.1%) and shallow anterior chamber (1.1%) were the most frequent complications. As for severe complications, four cases of malignant glaucoma (0.4%) and one case of retinal detachment have been reported. In the follow-up period, needling has been required in 32% of cases, and a total of 55 eyes (5.7%) required repeat filtering surgery or cyclodestructive procedure. CONCLUSION: XEN® Gel Stent appears effective for reducing IOP and the number of medications in OAG patients within 1 year postoperatively with an acceptable safety profile. However, vigilant postoperative follow-up and frequent postoperative maneuvers are required.

Intraocular pressure measurements and corneal biomechanical properties using a dynamic Scheimpflug analyzer, after several keratoplasty techniques, versus normal eyes.

PURPOSE: To evaluate the biomechanical properties of the cornea and their impact on intraocular pressure (IOP) measurement after lamellar keratoplasty, compared to healthy eyes, using a non-contact tonometer with a Scheimpflug camera. METHODS: This study, from 2014 to 2015, included 22 primary DSAEK, 5 DALK, 6 DSAEK after PK, and 50 control eyes. Using a non-contact tonometer with a high-speed Scheimpflug camera (CORVIS ST, Oculus Optikgeräte GmbH, Wetzlar, Germany), several biomechanical parameters were recorded, including radius at highest concavity (Rhc) and defomation amplitude (DA). Central corneal thickness (CCT) and uncorrected IOP, were also recorded. For the control eyes only, a corrected IOP was calculated, based on age, central corneal thickness, and biomechanical parameters. RESULTS: Rhc was significantly lower after DALK (Rhc=5.54±0.71, P=0.007) and DSAEK (Rhc=6.26±0.77, P=0.042) compared to control eyes (Rhc=6.82±0.76). DA was higher after DALK and DSAEK, but not significantly (respectively 1.24±0.09 P=0.41 and 1.22±0.15, P=0.923) compared to normal eyes (1.18±0.15). Uncorrected IOP was not significantly different between post-keratoplasty and control eyes. In control eyes, the corrected IOP (15.23±1.88) was lower than the uncorrected IOP (16.10±2.34); a statistically significant positive correlation between Rhc and CCT (R2=0.6020, P<0001), and a significant negative correlation between DA and CCT (R2=-0.641, P<0.0001) were found. CONCLUSION: Our study showed that, after lamellar keratoplasty, corneal biomechanics are altered. Corneas with higher ocular rigidity will show a lower DA and a higher Rhc.

[Retinal vein occlusion in a young patient: Where does intraocular hypertension come from?] / Occlusion de la veine centrale de la rétine chez un sujet jeune : chercher d'où vient l'augmentation de pression intraoculaire.

INTRODUCTION: Retinal vein occlusion presents as an acute, painless and unilateral sight loss. We report two cases of retinal vein occlusion (CRVO) in which the etiology was unusual. CASE REPORTS: Case 1. A 54-year-old woman without any significant past medical history presented with an acute loss of vision. Medical history taking revealed the practice of yoga with headstand posture like "Sirsana". Case 2. A 35-year-old woman presented with an acute loss of vision related to a retinal vein occlusion. The investigation found prolonged and repeated vomiting the days before the retinal vein occlusion. CONCLUSION: Cardiovascular assessment is recommended in the investigation of CRVO. Furthermore, especially in young patients, a situation causing an increase of intraocular pressure as the practice of yoga with taking reverse "head down" body positions or even repeated vomiting efforts may be the cause of slower circulation of blood flow in the retinal veins.