Ahmed Glaucoma Valve Implantation for Uveitic Glaucoma Secondary to Behçet Disease.

PURPOSE: To evaluate outcomes of patients with uveitic glaucoma secondary to Behçet disease (BD) who underwent Ahmed glaucoma valve (AGV) implantation. PATIENTS AND METHODS: A retrospective chart review of 14 eyes of 10 patients with uveitic glaucoma associated with BD who underwent AGV implantation at a tertiary referral center. Treatment success was defined as intraocular pressure (IOP) between 6 and 21 mm Hg with or without antiglaucoma medication, without further additional glaucoma surgery or loss of light perception. The main outcome measures were IOP, best-corrected visual acuity measured with Snellen charts, and number of glaucoma medications. RESULTS: Mean duration of postoperative follow-up was 18.2±6.6 months (range, 6 to 31 mo). Of the 14 eyes, 10 (71.4%) were pseudophakic and 5 (35.7%) had primary AGV implantation without a history of previous glaucoma surgery. At the most recent follow-up visit, 13 of the 14 eyes had an IOP between 6 and 21 mm Hg. Mean IOP was significantly reduced during follow-up, as compared with preoperative values (P≤0.005). The cumulative probability of surgical success rate was 90.9% at 18 months based on Kaplan-Meier survival analysis. The mean number of antiglaucoma medications required to achieve the desired IOP decreased from 3.4±0.5 preoperatively to 1.0±1.1 postoperatively (P≤0.05). Visual acuity loss of >2 lines occurred in 4 eyes (28.5%) due to optic atrophy associated with retinal vasculitis. Temporary hypotony developed during follow-up in 4 eyes (28.5%) at first postoperative week. CONCLUSIONS: For the management of uveitic glaucoma associated with BD, AGV implantation is a successful method for glaucoma control but requires additional surgical interventions for high early hypotony rates.

Assessment of anterior chamber angle using Visante OCT, slit-lamp OCT, and Pentacam.

PURPOSE: To assess and compare the anterior chamber angle (ACA) by different anterior segment imaging techniques. METHODS: Forty healthy eyes of 40 normal subjects were recruited and 3 consecutive measurements of ACA were determined prospectively utilizing Visante optical coherence tomography (OCT), slit-lamp OCT (SL-OCT), and Pentacam. Statistical significance of interdevice differences between measurements was evaluated by Wilcoxon signed rank test and Bland-Altman analysis. The repeatability of 3 consecutive measurements was analyzed by repeated measured analysis of variance. RESULTS: Mean nasal and temporal ACA were detected as 31.2+/-8.7 and 32.1+/-8.5 degrees by Visante OCT; 41.6+/-5.9 and 41.8+/-5.2 degrees by Pentacam; and 42.9+/-10.0 and 43.3+/-10.1 degrees by SL-OCT. All devices displayed a high intrasession repeatability (Scheffe multiple comparison, p>0.05). ACA detected by Visante OCT were found significantly different from ACA calculated by Pentacam and SL-OCT (p<0.05). On the other hand, ACA data obtained by Pentacam and SL-OCT were found to be statistically similar (p>0.05). CONCLUSIONS: Although noncontact ACA measurements using all modalities were easy to handle and demonstrated good repeatability in healthy participants, the tested devices were not regarded as comparable. Hence, the clinician should take the different modalities into consideration during ACA assessment using various devices.

Macular edema and iridocorneal endothelial syndrome: a case report.

PURPOSE: To report a case of cystoid macular edema (CME) in iridocorneal endothelial syndrome. METHODS: Case report. RESULTS: The authors describe the clinical history and ocular examination of a 38-year-old woman with iridocorneal endothelial syndrome and CME. This association has never been reported before. The mechanism of CME is unknown. CONCLUSION: CME may cause visual deterioration in iridocorneal endothelial syndrome. We emphasize the importance of posterior segment examination in these cases.