Reoperations for complications within 90 days after gel stent implantation or trabeculectomy.

PURPOSE: To describe reoperations in the operating room for complications that occurred within the first 90 days after gel stent implantation or trabeculectomy at a single institution over 5 years. METHODS: In this retrospective chart review, patients who have undergone gel stent implantation with mitomycin C (MMC) or trabeculectomy with MMC were enrolled. Postoperative complications that required reoperations within the first 90 days were evaluated. RESULTS: A total of 510 surgeries were performed on 392 patients over a 57-month period by 2 glaucoma surgeons. Of these, 284 were gel stent implantation, and 226 were trabeculectomy. Combined phacoemulsification was performed in 52/284 (18.3%) in the gel stent group and in 26/226 (11.5%) of eyes in the trabeculectomy group (p = 0.03). Reoperations took place in 13/510 (2.5%) eyes, including 4/284 (1.4%) in the gel stent group, 9/226 (4.0%) in the trabeculectomy group (p = 0.07). In the gel stent group, indications for reoperation were bleb failure (2), suprachoroidal hemorrhage (1), bullous keratopathy (1). In the trabeculectomy group, indications for reoperation were bleb failure (3), overfiltration (2), persistent wound leak (2), aqueous misdirection (2). CONCLUSIONS: The rates of reoperation for early postoperative complications after gel stent or trabeculectomy was low and comparable with previous studies. A slightly higher number of reoperations within 90 days was observed in the trabeculectomy group than the gel stent group despite the more significant number of combined procedures in the latter group. Bleb failure was the most common indications for reoperation in both groups. Excessive outflow was a cause of reoperation mostly in the trabeculectomy group.

Moving beyond the Slit-Lamp Gonioscopy: Challenges and Future Opportunities.

After almost a century from its introduction in clinical practice, slit-lamp gonioscopy is still considered the reference standard for evaluating the anterior chamber angle (ACA). Gonioscopy is essential for diagnosing angle closure disease, and ACA features are included in glaucoma's diagnostics and treatments algorithms. However, shortcomings of slit-lamp gonioscopy include a steep learning curve, lack of agreement between examiners and poor documentation. Thanks to advances in miniaturization and computing, new instruments for digital gonioscopy have been developed and marketed. This narrative review focuses on the Gonioscope GS-1, which permits semi-automated circumferential documentation of the ACA in real-colour photographs. Advantages and disadvantages of GS-1 compared with slit-lamp gonioscopy and other ACA imaging technologies such as optical coherence tomography are discussed. Finally, potential opportunities offered by this device for telemedicine, virtual clinics, and automatic classification with deep learning are presented.

Publication Rate of Abstracts Presented at AAPOS Annual Meetings: From Conference Abstract to Full-Text Article.

PURPOSE: To review and analyze abstracts presented at American Association for Pediatric Ophthalmology and Strabismus (AAPOS) annual meetings, and to identify publication rates and potential predictive factors for better outcomes. METHODS: All abstracts accepted for presentation at AAPOS annual meetings from 2013 to 2017 were examined. A comprehensive literature search via PubMed and Scopus was conducted to identify whether the abstracts had been published as full text. A multivariate analysis was achieved to assess the factors related to successful publication, and a Kaplan-Meier analysis was performed to evaluate the publication time course of abstracts. RESULTS: Of 819 analyzed abstracts, 437 (53%) were published in peer-reviewed journals with a median impact factor of 2.7. The overall mean time to publication was 3 ± 2.2 years. The multivariate analysis revealed that abstracts were more likely to be published if they were accepted at an AAPOS annual meeting as an oral paper (P < .001), if they were prospective (P > .001) and multicenter (P = .013) studies, and if they had strabismus, retina, and vitreous disorders and diagnosis as main topics (P = .022). The Kaplan-Meier analyses revealed significant differences in the publication time distribution for multicenter versus single-center abstracts and paper versus poster and e-poster (P < .05). CONCLUSIONS: More than half of the abstracts accepted for presentation at the AAPOS annual meetings were published in peer-reviewed journals within 3 years from submission to the meeting. The factors associated with a higher publication rate were the prospective study design, multicentricity, and presentation at the meeting as an oral paper. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XX-XX.].

Management of Pediatric Ophthalmology Patients During the COVID-19 Outbreak: Experience From an Italian Tertiary Eye Center.

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for coronavirus disease 2019 (COVID-19), which represents a public health threat and has been declared a pandemic by the World Health Organization. The authors describe the treatment of pediatric patients with ophthalmological problems during the COVID-19 pandemic in an Italian tertiary eye center. [J Pediatr Ophthalmol Strabismus. 2020;57(4):213-216.].

Predictors of Endothelial Cell Loss after Phacoemulsification for the Treatment of Primary Angle Closure.

PURPOSE: To investigate demographic and anatomical factors associated with a reduction in endothelial cell density (ECD) after phacoemulsification (PE) for the treatment of primary angle closure (PAC). METHODS: In this prospective case series, ECD was evaluated by noncontact specular microscopy and biometric parameters by both noncontact optical biometry and anterior segment optical coherence tomography, preoperatively and at 12 months after surgery. Anterior segment biomicroscopy and gonioscopy were also performed. The change in ECD and its relation to clinical characteristics and biometric parameters were evaluated by linear regression analysis. RESULTS: 44 patients with PAC were included in the study. The mean (SD) patient age was 71.6 (10.2) years; thirty-one (70.5%) of them were women. Coexistence of exfoliation syndrome (XS) was observed in 4 cases (9.1%). The mean (SD) ECD (cells/mm2) changed from 2275 (463) preoperatively to 1964 (613) postoperatively with a mean reduction of -310 (95% CI -445 to -176; p < 0.001). In the multivariate regression model, after correction for age and lens status, XS was the only parameter associated with ECD percentage change (B = -36.00; p=0.001). CONCLUSION: PE in angle closure causes a significant ECD reduction. In our population of PAC patients, XS is significantly associated with ECD change. In this group of patients, a careful preoperative endothelial evaluation should be performed.