Investigation of the reasons for delayed presentation in proliferative diabetic retinopathy patients.

AIM: To investigate reasons for delayed presentation in patients with proliferative diabetic retinopathy (PDR). METHODS: A questionnaire was designed to investigate consecutive PDR patients with delayed presentation who visited our center between January 2021 and December 2021. The questionnaire was divided into four sections: knowledge regarding diabetic retinopathy (DR), attitude toward DR treatment, difficulties adhering to follow-up plans, and medical care. The systemic disease status and severity of DR were recorded. Logistic analysis was undertaken to investigate DR treatment refusal and delay factors. RESULTS: A total of 157 patients were included in this study, with an average age of 50.0 ± 11.6 years. The median glycated hemoglobin level (HbA1c) was 7.8% (IQR 2.5%). Among the 157 eyes, most required vitrectomy intervention (144, 91.7%); 17 developed neovascular glaucoma (NVG), while only 13 required additional photocoagulation. Among the 36 patients with undiagnosed DM, the reason for delayed DR presentation was a lack of awareness of DM status among these patients (36 cases, 100.0%). Most of the patients with a known history of DM exhibited inadequate DR knowledge (29, 24.0%), believed their good visual acuity did not require DR screening (98, 81.0%), and had poorly controlled diabetes (113, 93.3%). Factors related to refusing DR treatment were patients with an inability to receive regular diabetes treatment in internal medicine clinics (OR 6.78, 95% CI 1.73-26.59, p = 0.006), patients who could not tolerate discomfort during ophthalmic examination and treatment (OR 15.15, 95% CI 2.70-83.33, p<0.001), and patients who did not have any retinal abnormalities detected and were not informed about the need for regular screening (OR 2.05, 95% CI 1.36-3.09, p<0.001). CONCLUSIONS: This study investigated the factors contributing to delayed presentation among patients with PDR. Many individuals in the delayed population were found to have undiagnosed DM. Among patients already aware of their DM status, reasons for delay included insufficient knowledge about DR, negative attitudes toward screening and treatment, and difficulties seeking medical care in real-life situations. Furthermore, there needed to be more improvements in the detection, treatment, and follow-up of DR by internal medicine practitioners and ophthalmologists.

Role of apparent diffusion map in the evaluation of retinoblastoma.

PURPOSE: This study aimed to analyze the association between magnetic resonance imaging apparent diffusion coefficient map value and histopathological differentiation in patients who underwent eye enucleation due to retinoblastomas. METHODS: An observational chart review study of patients with retinoblastoma that had histopathology of the lesion and orbit magnetic resonance imaging with apparent diffusion coefficient analysis at Hospital de Clínicas de Porto Alegre between November 2013 and November 2016 was performed. The histopathology was reviewed after enucleation. To analyze the difference in apparent diffusion coefficient values between the two major histopathological prognostic groups, Student's t-test was used for the two groups. All statistical analyses were performed using SPSS version 19.0 for Microsoft Windows (SPSS, Inc., Chicago, IL, USA). Our institutional review board approved this retrospective study without obtaining informed consent. RESULTS: Thirteen children were evaluated, and only eight underwent eye enucleation and were included in the analysis. The others were treated with photocoagulation, embolization, radiotherapy, and chemotherapy and were excluded due to the lack of histopathological results. When compared with histopathology, magnetic resonance imaging demonstrated 100% accuracy in retinoblastoma diagnosis. Optic nerve invasion detection on magnetic resonance imaging showed a 66.6% sensitivity and 80.0% specificity. Positive and negative predictive values were 66.6% and 80.0%, respectively, with an accuracy of 75%. In addition, the mean apparent diffusion coefficient of the eight eyes was 0.615 × 103 mm2/s. The mean apparent diffusion coefficient value of poorly or undifferentiated retinoblastoma and differentiated tumors were 0.520 × 103 mm2/s and 0.774 × 103 mm2/s, respectively. CONCLUSION: This study revealed that magnetic resonance imaging is useful in the diagnosis of retinoblastoma and detection of optic nerve infiltration, with a sensitivity of 66.6% and specificity of 80%. Our results also showed lower apparent diffusion coefficient values in poorly differentiated retinoblastomas with a mean of 0.520 × 103 mm2/s, whereas in well and moderately differentiated, the mean was 0.774 × 103 mm2/s.

Advances in Research Related to MicroRNA for Diabetic Retinopathy.

Diabetic retinopathy (DR) is a severe microvascular complication of diabetes and is one of the primary causes of blindness in the working-age population in Europe and the United States. At present, no cure is available for DR, but early detection and timely intervention can prevent the rapid progression of the disease. Several treatments for DR are known, primarily ophthalmic treatment based on glycemia, blood pressure, and lipid control, which includes laser photocoagulation, glucocorticoids, vitrectomy, and antivascular endothelial growth factor (anti-VEGF) medications. Despite the clinical efficacy of the aforementioned therapies, none of them can entirely shorten the clinical course of DR or reverse retinopathy. MicroRNAs (miRNAs) are vital regulators of gene expression and participate in cell growth, differentiation, development, and apoptosis. MicroRNAs have been shown to play a significant role in DR, particularly in the molecular mechanisms of inflammation, oxidative stress, and neurodegeneration. The aim of this review is to systematically summarize the signaling pathways and molecular mechanisms of miRNAs involved in the occurrence and development of DR, mainly from the pathogenesis of oxidative stress, inflammation, and neovascularization. Meanwhile, this article also discusses the research progress and application of miRNA-specific therapies for DR.

Photocoagulation Up to Ora Serrata in Diabetic Vitrectomy to Prevent Recurrent Vitreous Hemorrhage.

PURPOSE: To evaluate the role of performing photocoagulation up to ora serrata during vitrectomy in preventing recurrent vitreous hemorrhage (VH) in patients undergoing pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: This retrospective, nonrandomized study included 60 eyes from 60 patients who had undergone PPV for VH due to PDR. These patients were divided into two groups: group 1, those who underwent photocoagulation up to ora serrata using the scleral indentation technique during surgery; and group 2, those who did not undergo scleral indentation when photocoagulation and underwent photocoagulation up to vortex veins. Their hospital records were analyzed to investigate the recurrence rate of VH, the time until recurrence of VH after surgery, logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) measured before surgery and at 1, 2, and 3 years after surgery, and the occurrence of complications such as neovascular glaucoma (NVG) during follow-up. RESULTS: Group 1 exhibited lower recurrence rate of VH (2 of 30 [6.7%] vs. 10 of 30 [33.3%], p = 0.01) and lower occurrence of postoperative NVG (2 of 30 [6.7%] vs. 8 of 30 [26.7%], p = 0.038) compared with group 2. There were no statistically significant differences in logMAR BCVA measured at 1, 2, and 3 years between the two groups (at 1 year: 0.54 ± 0.43 vs. 0.54 ± 0.44, p = 0.954; at 2 years: 0.48 ± 0.47 vs. 0.55 ± 0.64, p = 0.235; at 3 years: 0.51 ± 0.50 vs. 0.61 ± 0.77, p = 0.200). Logistic regression analysis showed that among several factors that could affect recurrence rate of VH, only range of photocoagulation performed was a statistically significant factor (odds ratio, 0.119; 95% confidence interval, 0.022-0.659; p = 0.015). CONCLUSIONS: Photocoagulation treatment over a wider range with scleral indentation could be a beneficial adjunct procedure for preventing postoperative recurrent VH following diabetic vitrectomy.

Retinal vein changes in patients with high-risk proliferative diabetic retinopathy treated with conbercept and panretinal photocoagulation co-therapy: a cohort study.

Objective: This study aimed to observe and compare retinal vein diameter changes and other essential indicators in patients with high-risk proliferative diabetic retinopathy (PDR) treated with intravitreal injection of conbercept (IVC) combined with panretinal photocoagulation (PRP) versus PRP monotherapy. Methods: A retrospective analysis was conducted on data from patients with high-risk PDR who received specific treatment and were followed up for 24 months. Among 82 patients with high-risk PDR, 50 eyes received PRP combined with IVC, whereas 32 eyes received PRP alone. During the 24-month follow-up period, changes in best-corrected visual acuity (BCVA), central foveal thickness (CFT), retinal vein diameter, number of microaneurysms (MA), neovascularization (NV) area, hard exudate (HE) area, size of the foveal avascular zone (FAZ), superficial capillary plexus (SCP) blood flow density, and adverse effects were recorded and compared between the two groups at baseline and at 6, 12, 18, and 24 months after treatment. The relationship between each observation index and vein diameter was also analyzed. Results: During the 24-month follow up, significant improvements in the BCVA, CFT, retinal vein diameter, number of MAs, NV area, HE area, FAZ, and SCP were observed in the IVC+PRP group after treatment. The PRP group only showed significant reductions in NV and HE areas. The IVC+PRP group showed significant superiority over the PRP group in improving the vein diameter, number of MA, and HE area. However, no statistically significant difference in NV area reduction was found between the groups. Conclusion: In the treatment of high-risk PDR, IVC+PRP therapy has a significant advantage over PRP monotherapy. IVC+PRP therapy may reverse diabetes-induced retinal vein changes, restoring morphology and function.

Efficacy of subthreshold micropulse laser photocoagulation therapy versus anti-vascular endothelial growth factor therapy for refractory macular edema secondary to non-ischemic branch retinal vein occlusion.

OBJECTIVE: To assess the efficacy of subthreshold micropulse laser photocoagulation (SMLP) therapy versus anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with refractory macular edema (ME) secondary to non-ischemic branch retinal vein occlusion (BRVO). METHODS: This single-center, prospective, nonrandomized, case-control trial involved patients with refractory ME that responded poorly to three or more initial anti-VEGF injections. The patients were examined and divided into two groups according to their chosen treatment: the intravitreal ranibizumab (IVR) group and the SMLP group. Both groups were followed up monthly for 12 months. Therapeutic efficacy and safety were assessed throughout the follow-up period. RESULTS: The IVR group comprised 49 eyes, and the SMLP group comprised 45 eyes. The improvements in the optical coherence tomography findings and visual acuity were comparable between the two groups at the final follow-up. The total number of injections was significantly lower in the SMLP than IVR group. No serious adverse events occurred during the study period. CONCLUSIONS: SMLP therapy is better for patients with central macular thickness (CMT) of ≤400 µm. For patients with CMT of >400 µm, we advise continuation of anti-VEGF agents to reduce ME followed by application of SMLP therapy when CMT has decreased to ≤400 µm.

Toward a navigation framework for fetoscopy.

PURPOSE: Fetoscopic laser photocoagulation of placental anastomoses is the most effective treatment for twin-to-twin transfusion syndrome (TTTS). A robust mosaic of placenta and its vascular network could support surgeons' exploration of the placenta by enlarging the fetoscope field-of-view. In this work, we propose a learning-based framework for field-of-view expansion from intra-operative video frames. METHODS: While current state of the art for fetoscopic mosaicking builds upon the registration of anatomical landmarks which may not always be visible, our framework relies on learning-based features and keypoints, as well as robust transformer-based image-feature matching, without requiring any anatomical priors. We further address the problem of occlusion recovery and frame relocalization, relying on the computed features and their descriptors. RESULTS: Experiments were conducted on 10 in-vivo TTTS videos from two different fetal surgery centers. The proposed framework was compared with several state-of-the-art approaches, achieving higher [Formula: see text] on 7 out of 10 videos and a success rate of [Formula: see text] in occlusion recovery. CONCLUSION: This work introduces a learning-based framework for placental mosaicking with occlusion recovery from intra-operative videos using a keypoint-based strategy and features. The proposed framework can compute the placental panorama and recover even in case of camera tracking loss where other methods fail. The results suggest that the proposed framework has large potential to pave the way to creating a surgical navigation system for TTTS by providing robust field-of-view expansion.

Photocoagulation with GREENLIGHT© laser in radiation-induced haemorrhagic cystitis: Results of a single-center series.

INTRODUCTION: Radiation-induced haemorrhagic cystitis (RIHC) is one complication of the pelvic radiotherapy. The GREENLIGHT© laser (GL) has been barely studied in the treatment of radiation cystitis. The primary objective was to evaluate the efficacy of GL in refractory RIHC patients (RRC) in a single-centre series. MATERIALS AND METHODS: Twenty-nine patients were treated by GL bladder photocoagulation (GLBP). These patients showed signs of refractory haematuria in the context of RIHC. The primary endpoint was the absence of haematuria that would require a subsequent surgical intervention. Secondary endpoints were postoperative hospitalization length of stay, the occurrence of complications according to the Clavien-Dindo classification, the occurrence of functional urinary disorders and the number of cystectomies. RESULTS: After a median follow-up of 30 months, 24 (82.7%) patients had no recurrence of haematuria. No postoperative complications were reported. A disabling overactive bladder secondary to the procedure occurred in 9 patients (31.0%). Two patients needed a cystectomy at 1 and 11 months. CONCLUSION: GLBP may constitute an efficient line of treatment for RIHC. Despite overactive bladder it allowed to avoid or delay cystectomy.

Long-term real-world outcomes of retinal microvasculature changes in proliferative diabetic retinopathy treated with panretinal photocoagulation vs. intravitreal conbercept.

PURPOSE: To compare long-term real-world outcomes of retinal microvasculature changes in proliferative diabetic retinopathy (PDR) treated with panretinal photocoagulation (PRP) vs. intravitreal conbercept (IVC) and to explore the potential factors affecting these changes. METHODS: This study retrospectively included 96 treatment-naïve PDR eyes of 96 type 2 diabetes mellitus patients [59 PRP and 37 IVC]. Baseline characteristics and treatment details were collected. Optical coherence tomography angiography (OCTA) data of macular vessel density (VD) and optic disc capillary density (CD) at baseline and at the last follow-up were compared between groups. The differences between the baseline and the last follow-up OCTA data in each group were also tested for significance. The correlation between the change in each OCTA parameter from baseline and each baseline characteristic/treatment parameter was investigated in each group. RESULTS: During a mean follow-up of two years, greater superficial (SCP) (p = 0.004) and deep capillary plexus (DCP) VD (p < 0.001) were observed in the foveal area in the PRP than in the IVC. Compared to the baseline, SCP VD in the foveal area increased in the PRP (p = 0.012), while an increased SCP VD in some sectors in the parafoveal and perifoveal areas (p < 0.05), rather than the foveal area (p = 0.908), was seen in the IVC. For both groups, eyes with a higher VD/CD at baseline tended to develop capillary dropout more intensively (all p < 0.05). In the IVC group, foveal avascular zone (FAZ) area change showed a negative correlation with baseline FAZ area (p = 0.020), and complementary PRP exerted a negative influence on FAZ area change (p = 0.002). In the PRP group, SCP VD change was positively correlated with follow-up frequency, and was negatively correlated with diastolic blood pressure (all p < 0.05); DCP VD change showed a positive correlation with PRP shot number (p = 0.019). CONCLUSION: The aforementioned microvasculature changes should be considered when PRP or IVC is adopted in PDR long-term management.

Outcome of peripapillary polypoidal choroidal vasculopathy treatment using combination therapy intravitreal ranibizumab and thermal retinal laser photocoagulation.

We present the case of a middle-aged female Nigerian diagnosed to have right eye peripapillary polypoidal choroidal vasculopathy (PCV). At presentation, her right eye Snellen visual acuity was 6/24+ (unaided) and 6/12 (aided) and the left eye was 6/9 (unaided) and 6/6 (aided). Fundus fluorescein angiography showed a hyperfluorescent peripapillary subretinal lesion associated with subretinal fluid demonstrated on spectral-domain optical coherence tomography. The PCV lesion was successfully treated using a combination of 3 monthly doses of intravitreal ranibizumab initially, followed by one session of focal thermal retinal laser photocoagulation. Her clinical state has remained stable after 5 years of follow-up, requiring no further treatment. This case demonstrates the effectiveness of combination therapy and can be a strategy for treating this PCV type. Successful treatment using this approach will reduce the burden of intravitreal anti-vascular endothelial growth factor, e.g., ranibizumab injections.

Résumé Nous présentons le cas d'une Nigériane d'âge moyen diagnostiquée comme ayant une vasculopathie choroïdienne polypoïdale (VPC) péripapillaire de l'œil droit. Lors de la présentation, son œil droit Snellen avait une acuité visuelle de 6/24+ (sans aide) et de 6/12 (aidé) et l'œil gauche était de 6/9 (sans aide) et 6/6 (aidé). L'angiographie à la fluorescéine du fond d'œil a montré une lésion sous-rétinienne péripapillaire hyperfluorescente associée au liquide sous-rétinien démontrée par tomographie par cohérence optique dans le domaine spectral. La lésion VPC a été traitée avec succès en utilisant une combinaison de 3 doses mensuelles de ranibizumab intravitréen initialement, suivie d'une séance de photocoagulation laser thermique rétinienne focale. Son état clinique est resté stable après 5 ans de suivi, ne nécessitant aucun traitement supplémentaire. Ce cas démontre l'efficacité de la thérapie combinée et peut être une stratégie pour traiter ce type de VPC. Un traitement efficace utilisant cette approche réduira le fardeau du facteur de croissance endothélial antivasculaire intravitréen, par exemple les injections de ranibizumab. Mots clés: Facteur de croissance endothéliale antivasculaire, thérapie combinée, vasculopathie choroïdienne polypoïdale, ranibizumab, laser rétinien Photocoagulation.

Different incidences of diabetic retinopathy requiring treatment since diagnosis according to the course of diabetes diagnosis: a retrospective cohort study.

We aimed to estimate the cumulative incidence of treatment-requiring diabetic retinopathy since clinical diagnosis of diabetes based on the course of diagnosis in a retrospective cohort study using Japan's medical claims and health checkup data (JMDC Claims Database; 2009-2020). We included patients whose diabetes was first diagnosed at medical facilities (hospitals/clinics). We grouped them by health checkup participation before diagnosis, health checkup results, and antidiabetic medication promptly after the diagnosis. The incidence of treatment-requiring diabetic retinopathy (laser photocoagulation, intraocular injection, or vitrectomy) was compared among the groups. Of 126,696 patients, those who started an antidiabetic medication promptly after diabetes diagnosis without a recent health checkup faced the highest risk of treatment-requiring diabetic retinopathy (1-/5-year cumulative incidence: 3.1%/6.0%). This increased risk was consistently observed across various analyses, including the Cox proportional hazard model, sensitivity analysis restricting to those with an eye examination, and sensitivity analysis using vitrectomy as the outcome. Among patients with HbA1c ≥ 6.5% at recent health checkups, those who promptly started an antidiabetic medication had a higher risk (1.4%/3.8%) than those who did not (0.7%/2.7%). Taking the information about the course of diabetes diagnosis is important to manage risk stratification for diabetic retinopathy appropriately.

Therapeutic Efficacy of Intravitreal Conbercept Injections with or without Focal Macular Photocoagulation for Diabetic Macular Edema.

Objective: This study aimed to investigate the effectiveness and safety of intravitreal conbercept injections with or without focal macular photocoagulation in the treatment of diabetic macular edema (DME). Methods: This retrospective study included 60 DME patients (60 eyes) divided into two treatment groups. The conbercept group received monthly intravitreal injections for 5 consecutive sessions, while the combination therapy group received intravitreal injections and focal macular photocoagulation. Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were observed before and at months 1, 3, 6, 9, and 12 after treatment in both groups, along with the number of intravitreal conbercept injections administered. Results: At 1, 3, 6, 9, and 12 months after treatment, both the conbercept and combined treatment groups showed improvement in best-corrected visual acuity (BCVA) and decrease in central macular thickness (CMT) compared to before treatment, with statistical significant differences (P < .05). However, the differences in BCVA and CMT between the two groups at each time point after treatment were not significant (P > .05). During the 1-year follow-up period, the mean number of injections in the combined treatment group was 6.3±0.8, which was less than that in the conbercept treatment group (7.6 ± 0.9), with a significant difference (t = 5.556, P < .001). The incidence of subconjunctival hemorrhage was 10.9% and 10.5% in the two groups, respectively, with no significant inter-group difference (χ² = 0.013, P = .908). None of the patients exhibited serious treatment-related ocular and systemic complications during the treatment period. Conclusions: Treatment of DME with intravitreal conbercept injections, whether with or without focal macular photocoagulation, is safe and effective in improving the patients' visual acuity and retinal anatomy. However, patients who receive combined treatment require fewer intravitreal injections than those who receive conbercept treatment alone.

[Standardize the laser and anti-vascular endothelial growth factor treatment of retinopathy of prematurity].

Retinopathy of prematurity (ROP) is a retinal vascular proliferative disease occurring in premature and low birth weight infants, which is the leading cause of blindness and low vision in children. Laser photocoagulation is still recognized as the gold standard of treatment in ROP. Recently, anti-vascular endothelial growth factor (VEGF) therapy has become a novel alternative approach in clinical practice for ROP. However, there are still many improper and deviations in identifying indications and selecting therapeutic modalities, resulting in generalization and abuse of anti-VEGF drugs in treatment of ROP. The aim of this article is to summarize and objectively evaluate the treatment indications and methods of ROP based on related research at home and abroad, in order to strictly control the theraputic indications and scientifically and rigorously select appropriate therapeutic modalities for the benefit of children with ROP.

LASER PHOTOCOAGULATION FOR THE TREATMENT OF OPTIC NERVE HEAD PIT-RELATED MACULOPATHY IN A PATIENT WITH BILATERAL CHORIORETINAL COLOBOMA.

PURPOSE: To report a case of laser photocoagulation for the treatment of a combined coloboma and optic nerve head pit-related maculopathy in a patient with bilateral chorioretinal coloboma. METHODS: A case report. RESULTS: A 15-year-old woman, presented with the visual acuity of 20/100 in her right eye for six weeks. She was diagnosed with macular detachment secondary to optic nerve head pit in her right eye and bilateral chorioretinal coloboma. Multimodal imaging, including color photography, fluorescein angiography, and spectral-domain optical coherence tomography, was used to identify and demonstrate the location of the tract of fluid from the optic nerve head pit, isolated from the coloboma. Optical coherence tomography-guided laser photocoagulation treatment at the location of the tract resulted in complete resolution of macular fluid with visual recovery to 20/25. CONCLUSION: Our case stresses the value of correct diagnosis directing photocoagulation treatment of combined optic nerve head pit-related maculopathy in eyes with chorioretinal coloboma using multimodal imaging.

Rituximab, Intravitreal Bevacizumab and Laser Photocoagulation for Treatment of Macrophage Activation Syndrome and Retinal Vasculitis in Lupus: A Case Report.

Systemic lupus erythematosus (SLE) most commonly manifests as mild to moderate disease with severe manifestations such as diffuse alveolar hemorrhage, central nervous system vasculitis, macrophage activation syndrome (MAS) or retinal vasculitis (RV) with visual disturbances occurring in a significantly smaller proportion of patients, most of whom have a poor outcome. Macrophage activation syndrome and RV are insufficiently early and rarely recognized presentations of lupus-consequently there are still no treatment recommendations. Here we present the course of diagnosis and treatment of a patient with an SLE flare that resulted in both life-threatening disease (MAS) and vision-threatening disease (RV). The patient was successfully treated with systemic immunosuppressives, a high dose of glucocorticoids and rituximab (RTX), in parallel with intraocular therapy, intravitreal bevacizumab (BEV) and laser photocoagulation.

Outcomes of primary surgical treatment of medically recalcitrant post-keratoplasty glaucoma with transscleral cyclophotocoagulation.

PURPOSE: To report the outcomes of slow-coagulation continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) in post-keratoplasty glaucoma refractory to medical therapy. METHODS: Medical records of 47 patients (mean age of 70.7 ± 15.7 years and follow-up of 13.9 ± 7.1 months) were retrospectively enrolled. All patients had the diagnosis of secondary glaucoma after penetrating keratoplasty (PKP; n = 28) or Descemet's stripping automated endothelial keratoplasty (DSAEK; n = 19) with no previous history of incisional glaucoma or TSCPC surgeries. Study participants underwent slow-coagulation CW-TSCPC (1250-milliwatt power and 4-second duration). RESULTS: A statically significant reduction of IOP from 31.8 ± 8.0 mmHg preoperatively to 16.9 ± 9.0 mmHg postoperatively was noted (p < 0.001). Similarly, the number of glaucoma medications decreased from 4.0 ± 1.0 to 2.7 ± 1.4 (p < 0.001). The overall success rates at 12 and 24 months were 68.1% and 66.0%, respectively, with no difference in success rates between post-PKP and post-DSAEK subgroups (p = 0.836). No significant changes in VA or central corneal thickness (CCT) were observed (p = 0.345 and 0.311, respectively). One (3.3%) patient had a graft rejection. The majority of the complications noted during this study were mild and transient. CONCLUSIONS: Our study suggests that slow-coagulation TSCPC may be a safe and efficient surgical glaucoma treatment modality in patients with medically uncontrolled post-keratoplasty glaucoma.