Breaking News Related to Macular Degeneration, Cataract, Glaucoma, Corneal Disease and Other Eye Conditions » Glaucoma

Visualization of Drusen and RPE With New Software Application for Zeiss HD-OCT: A New Aid for Assessing Both Dry and Wet AMD

Irv Arons — Mon, 30 Jan 2012 14:35:34 +0000

In an announcement on January 20th, Carl Zeiss Meditec said that it had added new dry age-related macular degeneration (Dry AMD) and new glaucoma diagnostic tools for its Cirrus HD-OCT (High Definition Optical Coherence Tomography) device, and the new software, version 6.0, had received marketing clearance from the FDA.

As noted by both Drs. Phil Rosenfeld and Carmen Puliafito, who have used the new software, this new diagnostic tool will play an important role in assessing and speeding the development of new treatments for both dry and wet AMD, that are being researched and brought to the market.

To read the full story, please follow this link.

Trabeculectomy vs. Trabectome

Dr. Ari Weitzner — Mon, 09 Jan 2012 09:14:05 +0000

Trabectome is an FDA-cleared device for minimally invasive surgical treatment of open angle glaucoma. It safely ablates and removes a 60°-120° strip of trabecular meshwork using a focused electrosurgical pulse and re-establishes access to the eye’s natural drainage pathway.

But is it superior to a traditional trabeculectomy?

In a recent study, trabeculectomy delivered a better IOP (10) than Trabectome (16) with better success rate (76 vs. 22%).

My take is that if your patient has only mild-moderate glaucoma, chances are an IOP of 15 is pretty good. Also, you can always do trab later- so you have nothing to lose (especially if you are in the eye anyway doing phaco).

Trabeculectomy Beats Canaloplasty

Dr. Ari Weitzner — Thu, 22 Dec 2011 06:43:44 +0000

December Archives: Researchers compared trab with canaloplasty, and found that although canaloplasty works well, the trab worked better- lower IOP (43% reduction vs. 32%), fewer meds post-op and lower rate of failure (IOP>18–4% vs. 12%). Canaloplasty is a good procedure- one just has to pick the appropriate patient, namely, one with less severe glaucoma, at less risk of blindness, and a patient who declines the surgical risk of trab.

Does Diabetes Reduce Risk of Glaucoma?

Dr. Ari Weitzner — Wed, 30 Nov 2011 10:14:19 +0000

Archives: Researchers are curious as to why diabetes reduces the risk of ocular hypertensives converting to glaucoma, considering that diabetes damages the vascular system, and thus poor blood flow to the optic nerve would seem to make glaucoma more likely. They subjected rats to high glucose levels and high pressure and then analyzed optic nerve and retinal ganglion cell damage profiles, and noted a definite delay in cell death in the high glucose group. They speculate that energy metabolism is better in the high glucose group and perhaps that explains the improvement in diabetes.

New Syndrome- Bilateral Acute Iris Transillumination

Dr. Ari Weitzner — Tue, 29 Nov 2011 11:05:21 +0000

Archives: Researchers describe a series of patients who demonstrate acute pigment dispersion with high IOP and iris transillumination defects, some flare but no cells in the anterior chamber, with heavy deposition of pigment in the TM. The episodes were promptly relieved with topical steroids. Poor pupillary constriction is found later. The authors could not point to any etiology. I am willing to bet that if they performed anterior chamber paracentesis, they will find some kind of virus. The authors speculate it may very well be related to another new syndrome, BADI (bilateral acute depigmentation of the iris). Yup- I would agree!

Alternatives to Lumigan Eye Drops for Glaucoma?

Patient Letter to the Editor — Fri, 18 Nov 2011 13:51:55 +0000

Where can I find a list of FDA-approved eye drops for glaucoma?

I was using Lumigan, which my primary insurance covered, but my secondary would not cover the remainder, roughly an extra 40 dollars a month. I was then switched to Timolol. I do not like it as I have to use it twice a day and it burns. I also feel light headed and very tired. Is this normal? I do not take any other medications. I will follow up with my Dr. next week to check to see if the pressure is still being controlled. It was 32 and reduced to 23 with Lumigan. But due to cost and what my insurance would not cover, I had to switch.

Any feed back would be greatly appreciated.

Yeesh! Monocular Trial For Glaucoma Drops Useful After All?

Dr. Ari Weitzner — Mon, 14 Nov 2011 09:39:31 +0000

Ophthalmolgy: I have read several articles on this subject- whether using one eye as a control is helpful when starting a glaucoma drop, or just put in both eyes. The issue was whether the two eyes really behave the same way, whether fluctation in IOP would make the comparison invalid, etc. I thought it was settled- it didn’t work. Just put in both eyes. Researchers now state that with prostaglandins, it does work. Go figure.

Ahmed vs. Baerveldt – Who Won?

Dr. Ari Weitzner — Fri, 11 Nov 2011 09:17:44 +0000

Ophthalmology: Researchers compared at one year the results of shunt surgery comparing the Ahmed to the Baerveldt. Bottom line?- higher failure rate (43% vs 28%) and higher IOp (16.5 vs 13.6) in the Ahmed. One caveat- the Baerveldt required more interventions (42% vs. 26%) compared to Ahmed.

Modified Trabeculectomy With No Iridectomy Quick and Effective

Dr. Ari Weitzner — Mon, 07 Nov 2011 14:50:20 +0000

Surgeons in the U.K. describe a modified trabeculectomy, where a scleral pocket is made and a punch of trabecular tissue is excised inside the pocket using a Jacobs punch. No iridectomy. Viscoelastic is irrigated into the anterior chamber and is left in there- a small ooze of viscoelastic should be seen at the opening of the scleral pocket. No sutures. One can easily convert to standard trab by incising one or both sides of the scleral pocket, doing iridectomy and suturing the flap. The surgeons note perfectly comparable results to standard trab.

Vascular Abnormalities in Nail Bed Suggestive of Glaucoma

Dr. Ari Weitzner — Mon, 31 Oct 2011 09:31:03 +0000

A study recently reported in the Archives of Ophthalmology, found that nail bed hemorrhage and loss of nail capillaries were strongly associated with the presence of optic disc hemorrhage in patients with glaucoma.

Researchers studied the characteristics of nailfold capillary changes in patients with glaucoma and analyzed their possible relationship to other clinical characteristics of glaucoma. The researchers concluded that nail bed hemorrhage can thus serve as a clinical marker of optic disc hemorrhage in patients with glaucoma.

Click here to read an abstract of the study.