Ophthalmology. Glaucoma最新文献

{"title":"Patient Attitudes toward Distress Screening and Referral in Glaucoma Care","authors":"Eun Young Choi MD , Natalie Chou BS , Hannah M. Fisher PhD , Davina Malek MD , Alessandro A. Jammal MD, PhD , Tamara Somers PhD , Kelly Muir MD , Felipe A. Medeiros MD, PhD , Samuel I. Berchuck PhD","doi":"10.1016/j.ogla.2025.09.004","DOIUrl":"10.1016/j.ogla.2025.09.004","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 1","pages":"Pages 135-137"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraocular Pressure Fluctuations Recorded by a Telemetric Sensor after Nonpenetrating Glaucoma Surgery in Primary Open-Angle Glaucoma","authors":"Colya N. Englisch MD ,&nbsp;André M. Trouvain MD ,&nbsp;Philip Wakili MD ,&nbsp;Kaweh Mansouri MD ,&nbsp;H. Burkhard Dick MD ,&nbsp;Esther M. Hoffmann MD ,&nbsp;Marc J. Mackert MD ,&nbsp;Achim Langenbucher PhD ,&nbsp;Karl T. Boden MD ,&nbsp;Peter Szurman MD","doi":"10.1016/j.ogla.2025.07.007","DOIUrl":"10.1016/j.ogla.2025.07.007","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate short- and long-term intraocular pressure (IOP) fluctuations in patients with primary open-angle glaucoma (POAG) after successful nonpenetrating glaucoma surgery (NPGS, canaloplasty or deep sclerectomy).</div></div><div><h3>Design</h3><div>A prospective, open-label, multicenter interventional study.</div></div><div><h3>Subjects</h3><div>A total of 20 patients with POAG who underwent NPGS combined with permanent implantation of a suprachoroidal telemetric IOP sensor (EyeMate-SC, Implandata Ophthalmic Products GmbH). The mean age of the cohort was 66.9 ± 10.6 years. Half were female, and half were male.</div></div><div><h3>Methods</h3><div>Telemetric IOP measurements were obtained over a 3-year period, excluding the first 180 postoperative days and those during which ocular glaucoma medications were applied. One day was divided into 8 time-of-day (TOD) periods. The median absolute difference (MAD) in IOP between day <span><math><mrow><mi>χ</mi></mrow></math></span> and day <span><math><mrow><mi>χ</mi></mrow></math></span> + 7, 30, 90, 180, and 360 was calculated for each TOD and each eye, in which sequential IOP measurements were accordingly available.</div></div><div><h3>Main Outcome Measures</h3><div>Intraocular pressure fluctuations.</div></div><div><h3>Results</h3><div>The mean follow-up duration was 952.8 ± 276.6 days. For analysis, a total of 139 512 mean IOP values were paired. Overall, diurnal IOP decreased by 20.7%, from 11.1 ± 5.0 mmHg in the “early morning” to 8.8 ± 3.2 mmHg in the “late evening,” followed by a nocturnal IOP increase of 13.6% to 10.0 ± 3.8 mmHg in the “late night.” Independently of the TOD, fluctuations were smallest during the 7-day interval and largest during the 360-day interval. The awake period, lasting from early morning to early evening, displayed increasing MADs with growing time intervals, resulting in moderate IOP fluctuations in the short term (1.5 mmHg &lt; MAD &lt; 2.0 mmHg) and large fluctuations in the long term (MAD &gt; 2.0 mmHg). The late-night TOD displayed the lowest fluctuation amplitude.</div></div><div><h3>Conclusions</h3><div>Nychthemeral IOP fluctuations persist in eyes with an average IOP of 10 mmHg after successful NPGS. Short-term IOP fluctuations were moderate, whereas long-term fluctuations were large. Irregular IOP measurements are insufficient to assess IOP fluctuation and thus to determine optimal glaucoma management. The implementation of safe and accurate telemetric sensors has the potential to enhance glaucoma management.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 1","pages":"Pages 26-36"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes and Treatments of Malignant Glaucoma in the United States","authors":"Asahi Fujita MD ,&nbsp;William C. Kearney MS ,&nbsp;David S. Friedman MD, PhD ,&nbsp;Prashit Parikh BA ,&nbsp;Elizabeth Ciociola Kelly MD ,&nbsp;Yusrah Shweikh MD ,&nbsp;Connor Ross BS ,&nbsp;Tobias Elze PhD ,&nbsp;Alice C. Lorch MD, MPH ,&nbsp;Joan W. Miller MD ,&nbsp;Nazlee Zebardast MD, MPH","doi":"10.1016/j.ogla.2025.08.006","DOIUrl":"10.1016/j.ogla.2025.08.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the causes and treatments of malignant glaucoma (MG) in the United States.</div></div><div><h3>Design</h3><div>Retrospective cohort study</div></div><div><h3>Subjects</h3><div>Eyes with diagnosis codes for MG between 2014 and 2023 in the IRIS® Registry (Intelligent Research in Sight).</div></div><div><h3>Methods</h3><div>Precipitating procedures and treatment modality were identified using procedure codes and medication data. Using generalized estimating equations, we investigated factors associated with initial treatment with pars plana vitrectomy (PPV), those associated with undergoing laser or incisional surgeries after medication, and those associated with undergoing surgery or cyclophotocoagulation after laser hyaloidotomy.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were a breakdown of precipitating procedures and treatment modalities. The secondary outcomes included factors associated with initial treatment with PPV and those associated with undergoing additional procedures after medication or laser hyaloidotomy.</div></div><div><h3>Results</h3><div>A total of 3554 eyes were diagnosed with MG, among which pre-existing glaucoma was identified in 54.5%. Cataract surgery was the most common precipitating surgery (26.6%), and estimated incidence rate was the highest after tube shunt surgery (23.8/10 000). First-recorded treatment was medication in 54.8%, laser hyaloidotomy in 8.9%, and PPV in 31.9%. Higher intraocular pressure (IOP) at onset (odds ratio: 1.08 [95% confidence interval: 1.03–1.12] per 10 mmHg) and worse visual acuity at onset (odds ratio: 1.27 [95% confidence interval: 1.19–1.35] per 1 unit higher logarithm of the minimum angle of resolution) were associated with initial PPV; 34% and 24% of the eyes underwent additional procedures after medication and laser hyaloidotomy, respectively. Factors associated with subsequent procedures among medically treated eyes included aphakia or pseudophakia (odds ratio: 1.33 [95% confidence interval: 1.09–1.63]) and higher IOP at onset (odds ratio: 1.11 [95% confidence interval: 1.05–1.17] per 10 mmHg). Higher IOP at onset (odds ratio: 1.19 [95% confidence interval: 1.03–1.38] per 10 mmHg) was also associated with additional procedures after laser hyaloidotomy.</div></div><div><h3>Conclusions</h3><div>More than half of the eyes with MG had a pre-existing glaucoma diagnosis. Tube shunt surgery had the highest incidence rate of MG. More than half were initially treated with medication, and one-third were initially treated with PPV. Higher IOP at onset was associated with a higher likelihood of being initially treated with PPV as well as a higher likelihood of requiring additional procedures when initially treated with medication or laser hyaloidotomy.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 1","pages":"Pages 86-95"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Selective Laser Trabeculoplasty Efficacy","authors":"Tobias Dahlgren MD ,&nbsp;Marcelo Ayala MD, PhD ,&nbsp;Madeleine Zetterberg MD, PhD","doi":"10.1016/j.ogla.2025.08.008","DOIUrl":"10.1016/j.ogla.2025.08.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To investigate the impact of potential predictor variables on selective laser trabeculoplasty (SLT) efficacy in the Swedish Optimal SLT (OSLT) trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Post hoc analysis of a multicenter, masked, randomized controlled trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Subjects&lt;/h3&gt;&lt;div&gt;Five hundred twelve eyes from 399 patients enrolled in the OSLT trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Patients were randomized to one of 4 SLT variants, differing in treatment extent (180° or 360°), and laser power (standard or high). Analyses were performed with linear mixed models, which allowed optimal use of all the data and applied comprehensive adjustment to the results. A wide selection of potential predictors for SLT efficacy were first analyzed separately regarding their association with intraocular pressure reduction (IOPR). Predictors meeting a threshold of &lt;em&gt;P&lt;/em&gt; &lt; 0.1 were then included in a multivariable candidate model, which was refined through manual stepwise backwards selection until only significant variables (&lt;em&gt;P&lt;/em&gt; &lt; 0.05) remained. Thereafter, other variables of interest were evaluated in this model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;The mean IOPR 1 to 6 months after SLT.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Selective laser trabeculoplasty performed in 360 degrees, at an energy level giving a 50% to 75% cavitation bubble frequency (the 360/high protocol) remained the most efficacious SLT variant after adjustment for predictors (&lt;em&gt;P &lt;&lt;/em&gt; 0.001). The coefficient estimate (CE) of 360/high SLT was 2.0; SLT performed in 360 degrees, at an energy level titrated just below the cavitation bubble threshold (360/standard) CE was 0.9; and SLT performed in 180 degrees, at an energy level giving a 50% to 75% cavitation bubble frequency (180/high) CE was –0.1, with SLT performed in 180 degrees, at an energy level titrated just below the cavitation bubble threshold (180/low) as the reference. Higher baseline IOP was a positive predictor for both absolute IOPR (CE 0.35; &lt;em&gt;P&lt;/em&gt; &lt; 0.001) and relative IOPR (CE 0.72; &lt;em&gt;P&lt;/em&gt; &lt; 0.001). A larger IOPR from the prior SLT (CE 0.18; &lt;em&gt;P&lt;/em&gt; = 0.004), as well as IOPR in the contralateral eye (CE 0.57; &lt;em&gt;P&lt;/em&gt; &lt; 0.001), were also highly significant positive predictors. Conversely, the present analyses suggest that SLT efficacy is diminished by pseudoexfoliations (CE –0.69; &lt;em&gt;P&lt;/em&gt; = 0.02), the number of prior SLTs (CE –0.54; &lt;em&gt;P&lt;/em&gt; = 0.004), and increased corneal thickness (CE –0.01; &lt;em&gt;P&lt;/em&gt; &lt; 0.002). Consultants/specialists and residents achieved similar SLT results, but individual surgeon performance mattered (&lt;em&gt;P&lt;/em&gt; = 0.003), as well as if the surgeon used the dominant hand (CE 0.35; &lt;em&gt;P&lt;/em&gt; = 0.050). However, age, glaucoma medication, cataract surgery, anterior chamber angle pigmentation, inflammatory symptoms, or postoperative anterior chamber flare had no correlation with SLT efficacy.&lt;/div&gt;&lt;/di","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 1","pages":"Pages 15-25"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Hydrus Microstent Implantation for Open-Angle Glaucoma","authors":"Natalie R. Hamilton PhD ,&nbsp;Anam Akhlaq MBBS ,&nbsp;Patrick O. Nnoromele BS ,&nbsp;Nicolas Gasquet MPH ,&nbsp;Catalina Garzon MD ,&nbsp;Yulia Nam MD ,&nbsp;Leangelo Hall MD ,&nbsp;Pradeep Y. Ramulu MD, PhD ,&nbsp;Ian Pitha MD, PhD ,&nbsp;Mona Kaleem MD ,&nbsp;Jella An MD ,&nbsp;Elyse J. McGlumphy MD ,&nbsp;Jacob A. Kanter MD ,&nbsp;Thomas V. Johnson MD, PhD","doi":"10.1016/j.ogla.2025.08.011","DOIUrl":"10.1016/j.ogla.2025.08.011","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the clinical outcomes of Hydrus Microstent implantation with cataract extraction for the treatment of open-angle glaucoma (OAG) over a maximum of 4 years.</div></div><div><h3>Design</h3><div>A retrospective, single-center, single-arm, longitudinal cohort study.</div></div><div><h3>Subjects</h3><div>Three hundred eight patients (464 eyes) with OAG who underwent Hydrus Microstent implantation with cataract extraction between February 2019 and December 2021, followed for a median of 2.0 (interquartile range [IQR], 1.3–2.8) years.</div></div><div><h3>Methods</h3><div>Medical records were reviewed to collect demographic and clinical data. After assessment for Gaussian distribution, mean and standard deviation (SD) or median and IQR were calculated. Change from baseline was calculated with mixed-effects models and expressed as mean change and standard error.</div></div><div><h3>Main Outcome Measures</h3><div>(1) Intraocular pressure (IOP); (2) number of glaucoma medications; (3) need for additional glaucoma procedures; and (4) rate of glaucoma progression, calculated using mean deviation (MD) from standard automated perimetry and OCT peripapillary retinal nerve fiber layer (RNFL) thickness.</div></div><div><h3>Results</h3><div>Among 308 patients, 60.7% (n = 187) were White, and 50.6% (n = 156) were female. The median age was 74 (IQR, 68–78) years. Most eyes had mild (63.8%) or moderate (23.9%) OAG. Of 464 eyes, 99 (21.4%) had undergone prior procedures for glaucoma. At baseline, the mean (±SD) IOP was 16.0 ± 3.7 mmHg while taking 1.9 ± 1.1 glaucoma medications. After Hydrus implantation, a sustained reduction was observed in mean IOP [mean change ± standard error]: –1.9 ± 0.3 at 6 months (<em>P</em> &lt; 0.0001), –1.2 ± 0.2 at 1 year (<em>P</em> &lt; 0.0001), –1.2 ± 0.2 at 2 years (<em>P</em> &lt; 0.0001), –1.6 ± 0.3 at 3 years (<em>P</em> &lt; 0.0001), and –1.2 ± 0.7 at 4 years (<em>P</em> = 0.02). Glaucoma medications were reduced by 1.2 ± 0.1 at 6 months (<em>P</em> &lt; 0.0001), 1.1 ± 0.1 at 1 year (<em>P</em> &lt; 0.0001), 1.0 ± 0.1 at 2 years (<em>P</em> &lt; 0.0001), 0.9 ± 0.1 at 3 years (<em>P</em> &lt; 0.0001), and 0.5 ± 0.2 at 4 years (<em>P</em> = 0.03). Only 14 eyes (3.2%) required additional glaucoma procedures. Compared to the lookback period, the rates of visual field MD and RNFL loss decreased in the postoperative period by 0.18 ± 0.08 dB/year (–0.18 ± 0.02 vs. 0.004 ± 0.08 dB/year, <em>P</em> = 0.02) and 0.51 ± 0.29 μm/year (–0.47 ± 0.12 vs. 0.04 ± 0.21 μm/year, <em>P</em> = 0.07), respectively.</div></div><div><h3>Conclusions</h3><div>In this nontrial setting, cataract surgery with Hydrus Microstent implantation was associated with sustained reductions in IOP, glaucoma medication burden, and disease progression rate.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"9 1","pages":"Pages 48-61"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive Sleep Apnea as a Potentiator of Primary Open-Angle Glaucoma and Necessity for Interventional Therapy","authors":"Pranav Vasu MPH ,&nbsp;Isabella V. Wagner BS ,&nbsp;Paul Connor Lentz MD ,&nbsp;Priyanka Gumaste MD ,&nbsp;Yazan Abubaker MD ,&nbsp;Bryan C.H. Ang MD ,&nbsp;Abhimanyu S. Ahuja MD ,&nbsp;Emily Dorairaj BS ,&nbsp;Ibrahim Qozat MD ,&nbsp;Darby D. Miller MD, MPH ,&nbsp;Syril Dorairaj MD","doi":"10.1016/j.ogla.2025.05.005","DOIUrl":"10.1016/j.ogla.2025.05.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the rate of progression of primary open-angle glaucoma (POAG) in patients with obstructive sleep apnea (OSA) compared with non-OSA mild-moderate POAG comparators and to assess the utilization of surgical and laser intervention.</div></div><div><h3>Design</h3><div>A retrospective cohort study of the TriNetX US Collaborative Network was conducted by analyzing international electronic health record data from January 2004 to October 2024.</div></div><div><h3>Participants</h3><div>Patients in the TriNetX US Collaborative Network with a diagnosis of mild-moderate POAG, stratified with respect to OSA status.</div></div><div><h3>Methods</h3><div>Patients were assessed for outcomes at 3, 5, and 10 years. Propensity score matching was conducted between cohorts matched for baseline demographics, comorbidities, and medication use. Odds ratios (ORs) and 95% confidence intervals (CIs) were subsequently calculated.</div></div><div><h3>Main Outcome Measures</h3><div>Risk of development of severe POAG.</div></div><div><h3>Results</h3><div>After propensity score matching, 5277 patients with, and 5277 patients without OSA were included in final analysis. At 3 (OR, 2.791; 95% CI, 2.289–3.403), 5 (OR, 2.300; 95% CI, 1.947–2.717), and 10 years (OR, 2.198; 95% CI, 1.873–2.578), the OSA cohort demonstrated significantly higher odds of developing severe POAG than the non-OSA comparators. Secondary outcomes of minimally invasive glaucoma surgery and trabeculectomy surgery yielded no significant difference between both cohorts (<em>P</em> &gt; 0.05) at all follow-up times. However, laser therapy and tube shunt surgery demonstrated a significantly greater incidence in the OSA cohort at each time point.</div></div><div><h3>Conclusions</h3><div>The rate of glaucoma surgery appears similar between patients with POAG with and without OSA, despite those with OSA demonstrating a greater risk of rapid progression and vision loss. Future practice patterns should pay special attention to patients with OSA and consider offering more aggressive or earlier intervention, which may aid in limiting disease progression.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 553-559"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Hydrus Microstent with Cataract Surgery in Asian and Non-Asian Eyes with Normal Tension Glaucoma","authors":"Debbie S. Kuo MD ,&nbsp;Sharon Y.H. Lee OD ,&nbsp;Christos N. Theophanous MD, MBA","doi":"10.1016/j.ogla.2025.06.006","DOIUrl":"10.1016/j.ogla.2025.06.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the efficacy and safety of the Hydrus Microstent in conjunction with cataract surgery in patients with normal tension glaucoma (NTG) with minimum 12-month follow-up.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>Normal tension glaucoma eyes having Hydrus with cataract surgery and cataract-only controls.</div></div><div><h3>Methods</h3><div>Glaucoma was staged by the Hodapp–Parrish–Anderson criteria. Generalized estimating equations were used to account for intraocular correlation in regression analyses.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was medication reduction from baseline at 1 year. Secondary outcomes were medication reduction in subsequent years, mean intraocular pressure (IOP) change from baseline, proportion of eyes meeting IOP targets, and percentage of eyes requiring secondary surgical interventions (SSI) at yearly time points.</div></div><div><h3>Results</h3><div>Sixty-four eyes of 40 patients undergoing Hydrus Microstent and cataract surgery were included in the analysis, of which 32 eyes were from Asian patients. Thirty-nine eyes of 25 patients were used as cataract-only controls. Glaucoma severity was mild (37.5%), moderate (40.6%) and severe (21.9%) in treated eyes. The median follow-up available was 2.5 years (range: 1–5 years). Baseline IOP was 13.83 ± 2.93 mmHg on 2.11 ± 1.04 medication classes in treated eyes. At year 1, there was a mean reduction of medication classes by 1.25 ± 0.84 (<em>P</em> &lt; 0.0010) and IOP by 0.89 ± 2.61 mmHg (<em>P</em> = 0.02). Medication class reduction remained significant through year 4 and IOP reduction through year 3. Compared to controls, treated eyes had significant differences in mean medication change (−1.25 vs. −0.03 at year 1, <em>P</em> &lt; 0.001) and percentage of eyes with medication reduction (85.9% vs. 5.3% at year 1, <em>P</em> &lt; 0.001), which were sustained through at least year 4. There were no significant differences in medication reduction and IOP observed between treated Asian and non-Asian eyes at any time point. In treated eyes, IOP was 16 mmHg or less on same or fewer medications in more than 90% (range: 90.6%–100%) of eyes at all time points and medication-free in more than 31% (range: 31.3%–54.5%) at all time points. No SSI occurred during the study period.</div></div><div><h3>Conclusions</h3><div>Hydrus Microstent was safe and effective in all NTG eyes with a significant, sustained reduction in medication use through at least 4 years of follow-up.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 589-598"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of Patient Understanding and Satisfaction in Glaucoma Filtering Surgery","authors":"Farid Akkouche MD ,&nbsp;Paul Bastelica MD ,&nbsp;Christophe Baudouin MD, PhD ,&nbsp;Shaya Sable MD ,&nbsp;Antoine Labbe MD, PhD","doi":"10.1016/j.ogla.2025.06.007","DOIUrl":"10.1016/j.ogla.2025.06.007","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess patients' understanding of glaucoma surgery and their postoperative satisfaction, to study the factors that may influence them, and to investigate correlations between these 2 determining factors.</div></div><div><h3>Design</h3><div>A multicenter observational study.</div></div><div><h3>Subjects</h3><div>Patients scheduled for glaucoma filtration surgery were included.</div></div><div><h3>Methods</h3><div>Participants responded preoperatively to a questionnaire developed after literature review, evaluating their understanding of the surgery, and to a second questionnaire evaluating their postoperative satisfaction, between 2 and 3 months after surgery.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were the mean scores for preoperative understanding and postoperative satisfaction. The influence of demographic, clinical, and surgical factors on comprehension and satisfaction was analyzed using univariate and multivariate models.</div></div><div><h3>Results</h3><div>In this study, 97 patients responded to the questionnaire evaluating their understanding of the surgery preoperatively. Postoperative satisfaction could be evaluated in 86 of them. The mean understanding score was 13.4 ± 5.4 (out of 25). Level of education (<em>P</em> &lt; 0.01) and reading the French Society of Ophthalmology's information form on glaucoma filtering surgery (<em>P</em> &lt; 0.05) were statistically correlated with a better understanding after multivariate analysis. The mean postoperative satisfaction score was 7.13 ± 3.0 (out of 10). Needling (<em>P</em> &lt; 0.01) and resumption of hypotensive treatment (<em>P</em> &lt; 0.001) were statistically correlated with poorer satisfaction after multivariate analysis. In addition, poorer preoperative understanding was correlated with lower postoperative satisfaction with a Pearson coefficient of 0.42 (95% confidence interval: 0.23–0.57 [<em>P</em> &lt; 0.01]).</div></div><div><h3>Conclusions</h3><div>Overall, patient understanding was limited, and poor understanding negatively influenced postoperative satisfaction.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 634-642"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ologen-Augmentation of Ahmed Valves in Pediatric Glaucomas","authors":"Adam Jacobson MD ,&nbsp;Brenda L. Bohnsack MD, PhD","doi":"10.1016/j.ogla.2025.06.008","DOIUrl":"10.1016/j.ogla.2025.06.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Determine 2- to 6-year outcomes of Ologen augmentation of Ahmed glaucoma devices (OAGDs) in children with glaucoma.</div></div><div><h3>Design</h3><div>Retrospective interventional case series.</div></div><div><h3>Subjects</h3><div>Children (&lt;18 years of age) with glaucoma requiring surgery for intraocular pressure (IOP) control with at least 2 years of postoperative follow-up.</div></div><div><h3>Methods</h3><div>Placement of OAGD between 2018 and 2022.</div></div><div><h3>Main Outcome Measures</h3><div>Change in IOP, number of glaucoma medications and best-corrected visual acuity from preoperative to final follow-up, and success of surgery (complete defined as IOP 5 to 20 mmHg without additional medications, visually devastating complication or additional IOP-lowering surgeries, qualified success defined as above except IOP control was maintained ± glaucoma medications).</div></div><div><h3>Results</h3><div>Forty eyes of 28 patients underwent OAGD at median age of 2.6 years (interquartile range [IQR], 0.6–7.8). Primary congenital glaucoma was the most common diagnosis (12 eyes of 9 patients), followed by glaucoma secondary to nonacquired ocular anomaly (11 eyes of 6 patients). Twenty-two eyes of 16 patients had prior glaucoma surgery (median 2, [interquatile range (IQR), 1–2]). Preoperative IOP was a median of 27 mmHg (IQR, 24–35) on a median of 3 (IQR, 2–3) glaucoma medications. At final follow-up (median 3.6 years [IQR, 2.9–4.3]), IOP (median, 15 mmHg [IQR, 13–17]) and glaucoma medications (median, 0 [IQR, 0–0]) were significantly decrease (<em>P</em> &lt; 0.0001). Complete success at final follow-up was 55% (22 of 40 eyes) with 3- and 5-year survival rates of 75% (95% confidence interval [CI], 59–86) and 57% (95% CI, 35–74). Qualified success rate was 75% (30 of 40 eyes) with 3- and 5-year survival rates of 87% (95% CI, 71–95) and 67% (95% CI, 42–83), respectively.</div></div><div><h3>Conclusions</h3><div>Although OAGD decreased IOP and the number of glaucoma medications, the high survival rates seen over the first 3 years decreased by 5 years.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Pages 609-615"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Han et al.: Comparison of structural changes after epiretinal membrane peeling between nonglaucomatous eyes and eyes with open-angle glaucoma (Ophthalmology Glaucoma. 2025;8:351-359)","authors":"Chun-Hsiang Chang MD,&nbsp;Fu-Chin Huang MD,&nbsp;I-Huang Lin MD","doi":"10.1016/j.ogla.2025.09.002","DOIUrl":"10.1016/j.ogla.2025.09.002","url":null,"abstract":"","PeriodicalId":19519,"journal":{"name":"Ophthalmology. Glaucoma","volume":"8 6","pages":"Page e19"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}