Purpose: To evaluate the two-year outcomes of combined surgical peripheral iridectomy (SPI), goniosynechialysis (GSL), and goniotomy (GT) for advanced primary angle-closure glaucoma (PACG) without cataract.
Design: Multicenter prospective study.
Methods: The study included patients who received a combined SPI + GSL + GT for advanced PACG without cataract, all completed a 24-month follow-up. Outcome measures included changes in intraocular pressure (IOP), best-corrected visual acuity (BCVA), use of anti-glaucoma medications, surgical success, and postoperative complications over the 24-month period.
Results: A total of 63 eyes from 51 patients with advanced PACG were included in the study. Among these, 37 eyes (58.7 %) achieved complete success, and 55 eyes (87.3 %) achieved qualified success. The mean IOPs at baseline and after 24 months were 28.8 ± 7.51 mm Hg and 15.8 ± 4.40 mm Hg, respectively (P < 0.001). The average number of anti-glaucoma medications decreased from 1.9 ± 1.4-0.8 ± 1.2 over the 24-month period (P < 0.001). The overall BCVA was stable during the follow-up period (P = 0.225). The primary complications observed included IOP spike (n = 9), hyphema (n = 7), and shallow anterior chamber (n = 3), all of which occurred within the first month postoperatively. Regression analysis showed that older age was positively associated with both complete success [odds ratio (OR) = 1.05; P = 0.030] and qualified success (OR = 1.08; P = 0.024).
Conclusions: SPI + GSL + GT demonstrated safety and effectiveness in treating advanced PACG without cataract over the 24-month study period. This combined surgical approach should be considered a viable alternative to trabeculectomy for these patients.
Purpose: To evaluate the association between green space exposure and dry eye.
Design: Part I: case-control study. Part II: cross-sectional study.
Methods: Part I: The study contained 450 patients with dry eye and 900 controls recruited from Electronic Health Records. Logistic regression analysis was employed to investigate the relationship between green space exposure and the occurrence of dry eye. Part II: This study included 140 diabetic participants recruited from the community registry in Guangzhou, China. Linear regression analysis was used to assess the association between green space exposure and quantitative measures of the tear meniscus.
Results: Part I: A total of 1350 individuals were included in the study. On average individuals aged 31.07 ± 4.58 years and 59.33 % were female. Higher 10-year green space exposure was significantly associated with lower odds of dry eye (OR = 0.96; 95 % confidence interval [CI], 0.94, 0.97; p < 0.001) after adjusting for age, sex, rainfall, temperature, particulate matter, and other factors. Part II: A total of 140 diabetic patients were included in the study. On average individuals aged 64.48 ± 8.19 years and 53.57 % were female. Greater 10-year green space exposure was associated with a higher tear meniscus area (β = 0.07, 95 % CI, 0.02, 0.11; p = 0.007) after adjusting for age, sex, rainfall, temperature, particulate matter, and other factors.
Conclusions: Our findings suggest an association between green space exposure and diagnosis of dry eye and tear meniscus, offering novel insights into the strategies for preventing dry eye.