88 research outputs found
Ahmed glaucoma valve implant: surgical technique and complications
Ivano Riva,1 Gloria Roberti,1 Francesco Oddone,1 Anastasios GP Konstas,2 Luciano Quaranta3 1IRCCS “Fondazione GB Bietti per l’Oftalmologia”, Rome, Italy; 21st University Department of Ophthalmology, Glaucoma Unit, AHEPA Hospital, Thessaloniki, Greece; 3Department of Medical and Surgical Specialties, Section of Ophthalmology, University of Brescia, Brescia, Italy Abstract: Implantation of Ahmed glaucoma valve is an effective surgical technique to reduce intraocular pressure in patients affected with glaucoma. While in the past, the use of this device was reserved to glaucoma refractory to multiple filtration surgical procedures, up-to-date mounting experience has encouraged its use also as a primary surgery for selected cases. Implantation of Ahmed glaucoma valve can be challenging for the surgeon, especially in patients who already underwent previous multiple surgeries. Several tips have to be acquired by the surgeon, and a long learning curve is always needed. Although the valve mechanism embedded in the Ahmed glaucoma valve decreases the risk of postoperative hypotony-related complications, it does not avoid the need of a careful follow-up. Complications related to this type of surgery include early and late postoperative hypotony, excessive capsule fibrosis around the plate, erosion of the tube or plate edge, and very rarely infection. The aim of this review is to describe surgical technique for Ahmed glaucoma valve implantation and to report related complications. Keywords: glaucoma, surgical technique, glaucoma drainage devices, Ahmed glaucoma valve, complication
Needle revision with 5-fluorouracil for the treatment of ahmed glaucoma valve filtering blebs 5-fluoruracil needling revision can be a useful and safe tool in the management of failing ahmed glaucoma valve filtering blebs
Transforming the future of ophthalmology: artificial intelligence and robotics’ breakthrough role in surgical and medical retina advances: a mini review
Over the past decade, artificial intelligence (AI) and its subfields, deep learning and machine learning, have become integral parts of ophthalmology, particularly in the field of ophthalmic imaging. A diverse array of algorithms has emerged to facilitate the automated diagnosis of numerous medical and surgical retinal conditions. The development of these algorithms necessitates extensive training using large datasets of retinal images. This approach has demonstrated a promising impact, especially in increasing accuracy of diagnosis for unspecialized clinicians for various diseases and in the area of telemedicine, where access to ophthalmological care is restricted. In parallel, robotic technology has made significant inroads into the medical field, including ophthalmology. The vast majority of research in the field of robotic surgery has been focused on anterior segment and vitreoretinal surgery. These systems offer potential improvements in accuracy and address issues such as hand tremors. However, widespread adoption faces hurdles, including the substantial costs associated with these systems and the steep learning curve for surgeons. These challenges currently constrain the broader implementation of robotic surgical systems in ophthalmology. This mini review discusses the current research and challenges, underscoring the limited yet growing implementation of AI and robotic systems in the field of retinal conditions
Quality of Life in Glaucoma: A Review of the Literature
The ultimate goal of glaucoma management is
the preservation of patients’ visual function and
quality of life (QoL). The disease itself as well as
the medical or surgical treatment can have an
enormous impact on a patient’s QoL. Even the
mere diagnosis of a chronic, irreversible,
potentially blinding disorder can adversely
affect the patient’s sense of well-being and
QoL by eliciting significant anxiety. Patients
with primary open-angle glaucoma rarely
present with visual symptoms, at least early in
the course of the disease. A better
understanding of patient-reported QoL can
improve patient–physician interaction and
enhance treatment adherence by customizing
treatment options based on individual patient
profile, thus optimizing long-term prognosis.
These aspects are summarized and critically
appraised in this articl
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Vision-related quality of life and symptom perception change over time in newly-diagnosed primary open angle glaucoma patients
To evaluate the change over time of vision-related quality of life (QoL) and glaucoma symptoms in a population of newly-diagnosed primary open angle glaucoma (POAG) patients. Multicenter, prospective study. Consecutive newly-diagnosed POAG patients were enrolled and followed-up for one year. Follow-up visits were scheduled at 6 and 12 months from baseline. At each visit, vision-related QoL and glaucoma-related symptoms were assessed by the means of the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Glaucoma Symptom Scale (GSS), respectively. Trends over time for NEI-VFQ-25 and GSS scores were evaluated with longitudinal linear mixed models. One-hundred seventy-eight patients were included in the analysis. At baseline, early to moderate glaucoma stages were associated with higher scores for most GSS and NEI-VFQ-25 items, while lower best-corrected visual acuity was associated with lower scores for 4 of the 12 NEI-VFQ-25 items. During the follow-up, all the GSS scores, the NEI-VFQ-25 total score, and 7 of the 12 NEI-VFQ-25 scores significantly improved (p < 0.05). In multivariate model, higher increases of most GSS and NEI-VFQ-25 scores were modeled in patients with low scores at baseline. Vision-related QoL and glaucoma-related symptom perception significantly improved during the one-year follow-up in this population of newly diagnosed POAG patients
Elevated intraocular pressure in patients with acromegaly
To evaluate central corneal thickness (CCT) and intraocular pressure (IOP) in a cohort of acromegalic patients, and to correlate CCT with serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1)
Glaucoma and neuroinflammation: an overview
Glaucoma is an optic neuropathy characterized by well-defined optic disc morphological changes (i.e. cup enlargement, neuroretinal border thinning, and notching, papillary vessel modifications) consequent to retinal ganglion cell loss, axonal degeneration, and lamina cribrosa remodeling. These modifications tend to be progressive and are the main cause of functional damage in glaucoma. Despite the latest findings about the pathophysiology of the disease, the exact trigger mechanisms, and the mechanism of degeneration of retinal ganglion cells and their axons have not been completely elucidated. Neuroinflammation may play a role in both the development and the progression of the disease as a result of its effects on retinal environment and retinal ganglion cells. We summarize the latest findings about neuroinflammation in glaucoma and examine the connection between risk factors, neuroinflammation, and retinal ganglion cell degeneration
Bimatoprost Intracameral Implant (Durysta®): A New Era in Glaucoma Management Through Sustained-Release Innovation
Iordanis Vagiakis,1 Eleni P Papadopoulou,1 Efstratia Amaxilati,1 Georgios N Tsiropoulos,1 Anastasios G Konstas,1,* Georgios D Panos1,2,* 1First Department of Ophthalmology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2Division of Ophthalmology and Visual Sciences, School of Medicine, University of Nottingham, Nottingham, UK*These authors contributed equally to this workCorrespondence: Georgios D Panos; Iordanis Vagiakis, First Department of Ophthalmology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, Kiriakidi 1, Thessaloniki, 54636, Greece, Tel +30 231 330 3110, Email [email protected]; [email protected]: The bimatoprost intracameral implant (Durysta®) offers a sustained-release approach to glaucoma management, providing consistent intraocular pressure (IOP) reduction over several months and reducing the need for daily topical therapies. This review evaluates its pharmacology, efficacy, and safety, using data from pivotal clinical trials and recent real-world studies. The implant achieves IOP reductions comparable to topical prostaglandin analogs, with benefits for patient adherence and fewer common side effects. However, repeat administrations are associated with adverse effects such as endothelial cell loss, highlighting the need for optimized re-dosing schedules. Future research should explore its use in advanced glaucomas, cost-effectiveness, and combination with other IOP-lowering treatments. The bimatoprost intracameral implant represents a promising innovation in glaucoma therapy with potential for improved patient outcomes.Keywords: bimatoprost intracameral implant, glaucoma, intraocular pressure reduction, sustained-release therapy, primary open-angle glaucoma, ophthalmic drug delivery, patient adherence, prostaglandin analogs, endothelial cell safety, real-world evidence, cost-effectiveness, combination therapy in glaucom
Effect of trabeculectomy and canaloplasty on intra-ocular pressure modifications after postural changes in open-angle glaucoma
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