Trends in operating room-based glaucoma procedures at a single eye center from 2016–2020

AIM:To evaluate trends in glaucoma procedures at the Peking University Eye Center in 2016–2020.METHODS:A retrospective search of all glaucoma procedures performed at our institution were performed.Data were analyzed by calculating the absolute numbers and relative weightage of each procedure per year.RESULTS:The average age of glaucoma patients undergoing surgical procedures was 62.33±17.87y,and 55%were women.From 2016 to 2019,the number of surgical procedures performed in glaucoma patients showed an overall upward trend from 749 to 1460,although it decreased slightly in 2020(n=1393),probably due to the COVID-19 pandemic.The number of trabeculectomies did not change significantly in 2016(n=161)to 2018(n=164)but decreased in 2019(n=139)to 2020(n=121),indicating a reduction in its relative weightage among glaucoma procedures(from 21.50%to 8.69%).The number of glaucoma drainage device implantations and minimally invasive glaucoma surgeries both increased(50and 58 respectively in 2019),except in 2020.The number of transscleral cyclophotocoagulation procedures was relatively stable,increasing until 2017(n=218)and then decreasing.Cataract surgeries with or without glaucoma procedures accounted for a large number of the total surgeries,increasing from 247(32.97%)in 2016 to 967(69.42%),among which cataract extraction combined with goniosynechialysis was the most frequent.CONCLUSION:The overall increase in the number of operating room-based surgical procedures is significant.Trabeculectomy is one of the most commonly performed procedures,despite the relative decline in its weightage.Other procedures,including use of glaucoma drainage devices and mini shunts and minimally invasive glaucoma surgeries,are gaining greater acceptance.Notably,lensrelated surgery plays an important role in glaucoma management.

A pilot study of the precision of digital intraocular pressure measurement during vitrectomy

AIM:To evaluate the precision of digital intraocular pressure(IOP)measurement in silicone oil(SO)filled eyes during vitrectomy.METHODS:This is a retrospective,single-blind study.Patients who were diagnosed with retinal detachment and scheduled for vitrectomy with SO injection were consecutively enrolled.During the vitrectomy,IOP was digitally measured and then by a rebound tonometer(Icare PRO).The rebound tonometer readings were masked to the surgeons.The digitally measured IOP and that of rebound tonometer were compared,and the inter-methods agreement was assessed.The absolute deviation in IOP values between these two methods(△IOP)was also calculated,and correlations between△IOP and refractive status,lens status and levels of surgeons’experience were analyzed.RESULTS:A total of 131 patients(131 eyes)were recruited,with a mean age of 51.0±16.1 y.There was no significant difference in IOPs between digital measurement and the rebound tonometer(15.6±4.3 vs 15.7±5.1 mm Hg;t=0.406,P=0.686).Intraclass correlation coefficients(ICC)analysis indicated a strong correlation between these two measurements(ICC=0.830,P<0.001).The mean△IOP was 2.0±1.9 mm Hg(range:0-12.8 mm Hg),with 98 eyes(74.8%)had the△IOP within 3 mm Hg.△IOP was found to be negatively correlated with levels of surgeons’experience(r=-0.183;P=0.037),but not with the refractive status or lens status of the patients(both P>0.05).CONCLUSION:For experienced surgeons,the digital IOP measurement may be an acceptable technique for IOP measurement in SO filled eyes during vitrectomy.However,its use by inexperienced surgeons should be taken with caution.