Ex-PRESS implantation versus trabeculectomy in Chinese patients with POAG:fellow eye pilot study

AIM： To compare the outcomes of Ex-PRESS implantation in one eye versus trabeculectomy with mitomycin C in the fellow eye in Chinese patients with primary open-angle glaucoma （POAG）. METHODS： This was a prospective, non-randomized comparative study. Forty-eight eyes of 24 patients with bilateral POAG necessitating surgery were included and underwent Ex-PRESS implantation under the scleral flap in one eye and trabeculectomy in the other eye according to patients’ choice. Primary outcome measures included mean intraocular pressure （IOP） and success rate. Secondary outcome measures were aqueous flare, postoperative medication use, visual acuity, and incidence of complications.RESULTS： All 24 patients finished a 1-year follow-up. Both groups maintained significant reductions in IOP after surgery throughout the follow-up period. At any point in time, the IOP of the two groups did not differ significantly. The Kaplan-Meier survival curve analysis showed no significant differences in success between the two groups （P=0.289）. The mean number of anti-glaucoma medicines and visual acuity in both groups were not significantly different. Eyes with Ex-PRESS implantation had lower aqueous flare values on days 1 and 3 （both P〈0.05）. Instances of early postoperative hypotony and choroidal effusion were significantly fewer in frequency after Ex-PRESS implantation under the scleral flap compared with those after trabeculectomy （P〈0.001）. CONCLUSION： Ex-PRESS is comparable to trabeculectomy in terms of IOP, success rate, number of glaucoma medications used, and visual acuity. However, Ex-PRESS resulted in fewer cases of inflammation and a lower rate of complications.

Publication trends of Leber congenital amaurosis researches:a bibliometric study during 2002-2022

AIM:To analyze the changes in scientific output relating to Leber congenital amaurosis(LCA)and forecast the study trends in this field.METHODS:All of the publications in the field of LCA from 2002 to 2022 were collected from Web of Science(WOS)database.We analyzed the quantity(number of publications),quality(citation and H-index)and development trends(relative research interest,RRI)of published LCA research over the last two decades.Moreover,VOSviewer software was applied to define the co-occurrence network of keywords in this field.RESULTS:A total of 2158 publications were ultimately examined.We found that the focus on LCA kept rising and peaked in 2015 and 2018,which is consistent with the development trend of gene therapy.The USA has contributed most to this field with 1162 publications,56674 citations and the highest H-index value(116).The keywords analysis was divided into five clusters to show the hotspots in the field of LCA,namely mechanism-related,genotype-related,local phenotype-related,system phenotype-related,and therapy-related.We also identified gene therapy and antiretinal degeneration therapy as a major focus in recent years.CONCLUSION:Our study illustrates historical research process and future development trends in LCA field.This may help to guide the orientation for further clinical diagnosis,treatment and scientific research.

Eye Tumors Misdiagnosed as Glaucoma

INTRODUCTION Eye tumors can show diverse clinical signs.They can be misdiagnosed as glaucoma because of red eye,pain,severe headache,elevated intraocular pressure （IOP）,even adhesion of the angle of the anterior chamber.In a study by Shields et al.,[1] 58 in 144 （40%） of patients with iris melanoma were diagnosed as glaucoma on their initial visit.However,special clinical characteristics,ophthalmic examination,and imaging technology can assist in making the right diagnosis.Ultrasound examinations,high-resolution ultrasound biomicroscopy （UBM）,fluorescein angiography,optical coherence tomography,computerized tomography （CT）,magnetic resonance imaging （MRI）,and fine-needle aspiration biopsy are technologies that may help with early tumor detection.In this study,we highlighted the importance of correctly diagnosing tumor-related glaucoma through the review of nine cases that were initially misdiagnosed as glaucoma.