XEN Gel Stent exposure 7mo after primary implantation:a case report

Dear Editor,XEN Gel Stent 45 gm (Allergan Pic, Irvine, CA, USA) is a minimally-invasive procedure in glaucoma surgery perceived to reduce the risk of postoperative hypotony while sufficiently lowering the intraocular pressure (IOP) and requiring less topical antiglaucoma medications postoperatively.

加纳人发生进展期青光眼危险因素的评价

Purpose: This study was to determine factors associated with individuals presenting late with advanced glaucomatous optic nerve damage. Methods: A case-control study recruiting 123 patients with early features of primary open angle glaucoma (control) and 93 patients with advanced glaucoma (cases)-was carried out for risk-factor analysis. Exposures of interest included those already established as major risk factors for glaucoma. These were initial intraocular pressure (IOP), age, and family history. In addition, occupation, ethnic origin, history of diagnosis of diabetes mellitus, hypertension, sickle cell disease, and previous eye examination were of interest. Results: Univariate analysis showed that initial IOP > 31mmHg, age of > 60 years, absence of family history of glaucoma, occupational grouping, ethnicity, and male sex were associated with advanced glaucoma at presentation. Adjusted odds ratio or by multiple logistic regression model showed that initial IOP > 31mmHg in a patient was more likely to present with advanced glaucoma (OR 2.66, 95%confidence interval (CI) 1.45, 4.91; P-value 0.0017) than lower pressures. Patients aged 60-69 years (OR 2.53, 95%CI 1.01, 6.31; P-value 0.0473) and 70-90 years (OR5.16, 95%CI 1.97, 13.51; P-value 0.0008)were more likely to present with advanced glaucoma than younger ones. Conclusions: Subjects with initial IOP >31 mmHg were nearly three times more likely to present with advanced glaucoma than those with IOP< 32mmHg. Subjects over the age of 60 years were more than two times likely to present with advanced glaucoma than younger subjects.

The effect of 3% diquafosol on the improvement of ocular surface post cataract surgery:A meta-analysis for time of intervention

Purpose The effect of interventional time for 3% Diquafosol reatment in post-cataract surgery has not been well established.A meta-analysis was performed to evaluate the improvement of ocular surface condition in post-cataract surgery patients who received 3% DQS for various treatment durations.Methods Studies were performed based on 5 databases:PubMed,Cochrane Library,Web of Science,Embase,and China National Knowledge Infrastructure.Data on changes in Schirmer’s test,tear breakup time(TBUT),corneal staining score,and OSDI score were collected for meta-analysis.Results A total of 621 affected eyes from 9 independent clinical studies were included.6 studies conducted Schirmer's test after the application of 3% DQS.Meta-analysis showed that the difference between 3% DQS and control groups was not statistically significant for short-term application(less than or equal to 1 month)(WMD=0.14,P=0.27,95% CI:-0.11 to 0.39),but was statistically different for long-term application(longer than or equal to 3 months)(WMD=0.76,P=0.03,95% CI:0.08 to 1.45).For the corneal fluorescence staining score,the data from 6 studies indicated that the improvement was statistically significant for short-term application(WMD=-0.40,P<0.00001,95% CI:-0.72 to-0.08)and but not long-term application(WMD=-0.21,P=0.26,95% CI:-0.57 to 0.15).For TBUT,the data from 9 studies indicated that both short-term and long-term application showed significant improvement(WMD=1.70,P<0.00001,95% CI:1.38 to 2.03;WMD=1.52,P<0.00001,95% CI:1.09 to 1.95).Similar results were observed in data from 5 studies with OSDI scores,where both short-term and long-term application showed statistically significant improvements(WMD=-5.41,P<0.00001,95% CI:-7.02 to-3.81;WMD=-6.10,P<0.00001,95% CI:-8.52 to-3.67).Conclusions The application of 3% DQS in post-operative cataract patients has a positive effect on improving the ocular surface conditions.Short-term application resulted in lower corneal staining scores,prolonged TBUT,and improved OSDI scores.Long-term application improved Schirmer's test results,TBUT,and subjective symptoms.

Catquest-9SF functioning over a decade–a study from the Swedish National Cataract Register

Background:The Swedish National Cataract Register(NCR)collects data on cataract surgery outcomes during March,including patient-reported outcomes using the Catquest-9SF questionnaire for over 11 years.Previous studies from NCR have shown that the preoperative visual acuity has improved over time.The main purpose of this study was to evaluate the Catquest-9SF Rasch scoring performance in this changing environment.A second purpose was to describe clinical data over the same period for those who completed the questionnaire.Methods:The performance of the Catquest-9SF was analysed by a separate Rasch analysis for each year,resulting in a preoperative and postoperative score for each participating patient in the annual cohorts.The clinical data and questionnaire scoring were analysed for each year in the period 2008-2018 inclusive.Results:Data were available for 42,023 eyes for 11 annual cohorts(2008-2018).The psychometric properties of the questionnaire were stable during the study period.Person separation(precision)for the whole period was 2.58 and varied between 2.45 and 2.72.The person reliability was 0.87 and varied between 0.86 and 0.88.The targeting of question difficulty to person ability became less accurate over time meaning that the item activities became easier to carry out without difficulty.The average targeting for the whole period was−2.06 and changed from−1.92 in 2008 to−2.31 in 2018.The person score improved both before surgery and after surgery,indicating that patients are undergoing surgery at a more able level and getting better outcomes.The average improvement by surgery decreased from 3.41 logits in 2008 to 3.21 logits in 2018(p=0.003).Over time,patient age decreased from 75 to 74 years(p<0.001)and the proportion of women decreased from 63.9 to 57.9%(p<0.001).The mean preoperative visual acuity in both the operated eye and the better eye improved over time(0.47 to 0.40 logMAR,p<0.001 and 0.22 to 0.19 logMAR,p<0.001,respectively),as did the mean postoperative visual acuity in the operated eye(0.14 to 0.09 logMAR,p<0.001).Conclusions:The Catquest-9SF retained stable psychometric properties over this 11-year period although more recent cohorts included slightly younger patients with somewhat better vision.