PURPOSE: To investigate the middle-term intraocular pressure (IOP) results after implantation of a posterior chamber collagen copolymer phakic intraocular lens (IOL) (V4c Visian; STAAR Surgical Co., Nidau, Switzerland) with a central hole in patients with myopia. METHODS: This retrospective study enrolled patients who had implantation of a phakic IOL with a central hole. IOP, central vault, and adverse events were evaluated 1, 3, 6, 12, and 24 months postoperatively. RESULTS: The study enrolled 763 eyes (384 patients, 128 men and 256 women). Mean follow-up was 7.0 ± 7.2 months (range: 1 to 24 months). The mean IOP was 13.2 ± 2.1 mm Hg preoperatively. Postoperatively, the mean IOP was 12.4 ± 1.7 mm Hg at 1 month, 12.5 ± 1.8 mm Hg at 3 months, 12.6 ± 1.3 mm Hg at 6 months, 12.6 ± 1.4 mm Hg at 12 months, and 12.7 ± 1.1 mm Hg at 24 months. Only one case (0.13%) presented an increased IOP (> 21 mm Hg) during the observation period. No pupillary block or acute angle closure was recorded. IOP at the final follow-up visit was 12.8 ± 1.3 mm Hg. CONCLUSIONS: Implantation of central hole phakic IOL in myopic patients provided good and safe IOP outcomes throughout the 24-month observation period. [ J Refract Surg. 2017;33(4):244–249.]

Glaucoma is one of the leading causes of permanent vision loss worldwide and has a profound impact on patients’ quality of life. Vision impairment is strongly associated with several psychiatric disorders, like depression, anxiety, and sleep problems. These psychiatric issues are often exacerbated by the gradual, irreversible, and typically silent progression of the disease, contributing to increased mental health challenges for affected individuals. A systematic review was conducted following PRISMA guidelines across six different databases (CINAHL, MEDLINE, PsycINFO, Web of Science, Scopus, and the Cochrane Library) and one gray literature source (Google Scholar), covering the period from 2013 to 2024. Twenty-nine studies involving a total of 13,326,845 subjects were included in the synthesis, highlighting a considerable prevalence of psychiatric disorders among glaucoma patients. Depression and anxiety were the most common conditions identified, with depression rates ranging from 6.6% to 57% and anxiety from 12.11% to 49%. Other less frequent but still significant conditions like sleep disorders, psychosis, dementia, and post-traumatic stress disorder were also observed. The findings also indicated that psychiatric severity was influenced by socio-demographic factors, glaucoma severity, and treatment duration. Given the high occurrence of psychiatric pathologies among individuals with glaucoma, it is essential to develop comprehensive care strategies that address both eye and mental health needs. Multidisciplinary collaboration among ophthalmologists, psychiatrists, psychologists, and primary care physicians is crucial for developing personalized treatment plans that effectively manage both the ocular and psychological aspects of the disease.

To evaluate intraobserver, interobserver, within-session and between-session reproducibility of the measurement of optic nerve head (ONH) hemoglobin levels by color analysis using Laguna ONhE [optic nerve hemoglobin (ONH Hb)] program. This was an observational prospective study of 29 eyes (11 glaucomatous; 18 healthy eyes). Two examiners obtained 2 retinal photographs (Canon non-mydriatic retinal camera CD-DGi, Canon Inc.,Tokyo, Japan) in 2 testing sessions 3 weeks apart and analyzed the images using Laguna ONhE. The following parameters were quantified: ONH hemoglobin amounts across the whole disc (ONH Hb) and in the vertical disc diameter (8&20 Hb), cup-disc ratio (C/D), and the Glaucoma Discriminant Function (GDF). Agreement was illustrated using the Bland-Altman plots and reproducibility was assessed comparing the intraclass correlation coefficients (ICC). In session 1, examiner 1 found mean levels of ONH hemoglobin of 67.94±8.70% in healthy eyes and of 57.90±5.36% in glaucomatous eyes. Corresponding values for examiner 2 were 68.27±8.52% and 57.83±4.88%, respectively. ONH Hb and 8&20 Hb measurements were lower in glaucomatous eyes (P=0.002 and P=0.001 respectively). GDF was also more pathologic in glaucomatous group. C/D ratio estimation was greater in the glaucoma group (P=0.003). ONH Hb and 8&20 Hb showed the highest ICCs (all above 0.9). Variability was greater for GDF (ICC>0.8) and C/D ratio estimation (ICC>0.71). Measurement of ONH Hb levels using the Laguna ONhE program shows high reproducibility both in glaucomatous and nonglaucomatous ONHs.

Background: The mechanism that could increase intraocular pressure (IOP) during scleral lens (SL) wear is not fully understood, although it may be related to compression of the landing zone on structures involved in aqueous humor drainage. Methods: Thirty healthy subjects were fitted with two SLs of different sizes (L1 = 15.8 mm, L2 = 16.8 mm) for 2 h in the right eye and left eye as a control. Central corneal thickness (CCT), parameters of iridocorneal angle (ICA), Schlemm’s canal (SC), and optic nerve head were measured before and after wearing both SLs. IOP was measured with a Perkins applanation tonometer before and after lens removal and with a transpalpebral tonometer before, during (0 h, 1 h, and 2 h), and after lens wear. Results: CCT increased after wearing L1 (8.10 ± 4.21 µm; p < 0.01) and L2 (9.17 ± 4.41 µm; p < 0.01). After L1 removal, the ICA parameters decreased significantly (p < 0.05). With L2 removal, nasal and temporal SC area and length were reduced (p < 0.05). An increased IOP with transpalpebral tonometry was observed at 2 h of wearing L1 (2.55 ± 2.04 mmHg; p < 0.01) and L2 (2.53 ± 2.22 mmHg; p < 0.01), as well as an increased IOP with Perkins applanation tonometry after wearing L1 (0.43 ± 1.07 mmHg; p = 0.02). Conclusions: In the short term, SL resulted in a slight increase in IOP in addition to small changes in ICA and SC parameters, although it did not seem to be clinically relevant in healthy subjects.