Aims To evaluate changes in the corneal endothelial cell density (ECD) and corneal decompensation following Ahmed glaucoma valve (AGV) implantation. Methods This study was retrospective and observational case series. Patients with refractory glaucoma who underwent AGV implantation and were followed >5 years were consecutively enrolled. We reviewed the medical records, including the results of central corneal specular microscopy. Of the 127 enrolled patients, the annual change in ECD (%) was determined using linear regression for 72 eyes evaluated at least four times using serial specular microscopic examination and compared with 31 control eyes (fellow glaucomatous eyes under medical treatment). The main outcome measures were cumulative risk of corneal decompensation and differences in the ECD loss rates between subjects and controls. Results The mean follow-up after AGV implantation was 43.1 months. There were no cases of postoperative tube–corneal touch. The cumulative risk of corneal decompensation was 3.3%, 5 years after AGV implantation. There was a more rapid loss of ECD in the 72 subject eyes compared with the 31 controls (−7.0% and −0.1%/year, respectively; p<0.001). However, the rate of loss decreased over time and statistical significance compared with control eyes disappeared after 2 years postoperatively: −10.7% from baseline to 1 year (p<0.01), −7.0% from 1 year to 2 years (p=0.037), −4.2% from 2 years to 3 years (p=0.230) and −2.7% from 3 years to the final follow-up (p=0.111). Conclusions In case of uncomplicated AGV implantation, the cumulative risk of corneal decompensation was 3.3%, 5 years after the operation. The ECD loss was statistically greater in eyes with AGV than in control eyes without AGV, but the difference was significant only up to 2 years post surgery.

Background/aims: Helicobacter pylori is well known to be responsible for gastric mucosa-associated lymphoid tissue (MALT) lymphoma. This study evaluates whether H pylori is also responsible for conjunctival MALT lymphoma and which strain of H pylori is associated with conjunctival MALT lymphoma. Methods: Fifteen cases of conjunctival MALT lymphoma were investigated. Eight biopsies of normal conjunctiva were also investigated as controls. The specimens were investigated for the presence of H pylori DNA with polymerase chain reaction (PCR) using 16S rDNA primer. When the PCR using 16S rDNA was positive for H pylori, the specimens were analysed for the virulent gene with PCR using vacA s1/2 primer and vacA m1/2 primer. Results: H pylori DNA was identified in all 15 specimens of conjunctival MALT lymphomas and none of the controls. Of these 15 H pylori positive lymphoma specimens, the vacA s1 and vacA m2 alleles were detected in two, and only vacA s1 allele was detected in 11. Conclusions: H pylori is thought to play a role in the pathogenesis of conjunctival MALT lymphoma, and H pylori with vacA s1 allele appears to be a virulent strain for conjunctival MALT lymphoma.

Purpose: To investigate longitudinal changes in retinal nerve fiber layer (RNFL) thickness after panretinal photocoagulation (PRP) in diabetic retinopathy patients. Methods: This prospective study examined 31 eyes in 25 patients undergoing PRP, who were diagnosed with severe nonproliferative diabetic retinopathy or non–high-risk proliferative diabetic retinopathy. Optical coherence tomography was conducted before PRP and at 3, 6, 12, and 24 months after PRP to investigate changes in peripapillary RNFL thickness. Results: Superior, nasal, inferior, temporal, and mean peripapillary RNFL thickness increased until 6 months after PRP and then decreased. Superior RNFL thickness increased significantly at 3 and 6 months and decreased significantly at 24 months compared with the baseline RNFL thickness. Nasal RNFL thickness declined significantly at 24 months compared with the baseline RNFL thickness without any significant increase in thickness during the follow-up period. Inferior RNFL thickness increased significantly at 6 months and decreased significantly at 24 months compared with its baseline RNFL thickness. Temporal thickness increased significantly at 3, 6, 12, and 24 months compared with the baseline RNFL thickness. Mean RNFL thickness increased significantly at 6 months and decreased significantly at 24 months. Central subfield thickness increased significantly at 3, 6, 12, and 24 months compared with its baseline thickness. Conclusion: Peripapillary RNFL thickness increased at 6 months after PRP and then decreased at 24 months after PRP compared with baseline peripapillary RNFL thickness in diabetic retinopathy patients. This finding suggests that in addition to diabetes itself, diabetic retinopathy, and associated glaucoma, PRP may be a cause of RNFL thickness loss in patients with diabetes.

BACKGROUND/AIMS Among the various weakening techniques of inferior oblique muscle overaction, the most commonly used techniques include myectomy, recession, and anterior transposition. Anterior transposition and myectomy were compared to evaluate the surgical results in inferior oblique overaction. METHODS 20 children with bilateral +3 overacting inferior oblique muscles underwent a prospective randomised study by which the anterior transposition procedure in one eye was compared with the myectomy procedure in the other eye. RESULTS Postoperative follow up averaged 2 years. The success rates in two surgical procedures were 85% for the anterior transposition and 25% for the myectomy (standard of success was based on zero inferior oblique overaction). In only one case did the anterior transposition tend to limit the elevation of the eye in the midline, adduction, and abduction. Anterior transposition produced hypotropia at the primary position in only one case. Most eyes that underwent myectomy (75%) showed apparent residual overaction. CONCLUSION The anterior transposition appeared to be more effective in eliminating the overaction of inferior oblique muscle than the myectomy.

Purpose: The purpose of this study was to investigate changes in macular thickness after panretinal photocoagulation (PRP) in patients with severe diabetic retinopathy (DR) without macular edema and to compare the visual acuity outcomes. Methods: This prospective cohort study included 30 patients with severe nonproliferative DR or non–high-risk proliferative DR whose visual acuity was ≥0.8 before PRP. Sixty eyes of 30 patients with severe nonproliferative DR or non–high-risk proliferative DR received biweekly PRP treatment in 4 sessions. Macular thickness and visual acuity were measured before and at 1, 3, 6, and 12 months after PRP. Results: The visual acuities were 0.02 ± 0.11 before PRP and 0.04 ± 0.11, 0.04 ± 0.07, 0.02 ± 0.07, and 0.04 ± 0.08 at 1, 3, 6, and 12 months after PRP, respectively (P > 0.05 for each). Central macular thickness was increased at 1 (223.3 ± 40.6 μm), 3 (216.8 ± 23.5 μm), 6 (219.4 ± 33.1 μm), and 12 months (220.4 ± 17.3 μm) after PRP compared with that before PRP (199.0 ± 20.9 μm; P < 0.05 for each). Conclusion: Biweekly PRP (1,200–1,600 spots) had no effect on visual acuity in patients with severe DR without macular edema, which was determined by clinical and optical coherence tomography examination, although mild macular thickening frequently persists.

Purpose. We investigated longitudinal changes in retinal nerve fiber layer (RNFL) thickness following vitrectomy for epiretinal membrane (ERM). Methods. Thirty-one patients who underwent pars plana vitrectomy with internal limiting membrane (ILM) peeling for ERM were included. Average thickness and four quadrants of RNFL thicknesses were determined before and at 1, 3, 6, and 12 months after surgery by spectral-domain optical coherence tomography (SD-OCT). As macular lesions could affect RNFL thickness, we evaluated changes in RNFL thickness by dividing the RNFL into 12 o'clock hourly positions, defining pathologic area adjacent to the lesion and nonpathologic area. Results. Retinal nerve fiber layer thickness of the affected eyes increased at 1 month after vitrectomy and later decreased compared to baseline values. Temporal quadrant RNFL thickness was statistically significantly thicker in affected eyes at baseline and at 1 month after surgery and thinner after 12 months than fellow eyes. Retinal nerve fiber layer thickness in pathologic area decreased after surgery, and the RNFL was statistically significantly thinner at 3, 6, and 12 months postoperatively, compared to the baseline thickness. The RNFL thickness of pathologic area of affected eyes compared to fellow eyes was thicker both at baseline and 1 month after surgery but thinner at 12 months compared to baseline values. Conclusions. Postoperative RNFL thickness after vitrectomy combined with ERM removal tended to decrease postoperatively. Retinal nerve fiber layer thicknesses in temporal pathologic area were significantly reduced at 3, 6, and 12 months postoperatively compared to baseline values, whereas RNFL thicknesses in nasal nonpathologic area exhibited no significant postoperative changes. We found that ERM itself and the removal procedure resulted in decreased RNFL thickness.