We compared 1-year outcomes of trabeculectomy with mitomycin C (MMC) and Ahmed valve implantation with MMC as a first surgical procedure in patients with uveitic glaucoma. A total 38 eyes of 38 patients undergoing trabeculectomy (n =16) or Ahmed valve implantation (n = 22) were included. Surgical success was defined as intraocular pressure (IOP) ≤21 mmHg, IOP reduction ≥20% from baseline, no secondary glaucoma surgery, and no loss of light perception. The main outcome measurements including success rate, IOP, and the number of antiglaucoma medications and complications were compared. The overall success rates were comparable between the Ahmed and trabeculectomy groups (81.3 vs. 81.8%, p = 0.987). The mean IOPs were similar as well (p = 0.084), though the number of antiglaucoma medications was significantly lower in the trabeculectomy group than in the Ahmed group (1.0 ± 1.2 vs. 2.2 ± 1.1; p = 0.005). A statistically significant reduction in corneal endothelial cell density was noted in the Ahmed group (p = 0.004). Both treatments offered reasonable IOP control and safety for eyes with uveitic glaucoma. However, significantly fewer antiglaucoma medications were used in the trabeculectomy group. Furthermore, our results suggest that cautious postoperative monitoring with regard to corneal endothelial cell density should be additionally performed after Ahmed valve implantation.

PURPOSE: To evaluate the usefulness of infrared digital photography for determining scotopic pupil size by comparing infrared digital photography with a Colvard pupillometer (Oasis Medical). SETTING: Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea. METHODS: Scotopic pupil size in 50 eyes of 25 healthy individuals was measured with a Colvard pupillometer and a digital camera (DSC-F828) using infrared burst shots after 5 minutes of dark adaptation. Measurements were performed by 2 independent examiners (E1 and E2). The digital photograph images were read using the ruler function of Adobe Photoshop 7.0 by 2 independent readers (R1 and R2). Agreement and repeatability were analyzed using the comparison method described by Bland and Altman. RESULTS: The mean scotopic pupil diameter measured using the Colvard pupillometer was 6.69 mm ± 0.78 (SD) (E1) and 6.70 ± 0.71 mm (E2). The mean scotopic pupil diameter measured from the digital photograph images was 6.67 ± 0.75 mm (E1) and 6.66 ± 0.78 mm (E2). The mean difference between E1 and E2 with both devices was small; however, the result with the infrared digital camera was marginally smaller than with the Colvard pupillometer. The limits of agreement were –0.01 ± 0.70 mm with the Colvard pupillometer and 0.01 ± 0.20 mm with the digital photograph image. The digital photograph image showed better agreement. The coefficient of interrater repeatability was smaller for the digital photograph image (0.39) than for the Colvard pupillometer (0.70). CONCLUSIONS: Scotopic pupil measurement using an infrared digital camera with a burst shot had good agreement with the Colvard pupillometer and better repeatability. The infrared digital camera is less expensive, and pupil unrest can be overcome by taking serial images.

Purpose: To compare optic nerve head (ONH) parameters obtained by semi-automated disc analysis of stereo optic-disc photography (ODP) with those by spectral domain optical coherence tomography (SD-OCT) regarding their reproducibility, agreement and relationship with the retinal nerve fiber layer (RNFL) thickness. Patients and methods: In this cross-sectional retrospective study, 91 eyes (50 normal and 41 with open angle glaucoma) from 47 patients were examined. ONH parameters were obtained by ODP and SD-OCT. Agreement and reproducibility were assessed by intra-class correlation coefficients (ICCs). Inter-device agreement and precision were also evaluated. The structural factors related to the ONH measurements by both instruments and the disparity between the measurements were evaluated by the generalized estimating equation model. Results: ODP showed good intra-reader and inter-reader reproducibility, comparable to that of SD-OCT (ICC: >0.970). Disc area (DA) (ICC: 0.950) showed better inter-device agreement than rim area (RA) (ICC: 0.859). RNFL thickness was correlated with RA, but not with DA, for both devices. SD-OCT RA showed significant correlation with RNFL thickness in both the normal and glaucoma groups, whereas ODP RA correlated with RNFL only in the glaucoma group. The measurement disparity between the devices was influenced by the DA in both groups. The inter-device difference in RA was not correlated with RA, but instead with the RNFL thickness in the glaucoma group. Conclusion: ONH parameters obtained by semi-automated algorithms of ODP showed excellent reproducibility and good agreement with those measured by SD-OCT. SD-OCT RA was a better indicator of RNFL thickness, compared with ODP RA for both normal patients and glaucoma patients; however, the inter-device disparity of the RA was less in glaucoma patients who had a thinner RNFL.

Park HS, et al. J Korean Ophthalmol Soc. 2019 Oct;60(10):966-974. https://doi.org/10.3341/jkos.2019.60.10.966