Background: Intraocular pressure (IOP) remains the only treatable risk factor of progressive glaucoma. Recently a device became available to continuously record IOP fluctuation in contrast to classical, discreet IOP measurements. Objectives: To perform 24-h IOP fluctuation monitoring using a CE-marked silicone lens-embedded strain gauge sensor (SENSIMED Triggerfish) in five normal tension glaucoma patients in the presence and absence of anti-glaucomatous treatment and to show the clinical importance of this diagnostic tool. Methods: 24-h continuous IOP fluctuation monitoring was performed on two occasions separated by at least 6 weeks in each patient. In the control session patients were untreated or previous IOP-lowering medication was washed-out for at least 6 weeks. In the treatment session patients received IOP-lowering medication for at least 6 weeks. The continuous recordings were analyzed for differences between daytime and nighttime data and for repeatability over time. Furthermore, profiles recorded in each patient in treated and non-treated conditions were compared. Results: Highly individual and repeatable profiles were obtained. Data recorded during daytime portions of the recordings showed higher coefficients of variation than nighttime data. Positive and significant linear slopes for the transition period from wake time to sleep time were detected in all patients in the absence of anti-glaucomatous treatment, while in three patients of five no significant slopes were detected under treated conditions. Conclusion: Our data suggest that the continuous IOP fluctuation monitoring device is sensitive to individual IOP rhythms and to differences in such rhythms due to anti-glaucomatous drug therapy.

Background: The aim of our study was to investigate the safety and efficacy of the LDV Z8 femtosecond laser in cataract surgery compared to the conventional procedure. Methods: This prospective study was performed at the Swiss Eye Research Foundation, Eye Clinic ORASIS, Reinach, Switzerland. The study included 130 eyes from 130 patients: 68 treated with femtosecond laser-assisted cataract surgery (FLACS) using the FEMTO LDV Z8 and 62 treated with conventional phacoemulsification. Capsulotomy and lens fragmentation in the laser group were performed with the FEMTO LDV Z8 femtosecond laser system, which employs a new, low-energy, high repetition rate laser process for cataract surgery. In the conventional group, the capsulotomy was performed by a cystotome, and lens fragmentation was achieved by the stop-and-chop. Results: Ease of phacoemulsification (on a 4-point scale), the completeness of capsulotomy (on a 10-point scale), effective phacoemulsification time (seconds), uncorrected distance visual acuity (UCVA), best spectacle-corrected distance visual acuity (BSCVA), spherical equivalent (SE), and safety of the procedure were evaluated. The total follow-up time was three months. Conclusions: FLACS with the FEMTO LDV Z8 system was characterized by complete and reproducible capsulotomy and highly effective lens fragmentation. Postoperative visual outcomes were excellent, and the safety of the procedure was optimal.

(2010). Comparison of the effects of dorzolamide/timolol and latanoprost/timolol fixed combinations upon intraocular pressure and progression of visual field damage in primary open-angle glaucoma. Current Medical Research and Opinion: Vol. 26, No. 9, pp. 2213-2219.

Background: The purpose of this work is to report our experience using the new Z8 laser system for femtosecond laser-assisted cataract surgery (FLACS) and to provide a sample of the performance and safety results using this new technology. Methods: This prospective observational study was performed at the Swiss Eye Research Foundation, Eye Clinic ORASIS, Reinach, Switzerland. Fourteen patients were subjected to unilateral FLACS. Capsulotomy and lens fragmentation were performed with the aid of the LDV Z8 femtosecond laser system. Ease of phacoemulsification (on a 4-point scale), completeness of capsulotomy (on a 10-point scale), time for preparation of femtosecond laser (minutes), effective phacoemulsification time (seconds), total duration of surgery (minutes), and safety of the procedure were evaluated. Results: Ease of fragmentation and completeness of capsulotomy were estimated at 3.9 and 9.9, respectively. The preparation time for femtosecond was 3.6±0.7 minutes, effective phacoemulsification time was 2.5±3.1 seconds, and total duration of the FLACS procedure was 16.3±4.5 minutes. No major complications were observed. Approximately 42% of all patients (6/14) showed Descemet’s folds directly postoperatively. Conclusion: FLACS with the LDV Z8 system was characterized by complete capsulotomy and highly effective and reproducible lens fragmentation. The safety of the procedure was very good as perceived by the surgeon operating in this observational case series. The cost to benefit ratio should be further debated by assessing the results of a major prospective study, which is required for valid evaluation of the efficiency and safety of the LDV Z8 laser system and of FLACS in general.

Femtosecond laser-assisted cataract surgery has the potential to make critical steps of cataract surgery easier and safer, and reduce endothelial cell loss, thus, improving postoperative outcomes. This study compared FLACS with the conventional method in terms of endothelial cells behavior, clinical outcomes, and capsulotomy precision. Methods: In a single-center, randomized controlled study, 130 patients with cataracta senilis received FLACS or conventional cataract surgery. Results: A significant endothelial cell loss was observed postoperatively, compared to the preoperative values in both groups. The endothelial cell counts was significantly better in the FLACS group in cataract grade 2 (p = 0.048) patients, compared to conventionally at 4 weeks. The effective phaco time was notably shorter in grade 2 of the FLACS group (p = 0.007) compared to the conventional. However, no statistically significant differences were found for the whole sample, including all cataract grades, due to the overall cataract density in the FLACS group being significantly higher (2.60 ± 0.58, p < 0.001) as compared to conventional methods (2.23 ± 0.42). Conclusions: Low energy FLACS provides a better result compared to endothelial cell loss, size, and shape variations, as well as in effective phaco time within certain cataract grade subgroups. A complete comparison between two groups was not possible because of the higher cataract grade in the FLACS. FLACS displayed a positive effect on endothelial cell preservation and was proven to be much more precise.

Purpose The goal of this study is to show the efficacy and safety of an innovative surgical procedure regarding the treatment of open-angle and juvenile glaucoma known as sclerothalamotomy ab interno (STT ab interno). Patients and Methods Between February and July 2002 surgery was performed in 58 eyes of 58 consecutive patients, of which 53 were diagnosed with open-angle and 5 with juvenile glaucoma. The procedure was performed with the assistance of a custom-made high-frequency dissection probe (19 gauge with a tip of 0.3×1 mm), which applies a bipolar current of 500 kHz frequency. The probe penetrates approximately 1 mm into the nasal sclera (ab interno) and through the trabecular meshwork and Schlemm's canal, thus forming a deep sclerotomy or “thalami” of 0.3 mm height and 0.6 mm width. Results The average baseline intraocular pressure (IOP) was 25.6±2.3 mm Hg (range: 18–48 mm Hg) for the open-angle glaucoma group and 39.6±2.3 mm Hg (range: 34–46 mm Hg) for the juvenile glaucoma group. All patients had a minimum follow-up of 72 months. The mean IOP for the stated period was 14.7±1.8 mm Hg for the open-angle glaucoma group and 13.2±1.3 mm Hg for the juvenile group. The IOP after surgery was statistically significantly lower than the baseline IOP at all measured intervals (P<0.001). After 72 months only 11 eyes accounted for a 20.8% continuous antiglaucoma therapy. With regard to the procedure no serious complication was documented. Conclusions Sclerothalamotomy ab interno is a minimally invasive, safe, and efficient surgical technique for lowering the IOP in open-angle and juvenile glaucoma.