Précis: Goniotomy (GT) 120 degrees with or without phacoemulsification was sufficient to lower the intraocular pressure (IOP) and reduce hyphema for primary open angle glaucoma. Purpose: To compare the surgical outcomes and safety profiles of 120 degrees and 360 degrees GT with or without phacoemulsification cataract extraction and intraocular lens implantation (PEI) for primary open angle glaucoma. Patients and Methods: This multicenter retrospective study consisted of 139 eyes and was divided into 4 groups: (1) 120 degrees GT, (2) 360 degrees GT, (3) PEI + 120 degrees GT, and (4) PEI + 360 degrees GT. IOP, number of topical hypotensive medications, and complications were recorded and evaluated at baseline and at the final visit. The complete and qualified success rate and their potential associated factors were also investigated. The effectiveness and safety profile of the surgery were compared between different subgroups. Results: After a mean follow-up of 8.6 months, the IOP reduction was 13.2 ± 8.3 (38.8 ± 28.8%), 12.4 ± 8.3 (41.6 ± 18.2%), 12.8 ± 9.9 (39.4 ± 34.5%), and 13.8 ± 7.2 (46.0±17.1%) mm Hg in 120 degrees, 360 degrees, PEI + 120 degrees GT group, and PEI + 360 degrees GT, respectively. No significant difference was found in IOP, a decline of IOP from baseline, topical hypotensive medication, and complete or qualified success between either standalone 120 degrees versus 360 degrees GT, or PEI + 120 degrees versus PEI + 360 degrees GT (all Ps > 0.05). The PEI + 120 degrees GT group had a lower final IOP than the 120 degrees GT group (P = 0.0002) whereas there was no difference between PEI + 360 degrees GT and 360 degrees GT group (P = 0.893). Both 360 degrees GT and PEI + 360 degrees GT group had a significantly higher incidence of hyphema than the 120 degrees GT and PEI + 120 degrees GT groups (all Ps < 0.0001). Conclusions: GT of 120 or 360 degrees lowered IOP equally with or without cataract surgery, and hyphema was most commonly noted after complete GT. Partial GT alone or in combination with cataract surgery was an effective and safe approach to manage patients with open angle glaucoma.

Aging is characterized by a progressive loss of physiological integrity, leading to impaired function and increased vulnerability to death. Aging is an important risk factor for eye diseases. The gradual deterioration of ocular tissue structure and function with age leads to the onset and progression of ocular diseases. During aging, ocular tissues such as the lens, vitreous and retina are affected by age-related changes, such as oxidative stress and protein accumulation in the lens leading to cataract formation, and a decline in retinal pigment epithelial cell function associated with macular degeneration. This article reviews the relationships between aging and ocular diseases, takes age-related macular degeneration, age-related cataracts, glaucoma, diabetic retinal degeneration, and dry eye disease as focal points, analyses the complex interactions between aging and ocular diseases, and describes the therapeutic options and potential targets for age-related ocular diseases.

Précis: 240-degree and 360-degree goniotomy (GT) demonstrated similar efficacy in intraocular pressure (IOP) reduction, both outperforming 120-degree GT in patients with juvenile open angle glaucoma (JOAG) at postoperative 6-month follow-up. Objective: To compare the surgical efficacy and safety of 120-degree, 240-degree, and 360-degree GT for patients with JOAG. Patients and Methods: This multicenter retrospective study included 102 eyes of 102 patients with JOAG, who underwent GT with a follow-up of at least 6 months. Patients were categorized into 3 groups: (1) 120-degree GT, (2) 240-degree GT, and (3) 360-degree GT. IOP, glaucoma medications, and complications were recorded at baseline and the final visit. Complete success and qualified success were defined as a postoperative IOP ≤21 mm Hg without and with medications, respectively. Results: Mean age of the participants was 24.4 ± 7.9 years. After a mean follow-up of 8.1 ± 2.7 months, complete success rates were similar between the 240-degree GT (45.2%) and the 360-degree GT (63.2%; P = 0.135), and both were superior to 120-degree GT (18.2%; P < 0.05). Qualified success rates among patients in the 120-degree, 240-degree, and 360-degree GT groups were 93.9%, 96.8%, and 100%, respectively, and showed no statistically significant difference (P = 0.292). 360-degree GT required fewer medications than 240-degree GT and 120-degree GT (P < 0.05), with no significant difference in medications between 120-degree GT and 240-degree GT (P > 0.05). Hyphema was the most common postoperative complication, with a significantly higher incidence in the 360-degree GT (68.4%) compared with the 240-degree GT (41.9%) and 120-degree GT (33.3%; P < 0.05). Conclusions: 240-degree and 360-degree GT showed similar efficacy in IOP reduction and were superior to 120-degree GT. More extensive GT may provide better outcomes in JOAG.

Glaucoma is a common and complex neurodegenerative disease characterized by progressive loss of retinal ganglion cells (RGCs) and axons. Currently, there is no effective method to address the cause of RGCs degeneration. However, studies on neuroprotective strategies for optic neuropathy have increased in recent years. Cell replacement and neuroprotection are major strategies for treating glaucoma and optic neuropathy. Regenerative medicine research into the repair of optic nerve damage using stem cells has received considerable attention. Stem cells possess the potential for multidirectional differentiation abilities and are capable of producing RGC-friendly microenvironments through paracrine effects. This article reviews a thorough researches of recent advances and approaches in stem cell repair of optic nerve injury, raising the controversies and unresolved issues surrounding the future of stem cells.

This retrospective study evaluates the three-year efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with juvenile-onset primary open-angle glaucoma (JOAG). A total of 26 patients (35 eyes) with juvenile-onset primary open-angle glaucoma (JOAG) were included in this single-center, retrospective study. Clinical records of patients who underwent gonioscopy-assisted transluminal trabeculotomy (GATT) were analyzed to assess intraocular pressure (IOP), the number of glaucoma medications, and complications, while anterior chamber angle changes were observed by gonioscopy. The follow-up period was up to 36 months. At the time of surgery, the median age of the cohort was 26 years (range: 4–35 years), with a mean visual field deviation (MD) of -17.03 ± 8.67 dB. The mean intraocular pressure (IOP) was reduced from 29.89 ± 9.43 mmHg preoperatively (on 2.7 ± 0.7 glaucoma medications) to 15.70 ± 4.39 mmHg at 12 months (on 0.4 ± 0.9 medications), 15.27 ± 3.24 mmHg at 24 months (on 0.3 ± 0.6 medications), and 17.33 ± 3.37 mmHg at 36 months (on 0.5 ± 0.7 medications). Gonioscopic examinations indicated that peripheral anterior synechiae (PAS) primarily formed within the first 1–3 months and were fully established by 6 months, after which the extent of peripheral anterior synechiae (PAS) remained relatively stable. Kaplan–Meier survival analysis revealed complete and qualified success rates of 73.7% and 82.6% at 12 months, 73.7% and 76.7% at 24 months, 60.3% and 69.1% at 30 months, and 51.7% and 69.1% at 36 months, respectively. The cumulative total success proportion were 90.6% at 12 months, 96.7% at 18 months, 92.3% at 24 months, 86.4% at 30 months and 73.3% at 36 months. GATT is a safe and effective surgical option for JOAG, achieving sustained IOP reduction and favorable long-term success rates.

To evaluate the impact of prolonged use of topical glaucoma medications on the surgical outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in juvenile open-angle glaucoma (JOAG). This multicenter retrospective study included 100 eyes of 77 JOAG patients who underwent GATT with at least 12 months of follow-up. Patients were categorized into the short-duration (≤1.5 years) and long-duration (>1.5 years) groups. Intraocular pressure (IOP), glaucoma medications, and complications were recorded at baseline and the final visit. Success was defined as a postoperative IOP ≤ 21mmHg (criterion A), ≤ 18mmHg (criterion B), or ≤ 15mmHg (criterion C). Complete and qualified successes were defined as meeting these criteria without and with medications, respectively. The mean age of the participants was 23.2 ± 8.6 years with a mean follow-up of 14.2 ± 4.1 months. Qualified and complete success rates for the short-duration and long-duration groups were 98.0% and 92.0% (P = 0.369), 80.0% and 66.0% (P = 0.322) for criterion A; 92.0%, and 68.0% (P = 0.006), 78.0% and 50.0% (P = 0.021) for criterion B; 66.0% and 40.0% (P = 0.013), 58.0% and 30.0% (P = 0.015) for criterion C. The short-duration group had a significantly lower final IOP than the long-duration group (P = 0.011). No significant differences were observed in final medication and complications. Prolonged use of topical glaucoma medications may reduce the efficacy of GATT in achieving lower IOP in JOAG. Early surgical intervention may contribute to better postoperative outcomes.