Slow-coagulation continuous wave cyclophotocoagulation (SC-CWCPC) is a promising treatment option for refractory glaucoma. However, its efficacy following a failed MicroPulse transscleral cyclophotocoagulation (MP-TSCPC) procedure remains unexplored. This study evaluates the efficacy of SC-CWCPC in patients with uncontrolled intraocular pressure (IOP) after undergoing MP-TSCPC. A retrospective case series of patients with uncontrolled glaucoma who underwent SC-CWCPC following MP-TSCPC failure was conducted. All procedures were performed by a single glaucoma surgeon between January 2022 And October 2024. Patients with < 3 months follow-up were excluded. SC-CWCPC was performed using 1250-milliwatt power and 4-second applications. Surgical success was defined as IOP between 6 and 21 mmHg with a ≥ 20% reduction from baseline on topical medication, no incisional reoperation for glaucoma, and no loss of light perception vision. Eight patients (10 eyes) with a mean age of 43.75 ± 24.59 years were included. 90% (9/10) had prior Tube/Trabeculectomy procedures. Mean preoperative IOP was 26.10 ± 15.80 mmHg on 3.1 ± 1.20 antiglaucoma medications (AGM). At a mean follow up time of 10.97 ± 3.42 months, IOP decreased to 15.80 ± 5.31 mmHg ( p = 0.002) with 2.30 ± 1.49 AGM ( p = 0.070) with an overall success rate of 80%. One eye required Ahmed Glaucoma Valve implantation one year postoperatively while another had prolonged inflammation that resolved medically. No cases of persistent hypotony or significant visual acuity loss occurred. SC-CWCPC is an effective and safe surgical intervention in patients with refractory glaucoma following failed MP-TSCPC. The results of our study are helpful in expanding the role of the SC-CWCPC technique in the management of glaucomatous patients.

Purpose: To evaluate the efficacy and safety of adjunctive intravitreal anti-vascular endothelial growth factor (VEGF) therapy combined with standard ablative treatment in Coats disease. Methods: A search of PubMed, Embase, and SCOPUS was conducted to identify studies comparing ablative therapy alone versus ablative therapy with anti-VEGF for Coats disease. Five studies (136 eyes treated with ablation alone and 82 with combination therapy) were included. Data on treatment sessions, quiescence, visual acuity (VA) and tractional retinal detachment (TRD) were extracted. Results: Adjunctive anti-VEGF significantly reduced the treatment sessions required to achieve quiescence (Mean difference [MD] 0.47 sessions, 95% confidence interval [CI] 0.10-0.85, p = 0.01). No significant difference was found in anatomic outcomes with both groups having a similar number of eyes which resulted in phthisis. No significant difference was found in the BCVA at final follow up (MD = 0.20, 95% CI -0.20 to 0.59, p = 0.33) without significant heterogeneity (I ² =23%, p = 0.28). Eyes with adjunctive anti-VEGF were not found to be associated with a significantly higher risk of TRD (RR 2.64, 95% CI 0.34-20.30, p = 0.35). Due to the retrospective design of the included studies, the overall grade of evidence was deemed low. Conclusions: Adjunctive anti-VEGF therapy may reduce the total treatment burden while achieving similar anatomical and functional outcomes. In addition, there appears to be no significant increase in the risk of TRD. Judicious use of anti-VEGF may be a useful therapy to consider in patients with Coats disease requiring ablative therapy.

In light of the potential effects of spaceflight on the anterior segment of the eye, there is a pressing need for anterior segment imaging to be available and accessible to monitor astronauts’ ocular health, including alterations to the cornea and lens. We aim to highlight the clinical basis and need for anterior segment imaging for astronauts. We explore the impacts of spaceflight-associated hazards, including microgravity and radiation, on astronauts’ risk of developing anterior segment pathology including risk of ocular trauma, infection, dry eye symptoms, cataracts, and possibly additional pathologies from increased radiation exposure. Such risks highlight the potential value that longitudinal assessment of anterior ocular structures would offer in future spaceflight missions. Specifically, anterior segment imaging would enable evaluations of corneal morphology, including longitudinal monitoring for microgravity-induced changes, and evaluation of interventions that aim to preserve anterior segment health during spaceflight. Lastly, non-invasive anterior segment imaging allows for unique insights into astronaut ocular health and can be performed routinely through modalities such as anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM). We discuss these modalities and their implications for astronaut health during future spaceflight.