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.

To evaluate the efficacy of intravitreal ranibizumab (Lucentis) with verteporfin photodynamic therapy for patients with polypoidal choroidal vasculopathy. Retrospective interventional case series. Seventeen eyes of 17 patients with symptomatic polypoidal choroidal vasculopathy who received 3 monthly intravitreal ranibizumab injections with photodynamic therapy were retrospectively reviewed. The follow-up period lasted for more than 6 months after therapy. Best-corrected visual acuity, foveal thickness determined by optical coherence tomography, and abnormal vasculature in indocyanine green angiography were evaluated. The mean follow-up period was 13.8 months. The mean logarithm of the minimum angle of resolution best-corrected visual acuity was 0.43 ± 0.36 at baseline, 0.14 ± 0.24 at 6 months (P = 0.01), and 0.11 ± 0.23 at 12 months after treatment (P = 0.02). The mean foveal height was 351 ± 111 μm at baseline, 192 ± 44 μm at 6 months (P = 0.02), and 204 ± 31 μm at 12 months after treatment (P = 0.01). Patients received a mean of 3.2 ranibizumab treatments and 1.3 verteporfin photodynamic therapy treatments over the follow-up period. Re-treatment was performed in 5 of 17 eyes. The polypoidal lesions on indocyanine green angiography were regressed in six eyes, reduced in seven eyes, and unchanged in four eyes. Intravitreal ranibizumab with photodynamic therapy may stabilize visual acuity and reduce exudative retinal detachment because of decreased vascular leaking. The combination treatment appeared to be useful for regressing polypoidal lesions on indocyanine green angiography and in reducing their recurrence.

Purpose.: To investigate the longitudinal changes in retinal nerve fiber layer (RNFL) thickness after pars plana vitrectomy for rhegmatogenous retinal detachment. Methods.: This prospective study examined 33 vitrectomy patients who were diagnosed with rhegmatogenous retinal detachment. Optical coherence tomography was conducted 6, 12, and 24 months after vitrectomy to investigate the changes in RNFL thickness. The RNFL thickness in the retinal detached area of the affected eye was compared with its mirror image in the fellow eye. Results.: The respective RNFL thickness in retinal-detached area and its mirror image in the fellow eye was 120.7 ± 13.5 μm and 124.7 ± 21.5 μm at 6 months following vitrectomy (P > 0.05); 114.1 ± 19.6 μm and 124.0 ± 16.6 μm at 12 months (P < 0.05); and 107.5 ± 17.2 μm and 123.8 ± 14.3 μm at 24 months (P < 0.05). A significant difference was detected between the RNFL thickness in the detached area and the fellow eye after 12 and 24 months. The difference in the RNFL thickness in the area of undetached retina in the affected eye and its mirror image in the fellow eye during follow-up did not differ significantly (P > 0.05). Conclusions.: In patients undergoing vitrectomy for rhegmatogenous retinal detachment, the RNFL was significantly thinner in the area of the detached retina than in the fellow eye 12 and 24 months postoperatively.

To estimate the rate of visual field progression in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), we reviewed the medical records of POAG and PACG patients who had a minimum of 5-year longitudinal Goldmann visual field data. I4e and I2e isopters were quantified using grid systems. The rate of change was calculated from the slope of a linear fit to a series of average visual field scores. Twenty-three eyes of POAG patients and 25 of PACG patients were studied. The rate of visual field score change was -2.00 +/- 2.0% per year in the PACG group, and -0.81 +/- 1.0% per year in the POAG group. In these two patient groups, who were on conventional treatment at two referral hospitals, better visual field on initial presentation yielded faster progression in the POAG group, while the higher average of highest intraocular pressure in each year during follow-up was related to faster progression in the PACG group.