J. Glaucoma [JOURNAL]
Sun
200 papers
Reading Performance and Eye Movement Patterns in Glaucoma.
Chiba Ikeda M, Messias AMV, Teixeira SH … +7 more , Hamada KU, Bando AH, Nakamura VPL, Prata TS, Tatham AJ, Paranhos A, Gracitelli CPB
J Glaucoma · 2026 Jul · PMID 42335967 · Publisher ↗
PRCIS: Glaucoma patients of similar age and educational level, compared with healthy individuals, exhibit a greater number of saccades and fixations during eye-tracking-aloud reading, resulting in reduced reading speed....
PRCIS: Glaucoma patients of similar age and educational level, compared with healthy individuals, exhibit a greater number of saccades and fixations during eye-tracking-aloud reading, resulting in reduced reading speed. PURPOSE: To evaluate reading performance in patients with glaucoma compared with controls using an eye tracker and to explore the potential confounding effects of patients' contrast sensitivity and cognition. MATERIALS AND METHODS: A cross-sectional study was conducted with 111 participants (57 with glaucoma and 54 controls) with a best-corrected visual acuity of ≥0.5 logMAR. Cognition was assessed using the Montreal Cognitive Assessment, and contrast sensitivity was measured with the Freiburg Visual Acuity and Contrast Test. A reading performance evaluation was conducted using the Minnesota Low Vision Reading Test displayed on slides on a computer screen. Reading speed was calculated in words per minute, and an eye tracker was used to analyze saccade and fixation patterns during the reading task. RESULTS: Mean age was 61.8 (±11.6) and 66.5 (±13.7) in the glaucoma and control groups, respectively ( P =0.05). Best-corrected visual acuity was 0.18 (±0.16) and 0.04 (±0.10) logMAR in the glaucoma and control groups, respectively ( P <0.001). Montreal Cognitive Assessment score was 21.8 (±3.5) in the glaucoma and 21.4 (±4.0) in the control group ( P =0.566). A total of 26% of the glaucoma group and 33% of the control group had at least a primary education. Controls read faster and showed fewer saccades and fixations than patients with glaucoma ( P <0.05) across all 5 slides. CONCLUSIONS: Patients with glaucoma exhibit poorer reading performance, as evidenced by eye-tracking data, compared with controls of similar age, cognitive function, and educational level.
Phacoemulsification Combined With 360° Gonioscopy-Assisted Transluminal Trabeculotomy: Prospective 12-Month Outcomes in Primary Open-Angle and Primary Angle-Closure Glaucoma.
Maheshwari D, Nagdev NG, Pillai MR … +6 more , Shaji S, Grover DS, Uduman MS, Kader MA, Pawar N, Rengappa R
J Glaucoma · 2026 Jun · PMID 42328745 · Publisher ↗
PRECIS: This study concludes that combined gonioscopy assisted transluminal trabeculotomy-phacoemulsification have similar efficacy in terms of intraocular pressure and antiglaucoma medication reduction in primary open a...
PRECIS: This study concludes that combined gonioscopy assisted transluminal trabeculotomy-phacoemulsification have similar efficacy in terms of intraocular pressure and antiglaucoma medication reduction in primary open angle and primary angle closure glaucoma at 12 months follow-up. PURPOSE: To evaluate safety and efficacy of combined phacoemulsification with gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). PATIENTS AND METHODS: A prospective, interventional study included 180 eyes (90 POAG, 90 PACG) of 180 patients with uncontrolled glaucoma. All patients underwent 360-degree GATT combined with phacoemulsification. Outcome measures included changes in intraocular pressure (IOP), antiglaucoma medication (AGM), and best-corrected visual acuity (BCVA). Success was defined as at least 20%/25%/30% IOP reduction from baseline and IOP ≤21/18/ 15 mm Hg (Criteria 1, 2, and 3). Additionally, risk factors for surgical failure were analysed. RESULTS: The mean (SD) IOP and AGMs decreased from 20.97±4.23 mmHg with 1.66±0.80 AGMs and 21.02±6.13 mmHg with 1.87±0.93 AGMs to 12.60±2.72 mmHg with 0.09±0.36 AGMs, and 13.10±3.39 with 0.11±0.39 AGMs in POAG and PACG group respectively with no significant difference between them (P=0.685, P=0.940). 38.4% and 35.4% IOP reduction were found at the end of 12 months in POAG (93.3% meds-free) and PACG (91.8% meds-free), respectively. Success rate was 91.1% in POAG and 85.2% in the PACG group with criteria 1, with no significant difference between groups by all three criteria. Higher baseline IOP were found to have a reduced likelihood of failure (P<0.001) in both groups.14 patients (6 POAG, 8PACG) had IOP spikes, 63 (25 POAG,38 PACG) micro-hyphemas and 40 (16POAG, 24PACG) macro-hyphemas.10 (4POAG, 6PACG) patients required anterior chamber wash. CONCLUSION: Combined GATT with phacoemulsification is safe and effective with similar surgical outcomes in primary open-angle and primary angle closure glaucoma.
Clinical Outcomes of Combined Pars Plana Vitrectomy and PAUL Glaucoma Implant.
Liegl C, Liegl R, Finger R … +3 more , Ach T, Holz FG, Mercieca K
J Glaucoma · 2026 Jun · PMID 42328718 · Publisher ↗
In complex cases of secondary glaucoma following vitreoretinal surgery (VR) where patients require both intraocular pressure (IOP) control and treatment of coexisting vitreoretinal (VR) pathology, a combined surgical app...
In complex cases of secondary glaucoma following vitreoretinal surgery (VR) where patients require both intraocular pressure (IOP) control and treatment of coexisting vitreoretinal (VR) pathology, a combined surgical approach with VR surgery and glaucoma drainage devices (GDD) may be necessary. However, there is limited literature on the outcomes of PAUL® Glaucoma Implant (PGI) implantation in conjunction with pars plana vitrectomy (PPV). The goal of this study was to evaluate the clinical outcomes and safety of simultaneous combined PGI implantation and pars plana vitrectomy (ppV) in patients with complex or refractory glaucoma requiring concurrent VR surgery. This monocentric retrospective case series included six eyes of six patients who underwent combined PGI implantation and PPV at the University Eye Hospital Bonn, Germany, between October 2022 and March 2024. Pre- and postoperative data on IOP, best-corrected visual acuity (BCVA), number of glaucoma medications, complications, and reinterventions were collected over a minimum follow-up period of 12 months. Mean preoperative IOP was 34.0 mmHg (31-38 mmHg), which decreased to 12.01 mmHg (8 - 14 mmHg) after 12 months. The mean number of IOP-lowering medications was reduced from 2.83 (1-5) to 1.8 (0-2) without requiring systemic acetazolamide. BCVA improved from a mean of 1.80 logMAR to 1.15 logMAR. Complications included tube migration with exposure requiring explantation, silicone oil-related tube occlusion, and transient hyphema. Combined PGI implantation and PPV provided effective IOP control with an acceptable safety profile. These findings suggest that this combined approach represents a viable surgical option for challenging glaucoma cases requiring simultaneous vitreoretinal intervention.
Peripapillary Optical Coherence Tomography Artifacts in Pathologic Myopia: Prevalence and Impact on Glaucoma Diagnosis.
Xiang Y, Luo N, Ye L … +6 more , Huang J, Cheng L, Yan Y, Zhao M, Han Y, Huang J
J Glaucoma · 2026 Jun · PMID 42285170 · Publisher ↗
PRCIS: Peripapillary retinal nerve fiber layer thickness (pRNFLT) artifacts were more prevalent than Bruch's membrane opening-minimum rim width (BMO-MRW) artifacts in pathologic myopia. Considering artifacts, the diagnos...
PRCIS: Peripapillary retinal nerve fiber layer thickness (pRNFLT) artifacts were more prevalent than Bruch's membrane opening-minimum rim width (BMO-MRW) artifacts in pathologic myopia. Considering artifacts, the diagnostic performance of pRNFLT and BMO-MRW was comparable. PURPOSE: To investigate the prevalence of peripapillary retinal nerve fiber layer thickness (pRNFLT) and Bruch's membrane opening-minimum rim width (BMO-MRW) artifacts in pathologic myopia (PM) and the impact of artifacts on the diagnostic ability for open-angle glaucoma (OAG). METHODS: This cross-sectional study was conducted at Zhongshan Ophthalmic Center. PM eyes were divided into two groups based on OAG diagnosis. Artifacts of pRNFLT and BMO-MRW were classified and their prevalences were compared. The diagnostic ability of pRNFLT and BMO-MRW for OAG was compared before and after the inclusion of eyes with artifacts. RESULTS: A total of 136 participants with PM were included from July 2023 to January 2025, with a median (interquartile range) age of 49 (16) years and mean (standard deviation) axial length of 28.03 (2.01) mm. Seventy-four (54.4%) eyes were diagnosed as OAG. Seven and three types of pRNFLT and BMO-MRW artifacts were observed, respectively. Presence of pRNFLT artifacts was identified in 74.2% of eyes in the PM group and 63.5% of eyes in the PM with OAG (PMG) group, which was more prevalent than BMO-MRW artifacts (27.4% in the PM group and 4.1% in the PMG group, both P<0.001). Before and after including eyes with artifacts, the AUC of global RNFLT decreased from 0.927 to 0.869, and the AUC of global BMO-MRW slightly decreased from 0.884 to 0.882. CONCLUSION: Artifacts of pRNFLT were more complex and prevalent than those of BMO-MRW. In PM, the diagnostic ability of pRNFLT and BMO-MRW were comparable when artifacts were considered.
Association Between Systemic Comorbidity Burden and Glaucoma Progression: A 5-Year Cohort Study.
Zhou MY, Reed H, Singh RP … +2 more , Talcott KE, Li A
J Glaucoma · 2026 Jun · PMID 42224658 · Publisher ↗
PRCIS: Higher age-adjusted Charlson Comorbidity Index scores were significantly associated with increased odds of glaucoma progression, with differential effects by disease stage and baseline comorbidity burden, supporti...
PRCIS: Higher age-adjusted Charlson Comorbidity Index scores were significantly associated with increased odds of glaucoma progression, with differential effects by disease stage and baseline comorbidity burden, supporting integration of systemic health assessment into glaucoma risk stratification. PURPOSE: To evaluate whether higher comorbidity burden, measured by the age-adjusted Charlson Comorbidity Index (age-CCI), is associated with increased odds of glaucoma progression over a 5-year-period. METHODS: This retrospective cohort study included 11,863 patients aged 18 years of age or older diagnosed with primary open angle glaucoma, preglaucoma, or ocular hypertension at the Cole Eye Institute between 2018 and 2024 with at least 5 years of follow-up. Age-CCI scores were calculated using the 19-item index based on ICD-10 diagnoses. Glaucoma severity was categorized as early-stage, moderate-stage, or severe-stage. Patients were stratified into tertiles by age-CCI: T1 (n=3966, mean age-CCI=1.7), T2 (n=3967, mean=3.8), and T3 (n=3930, mean=7.1). Multivariate logistic regression examined associations between age-CCI and disease progression, adjusting for demographic and clinical covariates. RESULTS: Mean age was 72.6 years, and mean age-CCI was 4.2. Each one-point increase in age-CCI was associated with a 6% increased odds of progression from early-stage to moderate-stage (OR=1.06, 95% CI: 1.04-1.09, P=1.05×10⁻⁷) and 9% increased odds of progression to severe-stage (OR=1.09, 95% CI: 1.06-1.13, P=2.88×10-7). Stratified analyses revealed age-CCI was associated with progression to moderate-stage only in T1 (OR=1.34, P=8.94×10⁻⁸) and progression to severe-stage only in T3 (OR=1.07, P=0.03). Male sex, Black race, public insurance, ophthalmic procedure history, and additional prescribed medications were independently associated with higher odds of progression. CONCLUSION: Higher comorbidity burden, as measured by age-CCI, is significantly associated with glaucoma progression, with associations varying by disease stage and baseline comorbidity level. The age-CCI may serve as a practical risk stratification tool for targeted glaucoma management.
Long-Term Patient Acceptability and Adherence to Suprachoroidal Telemetric Intraocular Pressure Monitoring in Glaucoma.
Englisch CN, Trouvain AM, Wakili P … +6 more , Mansouri K, Dick HB, Hoffmann EM, Mackert MJ, Boden KT, Szurman P
J Glaucoma · 2026 Jun · PMID 42224657 · Publisher ↗
PRCIS: Glaucoma patients implanted with the suprachoroidal telemetric intraocular pressure sensor EyeMate-SC demonstrate sustained high acceptance and strong adherence to self-monitoring over 3 years, without compromised...
PRCIS: Glaucoma patients implanted with the suprachoroidal telemetric intraocular pressure sensor EyeMate-SC demonstrate sustained high acceptance and strong adherence to self-monitoring over 3 years, without compromised vision-related quality of life. PURPOSE: Continuous telemetric intraocular pressure (IOP) monitoring offers the potential to improve glaucoma management, yet long-term patient acceptance and adherence remain uncertain. We evaluated 3-year patient acceptability, self-monitoring adherence, and vision-related quality of life following implantation of a suprachoroidal telemetric IOP sensor. METHODS: Twenty-four patients implanted with the EyeMate-SC were scheduled to complete the Telemetric Sensor Acceptance Questionnaire (TSAQ) and the NEI-VFQ-25. TSAQ responses were recorded on a 7-point Likert scale (1=complete disagreement and 7=complete agreement). RESULTS: Twenty-one patients completed the TSAQ after 1 year (D360) and 16 after 3 years (D1080). Most would seriously consider using the sensor at home (D360: 6.6±0.6; D1080: 6.9±0.5), at work (6.1±1.1; 5.5±2.3), and while traveling (6.2±1.3; 6.4±1.0). Sensor-related problems (2.0±1.7; 1.7±1.4), subjective visual field impairment (1.6±1.4; 1.2±0.6), and foreign body sensation (1.8±1.7; 1.5±1.0) were rare. Daily routine was rarely disrupted (1.4±0.8; 1.5±1.1). Sensor use reduced anxiety about unnoticed IOP peaks in most patients (6.4±1.4; 6.5±1.1). Home monitoring variedly increased motivation to take medication (4.6±2.8; 4.3±2.6). Willingness to recommend the device was nearly unanimous (6.7±0.5; 6.6±0.6). Twenty-three patients completed the NEI-VFQ-25 at baseline, 21 at D360, and 16 at D1080. Overall, there was no significant time course (Baseline: 79.0±12.7; D360: 78.9±10.7; D1080: 77.1±10.9, p=0.7). CONCLUSIONS: The sensor was well accepted, with sustained adherence to IOP self-monitoring and stable vision-related quality of life over 3 years. This highlights the importance of patient engagement for the successful implementation of telemetric IOP self-monitoring in clinical practice.
Outcomes of Ahmed Glaucoma Valve Implantation in the Ciliary Sulcus Versus the Anterior Chamber.
Kuroda K, Hayashi Y, Asaoka S … +8 more , Komori T, Asada Y, Iwamoto S, Hirota A, Sasaki H, Saeki T, Yamagami S, Matsuda A
J Glaucoma · 2026 Apr · PMID 42153810 · Publisher ↗
PRECIS: AGV implantation through the ciliary sulcus offers similar IOP control to anterior chamber insertion with reduced corneal endothelial cell loss, despite technical difficulties during the insertion process. PURPOS...
PRECIS: AGV implantation through the ciliary sulcus offers similar IOP control to anterior chamber insertion with reduced corneal endothelial cell loss, despite technical difficulties during the insertion process. PURPOSE: To report the surgical outcomes of Ahmed glaucoma valve (AGV) implantation through the ciliary sulcus (CS). PATIENTS AND METHODS: We performed a retrospective analysis of 204 eyes of 204 patients with AGV implantation through the CS and 85 eyes of 85 patients with AGV implantation through the anterior chamber (AC). The cumulative probability of success was defined as an IOP between 5 and 18 mmHg and reduction of IOP≧20% from the preoperative IOP. Kaplan-Meier analysis evaluated success up to five years. RESULTS: AGV-CS/AC eyes included POAG (74/12 eyes), PACG (8/0), XFG (62/50), NVG (4/1) and secondary glaucoma (56/22), respectively. There was no significant difference in qualified success rates of AGV-CS (89.7%) and AGV-AC (87.1%). Intraoperative tube insertion difficulties occurred in 47 eyes (23.0%) in the CS group and none in the AC group. Layered hyphema was more frequently observed in CS group (25 eyes, 12.3%) than in AC group (5 eyes, 5.9%). The monthly loss of corneal endothelial cell density (per mm2) was significantly lower in CS group (14.5±20.4) than in AC group (24.5±34.3). CONCLUSIONS: Although the higher rates of intraoperative troubles for insertion and postoperative hyphema were observed, the IOP control of AGV-CS insertion is comparable to that of AC insertion with less detrimental effects on the corneal endothelium. With appropriate techniques, CS is a reasonable insertion site for refractory glaucoma.
Safety and Efficacy of Direct Selective Laser Trabeculoplasty in Patients With Ocular Hypertension or Open Angle Glaucoma.
Goldberg M, Shohat N, Garzozi D … +6 more , Carmel M, Givoni H, Bracha Z, Brosh K, Abulafia A, Zadok D
J Glaucoma · 2026 Jun · PMID 42148860 · Publisher ↗
PRECIS: DSLT is a safe and effective modality for IOP reduction in OHT or OAG, performing especially well as first-line therapy in treatment-naive eyes with high baseline IOP. PURPOSE: To evaluate the safety and efficacy...
PRECIS: DSLT is a safe and effective modality for IOP reduction in OHT or OAG, performing especially well as first-line therapy in treatment-naive eyes with high baseline IOP. PURPOSE: To evaluate the safety and efficacy of direct selective laser trabeculoplasty (DSLT) in ocular hypertension (OHT) or open angle glaucoma (OAG), including treatment-naive and medically treated eyes. METHODS: A retrospective, single-center study based on electronic medical records of consecutive patients with OHT or OAG who underwent 360-degree DSLT between January 2023 and October 2024 in a tertiary hospital in Jerusalem. Demographic and clinical data were collected. Intraocular pressure (IOP) was measured pretreatment, 30 minutes post-DSLT, and at 2-months. The primary outcome was treatment success, defined as ≥20% or ≥3 mm Hg IOP reduction at 2 months without extra therapy. Secondary outcomes were mean IOP change, adverse events, and best-corrected visual acuity (BCVA) change. RESULTS: The study included 218 eyes from 144 patients. At 2 months, 66.97% of eyes met treatment success criteria. Mean baseline IOP was 19.73±4.52 mm Hg and decreased by 3.42±3.62 mm Hg (15.57%). Treatment-naive eyes showed greater IOP reduction (4.54±2.88 mm Hg, 20.17%) and higher success rates (78.43%) compared with premedicated eyes (3.07±3.11 mm Hg, 14.17%; 63.47% success; P =0.038). Subconjunctival hemorrhages occurred in 54.6% of eyes. IOP spikes were rare (1.8%). BCVA remained stable ( P =0.152). No serious adverse events were observed. CONCLUSIONS: DSLT is a safe and effective method for lowering IOP in OHT or OAG patients, particularly in treatment-naive eyes. Its noncontact, rapid, and standardized approach may offer practical advantages over conventional SLT. Further prospective studies with extended follow-up are needed to confirm these findings.
Ocular Biometric Determinants of Intraocular Pressure and Risk Factors for Ocular Hypertension: The Chinese American Eye Study.
Rajagopalan A, Pardeshi A, Apolo G … +6 more , Burkemper B, Jiang X, McKean-Cowdin R, Torres M, Varma R, Xu BY
J Glaucoma · 2026 Jun · PMID 42148858 · Publisher ↗
PRCIS: Angle width and iris area measured by anterior OCT are increasingly predictive of intraocular pressure and ocular hypertension below parameter-specific angle width cutoffs. Cumulative gonioscopy score is weakly pr...
PRCIS: Angle width and iris area measured by anterior OCT are increasingly predictive of intraocular pressure and ocular hypertension below parameter-specific angle width cutoffs. Cumulative gonioscopy score is weakly predictive below all score cutoffs. PURPOSE: To assess ocular biometric determinants of intraocular pressure (IOP) and risk factors for ocular hypertension (OHTN). METHODS: CHES participants underwent Goldmann applanation tonometry, gonioscopy, ultrasound A-scan, and anterior segment OCT (AS-OCT) imaging. Biometric data from one eye per participant were used to develop linear and logistic regression models of IOP and OHTN (IOP >21 mm Hg), respectively, below different angle width cutoffs adjusted for central cornea thickness (CCT). RESULTS: A total of 2360 eyes of 2360 eligible participants (1518 female, 842 male) were analyzed. Mean age was 60.2±7.8 years. Multivariable stepwise linear regression models and change-point analysis showed that below a trabecular iris space area (TISA 750 ) measurement of 0.08 mm 2 , models became increasingly predictive of IOP up to an adjusted R 2 of 0.84. Smaller TISA 750 and iris area (IA) were the only parameters consistently associated ( P ≤0.04) with higher IOP for TISA 750 below 0.20, 0.10, and 0.05 mm 2 . In multivariable models of OHTN (AUC≤0.95), smaller TISA 750 was associated with OHTN for TISA 750 <0.20, 0.10, and 0.05 mm 2 ( P ≤0.03), while IA was associated with OHTN for TISA 750 <0.05 mm 2 ( P ≤0.03). Cumulative gonioscopy score (sum of gonioscopy grades) was weakly predictive of IOP at all cutoffs (adjusted R 2 ≤0.08). CONCLUSION: TISA 750 and IA become strongly predictive of IOP when angle width decreases below a TISA 750 cutoff of 0.08 mm 2 . The relationship between cumulative gonioscopy score and IOP is weak below all gonioscopy score cutoffs. AS-OCT measurements could supplement gonioscopy by helping identify individuals at higher risk for elevated IOP from angle closure.
Outcomes of the PreserFlo MicroShunt in Refractory Childhood Glaucoma.
Imtirat A, Abu Rabia-Huleihel M, Buhbut O … +3 more , Kalron Y, Tsumi E, Kratz A
J Glaucoma · 2026 Apr · PMID 42148852 · Publisher ↗
PRCIS: PreserFlo™ MicroShunt implantation significantly reduced intraocular pressure and medication burden in refractory childhood glaucoma. However, declining survival beyond 12 months indicates limited long-term durabi...
PRCIS: PreserFlo™ MicroShunt implantation significantly reduced intraocular pressure and medication burden in refractory childhood glaucoma. However, declining survival beyond 12 months indicates limited long-term durability. PURPOSE: Childhood glaucoma is a potentially blinding condition caused by elevated IOP, with particularly high prevalence in Southern Israel. Management is especially challenging in refractory cases. The Preserflo™ MicroShunt is a minimally invasive device designed to lower IOP by diverting aqueous humor to the subconjunctival space. This study presents our institutional experience with its use in refractory childhood glaucoma and, to our knowledge, represents the largest reported series to date. METHODS: We conducted a retrospective study of all consecutive children (≤18 y) with refractory glaucoma defined as inadequate IOP control despite prior glaucoma surgery and maximal medical therapy, who underwent PMS implantation between October 2023 and December 2024. Data collected included pre- and postoperative IOP and number of IOP-lowering medications. Complete success was defined as IOP <21 mmHg and ≥25% IOP reduction without medications; Qualified success allowed for medications. Failure was defined as <25% IOP reduction or need for further surgery. RESULTS: Thirty-four eyes from 27 patients (mean age 4.9 ± 3.6 y) were included. Mean follow-up was 14.85 ± 5.02 months. Mean IOP decreased from 24.29±6.05 mmHg to 17.95 ± 8.22 mmHg (P < 0.001), and mean medication numbers from 3.0 ± 0.0 to 0.9 ± 1.3 (P < 0.001). Overall success was 61.70%, 50% achieving complete success with an average follow-up time of 13.92±4.85 months. CONCLUSION: The PMS lowered IOP and reduced medication use in refractory childhood glaucoma. However, the declining survival rates (53% at 12 mo and 33% at 24 mo) indicate the need for further evaluation of its long-term efficacy in children.
Association of Epiretinal Membrane With Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma: Prevalence and Functional Impact.
Yilmazşamli TD, Kanra AY, Ürkmez S … +2 more , Özcan D, Demir ST
J Glaucoma · 2026 Jul · PMID 42148840 · Publisher ↗
PRCIS: Epiretinal membrane is more frequent in pseudoexfoliation glaucoma than in pseudoexfoliation syndrome or controls, and is independently associated with worse visual field sensitivity, in addition to retinal nerve...
PRCIS: Epiretinal membrane is more frequent in pseudoexfoliation glaucoma than in pseudoexfoliation syndrome or controls, and is independently associated with worse visual field sensitivity, in addition to retinal nerve fiber layer thinning. PURPOSE: To investigate the prevalence and clinical implications of vitreomacular interface disease, particularly epiretinal membrane (ERM), in eyes with pseudoexfoliation syndrome (PXS) and pseudoexfoliation glaucoma (PXG), and to evaluate the impact of ERM on visual field parameters. METHODS: This retrospective study included 258 eyes (105 PXS/PXG; 153 matched controls) from 160 participants. All subjects underwent detailed ophthalmologic examination, optical coherence tomography (OCT) imaging, and visual field testing. ERM was graded according to the OCT-based staging system proposed by Govetto et al. The visual field index (VFI) and MD were analyzed concerning ERM presence and retinal nerve fiber layer thickness (RNFLT). Logistic and linear regression analyses were performed using generalized estimating equations to account for intereye correlation. RESULTS: ERM was significantly more prevalent in PXG eyes (28.8%) compared with PXS (19.6%) and controls (8.5%) ( P <0.001). Complete posterior vitreous detachment was more common in controls, while incomplete posterior vitreous detachment was prevalent in PXS/PXG groups. After age adjustment, PXG was independently associated with ERM, with ∼3.6-fold higher odds compared with controls (OR=3.58; 95% CI: 1.34-9.57; P =0.011). In PXG patients, eyes with ERM showed significantly reduced VFI and MD compared with eyes without ERM ( P =0.011 and 0.034, respectively). Multivariate regression identified both ERM presence and reduced RNFLT as independent predictors of visual field loss. CONCLUSION: ERM was more prevalent and showed a more pronounced functional impact in PXG eyes. Routine OCT assessment in PXS/PXG patients may facilitate early detection of ERM and improve visual prognosis.
Comparative Efficacy and Safety of Micropulse Versus Continuous-Wave Transscleral Cyclophotocoagulation in the Management of Refractory Glaucoma: A Prospective Cohort Study.
Yang S, Liu X, Xie J … +1 more , Zhao C
J Glaucoma · 2026 May · PMID 42044484 · Full text
PRCIS: Micropulse transscleral cyclophotocoagulation (MP-TSCPC) has gained considerable acceptance as a preferred cyclodestructive intervention for refractory glaucoma, offering significantly enhanced safety profiles thr...
PRCIS: Micropulse transscleral cyclophotocoagulation (MP-TSCPC) has gained considerable acceptance as a preferred cyclodestructive intervention for refractory glaucoma, offering significantly enhanced safety profiles through precisely controlled pulse energy delivery while maintaining equivalent therapeutic outcomes compared with traditional modalities. OBJECTIVE: To compare the efficacy and safety profiles of MP-TSCPC versus continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) in patients with refractory glaucoma. MATERIALS AND METHODS: This prospective, randomized, single-blind study included 52 patients (52 eyes) with refractory glaucoma assigned to either MP-TSCPC or CW-TSCPC. Patients were followed for 18 months. Secondary outcomes included absolute IOP values, medication reduction, preservation of visual acuity, visual function parameters, quality of life, and complication rates. Success was defined as IOP between 6-21 mm Hg without medications (complete success), with medications (qualified success), or either (cumulative success). Patients were followed for 18 months. RESULTS: At 18 months, 47 eyes completed follow-up (24 in MP-TSCPC and 23 in CW-TSCPC). The MP-TSCPC group (n=24) achieved a 34.43% IOP reduction from baseline, compared with 42.86% in the CW-TSCPC group (n=23), P=0.052. Complete success rates were 25.00% (6/24) for MP-TSCPC and 21.74% (5/23) for CW-TSCPC (P=0.999), while qualified success rates were 29.16% (7/24) and 39.13% (9/23), respectively (P=0.550). The cumulative success rates were 54.17% for MP-TSCPC and 60.87% for CW-TSCPC (P=0.706). The CW-TSCPC group experienced significantly higher rates of postoperative pain (56.52% vs. 20.83%, P=0.012) and prolonged inflammation (34.78% vs. 8.33%, P=0.039). Visual function parameters remained stable in both groups throughout the study period. Quality of life improved significantly in the MP-TSCPC group but not in the CW-TSCPC group, although between-group differences were not statistically significant. CONCLUSION: MP-TSCPC demonstrated comparable efficacy to CW-TSCPC in IOP reduction and success rates for refractory glaucoma management, while offering a significantly improved safety profile with less postoperative pain and inflammation. These findings suggest that MP-TSCPC may be considered as a preferred initial cyclodestructive option when balancing efficacy and safety, though larger studies are needed to confirm these findings.
Dual-Task Gait Performance in Moderate-to-Severe Glaucoma.
Jia S, Winser SJ, Cheong AMY
J Glaucoma · 2026 May · PMID 42044483 · Publisher ↗
PRCIS: This study found that while overall dual-task gait alterations were similar between glaucoma patients and controls, specific joint flexion differences and sex-specific patterns emerged, with most gait measures sho...
PRCIS: This study found that while overall dual-task gait alterations were similar between glaucoma patients and controls, specific joint flexion differences and sex-specific patterns emerged, with most gait measures showing good reliability in glaucoma participants. BACKGROUND: Progressive visual field loss in glaucoma compromises mobility, yet its effects on dual-task performance (eg, obstacle crossing or visual search) remain unclear. This study aimed to compare gait parameters between glaucoma patients and healthy controls under dual-task conditions, investigate sex-specific differences, and evaluate the test-retest reliability of these gait measures in all participants. METHODS: Twenty-eight individuals with moderate-to-severe bilateral glaucoma and 25 age-matched controls participated in the study. Gait analysis was conducted using a 10-camera Vicon system on a 7 m walkpath with obstacles of varying heights (0, 5, 15 cm) during visual tasks (fixation, visual search). Group and condition effects were analyzed with Generalized Estimating Equations. Ten glaucoma participants repeated testing after 2 weeks; reliability was quantified using intraclass correlation coefficients (ICCs). RESULTS: Gait parameters did not differ significantly between the glaucoma and healthy control groups under dual-task conditions. Sex-specific differences revealed that males with glaucoma showed reduced knee and hip flexion during visual search compared with healthy counterparts (P<0.05). Most gait measures demonstrated moderate-to-excellent test-retest reliability for glaucoma (ICCs: 0.63-0.97). CONCLUSION: Glaucoma did not greatly alter dual-task gait alterations, although specific differences in knee and hip flexion were observed, with distinct sex-specific patterns. Most gait measures were reliable. These findings highlight the importance of considering sex-specific strategies when addressing dual-task challenges in individuals with glaucoma.
A Systematic Review of Patient-Reported Outcome Instruments Relevant to Glaucoma.
Kashaf MS, Nagarajan N, Le JT … +5 more , Rosman L, McCann P, E JY, Li T, Bicket AK
J Glaucoma · 2026 May · PMID 41962140 · Full text
PRCIS: A minority (13 of 91) of patient-reported outcome measures for adult glaucoma meet rigorous quality standards for development. Others, despite limited evidence describing development, have been validated in glauco...
PRCIS: A minority (13 of 91) of patient-reported outcome measures for adult glaucoma meet rigorous quality standards for development. Others, despite limited evidence describing development, have been validated in glaucoma populations and should be used judiciously. PURPOSE: To identify, characterize and assess the quality of existing patient-reported outcome measures (PROMs) relevant to adult glaucoma patients, focusing on development and validation. METHODS: We searched multiple databases for studies reporting development, validation, adaptation, or extension of vision-related PROMs in adults with glaucoma. Eligible reports were grouped by instrument for assessment using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) Risk of Bias checklist's "Standards for evaluating the quality of PROM development." RESULTS: Among 91 instruments represented by 140 reports, 57 were developed for use in glaucoma patients; the remainder were validated in glaucoma patients. The instruments vary in length and complexity and evaluate domains within several constructs: vision-related QoL, health-related QoL, glaucoma knowledge, disease symptoms, vision-related activity limitation, treatment preferences, treatment side effects, patient satisfaction, and psychological status. According to COSMIN criteria, "adequate" development was documented for just 17 of 91 instruments, with descriptions of constructs, population(s) and context(s) for use, and published studies in the target population. Among these 17, concept elicitation was described for 13, of which 7 were developed since 2021. CONCLUSIONS: Thirteen instruments stand out in rigorous quality analysis based on the COSMIN Risk of Bias checklist. Other instruments without evidence of sound development have nevertheless been rigorously validated. PROMs we commonly use should be understood in the context of what they were designed to do, what they do well, their efficiency and limitations. It behooves us to follow and document best practices for developing and validating novel instruments.
One-Year Efficacy of OMNI Canaloplasty With and Without Additional Hydrus Microstent During Cataract Surgery.
Rocks MC, Dossantos J, Tran HV … +4 more , Bonilla B, Dickinson A, Leidy L, An J
J Glaucoma · 2026 Jul · PMID 41949404 · Publisher ↗
PRCIS: After 1 year, OMNI canaloplasty, with or without a Hydrus Microstent, achieved comparable surgical outcomes, reductions in IOP, and medication reduction. PURPOSE: This study compares the 1-year effectiveness of pe...
PRCIS: After 1 year, OMNI canaloplasty, with or without a Hydrus Microstent, achieved comparable surgical outcomes, reductions in IOP, and medication reduction. PURPOSE: This study compares the 1-year effectiveness of performing a canaloplasty during concurrent cataract surgery (CS) with or without a microstent in patients with glaucoma. METHODS: A retrospective analysis was performed on 66 eyes: 33 received OMNI canaloplasty, and 33 received OMNI canaloplasty with an additional Hydrus Microstent during CS. The mean number of ocular hypotensive medications and intraocular pressure (IOP) were assessed after 1 year. The primary outcome was surgical success, defined as attaining the target IOP without additional medications or procedures. Eyes were matched (1:1) based on demographics and disease characteristics. Statistical analysis included paired t tests and regression modeling. RESULTS: Mean IOP at 1 year was reduced by 18.0% in the canaloplasty alone group and by 12.8% in the canaloplasty with microstent group ( P =0.445). Mean medications at 1 year were reduced by 47.8% in the canaloplasty alone group and by 60.0% in the canaloplasty with microstent group ( P =0.554). Surgical success at 1 year was 75.8% for canaloplasty alone and 87.9% for canaloplasty with microstent ( P =0.339). The total adverse event rate was 9.09% (n=6). CONCLUSION: Combining canaloplasty with a microstent did not yield statistically significant improvements in surgical success, IOP reduction, medication use, or safety outcomes at 1 year compared with standalone canaloplasty. This suggests that, for patients undergoing CS with concurrent canaloplasty, the addition of a microstent may not confer substantial long-term clinical benefit. Small cohort size and differences in population between groups may also affect this outcome.
Thirty-Six-Month Multicentre Outcomes of Combined Phacoemulsification and Hydrus Microstent Implantation in Eyes With Normal Tension Glaucoma.
Ang BCH, Betzler BK, Sim JJL … +6 more , Ramanathan R, Hong ASY, Chua CH, Khairy T, Salimi A, Harasymowycz P
J Glaucoma · 2026 Jun · PMID 41934671 · Publisher ↗
PRECIS: This retrospective multicentre study of 77 NTG eyes undergoing phacoemulsification and Hydrus implantation showed a sustained reduction in medication burden, while maintaining IOP levels. Complications were rare...
PRECIS: This retrospective multicentre study of 77 NTG eyes undergoing phacoemulsification and Hydrus implantation showed a sustained reduction in medication burden, while maintaining IOP levels. Complications were rare and nonsight-threatening. PURPOSE: To evaluate 36-month outcomes of combined phacoemulsification and Hydrus Microstent implantation (Phaco-Hydrus) in eyes with normal tension glaucoma (NTG). METHODS: This multicentre retrospective study included 77 NTG eyes from Singapore and Canada that underwent Phaco-Hydrus between 2014 and 2023. Primary outcomes were changes in intraocular pressure (IOP) and medication burden, and cumulative success probabilities from Kaplan-Meier (KM) analyses. Longitudinal changes were analysed using generalized estimating equations. RESULTS: Of 77 eyes, 31 completed 36 months of follow-up. Mean baseline IOP and medications was 13.5±2.5 mm Hg and 1.7±0.9, respectively. No significant reductions in IOP were observed. A sustained reduction in medication use was observed at all follow-up timepoints ( P ≤0.001). At 36 months, medication use decreased by -0.7±0.2 [adjusted mean difference±SE of the mean [SEM]]. Proportion of medication-free eyes increased from 7.8% (n=6/77) at baseline to 45.2% (n=14/31) at 36 months. Cumulative success probabilities varied widely based on definitions. When defined as a decrease in ≥1 medication from baseline without an increase in IOP, or IOP ≤15 mm Hg and reduced ≥20% from baseline while medication-free, and no additional laser or incisional glaucoma surgery, this was 40.7% at 36 months. No visual field mean deviation progression was detected. Adverse events were infrequent and nonsight-threatening. CONCLUSION: In eyes with NTG, Phaco-Hydrus may offer a greater role in medication reduction or achieving a medication-free status over 36 months, rather than absolute IOP reduction.
Twelve-Month Safety Profile of PreserFlo MicroShunt on Corneal Endothelium in Glaucoma Subtypes.
Okada Y, Mori K, Yoshii K … +2 more , Inatomi T, Kinoshita S
J Glaucoma · 2026 Jun · PMID 41911286 · Publisher ↗
PRCIS: PreserFlo MicroShunt implantation alone may be well tolerated for the corneal endothelium across glaucoma subtypes over 12 months, whereas combination with cataract extraction may increase the risk of endothelial...
PRCIS: PreserFlo MicroShunt implantation alone may be well tolerated for the corneal endothelium across glaucoma subtypes over 12 months, whereas combination with cataract extraction may increase the risk of endothelial compromise, with a tendency toward a more pronounced reduction in pseudoexfoliation glaucoma. PURPOSE: To evaluate the impact of PreserFlo MicroShunt (PMS) implantation on corneal endothelial cell density (ECD) over 12 months, stratified by glaucoma subtype and surgical procedure. PATIENTS AND METHODS: This retrospective cohort study included 103 eyes with primary open angle glaucoma, pseudoexfoliation glaucoma (PEXG), and secondary open angle glaucoma without PEXG, all undergoing PMS implantation [either alone or combined with cataract extraction (PMS-CE)] between August 2022 and December 2023. Changes in ECD, coefficient of variation (CV), and hexagonal cell percentage (HEX) were assessed. Firth logistic regression was used to evaluate risk factors for >10% ECD loss. Subgroup analyses were performed by surgical procedure. RESULTS: No significant within-group ECD, CV, or HEX changes were observed at 12 months in any glaucoma subtype. Thirteen eyes (12.6%) exhibited >10% ECD loss, predominantly in the PMS-CE group. Multivariate analysis identified PMS-CE as a significant risk factor [odds ratio (OR): 12.1; 95% CI: 2.69-75.0; P <0.001]. In the PMS-CE subgroup, PEXG was associated with greater risk of ECD loss (OR: 9.39; CI: 1.19-125.0; P =0.033). CONCLUSIONS: PMS-alone demonstrated a favorable safety profile for the corneal endothelium across glaucoma subtypes. However, PMS-CE may pose an elevated risk of endothelial compromise, with a tendency toward a more pronounced reduction in PEXG eyes.
Design and Baseline Characteristics of Participants in the Clarifying the Optimal Application of Selective Laser Trabeculoplasty (SLT) Therapy (COAST) Trial 1.
Realini T, Balasubramani GK, Kenkre T … +5 more , Wolsk J, Kass MA, Gazzard G, Wisniewski SR, COAST Study Investigators
J Glaucoma · 2026 Mar · PMID 41886500 · Publisher ↗
PRECIS: COAST was designed to investigate alternate approaches to SLT to provide more effective long-term disease control without the need for alternate therapies such as medications or surgery. Methodology and baseline...
PRECIS: COAST was designed to investigate alternate approaches to SLT to provide more effective long-term disease control without the need for alternate therapies such as medications or surgery. Methodology and baseline participant characteristics are described. PURPOSE: To describe the hypothesis and methodology for the ongoing Clarifying the Optimal Application of Selective Laser Trabeculoplasty (SLT) Therapy (COAST) trial 1 and participants' baseline characteristics. METHODS: COAST Trial 1 is a multicenter randomized trial comparing standard-energy versus low-energy SLT as initial therapy for newly-diagnosed ocular hypertension (OHT) or mild-moderate primary open-angle glaucoma (POAG). The hypothesis is that 12-month survival following low energy SLT will be non-inferior to 12-month survival with standard energy SLT. RESULTS: When enrollment ceased, 418 participants had been randomized to low-energy (n=203) or standard-energy (n=215) SLT. Demographic and clinical characteristics were similar between groups. Most participants were White (66.5% and 67.9%, respectively) or Black/African American (25.1% and 21.4%, respectively). Qualifying diagnoses were mild POAG (59.6% and 62.1%, respectively), ocular hypertension (32.8% and 30.5%) and moderate POAG (7.6% and 7.4%). Mean optical coherence tomography retinal nerve fiber layer thickness was 81.9 and 82.0 µm, respectively; mean visual field mean deviation was -1.6 dB in both groups. Mean baseline IOP was highest among eyes with ocular hypertension (24.5 and 24.4 mmHg, respectively) and lower in eyes with mild (21.8 and 21.4 mmHg) and moderate POAG (22.0 and 21.0 mmHg). CONCLUSIONS: COAST is a timely and potentially highly impactful trial that will clarify the optimal utilization of SLT for long-term glaucoma management without the need for alternative therapies such as medications or surgery. The COAST sample closely resembles the population of newly-diagnosed POAG/OHT patients for whom primary SLT would be appropriate, optimizing generalizability of study results when available.
Residual Structural Differences on Anterior Segment OCT After Laser Peripheral Iridotomy in Primary Angle Closure Disease.
Sng JJ, Park KH, Kim YK … +1 more , Jeoung JW
J Glaucoma · 2026 Jul · PMID 41886489 · Publisher ↗
PRCIS: AS-OCT parameters, especially ACD and nasal angle parameters, demonstrate persistent structural differences across the PACD disease spectrum even after LPI and may serve as a useful adjunctive tool for structural...
PRCIS: AS-OCT parameters, especially ACD and nasal angle parameters, demonstrate persistent structural differences across the PACD disease spectrum even after LPI and may serve as a useful adjunctive tool for structural assessment and risk stratification in treated eyes. PURPOSE: Although laser peripheral iridotomy (LPI) alleviates pupillary block in primary angle closure disease (PACD), structural differences across the disease spectrum may persist after treatment. This study aimed to evaluate anterior segment optical coherence tomography (AS-OCT) parameters in treated primary angle closure disease (PACD) and identify features associated with severity. PATIENTS AND METHODS: Retrospective analysis was performed on 160 eyes from 91 patients. AS-OCT was conducted using Tomey CASIA2 Angle Protocol. Disease severity was established before laser peripheral iridotomy (LPI) based on clinical gonioscopy and standard diagnostic criteria. All eyes underwent AS-OCT after LPI. One-way ANOVA with post hoc Tukey HSD and ROC curve analysis evaluated intergroup differences and diagnostic cutoffs. RESULTS: Significant differences in AS-OCT parameters were observed for ACD ( P =0.020), AOD ( P <0.001), TISA ( P <0.001), ARA ( P <0.001), ITC Index ( P =0.001), and ITC Area ( P =0.013). Acute angle closure glaucoma (AACG) had the most narrowing and the highest ITC values. ROC analysis demonstrated modest discriminative performance for individual AS-OCT parameters. ACD ≤1.82 mm demonstrated high sensitivity (100%) but low specificity (21.4%), while AOD 250/500 nasal cutoffs demonstrated high specificity (100%/96.4%) with low sensitivity. CONCLUSION: AS-OCT demonstrates persistent structural differences across the PACD spectrum after LPI and may serve as an adjunct for structural assessment and risk stratification in treated eyes.
Treatment Outcomes of Slow Coagulation Transscleral Cyclophotocoagulation for Medically Uncontrolled Glaucoma in Korean Patients.
Hwang YH, Lee S, Kim M … +1 more , Choi J
J Glaucoma · 2026 Mar · PMID 41886475 · Publisher ↗
PRÉCIS: Slow coagulation transscleral cyclophotocoagulation showed useful intraocular pressure control in Korean patients with medically uncontrolled glaucoma. PURPOSE: This study aimed to evaluate the treatment outcomes...
PRÉCIS: Slow coagulation transscleral cyclophotocoagulation showed useful intraocular pressure control in Korean patients with medically uncontrolled glaucoma. PURPOSE: This study aimed to evaluate the treatment outcomes of slow coagulation transscleral cyclophotocoagulation (SC-CPC) in Korean patients with medically uncontrolled glaucoma. METHODS: Medical records of 95 eyes from 95 patients who underwent SC-CPC to control intraocular pressure (IOP) were reviewed. Success was defined as an IOP of 6-21 mmHg with a ≥20% reduction from baseline, and no additional incisional surgery for glaucoma. Visual acuity presented as logarithm of the minimum angle of resolution (logMAR), the number of glaucoma medications, corneal endothelial cell count, and complications were analyzed. RESULTS: At 12 months postoperatively, mean IOP decreased from 32.7±13.8 mmHg to 16.2±9.4 mmHg (P<0.001) and the mean number of medications decreased from 2.6±0.9 to 2.0±1.0 (P<0.001). Mean visual acuity declined from 0.69±0.94 to 0.80±0.99 logMAR (P=0.015). No significant changes were found in corneal endothelial cell counts at any postoperative visits (P>0.05). Eighteen eyes (18.9%) underwent repeated SC-CPC treatments. The most common complication was transient hypotony (4.2%), followed by macular edema (3.2%), prolonged hypotony (1.1%), and corneal decompensation (1.1%). The 12-month success rate was 57.1%. CONCLUSION: SC-CPC is a useful method for IOP control in Korean patients with medically uncontrolled glaucoma.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe