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Ninth Annual Meeting of the American Glaucoma Society
Amelia Island, Florida, on February 18-20, 1999
Greg Skuta
Over 200 glaucomatologists attended the conference, which featured 26 free paper presentations, 17 scientific posters, and three focused mini-symposia. Abstracts for the free papers and scientific posters were published as a supplement to the February, 1999, issue of Journal of Glaucoma.
Among the free paper presentations, Dr. Martin Wand reported on six cases in which herpes simplex keratitis appeared to be related to the use of topical latanoprost. In at least one patient, the keratitis cleared after discontinuation of latanoprost and subsequently recurred when the patient was re-challenged with the drug.
In a study from the University of Oklahoma and the University of Michigan, Dr. Greg Skuta described the clinical and genetic findings in a large family with autosomal nanophthalmos. Mean refractive error and axial length in 22 affected family members were +9.99 diopters and 18.13 mm, respectively, and 12 of these had angle-closure glaucoma or occludable anterior chamber angles. Linkage analysis demonstrated evidence that nanophthalmos in this family is the result of a defect in a previously unidentified locus (NNO1) on chromosome 11. Of note, this locus appears to be distinct from the PAX6 gene on chromosome 11, which has been associated with conditions such as aniridia.
Dr. Mary Lynch and co-workers from Emory University retrospectively compared the surgical and visual outcome of children with primary infantile glaucoma who underwent either goniotomy (26 eyes of 13 patients) or 360 degree trabeculotomy (24 eyes of 15 patients). In the trabeculotomy group, 92% of eyes achieved successful IOP control after procedure. Forty-six percent of eyes in the goniotomy group were successfully controlled, but more than half of these eyes requires two or more procedures. Final visuaL acuity was 20/50 or better in 79% of the trabeculotomy eyes and 58% of the goniotomy eyes. Mean refractive error (spherical equivalent) was -0.15 diopters in the trabeculotomy group and -4.90 diopters in the goniotomy group.
Representing investigators in the Ocular Hypertension Treatment Study (OHTS), Dr. Chris Johnson reported on the frequency with which visual field abnormalities observed on follow-up visual fields were either confirmed or not confirmed. Of 14,488 regular follow-up visual fields performed in the 1,637 patients in the OHTS, 548 were abnormal. On retesting, the abnormalities were not confirmed in 482 (88.0%) of the fields. The authors concluded that in this population of ocular hypertensive patients, confirmation of visual field abnormalities through retesting is essential.
Dr. Thomas Samuelson of Minneapolis described the incidence of inflammatory giant cell deposits (IGCD) on the surface of three types of intraocular lenses placed in 151 patients who underwent combined phacoemulsification and trabeculectomy with mytomycin. Inflammatory deposits were most common with the silicone plate lens (33%), intermediate with the acrylic lens (15%), and least common with the three-piece silicone lens. Of additional note, chronic miotic therapy and the need for intraoperative pupillary stretch were significant risk factors for IGCD formation. Dr. Samuelson and co-workers further suggested that combined cataract and glaucoma surgery provides an excellent model to measure differences in intraocular lens biocompatibility.
In a mini-symposium entitled "The Business of Glaucoma," Dr. William L. Rich, III, Secretary for Federal Affairs for the American Academy of Ophthalmology, reported on reimbursement trends for glaucoma codes and efforts made by the Academy regarding office and procedure codes that impact glaucoma carc. Other mini-symposia included "Neuroprotection: Can We Achieve It?" and "Surgical Challenges and Controversies." The latter addressed the management of bleb leaks and overfiltration as well as management of coexisting cataract and glaucoma.
Dr. Douglas R. Anderson of Miami, Florida, delivered the Ninth AGS Lecture, entitled "The Tonographer," in honor of Dr. W. Morton Grant, who directed the Glaucoma Consultation Services at the Massachusetts Eye and Ear Infirmary in Boston, Massachusetts, until his retirement in 1982.
