(IGR: 15-3) | International Glaucoma Review #

Top-Ten of the VIth International Symposium of the National Academy Glaucoma Foundation
Sofia, Bulgaria, 26 April 2014

The results are presented of a clinical and genealogical analysis of 18 patients - probands with aniridia, who have been trained in school for visually impaired - in Sofia. Intra- and interfamilial study of phenotype in specific patients confirmed the presence of a broad clinical and genetic polymorphism in aniridia of organismal level. (Anna Popova, Bulgaria)

Our computer program for analysis of the optic disc parameters in glaucoma patients and suspects with Heidelberg Retina Tomograph 3 is based on the registration of optic disc individual size and the lesion degree with color encoding of each parameter. It provides the increase of pathological changes visibility and their more accurate assessment in eyes with an irregular optic disc area. (Vladimir Machekhin, Russia)

Selective laser trabeculoplasty (SLT) is a well-established, effective and safe method for IOP reduction in wide range of glaucoma patients. SLT can be successfully used as initial treatment in glaucoma as well as when topical medications are not efficient enough or are causing significant side effects. The unique aspects of this treatment along with observations from years of experience and treatment of patients are discussed. (Modi Goldenfeld, Israel)

Pseudoexfoliation (PXF) syndrome/glaucoma can present some unique obstacles to successful phacoemulsification. The increased risks associated with PXF cataract surgery can be managed or at a minimum anticipated with a thorough preoperative evaluation, with appropriate preparation and use of adjunctive devices. The current methods for overcoming the obstacles during cataract surgery in this patient population are provided. (Nirit Bourla, Israel)

Combining clinical and imaging methods brings new perspectives regarding the evaluation of trabeculectomy outcomes. The significance of AS-OCT is based on the potential for early recognition of blebs with increased risk for failure. It could be safe in the postoperative period to monitor the changes in bleb morphology. That would enable wound healing modulation and prevention complications. (Vesna Dimovska, Macedonia)

Class-CO₂ laser-assisted sclerectomy surgery is an alternative non-penetrating deep sclerectomy (NPDS) filtering procedure. A frequent complication of manual NPDS is inadvertent perforation into the anterior chamber, requiring conversion to a penetrating filtration procedure. New technique advantages include photoablation of dry tissue and effective absorption of laser energy by aqueous percolation that ceases ablation 'automatically'. ( Daniel Cotlear, Israel)

CyPass biocompatible polyimide micro-stent, ensures effective and sustained IOP-lowering due to aqueous outflow towards suprachoroidal space. The approach is ab interno through 1.5 mm clear corneal or phaco incision. One year follow-up of CyPass micro-stent standalone implantation in 17 patients results in IOP reduction with 23%, minimal complications and reduction of medications. (Bissera Samsonova, Bulgaria)

Malignant glaucoma is still considered one of the most devastating post-operative complications after glaucoma and cataract surgeries. Some important focuses on mechanisms and pathophysiology, updated knowledge about the prevalence and manifestation of this disease are revealed. Treatment options will be discussed, offering some encouraging prospects regarding successful alleviation of this potentially blinding complication. (Shlomo Melamed, Israel)

Ahmed glaucoma valve implantation can control IOP in the majority of extra complicated glaucoma cases. Previous intraocular surgery is a main risk factor for the early postoperative complications: choroidal effusion, shallow anterior chamber, hemorrhagic complications depend on the stage of the glaucoma and the preoperative IOP. Opthalmologists should be aware of these complications for the choice the correct medical approach. (Tatsiana Imshenetskaya, Belarus)

Surgical revision with Ologen^TM implantation was performed in eyes with glaucoma and Ex-PRESS^® implant due to a permanent IOP elevation. Postoperative results show that our new surgical procedure leads to IOP reduction and discontinuing of the IOP lowering medications. To our experience, the surgical approach we suggest is a successful alternative to the other possible revision procedures after filtration surgery, especially to these where antimetabolites are applied. (Botio Anguelov, Bulgaria)