This study investigated the efficacy and safety of a cross-linked collagen stent (XEN 45) with or without cataract surgery in the treatment of glaucoma. Setting: Real-life setting. Design: Prospective, open-label, multicenter clinical trial. Methods: Eligible patients with glaucoma inadequately controlled by treatment, or poor compliance or intolerance to topical therapy were included. Patients were divided into those with implant only (solo group; phakic and pseudophakic patients) and implant combined with cataract surgery (combo group). Differences in average intraocular pressure (IOP) and number of medications between baseline and study end (12 months), and the rate of qualified and complete success were evaluated. Results: Overall, there were 115 patients in the solo group (43 phakic and 72 pseudophakic) and 56 in the combo group. Compared with baseline, mean IOP (23.

Topical ropivacaine performed at least as well as topical lidocaine in efficacy and safety in cataract surgery. It provided sufficient and long-lasting analgesia without the need for supplemental intracameral anesthesia in most cases.

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Purpose: To compare the diagnostic accuracy of minimum rim width (MRW), peripapillary retinal nerve fibre layer (pRNFL) and multilayered macular analysis by Spectralis SD-OCT (Heidelberg Engineering, Germany) in discriminating perimetric glaucoma at different stages of the disease from healthy eyes. Methods: In this multicentre, prospective, evaluation of diagnostic tests study, multilayered macular analysis and MRW and pRNFL were obtained from one eye of 197 glaucoma (76 early, 68 moderate and 53 advanced) and of 83 healthy controls from the Multicenter Italian Glaucoma Imaging Study (MIGIS). The reference standard for classifying eyes as glaucomatous and for staging the disease was the visual field. The main outcome measures were area under the ROC curve (AUC) and sensitivity at fixed specificity (95%). Results: Average MRW and average pRNFL showed the highest and similar diagnostic accuracy in both the whole study population (AUC 0.968 and 0.939) and early glaucoma (AUC 0.956 and 0.929). Among the macular parameters, the three innermost retinal layers combined as the Ganglion Cell Complex provided the highest diagnostic accuracy (AUC 0.931) in the whole population, which was statistically similar to that of average pRNFL but inferior to that of average MRW. Compared to both average MRW and pRNFL, all macular parameters showed statistically significant lower accuracy in early glaucoma, but accuracy in moderate and advanced glaucoma showed no statistically significant differences among three protocols. Conclusion: The diagnostic accuracy of MRW, pRNFL and macular analysis by Spectralis SD-OCT is overall good. MRW and pRNFL analysis performs statistically and clinically better than macular analysis to discriminate early glaucoma from healthy eyes.

No significant difference in CCT was found between patients treated with PGA and TCAI, suggesting that these topical medications did not statistically and clinically change the CCT.

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Mitomycin C is a useful adjunct to glaucoma surgery. Adverse effects at the dosage used are mainly due to hypotony and are preventable with two-layer suture. Low-dose mitomycin C may be useful in standard primary trabeculectomy.

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