Purpose: The mechanisms of elevation of intraocular pressure (IOP) in eyes with open‐angle glaucoma are complex and probably include problems related to alterations in the trabecular network, Schlemm channel and distal collecting channels. Traditional surgeries, such as trabeculectomy and the implantation of a shunt microtube, avoid these structures and divert the aqueous humour to the subconjunctival space. Recently, a growing family of minimally invasive glaucoma (MIGS) surgeries has evolved to achieve the reduction of IOP without blistering by restoring flow through the conventional physiological route of exit. One of the devices in this family is the OMNI® surgical system, which was designed to address the three sources of resistance to output flow: trabecular network, Schlemm channel and distal collectors. Thanks to this device it is possible to perform two procedures with a single surgery and overcome three points of flow resistance. The relative novelty of this device makes it important to monitor and analyse long‐term results in normal clinical practice. Methods: We present 6 clinical cases of chronic open‐angle glaucoma that were subjected to surgery with the OMNI® device, associating cataract phacoemulsification in 5 of them. Results: The reduction in IOP that we have observed at 3 and 6 months is around 30%, which is very similar to what has been published in the literature. Conclusions: In our experience, the OMNI® surgical system has provided a clinically relevant decrease in IOP and the number of active ingredients needed, with a good safety profile, although a greater volume of patients and follow‐up time are required to draw more precise conclusions.
Purpose: Paddle tennis is considered a sport with high ocular risk. The most frequent eye injuries are caused by the impact of shovels, balls or earth particles, with injuries to the posterior pole of the eye (retina and vitreous) being the most serious and can lead to loss of vision due to retinal detachment, choroidal tears or eye burst many times due to not using adequate protection. In this paper, we analyse posterior pole injuries and their treatment. Methods: The cases of ocular injuries in the practice of paddle tennis in the last three years seen in the ophthalmology emergency service of our hospital have been collected. Results: 34 patients have been included, 30 men and 4 women, with a mean age of 34 years. The initial visual acuity was 0.74 and the final visual acuity was 0.9. The lesions seen have been retinal edema, vitreous haemorrhages, retinal haemorrhages, retinochoroidal tears, retinal tears, macular hole, vitreous base avulsion and angular recession glaucoma, in many cases associating more than one type of injury. In most cases, topical treatment (25 cases), topical and oral (5 cases), laser (5 cases) and surgery (3 cases) have been performed. In no case, did they use eye protection. Conclusions: Most of the cases presented good initial visual acuity, however, all presented potentially serious lesions in the posterior pole (retina and/or choroid), including two cases of retinal detachment and one angular recession glaucoma that required surgery. For this reason, it is necessary to insist on the use of approved polycarbonate protective glasses for all players and in case of ocular contusion, review by the ophthalmology service to assess the eye fundus regardless of the initial vision.
Purpose: To evaluate the effect of ocular hypo‐pressure treatment on refraction and neuroretina of rat eyes with chronic glaucoma by sex over 24 weeks, as compared to glaucomatous rats non‐treated and healthy controls. Methods: One hundred and fifty five Long‐Evans rat's eyes were analysed retrospectively. 25 glaucomatous (G) rat's eyes, 60 glaucomatous eyes treated with a hipo pressure formulation of Brimonidine ‐ LAPONITE® (G‐B) and 70 healthy (H) eyes. Intraocular pressure (IOP) was measured with rebound tonometer, retinal ganglion cells (RGC) functionality with electroretinography (ERG), and diopter power (D) and neuroretinal estructure with peripapilary retinal nerve fibre layer (pRNFL) and ganglion cell layer (GCL) protocols using non‐invasive technology of optic coherence tomography, over 6 months. Results: G‐B cohort presented lower IOP values during weeks 1, 4 and 8 (p < 0.001) compared to G cohort no treated, and even to H eyes during first week (10.36 ± 1.21 vs. 13.37 ± 2.58 mmHg; p < 0.001). All cohorts both sexes experienced a trend to emmetropia throughout the follow‐up, especially throughout the first 8 weeks of the study and in males (p < 0.033). G cohort showed the lowest diopter value (1.06 ± 3.94 D; p < 0.035), G‐B cohort showed the biggest value and no differences in refraction compared to H eyes (3.67 ± 0.00 vs 3.61 ± 1.90 D; p > 0.203) in week 24. pRNFL thickness differences were mainly found on the inferior sectors. G‐B cohort showed bigger thickness in pRNFL (p = 0.034) and GCL (p = 0.038) compared to G cohort at week 24. G‐B cohort registered higher ERG signal compared to G cohort (41.20 ± 8.75 vs. 18.68 ± 24.77 μV; p = 0.012) and even H eyes (41.2 ± 8.75 vs. 26.00 ± 22.50 μV; p = 0.001) at week 24. Conclusions: Ocular hypo pressure treatment slowed the trend of diopter power and neurorretinal thickness loss, and preserved better functionality of RGC compared to glaucomatous eyes non‐treated.
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