Bruch's membrane opening is more posteriorly located in older individuals. These differences are largely due to differences in choroidal thickness and suggest that BMO migrates posteriorly with age due to age-related choroidal thinning. However, additional studies in longitudinal datasets are needed to validate these findings.

Purpose To collect the normal value data of corneal hysteresis in Thais and study the variation of corneal hysteresis in glaucomatous eyes. Methods Retrospective cross-sectional study of corneal hysteresis (CH) in healthy non-glaucomatous and glaucomatous eyes. Demographic data, type and staging of glaucoma, Goldmann applanation tonometry (GAT) and ocular response analyzer parameters; CH, corneal-compensated intraocular pressure (IOPcc) and Goldmann-correlated intraocular pressure (IOPg) were collected. Results Data from one eye of 465 normal participants were included for the normal value data of CH. Mean CH, IOPcc and IOPg were 10.18 ± 1.48, 15.01 ± 3.04 and 14.16 ± 3.06 mmHg, respectively. Average age was 57.21 ± 14.4 years. CH at the fifth percentile was 8.0 mmHg. Women had significantly higher CH than men (10.29 ± 1.46 vs 9.90 ± 1.49 mmHg, p=0.009). Moderate negative correlation was found between age and CH, r = −0.338, p<0.001. There were 695 glaucomatous eyes from 429 patients including primary-open angle glaucoma (POAG), primary close-angle glaucoma (PACG), normal tension glaucoma (NTG) and ocular hypertension (OHT). CH in each glaucoma type and severity stage (early, moderate and severe) were as follows: POAG: 8.74 ± 1.52 mmHg (9.22 ± 1.47, 8.74 ± 1.23 and 7.92 ± 1.40 mmHg, p<0.001), PACG: 9.09 ± 1.72 mmHg (9.85 ± 1.45, 9.04 ± 1.68 and 8.45 ± 1.74 mmHg, p= 0.004), NTG: 9.55 ± 1.67 mmHg (9.47 ± 1.38, 9.75 ± 2.42 and 9.77 ± 1.34 mmHg, p 0.525) and OHT: 10.10 ± 1.40 mmHg. Conclusion Compared with normal value data of corneal hysteresis, CH in glaucomatous eyes was lower. The more advanced glaucoma stage was associated with lower CH. Arising from normal value data, a low percentile of CH could be applied as the deviation value from normal and this dynamic property of CH could represent a glaucoma predictor in an effort to improve glaucoma care.

Purpose Utility index is a significant outcome in terms of health economics assessment while patient-reported outcome measure (PROMs) evaluates quality of life (QOL) from patient’s perspective. Our objective was to evaluate both utility indices and PROMs using generic and eye specific QOL in glaucomatous patients compared with normal population. Methods This is a case-control study. We interviewed normal and glaucomatous participants with the European Quality of Life questionnaire (EQ-5D-5L), the European visual analogue scale (EQ-VAS) and the visual function questionnaire 28 (Thai version) (VFQ-28). The visual function questionnaire utility index (VFQ-UI) and generic utility index from EQ-5D-5L were calculated. Results There were 47 normal and 127 glaucomatous participants in this study. Amongst glaucoma group, 35 participants were in the early stage of the disease, 43 were in the moderate stage, 30 normal vision participants were in the severe stage, 14 participants had blindness one eye, and 5 had blindness both eyes. The mean age of the participants in both groups was statistically similar (63.78±6.84 vs 66.30±8.93 years old, respectively, p=0.062). Underlying diseases between groups were also comparable. The EQ-5D-5L utility index score and the EQ-VAS score were not statistically different between normal and glaucomatous groups, respectively (EQ-5D-5L: 0.874±0.122 vs 0.837±0.191, p=0.215; EQ VAS: 76.06±15.07 vs 74.02 ±15.10, p=0.43). By contrast, VFQ-UI of the glaucomatous group was significantly lower than that of the normal group, (VFQ-UI: 0.833±0.147 vs 0.895±0.070, accordingly, p<0.05). Conclusions Utility index from the VFQ-UI was a relevant PROMs for evaluating the QOL of glaucomatous patients in terms of visual function specificity and acceptable validity.

Purpose To study the surgical outcomes of glaucoma drainage device (GDD) implantation in refractory glaucoma patients. Patients and Methods Retrospective chart review of glaucoma patients undergoing GDD implantation, Ahmed glaucoma valve (AGV), Baerveldt glaucoma implants (BGI), and Aurolab aqueous drainage implantation (AADI) from January 2012 to June 2021. Glaucoma patients were classified into two groups: primary glaucoma including: primary open angle glaucoma (POAG), primary angle closure glaucoma (PACG) and juvenile open angle glaucoma (JOAG) and secondary glaucoma including: neovascular glaucoma (NVG), ocular surgery (vitreoretinal surgery, scleral buckling procedure, postoperative extra capsular cataract extraction, scleral fixation intraocular lens, penetrating keratoplasty), intraocular trauma, uveitis glaucoma, lens-induced glaucoma, pseudoexfoliation glaucoma (PXG), iridocorneal endothelial (ICE) syndromes and Axenfeld Rieger Syndrome. Surgical outcomes were studied. Results Primary glaucoma included 57 eyes from 49 patients. Secondary glaucoma included 87 eyes from 85 patients. The cumulative probability of complete or qualified success of refractory glaucoma patients at five years were 53.4% (95%CI: 38.4%, 66.3%). Higher success rate was discovered in primary glaucoma at 65.8% (95%CI: 38.4%, 83.3%) than 45.2% (95%CI: 26.9%, 61.9%) in secondary glaucoma group significantly with p =0.003. While the results among success rate, adverse events and complications was not different between types of GDD. Predictors for failure were neovascular glaucoma with unadjusted hazard ratio (HR) 3.62 (95%CI: 1.45, 9.04) with p =0.006, and lens-induced glaucoma with adjusted HR 4.19 (95%CI: 1.10, 15.86) with p =0.035 in multivariable analysis. Tube malposition and occlusion were the most frequent adverse events at 11.11%, corneal decompensation at 5.5%, hypotony at 2% in the nonvalved group, and endophthalmitis at 0.69%. Conclusion Surgical success in refractory primary glaucoma was superior to secondary glaucoma with no difference between nonvalved and valved GDD implantation. Lens-induced glaucoma was a strong predictor for failure in GDD implantation.

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