No abstract

Trabectome surgery is safe and effective for Japanese patients whose target IOP is 18 mmHg or above. However, it is necessary to carefully consider Trabectome surgery for advanced POAG cases.

Purpose: The purpose of this study was to evaluate the influence of trabectome surgery on corneal endothelial cells by site. Methods: Retrospective observational study. Trabectome surgeries were performed on 159 eyes of 132 adult Japanese patients. Corneal endothelial cells were measured at the center (C), inferior (I), nasal inferior (NI), nasal superior (NS), superior (S), temporal superior (TS), and temporal inferior (TI) sectors at <1 month preoperatively and 3, 6, 12, 24, and 36 months postoperatively, for changes in corneal endothelial cell density (ECD), coefficient of variation (CV), and incidence of hexagonal cells (6A). Results: Mean preoperative ECD in all groups were 2401±451 (SD)  cells/mm2 (C), 2366±450 cells/mm2 (I), 2397±479 cells/mm2 (NI), 2476±554 cells/mm2 (NS), 2493±596 cells/mm2 (S), 2464±558 cells/mm2 (TS), and 2329±510 cells/mm2 (TI). The 12-month postoperative mean ECDs were 2344±480 cells/mm2 (C), 2312±469 cells/mm2 (I), 2325±536 cells/mm2 (NI), 2473±517 cells/mm2 (NS), 2438±607 cells/mm2 (S), 2227±578 cells/mm2 (TS), and 2193±523 cells/mm2 (TI). There was no change in ECD in all sectors before and after surgery. ECD decreased at the TS and TI in combination with cataract surgery (2620±430 and 2445±384 cells/mm2) preoperatively to 2264±501 and 2216±477 cells/mm2 at 12 months postoperatively. CV and 6A did not change at all sites in all surgical procedures before and after surgery. Conclusions: Trabectome surgery involves minimal effects to corneal endothelial cells, although long-term prospective studies with greater sample sizes are necessary to confirm this conclusion.

No abstract

The aim of this cross-sectional study was to evaluate the results of a visual field (VF) test for patients with glaucoma and pseudo-fixation loss. These patients exhibit fixation loss (FL) rates >20% with the Humphrey Field Analyzer (HFA); however, actual fixation stabilizes when a head-mounted perimeter (imo) is used. This device is able to adjust the stimulus presentation point by tracking eye movements. We subjected 54 eyes of 54 patients with glaucoma and pseudo-FL to the HFA 30–2 or 24–2 Swedish Interactive Threshold Algorithm -Standard protocol. All patients also underwent the imo 30–2 or 24–2 Ambient Interactive Zipper Estimated Sequential Testing protocol after HFA measurement. We compared HFA and imo reliability indices [including false-positive (FP) responses, false-negative (FN) responses, and FL rate], global indices [including mean deviation (MD), visual field index (VFI), and pattern standard deviation (PSD)], and retinal sensitivity for each test point. There were no significant differences in MD, VFI, and PSD between HFA and imo, and these measures were strongly correlated (r > 0.96, p < 0.01). There were no significant differences in FP and FN between both devices, while FL measured with HFA (27.5%) was significantly reduced when measured with imo (13.2%) (p < 0.01). There was no correlation in FL and FN between both devices, and a weak correlation for FP (r = 0.29, p = 0.04). At each test point, retinal sensitivity averaged 1.7 dB higher with HFA, compared with imo (p < 0.01). There was no significant variability in global indices in patients with pseudo-FL. The FP response rate might have influenced measures of FL in patients with glaucoma and pseudo-FL.