Bleb appearance after XEN surgery seems to be different to classic trabeculectomy literature. The present data suggest correlation of IOP and surgical long-term success with bleb morphology in AS-OCT. Prevalence of small diffuse cysts is directly associated with lower IOPs, while cystic encapsulation at 3 months predicts higher surgical failure.

Purpose: The outer stent lumen can be located either deeper (in or under Tenon's layer) or more superficially in the conjunctival stroma after the transscleral XEN Glaucoma Gel Microstent (XEN-GGM; Allergan Plc., USA) implantation. The present study aimed to investigate the effect of the postoperative conjunctival implant position on surgical success and intraocular pressure (IOP) after XEN-GGM. Methods: Prospective data from 66 consecutive open-angle glaucoma eyes of 54 patients were collected preoperatively and 1 and 2 weeks, and 1, 6 and 12 months postoperatively. The layer of implantation was determined in the first month postoperatively as intra-and subtenon or intraconjunctival depending on the location of the outer lumen of the stent in OCT (Visante OCT; Zeiss, Germany). Primary outcome measures were differences in relative IOP reduction at 12 months between the two groups. Further, complete and qualified surgical success, number of secondary needlings and number of IOP-lowering medications and absolute IOP were assessed. Results: Relative IOP reduction was higher in intra-and subtenon group (n = 37/ 66, 56%) at week 1 (À54% versus À19%, p < 0.001), week 2 (À39% versus À21%, p = 0.02), month 1 (À42% versus À28%, p = 0.035) and month 12 (À39% versus À24%, p = 0.024). The mean absolute IOP was lower in intra-and subtenon group at week 1 (10.8 [95%CI,.0] mmHg, p < 0.001) and months 12 (13.9 [95%CI,] mmHg, p = 0.041). At month 6, a lower burden for IOP-lowering medication was shown for the intra-and subtenon group (0.2 AE 0.5 versus 1.0 AE 1.1, p = 0.034). The mean number of secondary needlings, which were done in 47/66 (71%) of the eyes, was lower in the intra-and subtenon group in the first year (1.9 AE 1.7 versus 1.2 AE 1.2, p = 0.03). Qualified surgical success was higher in the intra-and subtenon group (90% versus 61%, p = 0.01) after 1 year. Conclusion: The present study demonstrates a higher efficacy achieved with lower secondary needling rates in deeper implant positions in conjunctiva after XEN-GGM.

PURPOSE. Femtosecond laser-assisted cataract surgery (FLACS) is an increasingly common procedure. Most laser systems require corneal applanation and thereby increase intraocular pressure (IOP). The purpose of the present study was to evaluate the IOP changes that occur during the FLACS procedure performed using the Catalys femtosecond laser system. METHODS. IOP was measured by direct cannulation of the vitreous body of porcine cadaver eyes (N ¼ 20). By inserting a second cannula connected to a water column, all the eyes were set to a baseline IOP of 20 mm Hg. The eyes were lifted by custom-made stands to achieve the appropriate height and position under the Catalys system. The standard FLACS procedure was performed using varying fragmentation times to assess the influence of tissue fragmentation times on IOP peaks. RESULTS.We identified significant IOP elevations from baseline IOP levels during all steps of the FLACS procedure (baseline: 20.28 6 1.32 mm Hg; vacuum: 34.48 6 4.21 mm Hg; capture: 47.90 6 13.02 mm Hg; lock: 48.41 6 9.04 mm Hg; analysis: 47.15 6 5.97 mm Hg; capsulotomy: 45.74 6 6.52 mm Hg; fragmentation: 48.41 6 6.80 mm Hg; end: 17.81 6 1.61 mm Hg; all P < 0.001). Furthermore, the tissue fragmentation time had a significant effect on the peak IOP values detected (R ¼ 0.62, P ¼ 0.04, n ¼ 9).CONCLUSIONS. The present study reveals significant IOP increases during FLACS procedures carried out using the Catalys system.

In the present study, a 6-week treatment with LT or BT was equally effective in reducing IOP. In addition, none of the administered drugs induced a significant effect on ocular blood flow parameters.