While lasers have been used for many years for the treatment of glaucoma, proper indications and use of the procedures need to be considered before their application. This review summarizes the important laser procedures in Glaucoma.

Purpose: This study aimed to assess details of therapy required to achieve an intraocular pressure (IOP) of ⩽12 mmHg in patients with severe glaucoma of different etiologies. Methods: Patients with a follow-up of at least 1 year, who fulfilled inclusion criteria were selected, and data analyzed with respect to baseline IOP, number of medications, and/or surgeries required to achieve an IOP of ⩽12 mmHg and ⩾6 mmHg. Final IOP, visual field status and medications/surgery required were noted. Results: About 127 eyes of 85 patients met all criteria. There were 48 eyes having primary angle closure glaucoma (PACG), 16 eyes with primary open angle glaucoma (POAG), 17 eyes of juvenile open angle glaucoma (JOAG), and 46 eyes of secondary glaucoma. The mean baseline IOP was 33.14 ± 11.07 mmHg and final IOP 10.25 ± 1.81 mmHg. In the age group >40 years, 29.63% of patients were controlled on medication as compared to 9.09% and 5.71% in the age group of <20 years and 20–40 years ( p = 0.007). With a baseline IOP of <25 mmHg, 48.65% required a trabeculectomy, whereas for 25–30, and >30 mmHg, 62.5% and 97.29% respectively, required surgery ( p < 0.001).66.67% of patients having mean deviation of −12 to −16 dB (decibels) on Humphrey field analyzer (HFA) underwent surgery to achieve target IOP in comparison to 83.52% who had mean deviation greater than −16 dB ( p = 0.036). Conclusion: Only 21.26% of severe glaucoma eyes could be controlled on medications alone. A baseline IOP of >25 mmHg, age <40 years and mean deviation worse than −16 dB, had a higher frequency of trabeculectomies to achieve an IOP of ⩽12 mmHg.

No abstract

Purpose: To describe the demographics and clinical profile of pigment dispersion syndrome (PDS) in patients presenting to a multi-tier ophthalmology hospital network in India. Methods: This cross-sectional hospital-based study included 2,961,706 new patients presenting between August 2010 and September 2021. Patients with a clinical diagnosis of PDS in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 403 (0.014%) patients were diagnosed with PDS. Three fourth of the patients were male (75.43%) and 91.81% had bilateral affliction. The most common age group at presentation was during the fourth decade of life with 100 (24.81%) patients. In the 773 eyes, 443 (57.31%) eyes had mild or no visual impairment (<20/70) and blindness (>20/400) in 81 (10.48%) eyes. Krukenberg spindle was seen in 445 (57.57%) eyes and iris transillumination defects in 33 (4.27%) eyes. About a third of the eyes, 241 (31.18%) eyes had an intraocular pressure >21 mm of Hg at presentation. 328 (42.43%) eyes were on more than one anti-glaucoma medication. YAG peripheral iridotomy was documented in 100 (12.94%) eyes. In the 46 (5.95%) eyes that required a glaucoma related surgical intervention, combined surgery was performed in 30 (3.88%) eyes and trabeculectomy in 16 (2.07%) eyes. Conclusion: PDS is more common in males presenting during the fourth decade of life and is predominantly bilateral. A third of the eyes have raised intraocular pressure and a tenth of them are affected with blindness at presentation.

Most cases of refractory glaucoma not amenable to filtration surgery or glaucoma drainage device are managed by cyclodestructive procedures. An 84-year-old female had undergone oculus sinister (OS) transscleral cyclophotocoagulation (TSCPC) after a diagnosis of OS closed angle stage of neovascular glaucoma was made. On the 1st week post-TSCPC, discharge on the conjunctival surface was noted along with a 6 mm hypopyon in the anterior chamber and associated vitritis. Treatment on the lines of fungal endophthalmitis was initiated. At 1 month review, the reaction had reduced significantly. Cases with significant reaction and vitritis post-TSCPC must be treated aggressively on the lines of endophthalmitis to salvage the globe. A rather safe approach to the management of such cases, TSCPC does have rare complications such as inadvertent sclerostomy or panophthalmitis, being reported as isolated case reports. To the best of our knowledge, this is the first case of fungal endophthalmitis being reported post-TSCPC.