Pre-existing glaucoma or steroid-responsive ocular hypertension and race were the two factors that independently influenced relative risk of rejection after DSEK. Rejection risk was not increased if the fellow eye was grafted within the prior year with DSEK.

PURPOSE.To characterize the 24-hour pattern of intraocular pressure (IOP) in untreated ocular hypertensive (OHTN) patients.METHODS. IOP measurements were taken every 2 hours during a 24-hour period from 15 untreated OHTN patients (ages 41-77 years). Measurements were both sitting and supine (diurnal) and supine only (nocturnal). Mean diurnal and nocturnal IOPs in the OHTN group were compared to previously reported values in age-matched healthy and glaucomatous eyes. Post hoc analysis compared the 24-hour IOP pattern of the OHTN patients who converted to glaucoma and those who did not with that in the same healthy and glaucomatous eyes.RESULTS. Mean sitting and supine IOPs were significantly higher in the OHTN group than in the healthy control but not the glaucoma group. Similar to the glaucoma group, the OHTN group demonstrated significant differences from healthy controls in diurnal IOP variation and IOP changes upon awakening in habitual and supine positions. The 24-hour IOP curve acrophases and amplitudes for OHTNs were closer to those of the glaucoma than the healthy control group in the habitual position. Thirty-three percent of OHTNs developed glaucoma during a mean follow-up period of 4.3 6 3.8 years. Similar to findings in the glaucoma group, habitual IOP curve phase delay, habitual IOP variation, diurnal-to-nocturnal IOP changes, and IOP changes upon awakening of the converters were significantly different from those in healthy controls. There were no differences between nonconverters and other groups.CONCLUSIONS. Baseline 24-hour IOP pattern in OHTN patients is similar to that in glaucomatous patients. In contrast to nonconverters, OHTN patients who converted to glaucoma are significantly different from healthy controls. (Invest Ophthalmol Vis Sci. 2013;54:512-517)

Purpose To present and evaluate a new method of integrating event- and trend-based analyses of visual field progression in glaucoma. Design Observational cohort study Participants The study included 711 eyes of 357 glaucoma patients or suspects followed for an average of 5.0 ± 2.0 years with an average of 7.7 ± 2.3 standard automated perimetry visual fields. An additional group of 55 eyes of 55 glaucoma patients had repeated tests over a short-period of time to test the specificity of the method. Methods Event-based analysis of progression was performed using the Guided Progression Analysis (GPA). Trend-based assessment used the Visual Field Index (VFI). A hierarchical Bayesian model was built to incorporate results from the GPA in the prior distribution for the VFI slopes, allowing the event-based method to influence the inferences made for the trend-based assessment. Main Outcome Measures The Bayesian method was compared to the conventional ordinary least squares (OLS) regression method of trend-based assessment. Results From the 711 eyes followed over time, 64 (9%) had confirmed progression with GPA. Bayesian slopes of VFI change were able to detect 63 of these eyes (98%). An additional group of 49 eyes (7%) had progression by Bayesian slopes but not by GPA. Slopes of VFI change calculated by the OLS method were able to identify only 32 (50%) of the 64 eyes with GPA progression. The agreement with GPA was significantly better for the Bayesian compared to the OLS method (kappa of 0.68 vs. 0.43, respectively; P<0.001). Eyes progressing only by the Bayesian method had faster rates of change than those progressing only by the OLS method. When applied to the 55 eyes in the stable glaucoma group, both the Bayesian and the OLS methods had a specificity of 96%. Conclusion A Bayesian hierarchical modeling approach for integrating event- and trend-based assessments of visual field progression performed better than either method used alone. Estimates of rates of change obtained from the Bayesian model had increased precision and may be superior to the conventional OLS method for providing information on the risk of development of functional impairment in the disease.

Tissue resection length and phenylephrine response play small roles relative to pre-operative MRD in the determination of change in MRD with MMCR surgery.