Purpose To compare the effects of guided and non-guided Ahmed glaucoma valve (AGV) implantation on the corneal endothelium. Methods Medical records of patients who underwent AGV implantation in the anterior chamber (AC) were reviewed retrospectively. The eyes were divided into two groups depending on the use of a guidance technique with spatula and a 4–0 nylon intraluminal stent. Specular microscopy was performed to measure corneal endothelial cell density (ECD) loss after surgery, and the rate of ECD change was calculated. Tube parameters were measured using anterior segment optical coherence tomography (AS-OCT). Results The ECD loss during 2 years of follow-up was significantly lower in the guided AGV implantation (gAGV) group than in the non-guided implantation (ngAGV) group, and the rate of ECD change was -0.62 ± 1.23 and -1.42 ± 1.57%/month in the gAGV and ngAGV groups, respectively (p = 0.003). The mean tube–cornea distance (TCD) and mean tube–cornea angle (TCA) were significantly greater in the gAGV group than in the ngAGV group. The frequency of tube repositioning within 2 years after surgery was 0% in the gAGV group and 12.66% in the ngAGV group (p = 0.005). Conclusions The use of a guidance technique can reduce corneal endothelial loss during the first 2 years after AGV implantation in the AC. The tube was positioned at a more distant and wider angle from the cornea in the eyes of the gAGV group, which may have contributed to the reduced need for tube repositioning to prevent corneal decompensation.

Purpose:To evaluate the effect of panretinal photocoagulation and additive intravitreal bevacizumab injections on central retinal vessel diameters and characteristic retinal vascular caliber changes in diabetic retinopathy. Methods: Changes in central retinal vessel diameters were retrospectively analyzed before and 6 months after panretinal photocoagulation with or without additive intravitreal bevacizumab injections in 64 eyes first diagnosed with diabetic retinopathy. Vessel diameters and arteriovenous ratio (AVR) were measured using Interactive Vessel Analysis (IVAN) software and the Big six formula. Results: There were significant decreases in central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) in both groups, with and without additive intravitreal bevacizumab injections, 6 months after completion of panretinal photocoagulation (p < 0.001, p = 0.008), but no significant change in AVR (p = 0.338). Additive intravitreal bevacizumab injections did not produce significant changes in central retinal vessel diameters after 6 months compared to vessel diameters treated with panretinal photocoagulation only. Retinal vascular caliber of progressed diabetic retinopathy showed smaller CRAE, larger CRVE, and smaller AVR compared to those of normal or diabetic Korean subjects in a previous study and showed no significant association with age. Conclusions: CRAE and CRVE decreased significantly 6 months after panretinal photocoagulation in diabetic retinopathy, but additive intravitreal bevacizumab injections did not cause significant additive changes to central retinal vascular calibers in this study. We established the standard retinal vascular caliber of Korean subjects in diabetic retinopathy and analyzed the effects of retinopathy on retinal vessel caliber. J Korean Ophthalmol Soc 2016;57(6):917-923

Purpose: In the present study, a case of diffuse lamellar keratitis after trabeculectomy in a patient who had received laser in situ keratomileusis many years prior is reported. Case summary: A 54-year-old male diagnosed with binocular primary open-angle glaucoma underwent trabeculectomy in the left eye because of poor intraocular pressure control and visual field defect progression even with maximal medical treatments. Faint, non-progressing subepithelial opacities pre-existed in the left cornea but no treatment was administered. The patient had a history of laser in situ keratomileusis in both eyes 12 years prior. On the first postoperative day, conjunctival buttonhole was found and because leaking from the hole continued, topical steroid was discontinued on the fourth postoperative day. On the seventh postoperative day, diffuse lamellar keratitis developed on the central cornea without intraocular pressure elevation, and diffuse infiltration under the corneal flap was observed in the anterior segment on optical coherence tomography. The patient was treated with topical steroid eye drops every 3 hours for the first 2 days and the frequency was increased to every hour because the keratitis did not improve. On the ninth postoperative day, keratitis began to improve and 2 months postoperatively, subepithelial lamellar infiltration improved significantly but did not show complete remission. Conclusions: Diffuse lamellar keratitis can develop in an eye with laser in situ keratomileusis after trabeculectomy if appropriate treatment with topical steroid eye drops is not administered. J Korean Ophthalmol Soc 2017;58(1):87-92