Early adherence to treatment with a prostaglandin analogue is good, but patients prefer morning administration to evening administration. This may lead to greater adherence with morning administration, particularly among men. Adherence decreases from the first to second month after initiation of treatment. IOP response to this treatment is not significantly affected by morning versus evening administration.

Purpose: To develop an angle surgery training model for training an array of microincisional glaucoma surgery (MIGS) procedures. Methods: We describe a method for preparing an angle surgery training model using human cadaveric corneoscleral rims. The model provides realistic tactile tissue simulation and excellent angle visualization requiring bimanual technique. Corneoscleral rims may be used multiple times and are prepared at low cost, allowing for a high volume of practice surgeries. Results: This model allows for practice in bimanual surgical training using the gonioscopy lens for visualize alongside surgical tools. The in vivo surgical conditions and limited tactile feedback are recreated using human cadaveric eyes which nonhuman models fail to provide. Our model is prepared at low cost, with relative ease and also provides appropriate positioning of Schlemm canal and for high volume of practice as the canal can be used in 90-degree segments. Conclusions: Few angle surgery training models currently exist and none provide these necessary features. The model presented here aims to meet the growing demand for adequate training models required for technically advanced MIGS techniques.

We describe a method for eliciting an episcleral venous fluid wave (EVFW) in eyes presenting with reticular patterned episcleral venous plexus, after a hemi-gonioscopy assisted transluminal trabeculotomy (hemi-GATT). To reduce the risk of post-operative hyphema and reduce intraoperative tissue manipulation, a hemi-GATT (targeting 180-degrees of Schlemm’s canal) was performed. Post-hemi-GATT, the ability to inject balanced salt solution and obtain an EVFW in both the treated (inferior) and untreated (superior) sectors of the eye supports the surgical success of the technique, and demonstrates an enhanced fluid outflow and subsequent vessel blanching. The pre-operative intraocular pressure of 20/21 mmHg in a single subject decreased to 18-, 12- and 15-mmHg after one day, one month and 3 months post-op, respectively, and the subject was rendered medication-free. This method of performing a hemi-GATT to effectively obtain an EVFW provides evidence for novel treatment algorithms in patients with a reticular episcleral venous plexus where identification of major outflow vessels is less apparent.

No abstract