ABSTRACT.Purpose: To study the complications of Neodymium:YAG (Nd:YAG) goniopuncture after deep sclerectomy with collagen implant (DSCI). Methods: All patients who underwent a Nd:YAG goniopuncture after a successful DSCI for primary open-angle glaucoma were included in a nonrandomized clinical study. Results: Nd:YAG goniopuncture was performed in 31 patients. The mean time from surgery to goniopuncture was 3.2 AE 3.2 months. The mean intraocular pressure (IOP) before goniopuncture was 32.0 AE 10.8 mmHg (SD); the mean IOP 1-2 hours after goniopuncture was 16.5 AE 6.3 mmHg. After a mean followup of 5.4 AE 2.8 months, the mean IOP was 17.8 AE 11.6 mmHg. Three patients had a spontaneous iris prolapse after Nd:YAG goniopuncture and consequently high IOP. No signs of severe hypotension were observed. Conclusion: There are potentially serious complications relating to Nd:YAG goniopuncture after deep sclerectomy. However, further studies are needed to determine the safest time and level of IOP at which to perform Nd:YAG goniopuncture.

ABSTRACT.Purpose: To study colour vision and retinal nerve fibre layer (RNFL) photographs in patients with an Acrysof Ò Natural intraocular lens (IOL). Methods: We carried out a randomized double-blind study. An Acrysof Ò Natural IOL (model SN60AT) was implanted in 25 eyes of 19 patients and an Acrysof Ò IOL (model SA60AT) was implanted in 27 eyes of 18 control patients. The patients returned for colour vision tests and fundus photography 1-6 months after the surgery. Results: Standard pseudoisochromatic plates, part 2, were correctly interpreted and the Farnsworth-Munsell 100-hue test (FM 100) total and individual box scores were normal in all IOL eyes. In the FM 100 hue test there were no significant differences in the results of the total error scores or the error scores of the individual boxes between the eyes with Acrysof Ò Natural and those with Acrysof Ò lenses. The yellow coloration of the Acrysof Ò Natural IOL did not affect the visibility of the RNFL in photographs. Conclusions: The Acrysof Ò Natural IOL did not affect colour vision in the tested patients, even in the blue region of the spectrum, and can be implanted in patients who need to have normal colour vision for the purposes of their occupation. The Acrysof Ò Natural IOL does not interfere with RNFL photography and can also be used in patients with glaucoma.

. Purpose:  Tilted disc syndrome is a congenital anomaly of the eye characterized by mostly upper temporal visual field defects. The aim of the present study was to evaluate the effect of gradual myopic correction in the improvement of visual field defects associated with tilted disc syndrome. Methods:  The visual field was examined in 38 eyes of 24 patients using standard Goldmann perimetry. The isoptres IV‐4e, I‐4e, I‐3e and I‐2e were plotted. The defective isoptres were tested again with gradually increasing myopic correction until no further change was noted. Results:  The most common type of defect was a relative upper temporal defect (19 eyes). Temporal relative defects were found in five eyes, upper altitudinal field defects in six eyes, an enlarged blind spot in four eyes, and an inferior field defect in one eye. The visual field defect partly or totally disappeared with increased myopic correction in 18 (50%) eyes. The mean improvement was 17.0 ± 6.2 degrees and the mean additional myopic correction was 3.1 ± 1.5 D. Conclusions:  Even a small change in near correction during visual field examination may imply worsened or improved visual field defects in tilted disc syndrome. To prevent a false interpretation of field deterioration in a patient with tilted disc syndrome and glaucoma, visual field assessment should include examination with the myopic correction that provides the maximal improvement of the defective visual field.

Both latanoprost and brimonidine reduced intraocular pressure in patients with glaucoma or ocular hypertension after 6 months of treatment. However, latanoprost once daily was significantly more effective than brimonidine twice daily in reducing mean diurnal intraocular pressure. Latanoprost was better tolerated with less frequently occurring ocular allergy and systemic side effects.

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