Patients with OSA demonstrated significant 24-hour IOP fluctuations, with the highest values at night. CPAP therapy causes an additional IOP increase, especially at night. Regular screening of visual fields and the optic disc is warranted for all patients with OSA, especially those treated with CPAP.

Purpose To determine the incidence of clinically significant pseudophakic cystoid macular edema (CSPME) after phacoemulsification using the ‘bag-in-the-lens’ lens (BIL) implantation technique and to examine the influence of associated risk factors for clinically significant pseudophakic macular edema (CSPME), both ocular and systemic. Methods This retrospective study included 2419 first-operated eyes of 2419 adults who underwent phacoemulsification cataract surgery using the BIL implantation technique between January 2013 and December 2018 in the Antwerp University Hospital, Belgium. The significance of several risk factors (age, gender, previous history, intra- and postoperative complications) was examined by extraction of electronic medical files. Results The 3-month incidence of CSPME in the subgroup without risk factors was 0.00% (95% CI: 0.00 –NA). The 3-month incidence of CSPME in the subgroup with risk factors was 0.57% (95% CI 0.22–1.29%). The 3-month incidence of CSPME in the total population of 2419 patients was 0.29% (95% CI: 0.11–0.65%). The risk factors most significantly associated with CSPME included renal insufficiency (hazard ration [HR]: 5.42; 95% CI: 1.69–17.44; P = .014), exudative age-related macular degeneration (HR: 74.50, 95% CI: 25.75–215.6; P < .001) and retinal vein occlusion (HR: 22.48, 95% CI: 4.55–111.02; P = .005). Conclusions In the absence of risk factors, the incidence of CSPME was zero. We can conclude that Primary Posterior Continuous Curvilinear Capsulorhexis (PPCCC) does not increase the risk for CSPME. Non-inferiority of the BIL implantation regarding the development of CSPME, relative to the traditional ‘lens-in-the-bag’ (LIB) implantation, confirms that BIL is a safe surgical technique. This study also illustrates a previously undescribed risk factor for developing CSPME, namely renal insufficiency.

Glaucomatous disease may progress despite adequate intra ocular pressure (IOP) control. Large population based studies have shown that low ocular perfusion pressure (OPP) is a risk factor for glaucoma prevalence, incidence and progression. OPP can be calculated as the difference between arterial pressure and IOP. Obstructive sleep apnea (OSA) is a systemic condition associated with many eye conditions such as glaucoma. Its systemic implications are modifiable with Continuous positive airway pressure therapy (CPAP). In a population of OSA patients the increase in overnight IOP raise was significantly higher during CPAP therapy. The accompanied dip in nocturnal blood pressure results in a decreased ocular perfusion pressure. Moreover the auto regulatory mechanisms that need to compensate for perfusion pressure changes are affected in OSA by metabolic stresses, hypoxia and hypercapnea. Thus a higher glaucoma prevalence in OSA can be explained by the combination of an increased overnight IOP, decreased OPP and abnormal auto regulatory mechanisms that make the optic nerve more vulnerable for ischemic events.

Purpose To investigate whether cerebrospinal fluid (CSF) pressure and trans‐lamina cribrosa pressure gradient play a role in the pathogenesis of glaucoma. Our hypothesis is that a low cerebrospinal fluid (CSF) pressure may be correlated with the presence of glaucoma. The first objective is to investigate whether the CSF pressure in Alzheimer’s disease (AD) patients with glaucoma is lower than in AD patients without glaucoma. The second goal is to evaluate an animal model with AD for the incidence and prevalence of glaucoma. If glaucoma is present histopathological analysis will be performed on retina and optic nerve, to search for Alzheimer‐type changes. Methods Newly diagnosed AD suspects will undergo a lumbar puncture with CSF manometry, during neurological work‐up. Ophthalmological evaluation consists of best corrected visual acuity, slit lamp biomicroscopy, gonioscopy, fundoscopy and pachymetry. Diagnosis of glaucoma or ocular hypertension will be made on the basis of visual field examination, optic disc evaluation and IOP measurement. Correlation between CSF pressure, trans lamina cribrosa pressure gradient and the presence of glaucoma will be calculated. The prevalence of low tension glaucoma will be compared to the prevalence of chronic open angle glaucoma with elevated IOP. In the second part of the project a genetically modified strain of mice with AD will be examined and screened for the development of glaucoma. Opthalmological examination will consist of IOP measurement, corneal pachymetry, optic disc evaluation and visual evoked potentials with flash. Histopathological analysis will be performed by the team of Prof De Deyn PP. Results will follow Conclusion will follow

Purpose. We describe a modified trabeculectomy technique in which the iris is used to prevent fibrosis of the scleral flap. Material and Methods. A retrospective case series of patients with medically uncontrolled open angle glaucoma underwent trabeculectomy. Instead of performing a classical iridectomy, the iris was used as spacer underneath the scleral flap. Postoperative management was identical to classical trabeculectomy, with suture removal and needling if necessary. Five of the patients underwent simultaneous phacoemulsification through a separate temporal corneal incision. Patients should have two-year follow-up. Results. Data of ten patients were analysed, two had a previous failed trabeculectomy, two had LTP, and one had a corneal transplantation. In 3 patients MMC 0,1 mg/mL was used. After one and two years mean IOP was, respectively, 13,1 and 12,1 mmHg. IOP ≤ 16 mmHg was reached in 90% of patients without pressure lowering medication. No major complications were seen; no abnormal inflammatory reaction and no deformation or dislocation of the pupil occurred. Conclusion. By using the iris from the iridectomy as spacer under the scleral flap, fibrosis of the scleral flap is no longer possible. This iridenflip trabeculectomy technique gives an excellent complete success rate (IOP ≤ 16 mmHg) of 90%. A larger study is currently being done.