Michael M. Lin

Purpose To compare the structure-function correlations between optical coherence tomography (OCT) thickness parameters and the corresponding sectorial mean sensitivity (MS) values obtained with IMO visual function analyser (IMOvifa) and Humphrey field analyser (HFA) perimeters. Design Prospective cross-sectional study. Methods Glaucoma suspect, glaucoma and ocular hypertension patients underwent IMOvifa 24-2 Ambient Interactive Zippy Estimated Sequential Testing, HFA 24-2 Swedish Interactive Threshold Algorithm-Standard and OCT tests within 12 weeks. Based on the Garway-Heath map, the sensitivity points were divided in corresponding OCT peripapillary retinal nerve fibre layer (pRNFL) sectors, and also the central 10° points in corresponding ganglion cell–inner plexiform layer thickness over the macula. The structure-function correlations were analysed by Spearman’s rank coefficient and compared by Steiger’s test. Results 57 eyes of 57 patients (mean age 59.2 years, 61.4% female) with reliable field and adequate OCT strength were included in this analysis. IMOvifa had significantly shorter testing time (3.7 vs 5.3 mins), lower mean deviation (difference −0.6 dB) and greater visual field index (difference +1.0%) compared with HFA (pConclusions The IMOvifa test took less time and resulted in slightly less severe defects than HFA. MS in all sectors was moderately to strongly correlated. Function-structure correlations were similar when using either perimeter.

This report highlights the first known report of an intraocular eyelash embedded in the inferior midperipheral iris following a routine cataract surgery. A 74‐year‐old female presented 5 months postoperatively from a full‐thickness macular hole repair with a 3+ nuclear sclerotic cataract. She underwent an uneventful left eye cataract extraction with insertion of posterior chamber intraocular lens (PCIOL). Review of surgical video revealed well‐draped eyelashes and no introduction of an eyelash into the anterior chamber at any point during surgery. The first postoperative visit was notable for no foreign bodies and centered PCIOL. Then, 1 week postoperatively, the anterior segment examination revealed a linear foreign body embedded in the inferior midperipheral iris, without corneal endothelium touch. The foreign body was removed in the operating room and revealed to be an eyelash by pathology. The patient’s visual acuity during her first two postoperative visits was 20/30 and improved to 20/20 with refraction at her 1‐month postoperative visit. There was minimal postoperative inflammation and no evidence of endophthalmitis. To prevent introduction of an intraocular eyelash associated with cataract surgery, appropriate measures intraoperatively and postoperatively should be taken, including meticulous draping of the eyelashes and lids, diligent corneal wound hydration, and clear patient education.

Précis: This retrospective case series of patients with open angle glaucoma and prior trabeculectomy or tube shunt surgery found that selective laser trabeculoplasty (SLT) resulted in significant intraocular pressure (IOP) reductions in the intermediate follow-up period in select cases. Purpose: The purpose of this study was to assess the IOP-lowering effect and tolerability of SLT after prior trabeculectomy or tube shunt surgery. Materials and Methods: Open angle glaucoma patients at Wills Eye Hospital who previously underwent incisional glaucoma surgery and subsequently received SLT between 2013 and 2018 were included, along with an age-matched control group. Baseline characteristics, procedural data, and post-SLT data were recorded at 1, 3, 6, 12 months, and most recent visit. The primary success of SLT treatment was defined as IOP reduction of 20% or greater without the use of additional glaucoma medications compared to pre-SLT IOP. Secondary success was defined as IOP reduction ≥20% with the use of additional glaucoma medications compared to pre-SLT IOP. Results: There were 45 eyes in the study group and 45 eyes in the control group. In the study group, IOP decreased from a baseline of 19.5±4.7 mm Hg on 2.2±1.2 medications to 16.7±5.2 mm Hg (P=0.002) on 2.2±1.1 glaucoma medications (P=0.57). In the control group, IOP decreased from 19.5±4.2 mm Hg on 2.4±1.0 medications to 16.4±5.2 mm Hg (P=0.003) on 2.1±1.3 medications (P=0.36). There was no difference in IOP reduction or change in number of glaucoma medications after SLT at any postoperative visit between the 2 groups (P≥0.12 for all). Primary success rates at 12 months were 24.4% for the control group and 26.7% for the prior incisional glaucoma surgery group with no significant difference between the groups (P=0.92). There were no persistent complications after SLT treatment in either group. Conclusion: SLT may effectively lower IOP in patients with open angle glaucoma who have had previous incisional glaucoma surgery and should be considered in select cases.