Darrell WuDunn

To determine the efficacy and safety of surgical drainage of choroidal effusions that occurs following glaucoma surgical procedures. Ninety-four choroidal drainage procedures performed at a single institution from 1986 to 2001 were reviewed retrospectively. Sixty-three eyes of 63 persons who underwent one or more drainage procedures for choroidal effusions that developed following glaucoma surgical procedures were identified. Eyes diagnosed with suprachoroidal hemorrhage prior to intervention were excluded. The cases were evaluated for resolution of choroidal detachment, post-drainage complications, visual acuity, and intraocular pressure before and after drainage. Indications for choroidal drainage included flat anterior chamber (25 eyes), decreased vision (22 eyes), and persistent choroidal detachment (16 eyes). Complete resolution of choroidal effusions was achieved in 37 (59%) eyes by 1 month, 51 (81%) eyes by 2 months, and in 57 (90%) eyes by 4 months following the initial drainage procedure. Overall success rate per procedure at 12 months was 77% (60/78). Compared with pre-drainage, intraocular pressure was higher at 6 and 12 months post-drainage (P < 0.0001) and visual acuity was better at 6 and 12 months post-drainage (logMAR, P < 0.0001). Twenty-seven (77%) of 35 phakic eyes developed cataracts during the 12 months post-drainage. Choroidal effusions that develop after glaucoma surgery can usually be drained with minimal complications. Surgical drainage is associated with improved vision and resolution of hypotony. Cataracts may progress following choroidal drainage but this may be due to the pre-drainage hypotony conditions.

The application of molecular genetic techniques to the study of glaucoma has accelerated greatly during the past few years. In addition to localizing and identifying genes for specific types of glaucoma, researchers have begun to characterize the gene products and investigate molecular mechanisms involved in glaucoma. Much research has been focused on the gene expression, protein processing, and mutations of MYOC/TIGR, which is associated with both juvenile-and adult-onset primary open angle glaucoma. Investigations of other glaucoma-related genes, such as PITX2, FOXC1, and CYP1B1, are enabling a better understanding of anterior segment development and its relation to glaucoma.

Purpose. To evaluate the effects of mechanical stretching of trabecular meshwork cells on matrix metalloproteinase activity. Methods. Cultured bovine trabecular meshwork cells grown on collagen-coa...