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Objective To evaluate the effect of ab-interno goniotrabeculotomy (AIGT) on the intraocular pressure (IOP) in adult patients with primary open-angle glaucoma (POAG), compared with the effects of mitomycin C trabeculectomy (MT). Design Prospective, randomized, clinical trial. Participants Thirty-two eyes of 32 patients with medically uncontrolled POAG. Intervention Standard limbus-based trabeculectomy with adjunct mitomycin C (0.3 mg/mL for 3 minutes) in 16 eyes of 16 patients; AIGT was performed in 16 eyes of 16 patients. The groups were matched for age, preoperative IOP, duration of preoperative antiglaucoma treatment, use of preoperative beta-blockers and parasympathomimetics, and use of beta-blockers in the fellow eye. The IOP (average of the two highest values measured in the diurnal curve, from 8 am to 6 pm, every 2 hours) and complications were recorded 1, 3, 6, 12, 18, and 24 months after surgery. Main outcome measures Identification of complications and IOP. Results All patients were followed up for 24 months. More postoperative complications occurred in the MT group during the 2-year follow-up. One month after surgery, IOP was 10 ± 1.46 mmHg (range, 8–13) in the MT group and 12.12 ± 1.63 mmHg (range, 8–14) in the AIGT group (Student's t test, P = 0.001). Three months after surgery, IOP was 11.5 ± 1.59 mmHg (range, 8–14) and 12.75 ± 1.57 mmHg (range, 10–16) in the MT and AIGT groups, respectively (Student's t test, P = 0.033). From the 6th to the 24th postoperative month, no statistically significant difference in IOP was found between the two groups. At the end of follow-up, 14 of 16 eyes (87.5%) of the AIGT group and 13 of the 16 eyes (81.25%) of the MT group showed an IOP ≤14 mmHg. Conclusion Ab-interno goniotrabeculotomy appears to be a viable and safe surgical treatment for adult POAG. More extended follow-up, however, and a larger series of patients are needed to ascertain the actual effectiveness of this procedure in adult POAG.

Purpose: Color Doppler imaging (CDI) is a relatively new technique that allows quantification of blood flow velocity in orbital and ocular vasculature. Despite the numerous clinical studies that have used CDI, repeatability of this technique and agreement between observers have not been documented. Methods: The authors performed a prospective investigation of the repeatability and agreement between observers on ophthalmic artery blood flow velocity measurements in 35 patients (35 eyes). Results: Results on the estimated error of measurement (variability between repeated readings on the same subject) indicate good repeatability of the measurements; in fact, the measurement variances were only 5.6% for the peak systolic velocity, 11.4% for the end diastolic velocity, and 6.2% for the mean envelope velocity. The statistical analysis of repeatability showed a very narrow 95% confidence interval for both observers. The measurement of agreement between the two observers demonstrated the existence of a good concordance of the measurements taken by each observer on each subject. Conclusions: Results suggest that CDI is a reliable tool for quantitative assessment of ophthalmic artery blood flow velocity.

Purpose/Methods A 35-year-old woman, who had undergone an uncomplicated Scopinarotype biliopancreatic bypass for obesity nine years previously, was examined because of severe bilateral corneoconjunctival xerosis and markedly decreased vision. One month earlier she had had a bout of nonspecific enteritis. She was treated with intramuscular vitamin A. Results/Discussion After one month of therapy, the ocular xerosis had cleared completely and her vision had returned to normal. This case suggests that this kind of operation can cause instability of vitamin A absorption.