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Glaucoma drainage devices are invaluable in the management of secondary/ refractory glaucomas. This study aimed to compare the efficacy and safety of Aurolab Aqueous Drainage Implant (AADI) and the Ahmed Glaucoma Valve (AGV) in filtration-surgery-naïve secondary glaucoma eyes. For this purpose, a retrospective, comparative review was conducted on patients with secondary glaucoma (open and closed) who underwent primary tube procedures, either AADI or AGV. The primary outcome measure was intraocular pressure (IOP), and secondary measures included best-corrected visual acuity (BCVA), number of antiglaucoma medications (AGMs), and complications. This study included 59 eyes in the AADI group with a mean follow-up of 20.3 ± 12.9 months and 61 eyes in the AGV group with a mean follow-up of 19.8 ± 11.8 months. Preoperative IOP, AGM use, and BCVA did not significantly differ between the groups. However, at the last visit, both IOP and AGM use were significantly lower in the AADI group (12.9 ± 3.7 mmHg and 0.6 ± 0.9 vs. 15.7 ± 2.7 and 1.8 ± 1.0 respectively, all p < .001). Moreover, the AADI group exhibited a significantly higher rate of complete success (57.6%) compared to the AGV group (14.7%, p < .001); corresponding qualified success was 91.5% and 80.3%. Serious complication rates were comparable between the two groups. In conclusion, toth AADI and AGV procedures effectively reduced IOP and the need for AGMs. However, the reductions were significantly greater in the AADI group, which also showed a higher rate of complete success. Considering its affordability, AADI could have a substantial positive impact, particularly in resource-constrained settings., (Copyright © 2024 Indian Journal of Ophthalmology.)

Purpose: To investigate the efficacy and safety of endocycloplasty (ECPL) versus trabeculectomy when it is combined with phacotrabeculectomy in medically controlled or uncontrolled primary angle-closure (PAC) or primary angle-closure glaucoma (PACG) after laser peripheral iridotomy (LPI)., Design: Prospective, interventional, randomized control trial., Participants: Subjects with PAC/PACG aged 30 years or more after LPI with visually significant cataract., Methods: Subjects underwent computer-generated randomized sequence of either procedure, phaco-ECPL or phacotrabeculectomy, for standard indications of combined glaucoma and cataract surgery., Main Outcome Measures: Primary outcome measure was intraocular pressure (IOP). Secondary outcome measures were best-corrected visual acuity (BCVA), number of antiglaucoma medications (AGMs), complications, and failure., Results: A total of 45 eyes of 39 subjects were included. A total of 25 eyes underwent phaco-ECPL, and 20 eyes underwent phacotrabeculectomy. Five eyes in the phaco-ECPL group were excluded; 2 were excluded because laser was not delivered per protocol, and the rest had less than 3 months of follow-up. Mean follow-up was 16.25±8.1 months in the phaco-ECPL group and 18.9±9.5 months in the phacotrabeculectomy group. Mean preoperative and postoperative IOP, AGM, and BCVA did not differ between the groups. However, the rate of complications (P = 0.011) and interventions (P = 0.047) was greater in the phacotrabeculectomy group., Conclusions: Both procedures are efficacious in lowering IOP in PACG, but the rate of complication and interventions for these were more in the phacotrabeculectomy group. Longer follow-up is indicated to probe the feasibility of phaco-ECPL, a minimally invasive procedure, as first-step management in PAC disease, for which combined cataract and glaucoma surgery is indicated., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of the study is to report the outcomes of simultaneous cataract extraction (CE) and a new nonvalved glaucoma drainage device (GDD), Aurolab Aqueous Drainage Implant (AADI), in eyes with cataract and refractory glaucoma., Methods: This was a non-comparative, interventional, retrospective study. Consecutive patients who underwent AADI together with phacoemulsification from June-2015 to January-2017 by a single fellowship trained glaucoma surgeon with documented 3-months of follow-up were included. The main outcomes were intraocular pressure (IOP), antiglaucoma medication (AGM), visual acuity, and complications., Results: We included 19 eyes of 17 patients with average follow-up of 14.4 ± 8.4 months. IOP and AGM reduced from 36.9 ± 11.1 mmHg and 4 ± 0.8 preoperatively to 12 ± 4.5 mmHg and 0.8 ± 1.2, respectively (P < 0.001). Complications were seen in seven eyes (36.8%). Total success was seen in 17 eyes (89.5%). None of the patients lost vision., Conclusion: Combining cataract extraction with the new non-valved Aurolab Aqueous Drainage Implant, appears to be an effective and safe technique in eyes with refractory glaucoma and cataract. Larger studies and further follow-up is recommended for such patients., Competing Interests: There are no conflicts of interest

Purpose: To evaluate the impact of glaucoma on visual functioning in Indians., Methods: Patients attending the glaucoma service who had undergone a comprehensive glaucoma evaluation were recruited. Better mean deviation (MD, using Humphrey Field Analyzer program 24-2) between two eyes was used to classify participants into mild, moderate, and severe visual field (VF) loss groups. Participants were administered the Glaucoma Quality of Life-15 (GQL-15) questionnaire. Rasch analysis was used to validate the GQL-15 and its four subscales. Linear regression was used to determine associations between GQL-15 scores and VF loss after adjusting for sociodemographic variables., Results: A total of 198 patients (mean age ± SD, 59.8 ± 12.3 years; 67% male) were recruited. Participants with severe VF loss (39%) followed by mild loss (35%) comprised the largest group. Rasch analysis resulted in a 10-item reliable and valid questionnaire: the Glaucoma Activity Limitation-10 (GAL-10). Although a single subscale, "peripheral vision," met requirements of the Rasch model, it could not be preserved in the GAL-10. In multivariate analyses, the middle-income group (compared with higher income) and severe VF-loss (compared with mild VF-loss) participants reported significantly poorer functioning on GAL-10 ([β = 0.84; 95% confidence interval (CI), 0.16-1.52; P = 0.02] and [β = 1.19; 95% CI, 0.61-1.78; P < 0.000], respectively). None of these associations were, however, clinically significant., Conclusions: Glaucoma patients in India, especially those with severe VF loss, face significant challenges in performing daily tasks and in mobility. It is important to prevent progression such that activity limitation is minimized in glaucoma patients.

This article focuses on side-effects due to increasing use of the anti-impotency drug viagra or sildenafil citrate. It presents a case of visual loss that took place within 12 hour of intake of the drug. A 61-year-old taxi driver presented to the eye casualty with a 12-h history of loss of vision in his right eye following consumption of double his normal dose of Viagra (100mg). He was a high hypermetrope with an amblyopic left eye. Examination revealed Snellen acuity of counting fingers in the right eye and 6/12 in his amblyopic left eye. It was encouraging to see his visual acuity improve steadily with resolution of headaches.