To report refractive, topographic, aberrometric and tomographic outcomes 24 months after corneal cross-linking (CXL) in patients up to 18 years of age with progressive keratoconus, the following prospective, interventional case series involved 40 eyes that underwent riboflavin-ultraviolet A-induced CXL. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), sphere and cylinder, topography, aberrometry, tomography and endothelial cell counts were evaluated at baseline and at one, three, six, 12 and 24 months.

Mean logarithm of the minimum angle of resolution (logMAR) baseline UCVA and BSCVA were 0.79 ± 0.21 and 0.39 ± 0.10, respectively and mean UCVA and BSCVA at two years were 0.58 ± 0.18 and 0.20 ± 0.09, respectively. It was noted that the improvement in UCVA and BSCVA was significant throughout the postoperative follow-up (p<.05) and that mean spherical equivalent refraction showed a significant decrease of 1.57D at 24 months (p=.02). It was also reported that mean baseline simulated keratometry was 46.32D in the flattest meridian and 51.48D in the steepest meridian; at two years, the values were 45.30D (p=04) and 50.21D (p=.07), respectively. For a 3-mm pupil, there was a significant reduction (p<.05) in whole eye (total), corneal, higher-order and astigmatic wavefront aberrations at 24 months. A significant difference (p<.05) in total coma and total spherical aberration two years after CXL also was observed. Moreover, mean baseline pupil center pachymetry decreased significantly (p=.04) at six months, but recovered by 12 months and remained stable thereafter through the two-year follow-up. Endothelial cell counts did not change significantly (p=32).

It was concluded that CXL improved UCVA and BSCVA in the study patients, most likely by significantly reducing corneal asymmetry and corneal as well as total wavefront aberrations.

Three types of open-angle glaucoma (OAG) are frequently encountered: primary, pigmentary and pseudoexfoliative. In the following study, investigators aimed to compare demographic, ocular and systemic medical information collected on people with these three OAG types at diagnosis, and determine if the OAG type affected the prognosis.

They accessed information on 607 participants of the Collaborative Initial Glaucoma Treatment Study; descriptive statistics characterized their demographic, ocular and medical status at diagnosis. They also made comparisons using analysis of variance and χ² or Fisher's exact tests and also performed multinomial, mixed and logistic regression analyses.

Relative to people with primary OAG, the investigators found that those with pigmentary OAG were younger, more likely to be white, less likely to have a family history of glaucoma, and were more myopic. They also reported that those with pseudoexfoliative OAG were older, more likely to be white, more likely to be women, less likely to have bilateral disease, and presented with higher intraocular pressure (IOP) and better visual acuity. The type of glaucoma was not associated with IOP or visual field progression during follow-up.

Characteristics of newly diagnosed enrollees differed by the type of OAG. While some of these differences relate to the pathogenesis of OAG type, other differences are noteworthy for further evaluation within population-based samples of subjects with newly diagnosed OAG.

Researchers carried out the following comparative case series to determine the change in intraocular pressure (IOP) after cataract extraction in the observation group of the Ocular Hypertension Treatment Study (OHTS).

They included 42 participants (63 eyes) who underwent cataract surgery in at least 1 eye during the study and a control group of 743 participants (743 eyes) who did not undergo cataract surgery. They defined the “split date” as the study visit date at which cataract surgery was reported in the cataract surgery group and a corresponding date in the control group. The researchers also defined preoperative IOP as the mean IOP of up to three visits before the split date. Postoperative IOP was the mean IOP of up to three visits including the split date (zero, six and 12 months with “zero months” equaling the split date). In both groups, the researchers censored data after initiation of ocular hypotensive medication or glaucoma surgery of any kind. Difference in preoperative and postoperative IOP was the main outcome measure.

In the cataract group, postoperative IOP was significantly lower than the preoperative IOP (19.8 ± 3.2 mmHg vs. 23.9 ± 3.2 mmHg; p<0.001). The researchers noted that the postoperative IOP remained lower than the preoperative IOP for at least 36 months. They also observed that the average decrease in postoperative IOP from preoperative IOP was 16.5%, and 39.7% of eyes had postoperative IOP ≥20% below preoperative IOP. A greater reduction in postoperative IOP occurred in the eyes with the highest preoperative IOP. Furthermore, in the control group, the corresponding mean IOPs were 23.8 ± 3.6 before the split date and 23.4 ± 3.9 after the split date.

In conclusion, cataract surgery decreases IOP in patients with ocular hypertension over a long period of time.