IGS 2007 Meeting Highlights

Athens played host to the sixth annual International Glaucoma Society (IGS) congress, which ran from 28-31 March. Attended by more than 2,650 participants from around the world, the meeting earned the title of the most attended international glaucoma meeting ever held.

The comprehensive list of topics included advances in medical therapy and surgery as well as new ideas in diagnosis, management and imaging, to name just a few.

In case you were not fortunate enough to attend this event, we have hand-picked some of the presentations given during this successful meeting.

The use of implants in deep sclerectomy enhances success rates and lowers the need for postoperative medications, according to Petr Strnad, MD and colleagues from the Masaryk University, Czech Republic.

They conducted a retrospective review of 86 eyes of 56 patients who had undergone deep sclerectomy, with at least five-years follow-up. The patients were divided into three groups according to the type of surgery. The first group underwent deep sclerectomy without implant (40 eyes, 26 patients); the second underwent deep sclerectomy with an absorbable collagen implant (24 eyes, 16 patients) and the third group underwent deep sclerectomy with a non-absorbable implant (22 eyes, 14 patients).

The average preoperative intraocular pressure (IOP) of the three groups was recorded at 25.3, 25.9 and 23.7 mmHg, respectively and the number of anti-glaucoma medications was 3.1, 3.2 and 3.4. Mean follow-up time was 81.6, 78 and 69.8 months, respectively.

Average IOP, at the end of the follow-up period, was 17.25 mmHg for the group with no implant, 16.7 mmHg for those with the absorbable implant and 16.5 mmHg for those with the non-absorbable implant. The number of anti-glaucoma medications was 2.1, 1.6 and 0.8, respectively.

The researchers discovered that patients who received an implant during surgery achieved better outcomes than those who did not and that non-absorbable implants, in particular, offered better long-term IOP compensation than absorbable implants.

Travoprost and bimatoprost cause dry eye

The use of travoprost 0.004% and bimatoprost 0.03% can have adverse effects on the ocular surface and can result in dry eye symptoms, according to Samet Ermis and co-workers from the Kocatepe University School of Medicine, Turkey.

A total of 78 patients with primary open angle glaucoma (POAG) were enrolled; 44 patients received travoprost and 34 received bimatoprost. Complete ophthalmic examinations were performed before treatment and one week, one, three and six months after treatment. Intraocular pressure (IOP) was measured using Goldmann applanation tonometry and Schirmer and break-up time tests were performed during all examinations. Conjunctival cytology specimens were taken before and six-months after treatment and graded according to Nelson's classification and globlet cell density was evaluated.

In the travoprost group, mean IOP before treatment was 21.4±1.5 mmHg and 15.4±1.6 mmHg six months following treatment (p<0.05). In the bimatoprost group, mean IOP before treatment was 22.0±1.5 mmHg and 15.5 mmHg±1.4 mmHg six months after treatment (p<0.05). The authors found a statistically significant difference, between the two groups, in globlet cell density, Schirmer test and break-up time (p<0.05).

Although the decrease in IOP is statistically significant for both treatment groups, the study did show that travoprost and bimatoprost therapy can give rise to dry eye symptoms.

IOP not useful in mass glaucoma screening

Scanning laser polarimetry with customized cornea compensation (GDx-VCC) and Matrix Frequency Doubling Technology (M-FDT) are more accurate than intraocular pressure (IOP) measurements when employed for mass glaucoma screening, according to Dr Toth and co-workers from the Semmelweis University, Hungary.

In a non-population based trial, Caucasian subjects were screened for glaucoma with GDx-VCC, M-FDT and independent clinical examination. Sensitivity, specificity, accuracy, likelihood ratios and predictive values were calculated for GDx-VCC alone, M-FDT alone and combinations of the two.