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New Philadelphia, Pennsylvania, United States

Freidl K.B.,Glaucoma Research Center | Moster M.R.,Glaucoma Research Center
Survey of Ophthalmology | Year: 2012

It is important to equip future ophthalmic surgeons with appropriate surgical skills without compromising patient care. The ExPRESS implant surgery is very similar to trabeculectomy surgery in both efficacy and technique, but is less traumatic and may be prone to less postoperative hypotony and require less postoperative hypotensive medications. although affording a way to teach a novice surgeon the steps and technique of trabeculectomy and minimizing patient risk, ExPRESS implantation is a more expensive surgery that involves placing a foreign body in the eye. Further, needling an ExPRESS is a more technically challenging procedure than needling a trabeculectomy and more limited in its scope. © 2012 Elsevier Inc.. Source

Ekici F.,Glaucoma Research Center | Waisbourd M.,Glaucoma Research Center | Katz L.J.,Glaucoma Research Center
Open Ophthalmology Journal | Year: 2016

There has been tremendous progress in the past decades in the utilization of lasers for treating patients with glaucoma. This article reviews the use of lasers in different areas of glaucoma, including the shift from argon laser trabeculoplasty (ALT) to selective laser trabeculoplasty (SLT), laser trabeculoplasty as an initial treatment for glaucoma, new laser trabeculoplasty procedures under investigation, and other recent laser treatment modalities such as endoscopic cyclophotocoagulation and laser-assisted deep sclerectomy. © 2016, Ekici et al.; Licensee Bentham Open. Source

Kuchar S.,Glaucoma Research Center | Moster M.R.,Glaucoma Research Center | Reamer C.B.,Glaucoma Research Center | Waisbourd M.,Glaucoma Research Center
Lasers in Medical Science | Year: 2016

Glaucoma is the leading cause of irreversible blindness worldwide. The goal of this study was to describe our experience with the novel micropulse transscleral cyclophotocoagulation (MP-TSCPC; IRIDEX IQ810 Laser Systems, CA) in patients with advanced glaucoma. Patients with advanced glaucoma who underwent MP-TSCPC were included in our study. Laser settings were 2000 mW of 810 nm infrared diode laser set on micropulse delivery mode. The laser was delivered over 360° for 100–240 s. The duty cycle was 31.3 %, which translated to 0.5 ms of “on time” and 1.1 ms of “off time.” Surgical success was defined as an intraocular pressure (IOP) of 6–21 mmHg or a reduction of IOP by 20 % at the last follow-up visit. Failure was defined as an inability to meet the criteria for success or a need for incisional glaucoma surgery. Nineteen patients underwent MP-TSCPC with mean follow-up of 60.3 days. Mean IOP dropped from 37.9 mmHg preoperatively to 22.7 mmHg at last follow-up, representing a 40.1 % decrease. The success rate for initial treatment was 73.7 % (n = 14). Three patients underwent a second treatment, increasing the overall success rate to 89.5 % (n = 17). Four patients gained one line of vision, and four patients lost one line of vision. The novel MP-TSCPC laser had a high rate of surgical success after a short follow-up period in patients with advanced glaucoma. Further long-term evaluation and comparison to the traditional transscleral cyclophotocoagulation are warranted. © 2015, Springer-Verlag London. Source

Sun Y.,Glaucoma Research Center | Williams A.,Glaucoma Research Center | Waisbourd M.,Glaucoma Research Center | Iacovitti L.,Thomas Jefferson University | Katz L.J.,Glaucoma Research Center
Survey of Ophthalmology | Year: 2015

In recent years there has been substantial progress in developing stem cell treatments for glaucoma. As a downstream approach that targets the underlying susceptibility of retinal ganglion and trabecular meshwork cells, stem cell therapy has the potential to both replace lost, and protect damaged, cells by secreting neurotrophic factors. A variety of sources, including embryonic cells, adult cells derived from the central nervous system, and induced pluripotent stem cells show promise as therapeutic approaches. Even though safety concerns and ethical controversies have limited clinical implementation, some institutions have already commercialized stem cell therapy and are using direct-to-consumer advertising to attract patients with glaucoma. We review the progress of stem cell therapy and its current commercial availability. © 2015 Elsevier Inc. Source

Ekici F.,Glaucoma Research Center | Moster M.R.,Glaucoma Research Center | Cvintal V.,Glaucoma Research Center | Hu W.D.,Glaucoma Research Center | Waisbourd M.,Glaucoma Research Center
Clinical Ophthalmology | Year: 2015

Purpose: To investigate the clinical outcomes of tube shunt coverage using sterile gamma-irradiated cornea allograft. Patients and methods: The Wills Eye Hospital Glaucoma Research Center retrospectively reviewed the medical records of 165 patients who underwent glaucoma tube shunt procedures using sterile gamma-irradiated cornea allograft (VisionGraft) between December 2012 and November 2013. Demographic characteristics, type of tube shunt, and position were noted. Complications were recorded at 1 day; 1 week; 1, 3, 6, and 12 months; and on the final postoperative visit. Results: One hundred and sixty-nine eyes of 165 patients were included. The mean follow-up time was 4.8±3.5 (ranging from 1 to 16) months. There was no evidence of immunological reaction, infection, or exposure in 166 eyes (98.2%). Three eyes (1.8%) experienced graft or tube exposure within the first 3 postoperative months. Two of the cases had underlying diseases: bullous pemphigoid and chronic allergic conjunctivitis. Conclusion: Coverage of tube shunts using gamma-irradiated cornea allograft had a low exposure rate and was well tolerated. The graft can be stored long term at room temperature and has an excellent postoperative cosmetic appearance. © 2015 Ekici et al. et al. Source

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