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We report a case of an 84-year-old man who had an Ex-PRESS R-50 glaucoma shunt placed under a scleral flap in his right eye for primary open angle glaucoma and uncontrolled intraocular pressure. Twenty-one days after placing the implant, the patient returned with a dislocated shunt resting in the inferior angle of the anterior chamber. Corrected vision was 20/30 with an intraocular pressure of 13 mm Hg. There was no anterior chamber inflammation and no evidence of corneal decompensation. To our knowledge, this is the first report of an Ex-PRESS shunt dislocation into the anterior chamber. Ophthalmologists implanting this device should be aware of this possible complication of Ex-PRESS shunt insertion

OBJECTIVE: This retrospective study was designed to investigate the efficacy and tolerability of travoprost 0.004% substituted for latanoprost 0.005% in glaucoma patients at the Manhattan Veterans Administration Hospital. RESEARCH DESIGN AND METHODS: We conducted a chart review of patients with stable intraocular pressure (IOP) undergoing a formulary change in regimen from latanoprost 0.005% to travoprost 0.004%. Diagnoses included primary open angle glaucoma, ocular hypertension, pigment dispersion glaucoma, and pseudoexfoliation glaucoma. MAIN OUTCOME MEASURES: The primary outcome measures were IOP change between baseline and 6 months and patient-reported adverse events throughout the study. RESULTS: In the single therapy group (N = 60 eyes), the mean baseline IOP on latanoprost was 15.8 mmHg; after 6 months on travoprost, it was 14.9 mmHg (p < 0.1). In the concomitant therapy group (N = 126 eyes), the mean baseline IOP was 16.7 mmHg; after 6 months on travoprost, it was 15.9 mmHg (p < 0.01). A reduction of IOP >/= 3 mmHg occurred in 28 eyes of 21 patients at 6 months. An increase of IOP >/= 3 mmHg occurred in 5 eyes of 4 patients at 6 months. One patient was switched back to latanoprost due to irritation at 3 months. No other patient-reported adverse events, including increased hyperemia, were observed throughout the follow-up period. CONCLUSIONS: A change in therapeutic regimen from latanoprost 0.005% to travoprost 0.004% maintained IOP control in stable patients, and in some produced a further reduction in IOP. A change in therapy from latanoprost to travoprost was effective and well-tolerated for the glaucoma patients in this study