Omni Eye Services

In the real-world, retrospective, EXPAND study of consecutive adults with glaucoma, ab-externo gel stent implantation effectively lowered intraocular pressure (34%) and the medication burden (61%), with transient/self-resolving hypotony as the most frequent adverse event (28%). To assess effectiveness and safety of ab-externo gel stent (GS) implantation in glaucoma. Multicenter, real-world, retrospective study. Consecutive adults with glaucoma and ab-externo GS implantation (with/without phacoemulsification or open/closed conjunctiva) ≥12 months before study entry. Data were extracted between the baseline/preoperative and last follow-up visit or date of secondary surgical intervention (SSI). Primary effectiveness endpoint: proportion of primary eyes (first eye in bilaterally implanted patients) at month 12 (M12) achieving ≥20% intraocular pressure (IOP) reduction from baseline without medication increase, clinical hypotony, vision loss to counting fingers, or SSI. Secondary effectiveness endpoints included complete success (IOP ≤18mmHg and ≥20% IOP reduction from medicated baseline without medication, clinical hypotony, or SSI); qualified success (same but without medication increase); and needling rate. Key safety endpoints (all eyes): intraoperative complications, postoperative adverse events (AEs), and SSIs. The safety population included 466 eyes; 80.7% received the GS alone and 85.0% were implanted with closed conjunctiva. At M12, 39.1% of all primary eyes (N=413) and 54.9% of primary eyes with IOP and medication data at baseline and M12 (N=213) achieved the primary endpoint. At M12 among all primary eyes, the complete success, qualified success, and needling rates were 33.5%, 56.5%, and 28.6%. Most eyes (97.9%) had no intraoperative complications. The most frequent postoperative AE was transient/self-resolving hypotony (IOP <6mmHg; 28.1%). Sixty-nine (14.8%) eyes required an SSI. Ab-externo GS placement effectively lowered IOP and the medication count without unexpected complications/AEs, expanding implantation options based on patients' needs and surgeons' preferences.

Purpose:To describe a rare case of blepharochalasis that progressed from unilateral to bilateral involvement at five years after disease onset.Case Report:A previously healthy five-year-old white boy presented to our hospital for a screening visual examination. He was found to have a 2-mm right eyelid ptosis with crepe-like skin and subcutaneous telangiectatic vessels. His mother noted that since the age of three, the child has been having two to seven day-long episodes of right upper eyelid swelling and edema with tenderness. The episodes eventually progressed to involving the left eyelid as well. Oral steroid taper was found to effectively resolve these exacerbations, and a diagnosis of blepharochalasis was made.Conclusion:Blepharochalasis should be in the differential diagnosis for young children presenting with unilateral or bilateral ptosis with periorbital skin abnormalities.

Floppy eyelid syndrome (FES), a clinically recognized condition of lax and rubbery eyelids, is commonly under-diagnosed. It is associated with chronic papillary conjunctivitis and is often, although not always associated with obesity and obstructive sleep apnea. Symptoms of FES mimic those of ocular surface disease; indeed FES itself can contribute to ocular surface damage. Diagnostic signs of FES can include foreign body sensation, ocular discharge, injection, and eyelid and eyelash ptosis. Palliative topical measures may be inadequate for symptomatic relief necessitating surgical eyelid repair.