Corneal transplantation is a procedure involving the partial or total replacement of a damaged cornea with a healthy one, serving multiple purposes such as improving visual acuity, for aesthetic reasons, and for tectonic support. The most common procedure used in our clinic is penetrating keratoplasty, which can be burdened with a series of intraoperative and postoperative complications. . The aim: In this article, we will present our clinic's experience with patients who have undergone and been diagnosed with corneal pathologies through penetrating keratoplasty technique, and the medium and long-term therapeutic difficulties encountered by these patients from 2020 to 2024, at the Ophthalmology Clinic of " Sf. Spiridon" " County Clinical Emergency Hospital Iasi. Materials and methods: : Patients with a history of chemical burns to the cornea, herpetic infection, keratoglobus associated with lagophthalmos, chronic smokers, and those with advanced pseudoexfoliative glaucoma in one eye are included. Results: Among the postoperative complications, infections and rejection reactions can occur between 2 weeks and 8 months and are quite challenging to manage. Postoperative infections can be present due to non-conforming sutures, prolonged use of contact lenses, and systemic immunosuppression. Rejection reactions can occur as early as two weeks, with corneal vascularization in the host cornea increasing the risk of graft rejection. Early identification and prompt treatment of inflammation and early infection are facilitating factors in preventing graft rejection. Conclusions: Although, in terms of survival, corneal transplantation is the most successful transplant performed in humans, rejection is still the main cause responsible for graft failure. Keratoplasty involves a lengthy healing process; preoperative evaluation and dialogue with the patient are essential to understand the benefits, possible complications, and the need for prolonged treatment.

Aim: Evaluating the functional outcomes in patients with history of uveitis who previously underwent cataract surgery during 2009-2019, analysis of the best postoperative visual acuity and IOP after first day, one month, 3 months and last postoperative. Material and methods: Comparative/retrospective study which included cataract surgery patients with a history of uveitis evaluated between January 2009 and December 2019 in Iasi, Department of Ophthalmology, "Sf. Spiridon" County Clinical Emergency Hospital. The study included a number of 102 eyes divided into two groups: 59 eyes from 51 patients (25 women and 26 men) the cataract and uveitis group (study group) and 43 cataract eyes (control group). All patients had cataract surgery performed by phacoemulsification and IOL-PC implantation, while the pre- and postoperative evaluation was performed according to a standardized protocol. The database was built in the EXCEL program and was statistically processed with the SPSS 18.0 program. Postoperative followup was performed at 1 day, 1 month, 3 months and last postoperative follow up (six month). Results: The average age of patients of the 2 groups was 65 years. In all cases, pre-operative topical steroid anti-inflammatory treatment was administered for 1 week and post-operatively, for 6 weeks. General anti-inflammatory steroids (CSR) were administered pre-operatively and post-operatively in 9 patients with intermediate or posterior uveitis for 8 weeks. In two cases a capsular tension ring was used to stabilize the bag. One case required ECCE + placement of IOL in the sulcus. Only one case required IOL explantation due to severe inflammation. Among the postoperative complications, the inflammatory glaucoma and recurrent uveitis predominated. Conclusions: Cataract surgery with IOL implantation resulted in improved postoperative visual acuity in patients with cataract and uveitis, which was maintained at the last follow-up. In the immediate postoperative period, both groups had similar functional results.

Purpose of the study: To outline the influence of diabetes on the progression of glaucoma. Material and methods: The study (prospective, case-control) analyzed the data from 102 patients with glaucoma admitted to the Clinic I Ophthalmology of "Sf. Spiridon" County Clinical Emergency Hospital from Iasi, between October 2011 and November 2015, divided into two study groups, depending on the presence of diabetes, as follows: First group 51 patients with Diabetes and Glaucoma (study group) and Group II 51 patients with glaucoma, without Diabetes (control group). In all patients, the following parameters were recorded: VA (visual acuity), IOP (intraocular pressure), visual field progression, corneal thickness, and fundus appearance, where the presence of DR (diabetic retinopathy), its progression and form when it existed, as well as optic disc appearance. Also, it was noted: the duration of glaucoma, diabetes and the type and quantity of antiglaucoma and antidiabetic medications used and the number of VF examinations (visual field) and OCT (ocular coherence tomography), glycemic and HbA1c values. Results: At the end of the study, for the patients in group I there was a significantly decrease visual acuity in patients with s evere glaucoma (p = 0.001). The mean IOP values did not show statistically significant differences compared to the evolution of glaucoma. At the end of the study, the C/D ratio (cup / disc) was significantly higher in patients in group II (p = 0.017). The presence of Diabetes had a negative impact on RNFL (retinal nerve fiber layer) among patients with an advanced form of glaucoma. For the patients in the study group, who had a high blood glucose level, it was noted: a significant decrease in the mean IOP, a significant decrease PSD (pattern deviation) and significant decrease mean MD (mean deviation). Conclusions: In our study, the data from the analysis of VF, OCT and clinical examination parameters indicate an unfavorable progression of glaucoma among diabetic patients compared to those without.

Chalazion is a granulomatous inflammation caused by blocking the Meibomian glands, which affect the eyelids, predominantly the upper ones. The purpose of this article is to highlight the clinical and histopathological aspects of chalazia at children. This paper is a retrospective study of a child, 3-year-old, who presents with multiple upper and lower eyelid chalazia in both eyes, mechanical ptosis, blepharospasm and ocular pain. The history of the disease begins 2 months ago with the initial RE (right eye), for which it received general antibiotic and local treatment for 10 days with unfavorable evolution. The child was subsequently examined by another physician recommending topical treatment with Sinerdol ( Rifampicin) and Dexamethasone, and empirical treatment consisting of applying a wooden spoon to injuries and hot compresses. Inappropriate treatment has led to an unfavorable evolution, and its continuing may lead to several local complications. After attempting to identify other etiologies, surgical excision was performed with slow favorable evolution. Postoperatively, general and local antibiotic and anti-inflammatory treatment with slow development was recommended. Appropriate treatment initiated from onset would have limited the extension of the chalazia; with the possibility of avoiding the surgical risk involved in general anesthesia. Conclusions: Ophthalmologists should consider acne rosacea as a potential diagnostic for any child who has any combination of Meibomian disease, chronic blepharitis, recurrent chalazion and chronic symptoms of photophobia, eye irritation and redness that does not respond to routine medical treatment.

Aim of study was to emphasize the clinical changes and biometric alterations that appear in primary open angle glaucoma (POAG) patients if diabetes was associated. Material and methods: The study was designed in a cross-sectional manner, between 2015-2016 in the Ophthalmology Clinic of “Sf. Spiridon” County Clinical Emergency Hospital from Iasi. We included 87 eyes, from 87 patients, distributed in 4 groups: 24 patients - the control group (cataract), 26 patients - the type II diabetes group, 16 patients – POAG group, 21 patients - the combined disease group (POAG + diabetes). We recorded data related to the age of the patients (years), best corrected visual acuity (BCVA), intraocular pressure (IOP-mmHg), perimetry parameters (MD, PSD-dB), biometric parameters (axial lengths, anterior chamber depth, CDE - Cumulative Dissipated Energy, lens thickness). The duration of glaucoma/diabetes, the type and number of glaucoma medications were noted. Similarly, the duration of diabetes mellitus, glycemic value and glycosylated hemoglobin were recorded. Results: Mean age calculated for the control group was 72.33+/-11.26 years, 69.04+/-9.46 years for the DM group, 75.69+/-5.54 years for the POAG group and 59.95+/-3.89 years for the combined pathology. Secondly, we found the highest IOP in the POAG+DM group, compared with the rest of the study categories (20.33+/-2.3 mmHg in group IV vs. 18.19+/-4.3 mmHg in group III vs. 15.50+/1.9 mmHg vs. 14.21+/-2.68 mmHg in group I), p<0.05. We found statistically significant differences between the four groups in respect of lens size and the CDE mean values. Our data revealed that the smallest energy was used in group IV (CDE=8.5+/-1.77), compared to all the other categories: I (CDE=17.79+/-7.36, p = 0.000), II (CDE=18.15+/-11.74, p = 0.000), III (CDE=13.90+/-8.11, p = 0.000). Estimated lens volume in group IV was 4.85+/-0.17mm in POAG+DM patients, significantly larger than the rest of the groups (p<0.05) Conclusions: younger age, higher IOP, larger lens volume and lower CDE mean values were the parameters significantly different in POAG patients, if diabetes was associated.

The aim of the paper was the evaluation of the modifications of the retinal nerve fiber layer for the patients with primary open angle glaucoma or ocular hypertension associated with diabetes mellitus. Material and method: a prospective study that included a number of 25 patients. The study group was made up of 17 patients: 12 patients with primary open angle glaucoma (POAG) and diabetes mellitus and 5 patients with ocular hypertension (OH) and diabetes mellitus. The control group included 8 patients without glaucoma. All the patients with an accurate diagnosis of primary open angle glaucoma and intraocular hypertension that were medically and/or surgically treated or not, associated with diabetes mellitus, were included in the study. The patients with other types of glaucoma (closed angle, pigmentary, cortisone related, pseudoexfoliative), the ones without an accurate diagnosis of glaucoma or without associated diabetes mellitus were excluded. The control group was made up of subjects without a glaucoma diagnosis or clinical elements related to glaucoma, without surgical interventions in their medical records. All participants were evaluated with CIRRUS HD-OCT.

AIM:To monitor the influence of glaucoma on the changes caused by diabetes in the anterior ocular segment.MATERIAL AND METHODS:Prospective, comparative clinical study, which included the patients with glaucoma and diabetes assessed at the Iaşi "Sf. Spiridon" Hospital, "Euro Medi Center" Clinic and "Oftaprof" Clinic. The study included a number of 142 patients, divided into two groups: 67 patients with glaucoma and diabetes (study group) and 75 patients with diabetes mellitus (control group). Upon enrollment the patients were subjected to a complete assessment of their ophthalmologic and metabolic status. Monitored aspects: prevalence of lens changes, extent of ocular surface disease and identification of the changes in corneal biomechanical parameters in the patients with glaucoma and diabetes.RESULTS:In both monitored groups, the cortical lens changes prevailed, both at the beginning and at the end of the study, with no statistically significant differences between groups (p>0.05). The risk of developing lens changes reaches 50% in the patients who have had diabetes for 20 years. In the patients in the study group, tear secretion was significantly lower at the end of the study (Schirmer's test values 11.61 vs. 10.67 mm, p=0.045). Tear film instability was present in 37.3% of the patients. Corneal hysteresis (CH) and comeal resistance factor were significantly reduced in the group with glaucoma and diabetes, as compared to the group with diabetes (p=0.001).CONCLUSIONS:There is significant ocular surface disease in the patients with glaucoma and diabetes, as compared to those with diabetes alone. Glaucoma and the number of antiglaucoma drugs are associated with a significant reduction in tear secretion. The association of glaucoma resulted in the reduction in CH and corneal resistance factor in the patients with glaucoma and diabetes as compared to the healthy ones.

AIM OF STUDY Progression rate in patients with glaucoma and diabetes. MATERIAL AND METHOD cohort prospective study in Ophthalmology Clinic "Sf. Spiridon" University Hospital Iasi. We recruited patients with positive history for diabetes and of open angle glaucoma (OAG). The control group included subjects with OAG (74 eyes from 74 patients) and the study group (44 eyes, from 44 patients) included subjects with OAG and diabetes. At enrollment all patients had a complete ophthalmologic evaluation along with full metabolic status assessment. There were included only incipient and moderate forms of glaucoma, with mild or no diabetic retinopathy changes. Perimetric progression was assessed at 24 months with automated methods. RESULTS globally, from 118 investigated eyes, 56.40% cases had primary open angle glaucoma, 41.03% normal tension glaucoma and 2.36% pseudoexfoliative glaucoma. Glaucoma severity classification showed early defects (mean deviation < -6 db) in the study group of 77.27% vs. 83.78% in control group, whereas moderate defects (mean deviation > -6 db) were found in 22.63% in study group vs. 16.21.0% in control group. Mean age of the patients was higher in absolute value in the open angle glaucoma group (64.31 +/- 1.66 years), vs. diabetes + open angle glaucoma (62.69 +/- 1.8 years), with comparable visual acuities (0.91 +/- 0.15 vs. 0.89 +/- 0.16), CID ratios and other clinical pa- rameters (p > 0.05). Mean baseline lOP in the study group was 18.18 +/- 3.55 mrnHg vs. 17.08 +/- 2.4 nimHg in controls (p > 0.05). Analysis of visual field parameters at baseline showed a significant difference (p = 0.48) between groups in MD levels -3.63 +/- 3.35 db (control group) vs. -4.40 +/- 5.78 db (study group), but no difference (p > 0.05) in PSD levels: 3.71 +/- 3.06 db (control group) vs. 4.05 +/- 3.04 dB (study group). Perimetric progression was estimated at 24 months by Glaucoma Progression Analysis software (GPA-Humphrey Visual Field Analyzer II) using 6 reliable visual field (VF) exams. Progression rate was similar between groups--0.19 +/- 0.78 dB/year (OAG) vs. -0.18 +/- 0.05 dB/year (OAG+DM), p > 0.05 and no other risk factor could have been linked to an increased progression rate, except visual field parameters at final and baseline evaluation, in both groups. CONCLUSIONS On short term, functional deterioration in open angle glaucoma patients having early or moderate stages, occurs similarly in the presence or absence of diabetes.

Aim: To evaluate intraocular biodistribution of fluorescent nanoparticles composed of dexamethasone bound to chitosan after intravitreal administration in rabbit eyes. Material and methods: The chitosan and gelatin based nanoparticles were synthetized using a reverse emulsion-double crosslinking technique (ionic and covalent) and then dexamethasone was bound. Two units of 1% suspension of these nanoparticles in saline solution were injected intravitreally into rabbit eyes. The histologic sections obtained at 72 hours were analyzed by confocal microscopy. Results: The chitosan-fluorescein conjugate bound to dexamethasone was present in all ocular tissues at 72 hours. The nanoparticles were present in the retina and lens in a larger amount than in the other ocular tissues. Conclusions: The reverse emulsion-double crosslinking technique was efficient in synthesizing a biocompatible polymeric nanosystem. The in vivo study of intraocular biodistribution of fluorescein-marked nanoparticles capable of binding dexamethasone revealed their affinity for the retina and lens after intravitreal administration.

Diabetic macular edema is the main cause of vision loss in developed countries among working people. Laser photocoagulation was the mainstay of treatment for many years, but it could only preserve visual acuity, and not increase it. The anti-VEGF (Vascular Endothelial Growth Factor) agents proved their efficacy in reducing macular thickness and increasing visual acuity, although a minority of patients (30 %) achieved good visual acuity (20/40). Corticosteroids were most effective in reducing macular edema, but this reduction in macular thickness did not correlate with the level of visual acuity. They were associated with secondary cataract and glaucoma.

Diabetic macular edema is the main cause of vision loss in developed countries among working people. Laser photocoagulation was the mainstay of treatment for many years, but it could only preserve visual acuity, and not increase it. The anti-VEGF (Vascular Endothelial Growth Factor) agents proved their efficacy in reducing macular thickness and increasing visual acuity, although a minority of patients (30 %) achieved good visual acuity (20/40). Corticosteroids were most effective in reducing macular edema, but this reduction in macular thickness did not correlate with the level of visual acuity. They were associated with secondary cataract and glaucoma.

UNLABELLED:Glaucoma and diabetes are two chronic diseases with a long suspected pathogenic relationship.PURPOSE:Screening for glaucoma in patients with diabetes.MATERIAL AND METHODS:A retrospective study on 92 eyes from 46 patients with primitive open angle glaucoma (POAG) (normal and hypertensive) and intraocular hypertension (OHT) receiving medication and/or surgery associated with diabetes mellitus (DM) (type I, type II, mixed) is presented. Participants were divided into two groups as following: 16 eyes with glaucoma and diabetic retinopathy changes (group 1) and 76 eyes with glaucoma and without diabetic retinopathy changes (group 2). The following parameters were analysed: ocular pressure (Goldmann aplanotonometry), perimeter development (computerized perimetry) and fundus condition (absence, presence or progression of diabetic retinopathy).RESULTS:In patients with glaucoma and diabetic retinopathy (8 patients) we found a mean difference between treated intraocular pressure (IOP) and IOP last untreated control of 4.95 mmHg; a depreciation of the MD by 4.18 dB and an average number of glaucoma medications used of 0.889 +/- 1.054. Predominant changes in proliferative diabetic retinopathy were mild. In patients with glaucoma in the absence of diabetic retinopathy, the average difference between untreated IOP and IOP under treatment at the last check-up was 1.63 mmHg, the MD depreciation was by 0.65 dB and the average number of glaucoma medications used was 0.795 +/- 0.978.CONCLUSIONS:No statistically significant differences in terms of initial and final pressure were found. No statistically significant differences in the evolution of changes in perimeter between the two groups were observed. The presence of non-proliferating diabetic retinopathy influenced (only marginally statistically) the glaucomatous disease progression. Large comparative prospective studies are needed for the long-term follow up.

PURPOSE:To evaluate the incidence of IFIS in male patients whith alfa 1-AB treatment for benign prostatic hyperplasia (BPH) who underwent cataract surgery and also the pre and intraoperatory management and IFIS profilaxy.SETTING:Iasi "Sf Spiridon" Emergency Hospital and "Oftaprof" private practiceMETHODS:Observational retrospective study that took place over a period of 2 years (july 2009-july 2011) and reviewed 2484 eyes that underwent cataract surgery. A number of 1199 eyes were from 1049 male patients.RESULTS:Out of the 1049 male patients, 139 (13,25%) underwent treatment for BHP using the medication as follows: 119 used tamsulosin (85,6%); 18 used doxazosin, (12,94%); 2 used alfuzosin (1,43%). Out of the 139 men, 32 (23,02%) showed IFIS but only the ones treated with tamsulosin. After introducing a surgical protocol that comprised of the use of large amounts of vascoelastic material (Viscoat), intracamerular fenilefrin (Mezaton), the use of iris retractors and low faco parameters the incidence and severity of IFIS was significantly reduced.CONCLUSIONS:Correct evauation before surgery is necessary in order to anticipate the condition as its frequency and severity can be reduced by a proactive behavior which demands experience and adequate endowment.

PURPOSE:To determine the visual outcome at 5 years postoperatively in patients operated for cataract associated with diabetes mellitus.PATIENTS AND METHODS:Retrospective study on a group of 41 eyes in patients with diabetes, who were operated for cataract (the same surgeon) by facoemulsification and IOL implantation in the capsular bag, without intraoperative complications, for 60 months (during 2003-2007).RESULTS:27 patients with diabetes were included in the study, the average duration of diabetes was 10, 3 years. Average postoperative visual acuity (VA) was 0.5 at six weeks postoperatively. Preoperative VA improvement was observed in 78%. There was a decrease in VA of 85% at more than 5 years after surgery and 15% of eyes had preserved VA. VA decrease was due to the occurrence, progression and worsening of retinopathy (69%) and diabetic maculopathy, posterior capsular opacification (34%), glaucoma, age-related macular degeneration (12%).CONCLUSIONS:Visual acuity was maintained in 15% and decreased in 85% of patients due to diabetic retinopathy, glaucoma, age-related macular degeneration.

PURPOSE:To compare two new optical biometry devices with an ultrasonic immersion biometer.SETTING:Oftaprof Clinic, Iasi, Romania.METHODS:In this prospective comparative observational study were included 420 eyes that underwent cataract extraction. Axial length measurements were performed using a Allegro BioGraph biometer, which uses optical low-coherence reflectometry (OLCR), an IOLMaster 500 biometer, which uses partial coherence interferometry (PCI) and an OcuScan ultrasonic biometer. The measurement duration and the number of eyes in which the measurements with each device could be performed were compared. Intraocular lens (IOL) power calculation was performed and the IOL prediction error was calculated for each eye four weeks postoperatively.RESULTS:The mean difference in axial length measurements was 0.02 mm +/- 0.04 (SD) between the new PCI and the OLCR device, 0.14 +/- 0.13 (SD) mm between the ultrasonic biometer and the new PCI device and 0.18 +/- 0.09 (SD) mm between the ultrasonic biometer and the OLCR device (P=.52, P=.001 and P<.001, respectively). Measurements with the OLCR device took significantly longer than with the ultrasonic device (mean difference 88 +/- 27 seconds), and measurements with the ultrasonic device took significantly longer than with the new PCI device (mean difference 188 +/- 46 seconds) (P<.001). The mean absolute error in IOL power prediction was 0.49 D +/- 0.29 (SD) with the OLCR device and 0.52 +/- 0.33 (SD) D with the PCI unit and 0.77 +/- 0.65 (SD) with the ultrasonic biometer. The measurements could be performed in 420 eyes (100%) with the ultrasonic biometer, in 152 eyes (36.2%) with the OLCR device and in 151 eyes (35,9%) with the new PCI device.CONCLUSIONS:Measurements of the axial length were comparable between OLCR device and the new PCI device. There was a good correlation between the measurements with optical devices and the ultrasonic biometer. Measurements with the OLCR device took the longest to perform. Implant power calculation were comparable between the two optical devices. The ultrasonic biometry remains a very useful tool in cases with severe lens opacification which are extremely frequent in our service.

PURPOSE:To assess the effect of panretinal photocoagulation (with or without focal macular photocoagulation) on central retinal thickness measured by OCT METHOD: Prospective, interventional, non-comparative case series. Panretinal photocoagulation (PRP) was performed in 3 sessions in 28 eyes with proliferative diabetic retinopathy In 9 eyes who had also initial macular edema we have associated focal macular laser treament concomitant with the first PRP session. Macular thickness was assessed by optical coherence tomography at baseline and after 4 and 10 weeks.RESULTS:Baseline mean central retinal thickness was 252 +/- 95 microm. It was modified to 260 +/- 105 microm at 4 weeks, then to 232 +/- 49 microm at 10 weeks. There was no statistical significance of these variations. In 2 eyes (7, 14%) we have noticed an increase of more than 100 microm in central retinal thickness. In the subgroup of 9 eyes with associated initial macular edema, combined PRP-focal treatment resulted in the decrease of central retinal thickness from 306 +/- 123 microm to 236 +/- 49 microm at 10 weeks.CONCLUSIONS:Panretinal photocoagulation can be associated with a significant increase of central retinal thickness in a small percentage of eyes. The PRP-focal macular laser combination is effective in eyes who present with proliferative diabetic retinopathy and macular edema.

OBJECTIVES:evaluation of the treatment with bevacizumab for advanced exudative AMD. MATERIAL AND METHOD:prospective study on 163 patients (December 2006-February 2009). All patients received a series of 3 intravitreal injections with bevacizumab (1.25 mg/0.05 ml) at 6 weeks intervals followed by surveillance and continuation or restart of therapy based on clinical criteria and central macular thickness (CMT). The series was subdivided in three groups based on initial VA (VA < or = 0, 1; VA = 0, 1-0, 3; VA > or = 0,3). RESULTS:Final VA increased or remained constant in 88% of patients. VA increased in all three groups: from 0.029 to 0.069 in the first group; from 0.152 to 0.245 in the second group; and from 0.409 to 0.612 in the third group. In all three groups the increase in VA achieved statistical significance (p < 0.001). The whole series manifested an anatomical improvement (final mean CMT of 243.3 microm, as compared to initial mean CMT of 345.3 microm). CONCLUSION:intravitreal treatment with bevacizumab is efficient but should be followed by aggressive follow-up and rapid resume of the treatment if recurrence is diagnosed.

PURPOSE:analysis of the influence of peripheral iridectomy on the efficiency and safety of trabeculectomy and phacotrabeculectomy in patients with open-angle glaucoma.METHODS:interventional, prospective, randomized and comparative study with two groups: 44 eyes with trabeculectomy (group 1) and 24 eyes with phacotrabeculectomy (group 2). Each of the two groups was divided into two main subgroups (with and without iridectomy), compared with each other in terms of efficacy and safety of surgical procedure.RESULTS:Iridectomy was performed on 22 eyes in group 1 (subgroup 1A) and on 12 eyes in group 2 (subgroup 2A), the remaining cases in each group forming subgroups without peripheral iridectomy (subgroup 1B, 2B respectively). Statistical analysis reveals that iridectomy does not seem to influence the efficiency of filtration procedure, regardless of the postoperative moment of analysis (early or final). In all four subgroups at 1 year was a significant decreasing of intraocular pressure, with a low rate of complications.CONCLUSIONS:A proper selection of open-angle glaucoma cases allows the abandonment of peripheral iridectomy in trabeculectomy and phacotrabeculectomy.

PURPOSE: To find the indications that would benefit the most from non penetrating deep sclerectomy (NPDS) major advantages. METHOD: Retrospective study that included 40 eyes with open angle glaucoma (primary or pseudoexfoliative) which were subject to NPDS as ambulatory surgery without an implant, but with intraoperative application of mitomycin C. We have determined the LOP C/D ratio, visual acuity and the number of antiglaucoma drugs preoperatively and at 3 months postoperatively. We have analyzed the intraoperative and postoperative complications of NPDS and also the profile of the patients selected for this surgery. RESULTS: Global success (LOP < 21 mmHg + C/D ratio that remained unchanged postoperatively + visual acuity that remained unchanged postoperatively) was obtained in 90% of cases; the number of antiglaucoma drugs was significantly decreased (from 2.72 +/- 0.73 preoperatively to 0.26 +/- 0.21 postoperatively, p < 0.00002). Complete success (LOP < 21 mmHg without antiglaucoma medication) was achieved in 80% of cases. The rate of qualified success (LOP < 21 mmHg with antiglaucoma medication) was 95%; 50% of eyes have LOP < 15 mmHg at 3 months. Intraoperative complications were rare (4 cases) and minor. Postoperative complications were: ocular hypotony (1 case), bleb fibrosis (2 cases), bleb-related endophthalmitis (1 case). The best candidates for NPDS were patients over 70 years with important extraocular comorbidities, advanced open angle glaucoma with preserved visual acuity or monophthalmic patients. CONCLUSIONS: NPDS with intraoperative application of Mitomycin C as ambulatory surgery provides significant LOP reduction while preserving visual acuity and has a low rate of complications in elderly patients with advanced open angle glaucoma or monophthalmic patients.

PURPOSE:To identify threshold values above which the intersession reduction of the retinal nerve fibers layer (RNFL) can be considered significant.METHOD:In 79 eyes (41 patients) we have performed RNFL measurements with the Stratus OCT twice in the same session. The differences between these measurements were used to calculate the test-retest variability (on clock hours, quadrants and the average RNFL thickness) using the formula: Test-retest variability = 1.96 x standard deviation (95% confidence) The resulted "threshold values" were used to identify the possible progression in a study group of 119 eyes (61 patients), followed for an average of 2 years.RESULTS:RNFL reduction exceeding the "threshold values" in 2 consecutive sessions was noticed in 18 eyes (15.12%). 12 eyes (10.08%) have fulfilled this criterion on 2 or more clock hours. 3 patients have had the criterion present on both eyes.CONCLUSIONS:This appears to be a plausible method for identifying the progression of structural damage in glaucoma, deserving further researches for validation.