The edition · Ophthalmology
Only half of grafts survive three years after keratoplasty in post-glaucoma-surgery eyes
Plus prompt anti-VEGF dosing in retinal vein occlusion, how often aphakic children actually get a lens, and what the pooled data really say about cannabis and glaucoma.
The edition in brief
Today's ophthalmology edition leads on endothelial keratoplasty in eyes with previous glaucoma surgery. A meta-analysis of 22 studies and 943 grafts found three-year graft survival of only 57% overall and 50% in eyes with a glaucoma drainage device, with high early endothelial cell loss — a sobering basis for risk counselling, with DSAEK numerically favoured over DMEK in these eyes though not significantly head-to-head. A randomised comparison of conbercept dosing for macular oedema after branch retinal vein occlusion showed an early visual advantage from prompt pro-re-nata dosing that narrowed by one year, with a good safety profile. Long-term data from the Infant Aphakia Treatment Study found that whether an aphakic child receives a secondary intraocular lens is driven more by centre practice patterns and family preference than by vision. A pearl reaffirms structured diabetic retinopathy screening. The practice-changer: pooled evidence shows cannabis lowers intraocular pressure only briefly and mainly intravenously, and not significantly versus control — it is not a glaucoma treatment.
Half of grafts fail by three years after keratoplasty in post-glaucoma-surgery eyes
Before endothelial keratoplasty in a post-glaucoma-surgery eye, counsel that only about half of grafts survive three years — more so with a drainage device.
Prompt anti-VEGF dosing gave an early vision edge in retinal vein occlusion
Treat macular oedema from branch retinal vein occlusion with anti-VEGF promptly — early dosing recovers vision sooner, and delay costs letters even if partly regained.
Whether an aphakic child gets a lens depends on the centre, not the vision
Frame secondary intraocular lens implantation in aphakic children as a preference-sensitive decision, since it is driven by centre practice and family choice rather than visual benefit.
Put every diabetic into a structured retinal screening schedule
Enrol every diabetic in a structured retinal screening schedule — from diagnosis in type 2, from 5 years in type 1, then annually.
The pooled evidence does not support cannabis as a glaucoma treatment
Tell patients cannabis is not a glaucoma treatment — any intraocular-pressure effect is brief, mainly intravenous, and not significant versus control by usable routes.
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