Explore the vast range of titles available.

This paper evaluates the effectiveness and safety of XEN63 stent, either standalone or in combination with phacoemulsification, in patients with primary open-angle glaucoma (POAG). Eighty eyes from 80 patients with medically uncontrolled POAG were assigned to undergo XEN63 implant. The primary outcome was the surgical success, defined as an intraocular pressure (IOP) lowering from preoperative values ≥ 20% and an IOP absolute value between 6 and 18 mmHg, with or without antiglaucoma medications. Forty-three (53.7%) eyes underwent XEN63-standalone and 37(46.2%) eyes a XEN63 + Phacoemulsification procedure. Success rate was 68.8% (55/80) eyes in the overall study sample, 69.8% (30/43) eyes in the XEN63-standalone group; and 67.6% (25/37) eyes in the XEN63 + Phaco group (p = 0.6133). Preoperative IOP was significantly lowered from 22.1 ± 4.9 mmHg and 19.8 ± 3.7 mmHg to 14.7 ± 5.3 mmHg and 13.8 ± 3.4 mmHg in the XEN63-standalone and XEN63 + Phaco groups, respectively (p < 0.0001 each, respectively); without significant differences between them at any of the time-points measured. Preoperative number of ocular-hypotensive drugs was significantly reduced from 2.3 ± 0.8 to 0.3 ± 0.7 drugs, from 2.5 ± 0.7 to 0.3 ± 0.7 drugs; and from 2.0 ± 0.8 to 0.3 ± 0.7 drugs, in the overall, XEN63-standalone, and XEN63 + Phaco groups, respectively. Regarding safety, 3(42.5%) eyes had transient hypotony at some point during the study, although only in one (1.2%) eye was clinically significant. Four (5.0%) eyes underwent a needling, 4 (5.0%) eyes underwent surgical-bleb-revision, 1 (1.2%) eye required a device replacement and 1 (1.2%) eye a device removal due to maculopathy. XEN63, either alone or in combination with phacoemulsification, significantly lowered IOP and reduced the number of ocular hypotensive medications. The rate of ocular hypotony was relatively high, although it was clinically relevant only in one eye.

Justin Spaulding Cataract & Laser Institute of Southern Oregon, Medford, OR, USACorrespondence: Justin Spaulding, Cataract & Laser Institute of Southern Oregon, 1408 E Barnett Road, Medford, OR, 97504, USA, Tel +1 541 779 2020, Email jspaulding@medfordeyedoctors.comPurpose: To evaluate the efficacy and safety of ab-interno canaloplasty combined with microstent implantation in patients with severe glaucoma.Patients and Methods: This retrospective study included patients with severe glaucoma (mean age 74.6± 8.7 years), predominantly primary open-angle (90%). All eyes underwent combined ab-interno canaloplasty using the iTrack (Nova Eye Medical) with concurrent Hydrus Microstent (Alcon) implantation during cataract surgery. The primary outcome measures were intraocular pressure (IOP), number of glaucoma medications, visual field mean deviation (VFMD), postoperative complications.Results: Sixty-nine eyes of 56 patients were followed for mean 27.9± 13.8 months. Mean IOP decreased from 17.8± 6.3 at baseline to 15.5± 4.7 mmHg at last follow-up (p=0.012), and mean number of medications decreased by 47%, from 2.10± 1.1 to 1.12± 1.2 (p< 0.001). Medication-free eyes increased from 7% at baseline to 43% at last follow-up. Among eyes that were on 3 and 4 medications preoperatively (n=17; n=7), the number of medications significantly decreased by 53% (p< 0.001) and 57% (p=0.002) at last follow-up, while IOP remained stable. Eyes with baseline IOP > 18 mmHg (n=21) experienced a significant mean IOP reduction of 9.8 mmHg (from 24.8± 6.7 to 15.0± 4.6 mmHg; − 40%, p< 0.001). No intraoperative or postoperative complications were reported; 6 eyes (9%) required additional glaucoma procedures during follow-up.Conclusion: Combining ab-interno canaloplasty with Hydrus Microstent implantation during cataract surgery resulted in modest but sustained reductions in intraocular pressure and glaucoma medication burden, with a favorable safety profile. However, postoperative IOP frequently remained above levels required for very low target pressures. These findings suggest that this mixed MIGS approach may be considered in carefully selected patients but should not be viewed as a substitute for traditional filtering surgery in advanced disease.Keywords: primary open-angle glaucoma, minimally invasive glaucoma surgery, MIGS canaloplasty, Hydrus Microstent, combined MIGS, IOP reduction

To evaluate the efficacy and safety of ab-interno canaloplasty combined with microstent implantation in patients with severe glaucoma. This retrospective study included patients with severe glaucoma (mean age 74.6±8.7 years), predominantly primary open-angle (90%). All eyes underwent combined ab-interno canaloplasty using the iTrack (Nova Eye Medical) with concurrent Hydrus Microstent (Alcon) implantation during cataract surgery. The primary outcome measures were intraocular pressure (IOP), number of glaucoma medications, visual field mean deviation (VFMD), postoperative complications. Sixty-nine eyes of 56 patients were followed for mean 27.9±13.8 months. Mean IOP decreased from 17.8±6.3 at baseline to 15.5±4.7 mmHg at last follow-up (p=0.012), and mean number of medications decreased by 47%, from 2.10±1.1 to 1.12±1.2 (p<0.001). Medication-free eyes increased from 7% at baseline to 43% at last follow-up. Among eyes that were on 3 and 4 medications preoperatively (n=17; n=7), the number of medications significantly decreased by 53% (p<0.001) and 57% (p=0.002) at last follow-up, while IOP remained stable. Eyes with baseline IOP >18 mmHg (n=21) experienced a significant mean IOP reduction of 9.8 mmHg (from 24.8±6.7 to 15.0±4.6 mmHg; -40%, p<0.001). No intraoperative or postoperative complications were reported; 6 eyes (9%) required additional glaucoma procedures during follow-up. Combining ab-interno canaloplasty with Hydrus Microstent implantation during cataract surgery resulted in modest but sustained reductions in intraocular pressure and glaucoma medication burden, with a favorable safety profile. However, postoperative IOP frequently remained above levels required for very low target pressures. These findings suggest that this mixed MIGS approach may be considered in carefully selected patients but should not be viewed as a substitute for traditional filtering surgery in advanced disease.

Fusarium fungi are a pervasive threat to global agricultural productivity. They cause a spectrum of plant diseases that result in significant yield losses and threaten food safety by producing mycotoxins that are harmful to human and animal health. In recent years, the exploitation of the RNA interference (RNAi) mechanism has emerged as a promising avenue for the control of Fusarium‐induced diseases, providing both a mechanistic understanding of Fusarium gene function and a potential strategy for environmentally sustainable disease management. However, despite significant progress in elucidating the presence and function of the RNAi pathway in different Fusarium species, a comprehensive understanding of its individual protein components and underlying silencing mechanisms remains elusive. Accordingly, while a considerable number of RNAi‐based approaches to Fusarium control have been developed and many reports of RNAi applications in Fusarium control under laboratory conditions have been published, the applicability of this knowledge in agronomic settings remains an open question, and few convincing data on RNAi‐based disease control under field conditions have been published. This review aims to consolidate the current knowledge on the role of RNAi in Fusarium disease control by evaluating current research and highlighting important avenues for future investigation. We review biotechnology‐based crop protection against Fusarium diseases with novel RNA delivery technologies and RNA active ingredients.

To compare postsurgical anterior chamber flare (ACF) among conventional (trabeculectomy, LEC) and novel (EX-PRESS Shunt, EXP) filtration surgeries and microhook ab interno trabeculotomy (μLOT), a novel minimally invasive glaucoma surgery (MIGS). This retrospective study included 125 primary open angle glaucoma eyes (89 consecutive subjects) treated with μLOT (n=38), LEC (n=12), or EXP (n=75). The intraocular pressure (IOP), numbers of antiglaucoma medication, and ACF at preoperatively and 2 weeks; 1, 3, and 6 months postoperatively were compared among the surgical groups using a mixed-effects regression model. The postoperative IOP ( <0.0001) and medication use were significantly ( <0.0001) lower in the LEC and EXP groups than with μLOT for up to 6 months postoperatively. The ACF differed significantly ( =0.0004) among groups; the ACF was significantly higher ( =0.0097, post-hoc Student's -test) with μLOT (33.6±52.8 pc/msec) than the EXP (15.7±19.9 pc/msec) at 2 weeks and was significantly ( =0.0111, post-hoc -test) lower with μLOT (7.9±2.0 pc/msec) than LEC (12.0±6.1 pc/msec) at 6 months. Considering our observation, although its clinical significance is unclear, not all MIGS are minimally invasive regarding early postsurgical inflammation.

Mark F Pyfer,1,2 Christine Funke,3 Sameh Mosaed,4 Erin Zwick,5 Jennifer Toth,5 Kristian Garcia,5 Nathan M Radcliffe6 1Northern Ophthalmic Associates, Jenkintown, PA, USA; 2Wills Eye Hospital, Philadelphia, PA, USA; 3Barnet, Dulaney & Perkins Eye Center, Mesa, AZ, USA; 4Gavin Herbert Eye Institute, University of California, Irvine, Irvine, CA, USA; 5Verana Health, San Francisco, CA, USA; 6Ophthalmology, Mt Sinai School of Medicine, New York, NY, USACorrespondence: Nathan M Radcliffe, Email drradcliffe@gmail.comPurpose: To characterize clinical outcomes of canaloplasty and trabeculotomy using the OMNI Surgical System (Sight Sciences) as a standalone procedure in primary open-angle glaucoma (POAG) subgroups (phakic, pseudophakic; mild, moderate, severe disease).Design: Retrospective, observational cohort study utilizing the American Academy of Ophthalmology (Academy) IRIS® Registry (Intelligent Research in Sight).Methods: Patients with POAG undergoing standalone OMNI surgery with known laterality between January 2018 and December 2021 and followed for a minimum of 6 months and up to 36 months were included. Analyses divided the cohort into mild, moderate, and severe glaucoma subgroups (International Classification of Disease-10 coding), and lens status (phakic and pseudophakic) subgroups. Outcomes included changes in intraocular pressure (IOP) and glaucoma medication class use.Results: Data from 220 eyes of 187 patients were analyzed. Mean IOP reductions from baseline were clinically and statistically significant at every time point across disease severity groups; mild, 5.5– 9.4 mmHg (p < 0.0026); moderate, 5.3– 7.4 mmHg (p < 0.0001 at all time points); severe, 5.8– 7.6 mmHg (p < 0.0004). Mean IOP reductions were 5.1– 7.4 mmHg in phakic eyes and 5.8– 6.7 mmHg in pseudophakic eyes; p < 0.0001 all time points, both subgroups. Mean medication reductions from baseline were clinically and statistically significant at month 6 and month 12 in the mild and severe groups, and insignificant at all other time points in the three groups. Medication reductions averaged 0.3– 0.4 in phakic eyes (non-significant) and statistically significant reductions of 0.4– 0.6 in pseudophakic eyes (months 6, 12, and 18 [p < 0.01]), with non-significant reductions (0.3– 0.4 medications) at later time points.Conclusion: In this study, standalone OMNI surgery significantly decreased IOP for up to 3 years regardless of disease severity or lens status. This procedure may be considered for phakic or pseudophakic patients with all stages of glaucoma whose therapeutic goals fall within the ranges achievable with standalone surgery.Keywords: MIGS, canaloplasty, primary open-angle glaucoma, pseudophakic, OMNI

PurposeThe XEN45 Gel Stent is a flexible hydrophilic tube placed under the conjunctiva via the anterior chamber. This study investigates the IOP (intraocular pressure)-lowering potential, the risk profile, and the success rate of the XEN45 Gel Stent.MethodsTwo hundred and sixty-one eyes underwent surgery. The mean follow-up time was 8.5 months. The aim of the treatment was to achieve adequate IOP reduction without medication. Therefore, all patients who did not show sufficiently reduced IOP underwent a surgical revision with opening of the conjunctiva. To determinate the success rate, we carried out two kinds of analysis: 1) the primary success rate: eyes with appropiate IOP control without medication or surgical revision, and 2) overall success rate: one surgical revision was allowed.ResultsIntraocular pressure was lowered from 24.3 mmHg (SD 6.6) to 16.8 mmHg (SD 7.6), and the medication score was lowered from 2.6 (SD 1.1) to 0.2 (SD 0.7). Revisional surgery was performed in 80 eyes (34%). After a first revision, intraocular pressure was lowered to 14.0 mmHg (SD 5.1), and the medication score was lowered to 0.2 (SD 0.6). The primary success rate was 66% and the overall success rate 90%. The primary success rate was higher in pseudophakic eyes (73%) than in phakic eyes (53%) or combined surgery (55%).ConclusionsWe conclude from our data that the XEN45 Gel Stent has an IOP-lowering potential and few side-effects. Pseudophakic eyes seem to have a better primary prognosis compared to combined surgery or surgery in phakic eyes.

Jan Niklas Lüke, Vincent Lüke, Thomas Dietlein, Johanna Wiedemann, Alexandra Lappas Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Cologne, 50937, GermanyCorrespondence: Jan Niklas Lüke, Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Köln, DE-50937, Germany, Tel +49 0221-478 4300, Fax +49 0221-478 86052, Email jan.lueke@uk-koeln.dePurpose: To investigate the efficacy of MINIject® (suprachoroidal stent) in lowering intraocular pressure (IOP) in eyes following failed filtering glaucoma surgery.Methods: In this single-center retrospective study, 18 patients who had undergone suprachoroidal stent implantation after failed filtering surgery were analyzed. Follow-up was at least 12 months, and surgical success was measured by 12-month postoperative intraocular pressure (IOP), glaucoma medication, and revision surgery (criteria A: IOP < 21 mmHg, IOP reduction > 20%, no revision surgery; criteria B: IOP < 18 mmHg, IOP reduction > 20%, no revision surgery; criteria C: IOP ≤ 15 mmHg, IOP reduction ≥ 40%, no repeat surgery).Results: After a follow-up period of 12 months, the mean IOP decreased from 27.11± 5.65 mmHg to 15.94± 9.56 mmHg (p< 0.01). The median 12-month postoperative IOP was 14.0 mmHg (IQR: 10.0– 20.0 mmHg). The probability of surgical success was 66.66% for criteria A and B and 50% for criteria C. The identical success rates for criteria A and B were due to overlapping responder groups in this limited sample. Topical medication was significantly reduced from 4.06± 1.08 to 2.13± 1.36 (p< 0.0001).Conclusion: Supraciliary stent implantation provided an effective and safe treatment option for advanced glaucoma following failed filtering surgery and demonstrated significant intraocular pressure reduction. However, the small sample size limits the generalizability of these findings.Keywords: intraocular pressure, CyPass Micro-Stent, MIGS, trabeculectomy, supraciliary, glaucoma drainage device

Despite holding promise, reports of using MIGS in severe glaucoma are scarce, and none has described combining multiple MIGS in this population. To the best of our knowledge, this is the largest study to report outcomes of phacoemulsification and MIGS (Phaco/MIGS) in patients with severe glaucoma. This retrospective review comprised 327 clinical visits of 71 patients with severe glaucoma who underwent Phaco/MIGS with iStent, endocyclodestruction, Kahook Dual Blade, Hydrus Microstent, or a combination of these MIGS (cMIGS) performed between 2016 and 2021. Primary outcomes included intraocular pressure (IOP) and medication burden evaluated by Generalized Estimating Equations, as well as Kaplan-Meier Estimates. Further analyses compared the efficacy of cMIGS and single Phaco/MIGS (sMIGS), procedure duration, visual acuity, and complications. Mean preoperative IOP was 16.7 mmHg ± 5.8 (SD) on 2.3 ± 1.9 medications overall (N = 71), 16.9 ± 6.3 mmHg on 1.7 ± 1.9 medications in the sMIGS group (N = 37), and 16.4 ± 5.3 mmHg on 2.9 ± 1.6 medications in the cMIGS group (N = 34). Throughout 12 months, Phaco/MIGS led to significant reduction patterns in IOP (p < 0.001) and medications (p = 0.03). At 12 months, 47.5%, 87.5%, and 64.7% of the patients achieved IOP ≤ 12 mmHg, 17 mmHg, or predetermined goal IOP, respectively, without additional medication or procedure. Mean 12-month IOP was 13.5 ± 3.1 mmHg on 1.8 ± 1.7 medications. After adjusting for baseline medication burden, the reduction pattern in IOP (p < 0.05) was different between cMIGS and sMIGS, favoring cMIGS, and the groups had similar reduction patterns in medications (p = 0.75). The use of Phaco/MIGS in patients with cataract and severe glaucoma may significantly reduce IOP and medication burden throughout 12 months and, thus, may serve as a stepping stone in severe glaucoma patients with visually significant cataract before proceeding with more invasive glaucoma surgery. This effect may be potentiated by the combination effect of cMIGS.

Topical glaucoma medications have favorable safety and efficacy, but their use is limited by factors such as side effects, nonadherence, costs, ocular surface disease, intraocular pressure fluctuations, diminished quality of life, and the inherent difficulty of penetrating the corneal surface. Although traditionally these limitations have been accepted as an inevitable part of glaucoma treatment, a rapidly-evolving arena of minimally invasive surgical and laser interventions has initiated the beginnings of a reevaluation of the glaucoma treatment paradigm. This reevaluation encompasses an overall shift away from the reactive, topical-medication-first default and a shift toward earlier intervention with laser or surgical therapies such as selective laser trabeculoplasty, sustained-release drug delivery, and micro-invasive glaucoma surgery. Aside from favorable safety, these interventions may have clinically important attributes such as consistent IOP control, cost-effectiveness, independence from patient adherence, prevention of disease progression, and improved quality of life.