Table of Contents - WOC 2012

WOC2012 Abstract Book
Angle Closure
Fri 17 Feb 8:30 - 10:00 Hall 7 - Tokyo Hall
IS-GLA-FR 56 (1)
Mechanisms of Angle-closure
Sakai Hiroshi (1)
1. Ophthalmology, University of the Ryukyus
Several mechanisms for angle closure were postulated from clinical
examinations, results from medical or surgical treatments or imaging devices.
Laser iridotomy is a first line treatment even nowadays; suggesting pupillary
block mechanism is a key mechanism of primary angle closure. Dramatical
effect of lens extraction for primary angle closure proves the importance of
the lens thickness. In addition to these mechanisms, plateau iris or subclinical
uveal effusion has been highlighted using imaging devices.
IS-GLA-FR 56 (2)
Update on Epidemiology of Angle Closure Glaucoma
Nolan Winnie (1)
1. Moorfields Eye Hospital
The evolution of standardized international definitions of angle closure and
data from a number of cross-sectional glaucoma surveys have resulted in a
greater knowledge of the prevalence of primary angle closure glaucoma in
different populations and its contribution of blindness. This presentation will
cover these topics and also discuss mechanisms of angle closure and how
these may vary within and between different populations.
IS-GLA-FR 56 (3)
Surgery for Angle Closure Glaucoma
Sihota Ramanjit
Primary angle closure disease can be divided into stages for appropriate
surgical management. PACS eyes do not require any surgery, only review.
PAC eyes with evidence of closure, but an IOP within normal limits, Stage
I, need to have an iridotomy, and in areas where access to laser is limited,
one could consider doing a surgical iridotomy. Such eyes should later have a
diurnal phasing to determine the need for long-term medications. PAC eyes
having a chronically raised IOP but no glaucomatous neuropathy, Stage II,
uncontrolled with maximally tolerated topical medications after an iridotomy,
could be considered for a trabeculectomy. This is especially so, if progression
of the neuropathy can be documented by imaging etc. Phacoemulsification
of a clear lens is not advised till date. PACG eyes, Stage III, uncontrolled
with maximally tolerated topical medications after an iridotomy, should be
considered for a trabeculectomy to lower IOP to ‹target› levels, depending on
the severity of the neuropathy. It should be done as the first procedure in eyes
having a severe glaucomatous loss. Phacotrabeculectomy is advised in PACG
eyes, with a visually significant cataract, and mild to moderate Glaucomatous
neuropathy. The role of cataract surgery alone, especially in clear lenses,
for the management of PAC/ PACG is still controversial, with no randomized
controlled studies available.
IS-GLA-FR 56 (4)
Laser Iridotomy - Indications and Techniques
Ho Park Ki (1)
1. Seoul National University College of Medicine
In angle closure glaucoma, laser treatment is performed to restore the anatomic
configuration of the anterior chamber angle or to prevent angle closure. Laser
iridotomy relieves pupillary block by making a hole in the peripheral iris and
eliminating the pressure gradient between the posterior and anterior chamber.
Laser iridotomy by argon laser followed by Nd:YAG is used more frequently
than by one laser alone to prevent iris bleeding, to lower the closure rate of the
hole, and to minimize corneal damage.
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IS-GLA-FR 56 (5)
Peripheral Iridoplasty
Ritch Robert (1)
1. New York Eye and Ear Infirmary
Peripheral iridoplasty is a simple, effective way to eliminate appositional angle
closure when iridotomy does not because of non-pupillary block mechanisms.
Long duration, low power, large spot size contraction burns to the iris periphery
compact the stroma, physically opening the angle. ALPI is invaluable in
reversing an attack of acute angle-closure. Facility with darkroom indentation
gonioscopy is necessary for diagnostic purposes.
Indications: Acute and chronic angle closure, plateau iris syndrome, lensrelated
angle closure, malignant glaucoma, nanophthalmos.
Contraindications: Severe corneal edema or opacity, flat anterior chamber,
synechial angle closure.
IS-GLA-FR 56 (6)
Management of Acute Angle-closure
Tham Clement (1)
1. The Chinese University of Hong Kong
The indications, techniques, results, and potential complications of various
treatment options for acute primary angle closure (APAC) will be presented.
These options include laser peripheral iridoplasty, anterior chamber
paracentesis, corneal indentation, laser peripheral iridotomy, and lens
extraction. Participating delegates will be able to select the most appropriate
treatment option for their APAC patients.
Recent Advances in Glaucoma Surgery
Fri 17 Feb 8:30 - 10:00 Hall 11
IS-GLA-FR 57 (1)
Ologen Collagen Matrix Implant
Sarkisian Steve (1)
1. University of Oklahoma College of Medicine
The collagen matrix (Ologen) is an advancement in wound modulation in
glaucoma surgery. It is biodegradable and forms blebs resembling natural
architecture rather than the thin avascular blebs associated with antifibrotic
agents. There is limited data available for Ologen. A case series that represents
the first report of the use of the newest version of Ologen in the US with at least
one year follow up will be presented, as well as clinical pearls in achieving
success when Ologen in glaucoma surgery.
IS-GLA-FR 57 (2)
CO2 Laser Sclerectomy
Melamed Shlomo (1)
1. The Sam Rothberg Glaucoma Center
A new methodology using the CO2 laser for unroofing of Schlemms Canal is
described. A new design allows mounting of the CO2 laser on the operating
microscope with specific scleral ablating designs. The maximal absorption of
laser energy by water provides protection of deeper tissue after unroofing of
canal and aqueous percolation are achieved. The technique of CLASS will be
described and 2 years follow up from several centers will be reported.