Eyeworld

EW GLAUCOMA 92 March 2018 by Liz Hillman EyeWorld Staff Writer One study 1 published in the British Journal of Ophthalmology eval- uated caffeinated and decaffeinated coffee, iced tea, hot tea, and soft drink consumption among a popu- lation of 1,679 survey participants weighted with the National Health and Nutrition Examination Survey (2005–2006) design. The intent of the study was to evaluate caffein- ated and decaffeinated drinks and glaucoma because previous research had shown both could be associated with temporarily elevated IOP. these lifestyle changes as a potential preventive measure can't hurt. "It's important for [glaucoma specialists] to educate their patients that they must take their med- ications and keep up with their follow-ups, but I think there's also the potential for them to discuss lifestyle modifications that might help—they might not, but they might," Dr. Coleman said. "If pa- tients are aware of it and can poten- tially change their habits, this might lower their pressure and protect their optic nerve in the future." Two studies from the University of California, Los Angeles, estab- lished that people who drank hot tea daily or participated in what was considered moderate to vigorous exercise were 74% and 73%, respec- tively, less likely to have glaucoma. Anne Coleman, MD, Fran and Ray Stark professor of ophthalmolo- gy, Stein Eye Institute, and professor of epidemiology, Fielding School of Public Health, UCLA, is quick to note that this association does not establish causation, but adopting Recent studies look at lifestyle changes to potentially reduce risk for sight-threatening disease W hat do a daily cup of hot tea and regular moderate to vigorous exercise have in com- mon? Besides being part of a generally healthy lifestyle, recent research from separate studies has shown both to have an associa- tion with lower glaucoma risk. Hot tea and exercise associated with lower glaucoma risk glaucoma drainage devices and in- serting these at the time of surgery, may be more difficult to manage, he said. Many eyes that require the Boston KPro are in rough shape already, with a history of glaucoma, Dr. Chew pointed out. "It is recom- mended that a glaucoma procedure be done, either prior to the kerato- prosthesis procedure or concurrent- ly," he said. The study indicated that while glaucoma can still develop with the newer style endothelial and lamellar keratoplasties, the good news is there's a reduced preva- lence of this occurring, Dr. Chew stressed. He hopes that the study helps to highlight the advances that have been made in corneal trans- plantation, as well as the possible advances of glaucoma treatment in these cases. There could be some opportunities for using MIGS in the future here, due to its minimally invasive nature, with less damage to the corneal endothelium and corneal surface. "It's less invasive than performing a trabeculectomy with mitomycin-C or a tube shunt," he said. "But it's not as powerful in reducing pressure." Overall, Dr. Chew hopes that practitioners come away from the study with new consideration for how exciting corneal transplanta- tion is currently. "Up until the last few decades, corneal transplantation was very standardized and had only minor changes," he said. "It has been exciting to see the evolution of the endothelial keratoplasties, the lamellar keratoplasties and the pros- thetic corneal transplants." These have opened up better treatment options, resulting in better and safer outcomes, he concluded. EW Reference 1. Baltaziak M, et al. Glaucoma after corneal replacement. Surv Ophthalmol. 2018;63: 135–148. Editors' note: Dr. Chew has no finan- cial interests related to this comments. Contact information Chew: hall.chew@utoronto.ca Glaucoma continued from page 90

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