Investigators compared early visual and anatomical outcomes after sulfur hexafluoride (SF₆) or perfluoropropane (C₃F₈) tamponade for macular hole repair.

A total of 147 eyes affected by primary full-thickness macular hole underwent pars plana vitrectomy with dye-assisted removal of the internal limiting membrane and gas tamponade. Prone position was prescribed for 48 hours after surgery. All individuals were divided into three groups depending on the size of the hole: small (<250 µm), medium (>250–<400 µm) or large (>400 µm). Eyes within the same group randomly received either SF6 (70 eyes) or C₃F₈ (77 eyes). A complete ophthalmic evaluation, including best-corrected visual acuity and anatomic status of the macular holes, was conducted preoperatively, at one week and one month after surgery. Macular hole volume was calculated using optical coherence tomography scans. The Wilcoxon Signed Ranks Test, the Mann-Whitney Test, the Spearman’s rank-order correlation coefficient and the study of variance for repeated measures were used for statistical analysis.

Mean best-corrected visual acuity improved from 0.92 logMAR to 0.28 logMAR (p<0.001). A reduction of the dimensions of macular holes was observed in all cases, with a total repair of 90 percent (63/70 eyes) in the SF₆ group and 91 percent in the C₃F₈ group (70/77 eyes). There was a negative correlation between the initial minor diameter, the volume of the hole and the rate of anatomic success.

Investigators determined that short-term anatomical and visual outcomes were similar in eyes treated with either SF₆ or C₃F₈, independent of the stage of the macular hole. They offered that initial volume and the minor diameter of the hole may be considered as valid tools for predicting surgical success, adding that age and gender did not appear to influence the prognosis.

Scientists evaluated the efficacy and safety of BAK-free latanoprost, as part of a prospective, open-label, single-arm, multicenter, eight-week study in individuals with primary open-angle glaucoma or ocular hypertension taking BAK-containing latanoprost for ≥12 months.

Individuals were switched to BAK-free latanoprost ophthalmic solution 0.005% administered once daily, and eyes were assessed after 28 and 56 days. Primary efficacy and safety variables were TBUT and treatment-emergent AEs.

At day 56, 40 eyes were evaluable. Mean TBUT increased significantly from baseline (3.67 ±1.60 seconds) to 5.03 ±2.64 and 6.06 ±3.39 seconds after 28 and 56 days of treatment with BAK-free latanoprost (p<0.0001). Ocular Surface Disease Index score also decreased significantly to 12.06 ±13.40 at 28 days and 7.06 ±10.75 at 56 days vs. baseline (18.09 ±18.61, p<0.0001). In addition, inferior corneal staining score decreased significantly to 0.53 from baseline (0.85, p=0.0033). A reduction in conjunctival hyperemia and intraocular pressure was observed at both time points. No treatment-related serious AEs were evident and 12 (26.08 percent) treatment-emergent AEs occurred in seven people, with eye pain and irritation being the most frequent. No clinically significant changes in vital signs or slit-lamp examinations were observed.

Results indicated that switching from BAK-containing latanoprost to BAK-free latanoprost resulted in significant improvements in TBUT; OSDI score; inferior corneal staining score; and measurable reductions in conjunctival hyperemia score. Furthermore, BAK-free latanoprost was well-tolerated, with only mild-to-moderate and self-limiting AEs.

Scientists concluded that BAK-free latanoprost appeared to be effective in protecting ocular surface integrity in individuals with glaucoma, but suggested that further studies are needed to confirm this beneficial effect.

Researchers compared a topical bimatoprost ocular insert with twice-daily timolol eye drops in individuals with open-angle glaucoma or ocular hypertension treated for six months, as part of a parallel-arm, multicenter, double-masked, randomized, controlled trial.

A total of 130 adults with OAG or OHT participated. Eligible participants were randomized 1:1 to receive a bimatoprost insert plus artificial tears twice daily, or a placebo insert plus timolol (0.5% solution) twice daily for six months after a screening washout period. Diurnal IOP measurements (at zero, two and eight hours) were obtained at baseline; and weeks two, six and 12; and months four, five and six. Key eligibility included washout IOP of 23 mmHg or more at time zero; IOP of 20 mmHg or more at two and eight hours; IOP of 34 mmHg or less at all time points; no prior incisional surgery for OAG or OHT; and no known nonresponders to prostaglandins.

The primary efficacy end point examined the difference in mean change from baseline in diurnal IOPs (point estimate, 95 percent confidence interval) across nine coprimary end points at weeks two, six and 12, comparing the bimatoprost arm with the timolol arm, using a noninferiority margin of 1.5 mmHg. Secondary end points were diurnal IOP measurements at months four, five and six, and adverse events (AEs).

A mean reduction from baseline IOP of −3.2 mmHg to −6.4 mmHg was observed for the bimatoprost group compared with −4.2 mmHg to −6.4 mmHg for the timolol group over six months. The study met the noninferiority definition at two of nine time points but was underpowered for the observed treatment effect. Adverse events were consistent with bimatoprost or timolol exposure; no unexpected ocular AEs were observed. Primary retention rate of the insert was 88.5 percent of individuals at six months.

Researchers observed a clinically relevant reduction in mean IOP over six months with a bimatoprost ocular insert, suggesting the insert seemed to be safe and well-tolerated. They found that the topically applied device may provide an alternative to daily eye drops to improve adherence, consistency of delivery and reduction of elevated IOP.