Scholars@Duke
Leon Walker Herndon Jr.

Leon Walker Herndon Jr.

Professor of Ophthalmology
Ophthalmology, Glaucoma
hernd012@mc.duke.edu
Box 3802 Med Ctr, Durham, NC 27710
Wadsworth Bldg, Durham, NC 27710
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Selected Publications

Primary Practice Patterns for the Initial Management of Open Angle Glaucoma.

Journal Article J Glaucoma · September 1, 2024 PRCIS: About one-fourth of survey respondents from an ASCRS database initiate treatment for primary open angle glaucoma (POAG) with laser trabeculoplasty. Factors impacting physicians' choice of laser versus topical treatment for POAG were explored. PURPOS ... Full text Link to item Cite

Surgical Outcomes, Ocular Safety and Tolerability of Bio-Interventional Cyclodialysis with Allograft Scleral Reinforcement: Clinical Experience of More than 240 Cases.

Journal Article J Clin Med · August 6, 2024 Background: To report the surgical safety of reinforced bio-interventional cyclodialysis with scleral allograft reinforcement. Methods: This was a consecutive case series of 243 eyes with open-angle glaucoma who underwent a bio-scaffolded cyclodialysis (BS ... Full text Link to item Cite

The Effect of Bimatoprost Implant on Glaucoma Patients: An Observational Study.

Journal Article J Glaucoma · June 1, 2024 PRCIS: In this retrospective study of glaucoma patients receiving the bimatoprost implant at Duke Eye Center, the number of topical intraocular pressure-lowering medications was significantly reduced through 12 months after the implant. PURPOSE: To study t ... Full text Link to item Cite

Minimally Invasive Glaucoma Surgery: Past, Present, and Future

Journal Article Advances in Ophthalmology and Optometry · August 1, 2023 Full text Cite

Younger Age and Longer Case Times Associated With Emergency Department Visits After Cataract Surgery.

Journal Article Am J Ophthalmol · January 2023 PURPOSE: To characterize the frequency, reasons, hospital costs, and risk factors for emergency department (ED) visits within 30 days of cataract surgery. DESIGN: Retrospective cohort study. METHODS: A retrospective review of all cataract surgeries at Duke ... Full text Link to item Cite

Intracanalicular Dexamethasone Insert or Topical Prednisolone Following iStent and Hydrus Surgery for Glaucoma.

Journal Article J Glaucoma · August 1, 2022 PRCIS: Using an intracanalicular dexamethasone insert or topical prednisolone following iStent and Hydrus surgery provided similar short-term control of postoperative inflammation. PURPOSE: The purpose of this study was to compare postoperative inflammatio ... Full text Link to item Cite

Incidence of Glaucoma Progression and Rate of Visual Field Deterioration in a Cohort of Urban Ghanaians.

Journal Article J Glaucoma · July 1, 2022 PRCIS: The annual incidence of glaucoma progression (9.7%) and rates of visual field mean deviation (MD) change in progressors (-1.02±0.06 dB/y) are high in a small cohort of urban Ghanaians. PURPOSE: To report the incidence of glaucoma progression and the ... Full text Link to item Cite

Clinical characteristics and mortality rates for suprachoroidal hemorrhage: seven-year experience at a tertiary eye center.

Journal Article Graefes Arch Clin Exp Ophthalmol · March 2022 PURPOSE: To investigate comorbidities and medications associated with acute (ASCH) and delayed (DSCH) suprachoroidal hemorrhage (SCH), and to explore visual outcomes and mortality following SCH. METHODS: Retrospective review of SCH cases diagnosed at a ter ... Full text Link to item Cite

Risk Factors for Corneal Striae in Eyes After Glaucoma Surgery.

Journal Article J Glaucoma · February 1, 2022 PRCIS: Eyes with corneal striae had steeper cornea, induced astigmatism, and higher corneal hysteresis (CH), which implies a relationship between striae, corneal shape, and the cornea's resistance to deformation at low intraocular pressures (IOPs). BACKGRO ... Full text Link to item Cite

Hydrogel Sealant for Closure of Clear Corneal Incisions in Combined Glaucoma Procedures.

Journal Article Clin Ophthalmol · 2022 PURPOSE: The purpose of this study is to determine whether ReSure hydrogel sealant is superior to standard suture for closure of clear corneal incisions in the setting of combined glaucoma procedures. SETTING: Glaucoma Department, Duke University Eye Cente ... Full text Link to item Cite

Effect of Nylon Wick Technique on Early Intraocular Pressure Control in Nonvalved Aqueous Shunt Surgery.

Journal Article J Glaucoma · January 1, 2021 PRECIS: The use of nylon wicks with fenestrations in nonvalved aqueous shunt surgery significantly reduces intraocular pressure (IOP) and glaucoma medication usage in the immediate postoperative period compared with the use of fenestrations alone. PURPOSE: ... Full text Link to item Cite

Trabecular Microbypass Stent and Phacoemulsification in African American Patients With Open-angle Glaucoma: Outcomes and Effect of Prior Laser Trabeculoplasty.

Journal Article J Glaucoma · January 1, 2021 PRECIS: In African American patients with glaucoma, iStent/phacoemulsification lowered intraocular pressure and reduced glaucoma medication usage for up to 1 year, even in patients with prior selective laser trabeculoplasty (SLT). PURPOSE: Currently, no st ... Full text Link to item Cite

Visual outcomes of combined cataract surgery and minimally invasive glaucoma surgery.

Journal Article J Cataract Refract Surg · October 2020 Minimally invasive glaucoma surgery (MIGS) has become a reliable standard of care for the treatment of glaucoma when combined with cataract surgery. This review describes the MIGS procedures currently combined with and without cataract surgery with a focus ... Full text Link to item Cite

Open-Angle Glaucoma: Burden of Illness, Current Therapies, and the Management of Nocturnal IOP Variation.

Journal Article Ophthalmol Ther · March 2020 Glaucoma is a chronic, debilitating disease and a leading cause of global blindness. Despite treatment efforts, 10% of patients demonstrate loss of vision. In the US, > 80% of glaucoma cases are classified as open-angle glaucoma (OAG), with primary open-an ... Full text Link to item Cite

Association of Genetic Variants With Primary Open-Angle Glaucoma Among Individuals With African Ancestry.

Journal Article JAMA · November 5, 2019 IMPORTANCE: Primary open-angle glaucoma presents with increased prevalence and a higher degree of clinical severity in populations of African ancestry compared with European or Asian ancestry. Despite this, individuals of African ancestry remain understudi ... Full text Link to item Cite

Consultation Section: Glaucoma. July consultation #6.

Journal Article J Cataract Refract Surg · July 2019 Full text Link to item Cite

Eight-Year Incidence of Open-Angle Glaucoma in the Tema Eye Survey.

Journal Article Ophthalmology · March 2019 PURPOSE: To determine the incidence of open-angle glaucoma (OAG) and its risk factors in the Tema Eye Survey in Ghana, West Africa. DESIGN: Longitudinal, observational population-based study. PARTICIPANTS: One thousand two hundred five of 1500 participants ... Full text Link to item Cite

Association of Long-term Ambient Black Carbon Exposure and Oxidative Stress Allelic Variants With Intraocular Pressure in Older Men.

Journal Article JAMA Ophthalmol · February 1, 2019 IMPORTANCE: Elevated intraocular pressure is a major risk factor for glaucoma, a leading cause of irreversible blindness worldwide. Environmental air pollution has been suggested as a potential contributor to elevated intraocular pressure; however, no stud ... Full text Link to item Cite

Scheduled Postoperative Ripcord Removal in Baerveldt 350 Implants: A Prospective, Randomized Trial.

Journal Article J Glaucoma · February 2019 PURPOSE: Many surgeons remove the ripcord in the Baerveldt glaucoma drainage device to better control tube opening and intraocular pressure (IOP) lowering postoperatively. However, complications following Baerveldt implant surgery with or without ripcord r ... Full text Link to item Cite

Primary Practice Patterns for the Initial Management of Open Angle Glaucoma.

Journal Article J Glaucoma · September 1, 2024 PRCIS: About one-fourth of survey respondents from an ASCRS database initiate treatment for primary open angle glaucoma (POAG) with laser trabeculoplasty. Factors impacting physicians' choice of laser versus topical treatment for POAG were explored. PURPOS ... Full text Link to item Cite

Surgical Outcomes, Ocular Safety and Tolerability of Bio-Interventional Cyclodialysis with Allograft Scleral Reinforcement: Clinical Experience of More than 240 Cases.

Journal Article J Clin Med · August 6, 2024 Background: To report the surgical safety of reinforced bio-interventional cyclodialysis with scleral allograft reinforcement. Methods: This was a consecutive case series of 243 eyes with open-angle glaucoma who underwent a bio-scaffolded cyclodialysis (BS ... Full text Link to item Cite

The Effect of Bimatoprost Implant on Glaucoma Patients: An Observational Study.

Journal Article J Glaucoma · June 1, 2024 PRCIS: In this retrospective study of glaucoma patients receiving the bimatoprost implant at Duke Eye Center, the number of topical intraocular pressure-lowering medications was significantly reduced through 12 months after the implant. PURPOSE: To study t ... Full text Link to item Cite

Minimally Invasive Glaucoma Surgery: Past, Present, and Future

Journal Article Advances in Ophthalmology and Optometry · August 1, 2023 Full text Cite

Younger Age and Longer Case Times Associated With Emergency Department Visits After Cataract Surgery.

Journal Article Am J Ophthalmol · January 2023 PURPOSE: To characterize the frequency, reasons, hospital costs, and risk factors for emergency department (ED) visits within 30 days of cataract surgery. DESIGN: Retrospective cohort study. METHODS: A retrospective review of all cataract surgeries at Duke ... Full text Link to item Cite

Intracanalicular Dexamethasone Insert or Topical Prednisolone Following iStent and Hydrus Surgery for Glaucoma.

Journal Article J Glaucoma · August 1, 2022 PRCIS: Using an intracanalicular dexamethasone insert or topical prednisolone following iStent and Hydrus surgery provided similar short-term control of postoperative inflammation. PURPOSE: The purpose of this study was to compare postoperative inflammatio ... Full text Link to item Cite

Incidence of Glaucoma Progression and Rate of Visual Field Deterioration in a Cohort of Urban Ghanaians.

Journal Article J Glaucoma · July 1, 2022 PRCIS: The annual incidence of glaucoma progression (9.7%) and rates of visual field mean deviation (MD) change in progressors (-1.02±0.06 dB/y) are high in a small cohort of urban Ghanaians. PURPOSE: To report the incidence of glaucoma progression and the ... Full text Link to item Cite

Clinical characteristics and mortality rates for suprachoroidal hemorrhage: seven-year experience at a tertiary eye center.

Journal Article Graefes Arch Clin Exp Ophthalmol · March 2022 PURPOSE: To investigate comorbidities and medications associated with acute (ASCH) and delayed (DSCH) suprachoroidal hemorrhage (SCH), and to explore visual outcomes and mortality following SCH. METHODS: Retrospective review of SCH cases diagnosed at a ter ... Full text Link to item Cite

Risk Factors for Corneal Striae in Eyes After Glaucoma Surgery.

Journal Article J Glaucoma · February 1, 2022 PRCIS: Eyes with corneal striae had steeper cornea, induced astigmatism, and higher corneal hysteresis (CH), which implies a relationship between striae, corneal shape, and the cornea's resistance to deformation at low intraocular pressures (IOPs). BACKGRO ... Full text Link to item Cite

Hydrogel Sealant for Closure of Clear Corneal Incisions in Combined Glaucoma Procedures.

Journal Article Clin Ophthalmol · 2022 PURPOSE: The purpose of this study is to determine whether ReSure hydrogel sealant is superior to standard suture for closure of clear corneal incisions in the setting of combined glaucoma procedures. SETTING: Glaucoma Department, Duke University Eye Cente ... Full text Link to item Cite

Effect of Nylon Wick Technique on Early Intraocular Pressure Control in Nonvalved Aqueous Shunt Surgery.

Journal Article J Glaucoma · January 1, 2021 PRECIS: The use of nylon wicks with fenestrations in nonvalved aqueous shunt surgery significantly reduces intraocular pressure (IOP) and glaucoma medication usage in the immediate postoperative period compared with the use of fenestrations alone. PURPOSE: ... Full text Link to item Cite

Trabecular Microbypass Stent and Phacoemulsification in African American Patients With Open-angle Glaucoma: Outcomes and Effect of Prior Laser Trabeculoplasty.

Journal Article J Glaucoma · January 1, 2021 PRECIS: In African American patients with glaucoma, iStent/phacoemulsification lowered intraocular pressure and reduced glaucoma medication usage for up to 1 year, even in patients with prior selective laser trabeculoplasty (SLT). PURPOSE: Currently, no st ... Full text Link to item Cite

Visual outcomes of combined cataract surgery and minimally invasive glaucoma surgery.

Journal Article J Cataract Refract Surg · October 2020 Minimally invasive glaucoma surgery (MIGS) has become a reliable standard of care for the treatment of glaucoma when combined with cataract surgery. This review describes the MIGS procedures currently combined with and without cataract surgery with a focus ... Full text Link to item Cite

Open-Angle Glaucoma: Burden of Illness, Current Therapies, and the Management of Nocturnal IOP Variation.

Journal Article Ophthalmol Ther · March 2020 Glaucoma is a chronic, debilitating disease and a leading cause of global blindness. Despite treatment efforts, 10% of patients demonstrate loss of vision. In the US, > 80% of glaucoma cases are classified as open-angle glaucoma (OAG), with primary open-an ... Full text Link to item Cite

Association of Genetic Variants With Primary Open-Angle Glaucoma Among Individuals With African Ancestry.

Journal Article JAMA · November 5, 2019 IMPORTANCE: Primary open-angle glaucoma presents with increased prevalence and a higher degree of clinical severity in populations of African ancestry compared with European or Asian ancestry. Despite this, individuals of African ancestry remain understudi ... Full text Link to item Cite

Consultation Section: Glaucoma. July consultation #6.

Journal Article J Cataract Refract Surg · July 2019 Full text Link to item Cite

Eight-Year Incidence of Open-Angle Glaucoma in the Tema Eye Survey.

Journal Article Ophthalmology · March 2019 PURPOSE: To determine the incidence of open-angle glaucoma (OAG) and its risk factors in the Tema Eye Survey in Ghana, West Africa. DESIGN: Longitudinal, observational population-based study. PARTICIPANTS: One thousand two hundred five of 1500 participants ... Full text Link to item Cite

Association of Long-term Ambient Black Carbon Exposure and Oxidative Stress Allelic Variants With Intraocular Pressure in Older Men.

Journal Article JAMA Ophthalmol · February 1, 2019 IMPORTANCE: Elevated intraocular pressure is a major risk factor for glaucoma, a leading cause of irreversible blindness worldwide. Environmental air pollution has been suggested as a potential contributor to elevated intraocular pressure; however, no stud ... Full text Link to item Cite

Scheduled Postoperative Ripcord Removal in Baerveldt 350 Implants: A Prospective, Randomized Trial.

Journal Article J Glaucoma · February 2019 PURPOSE: Many surgeons remove the ripcord in the Baerveldt glaucoma drainage device to better control tube opening and intraocular pressure (IOP) lowering postoperatively. However, complications following Baerveldt implant surgery with or without ripcord r ... Full text Link to item Cite

The Effect of Suture Wick Technique on Early Intraocular Pressure Control After Nonvalved (Baerveldt 350) Glaucoma Drainage Device Surgery.

Journal Article J Glaucoma · December 2018 PURPOSE: The purpose of this study was to compare early postoperative outcomes of patients who underwent Baerveldt 350-mm aqueous drainage device (Abbott Medical Optics Inc., Santa Ana, CA) implantation with and without 7-0 polyglactin (vicryl) suture plac ... Full text Link to item Cite

Reply.

Journal Article Am J Ophthalmol · April 2018 Full text Link to item Cite

The Short-term Effect of Subtenon Sponge Application Versus Subtenon Irrigation of Mitomycin-C on the Outcomes of Trabeculectomy With Ex-PRESS Glaucoma Filtration Device: A Randomized Trial.

Journal Article J Glaucoma · February 2018 PURPOSE: Traditionally, during trabeculectomy, Mitomycin-C (MMC) is applied to the tissues using surgical sponges. However, alternate modes of application exist. This study assessed the success rates, complication rates, final intraocular pressure (IOP), a ... Full text Link to item Cite

Longitudinal Change in Central Corneal Thickness in the Tema Eye Survey.

Journal Article Am J Ophthalmol · February 2018 PURPOSE: To determine the change and rate of change in central corneal thickness (CCT) and their determinants. DESIGN: Longitudinal observational population-based study. METHODS: A total of 758 normal and 58 glaucomatous subjects underwent complete eye exa ... Full text Link to item Cite

A comparison of cup-to-disc ratio estimates by fundus biomicroscopy and stereoscopic optic disc photography in the Tema Eye Survey.

Journal Article Eye (Lond) · August 2017 PurposeTo determine if there are systematic differences in cup-to-disc ratio (CDR) grading using fundus biomicroscopy compared to stereoscopic disc photograph reading.MethodsThe vertical cup-to-disc ratio (VCDR) and horizontal cup-to-disc ratio (HCDR) of 2 ... Full text Link to item Cite

Genetic association study of exfoliation syndrome identifies a protective rare variant at LOXL1 and five new susceptibility loci.

Journal Article Nat Genet · July 2017 Exfoliation syndrome (XFS) is the most common known risk factor for secondary glaucoma and a major cause of blindness worldwide. Variants in two genes, LOXL1 and CACNA1A, have previously been associated with XFS. To further elucidate the genetic basis of X ... Full text Link to item Cite

Cost-comparison of two trabecular micro-bypass stents versus selective laser trabeculoplasty or medications only for intraocular pressure control for patients with open-angle glaucoma.

Journal Article J Med Econ · July 2017 AIM: Patients with open-angle glaucoma (OAG) whose intraocular pressure is not adequately controlled by one medication have several treatment options in the US. This analysis evaluated direct costs of unilateral eye treatment with two trabecular micro-bypa ... Full text Link to item Cite

Simultaneous Implantation of an Ahmed and Baerveldt Glaucoma Drainage Device for Uncontrolled Intraocular Pressure in Advanced Glaucoma.

Journal Article J Glaucoma · February 2017 PURPOSE: To evaluate efficacy and safety of a novel technique, simultaneous implantation of Ahmed and Baerveldt shunts, for improved control of intraocular pressure (IOP) in advanced glaucoma with visual field defects threatening central fixation. PATIENTS ... Full text Link to item Cite

Assessing the Role of the Family/Support System Perspective in Patients With Glaucoma.

Journal Article J Glaucoma · July 2016 PURPOSE: To investigate the role of the family/friends support system for patients with glaucoma and their perspective on barriers to effective glaucoma management. METHODS: Six focus groups were conducted in 3 geographically and ethnically diverse areas o ... Full text Link to item Cite

Why Patients With Glaucoma Lose Vision: The Patient Perspective.

Journal Article J Glaucoma · July 2016 PURPOSE: To explore why glaucoma patients believe that glaucoma continues to cause vision loss despite the availability of effective treatment. METHODS: Nine focus groups were conducted in 3 geographically and ethnically diverse areas of the United States ... Full text Link to item Cite

Mathematical Modeling of Outflow Facility Increase With Trabecular Meshwork Bypass and Schlemm Canal Dilation.

Journal Article J Glaucoma · April 2016 PURPOSE: To mathematically model the conventional aqueous humor outflow system with trabecular meshwork (TM) bypass and Schlemm canal (SC) dilation. METHODS: The SC was modeled as a rectangular channel with the TM modeled as a permeable membrane. The colle ... Full text Link to item Cite

Postoperative Complications in the Ahmed Baerveldt Comparison Study During Five Years of Follow-up.

Journal Article Am J Ophthalmol · March 2016 PURPOSE: To compare the late complications in the Ahmed Baerveldt Comparison Study during 5 years of follow-up. DESIGN: Multicenter, prospective randomized clinical trial. METHODS: setting: Sixteen international clinical centers. STUDY POPULATION: Two hund ... Full text Link to item Cite

Primary Open-Angle Glaucoma Preferred Practice Pattern(®) Guidelines.

Journal Article Ophthalmology · January 2016 UNLABELLED: PRIMARY OPEN-ANGLE GLAUCOMA PREFERRED PRACTICE PATTERN® GUIDELINES: Evidence-based update of the Primary Open-Angle Glaucoma Preferred Practice Pattern® (PPP) guidelines, describing the diagnosis and management of patients with primary open-ang ... Full text Link to item Cite

Primary Angle Closure Preferred Practice Pattern(®) Guidelines.

Journal Article Ophthalmology · January 2016 UNLABELLED: PRIMARY ANGLE CLOSURE PREFERRED PRACTICE PATTERN® GUIDELINES: Evidence-based update of the Primary Angle Closure Preferred Practice Pattern® (PPP) guidelines, describing the diagnosis and management of patients with primary angle closure with d ... Full text Link to item Cite

Primary Open-Angle Glaucoma Suspect Preferred Practice Pattern(®) Guidelines.

Journal Article Ophthalmology · January 2016 UNLABELLED: PRIMARY OPEN-ANGLE GLAUCOMA SUSPECT PREFERRED PRACTICE PATTERN® GUIDELINES: Evidence-based update of the Primary Open-Angle Suspect Glaucoma Preferred Practice Pattern® (PPP) guidelines, describing the diagnosis and management of patients with ... Full text Link to item Cite

IOP: Corneal hysteresis

Chapter · January 1, 2016 Full text Cite

A common variant near TGFBR3 is associated with primary open angle glaucoma.

Journal Article Hum Mol Genet · July 1, 2015 Primary open angle glaucoma (POAG), a major cause of blindness worldwide, is a complex disease with a significant genetic contribution. We performed Exome Array (Illumina) analysis on 3504 POAG cases and 9746 controls with replication of the most significa ... Full text Link to item Cite

July consultation #6.

Journal Article J Cataract Refract Surg · July 2015 Full text Link to item Cite

The effect of scheduled ripcord removal on the outcomes of Baerveldt 350 implants

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · June 1, 2015 Link to item Cite

December consultation #6.

Other J Cataract Refract Surg · January 2015 Full text Link to item Cite

The effect of medical therapy on IOP control in Ghana.

Journal Article Ghana Med J · September 2014 BACKGROUND: To investigate IOP control following twelve months of continuous medical therapy in Ghana. METHODS: This retrospective case series included 163 glaucoma patients diagnosed at a referral eye center between 1996 and 2006. Information collected in ... Full text Link to item Cite

Simultaneous Implantation of Two Glaucoma Drainage Devices for Uncontrolled Advanced Glaucoma

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · April 1, 2014 Link to item Cite

January consultation # 7.

Other J Cataract Refract Surg · January 2014 Full text Link to item Cite

Osteogenesis imperfecta and primary open angle glaucoma: genotypic analysis of a new phenotypic association.

Journal Article Mol Vis · 2014 PURPOSE: Osteogenesis imperfecta (OI) is a group of inherited disorders characterized by bone fragility. Ocular findings include blue sclera, low ocular rigidity, and thin corneal thickness. However, there are no documented cases linking OI and primary ope ... Link to item Cite

Glaucoma risk factors: The cornea

Chapter · January 1, 2014 Assessment of rates of disease progression, along with considerations about life expectancy and treatment side effects, can help clinicians customize aggressiveness of therapy to increase the chances that patients will avoid functional impairment during th ... Full text Cite

Investigation of known genetic risk factors for primary open angle glaucoma in two populations of African ancestry.

Journal Article Invest Ophthalmol Vis Sci · September 17, 2013 PURPOSE: Multiple genes have been associated with primary open angle glaucoma (POAG) in Caucasian populations. We now examine the association of these loci in populations of African ancestry, populations at particularly high risk for POAG. METHODS: We geno ... Full text Link to item Cite

Prevalence of glaucoma in an urban West African population: the Tema Eye Survey.

Journal Article JAMA Ophthalmol · May 2013 IMPORTANCE: Multiple studies have found an increased prevalence, younger age at onset, and more severe course of glaucoma in people of African descent, but these findings are based on studies conducted outside Africa. OBJECTIVE: To determine the prevalence ... Full text Link to item Cite

Osteogenesis Imperfecta and the Eye

Chapter · January 1, 2013 While the many skeletal, auditory, dental and other anomalies in osteogenesis imperfecta (OI) have been well documented in the medical literature, the eye and the visual system are also commonly affected in patients with OI. As type I collagen fibers are a ... Full text Cite

Blindness and visual impairment in an urban West African population: the Tema Eye Survey.

Journal Article Ophthalmology · September 2012 OBJECTIVE: To determine the prevalence, causes, and risk factors of blindness and visual impairment among persons aged 40 years or older residing in an urban West African location. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 5 ... Full text Link to item Cite

Treatment outcomes in the Tube Versus Trabeculectomy (TVT) study after five years of follow-up.

Journal Article Am J Ophthalmol · May 2012 PURPOSE: To report 5-year treatment outcomes in the Tube Versus Trabeculectomy (TVT) Study. DESIGN: Multicenter randomized clinical trial. SETTINGS: Seventeen clinical centers. STUDY POPULATION: Patients 18 to 85 years of age who had previous trabeculectom ... Full text Link to item Cite

Postoperative complications in the Tube Versus Trabeculectomy (TVT) study during five years of follow-up.

Journal Article Am J Ophthalmol · May 2012 PURPOSE: To describe postoperative complications encountered in the Tube Versus Trabeculectomy (TVT) Study during 5 years of follow-up. DESIGN: Multicenter randomized clinical trial. SETTINGS: Seventeen clinical centers. STUDY POPULATION: Patients 18 to 85 ... Full text Link to item Cite

The Tube Versus Trabeculectomy Study: interpretation of results and application to clinical practice.

Journal Article Curr Opin Ophthalmol · March 2012 PURPOSE OF REVIEW: The Tube Versus Trabeculectomy (TVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube-shunt surgery to trabeculectomy with mitomycin C (MMC) in eyes with previous cataract and/or failed glaucoma ... Full text Link to item Cite

Glaucoma Progression Analysis software compared with expert consensus opinion in the detection of visual field progression in glaucoma.

Journal Article Ophthalmology · March 2012 PURPOSE: To compare the results of Glaucoma Progression Analysis (GPA, Carl Zeiss Meditec, Dublin, CA) to subjective expert consensus in the detection of glaucomatous visual field progression. DESIGN: Retrospective, observational case series. PARTICIPANTS: ... Full text Link to item Cite

Low prevalence of myocilin mutations in an African American population with primary open-angle glaucoma.

Journal Article Mol Vis · 2012 PURPOSE: Mutations in the myocilin gene (MYOC) are associated with primary open-angle glaucoma (POAG) in many different populations. This study represents the first large survey of MYOC mutations in an African American population. METHODS: We recruited 529 ... Link to item Cite

GALC deletions increase the risk of primary open-angle glaucoma: the role of Mendelian variants in complex disease.

Journal Article PLoS One · 2011 DNA copy number variants (CNVs) have been reported in many human diseases including autism and schizophrenia. Primary Open Angle Glaucoma (POAG) is a complex adult-onset disorder characterized by progressive optic neuropathy and vision loss. Previous studi ... Full text Link to item Cite

Genome-wide linkage scan for primary open angle glaucoma: influences of ancestry and age at diagnosis.

Journal Article PLoS One · 2011 Primary open-angle glaucoma (POAG) is the most common form of glaucoma and one of the leading causes of vision loss worldwide. The genetic etiology of POAG is complex and poorly understood. The purpose of this work is to identify genomic regions of interes ... Full text Link to item Cite

A comparison of the Ex-PRESS™ mini glaucoma shunt with standard trabeculectomy in the surgical treatment of glaucoma.

Journal Article Ophthalmic Surg Lasers Imaging · 2011 BACKGROUND AND OBJECTIVE: To compare the success and complication rates of patients with glaucoma who had an Ex-PRESS mini glaucoma shunt device implantation (Optonol, Ltd., Neve Ilan, Israel) to those who had conventional trabeculectomy. PATIENTS AND METH ... Full text Link to item Cite

Interobserver agreement and intraobserver reproducibility of the subjective determination of glaucomatous visual field progression.

Journal Article Ophthalmology · January 2011 PURPOSE: To determine the extent of interobserver agreement and intraobserver reproducibility of the subjective determination of visual field progression with achromatic automated static perimetry in eyes with glaucoma, and to determine the impact of acces ... Full text Link to item Cite

IOP: Corneal hysteresis

Chapter · December 1, 2010 Corneal hysteresis (CH) is a measurement that reflects the viscoelastic properties of the cornea and its biomechanical integrity. Hysteresis is expressed in units of mmHg, just like intraocular pressure (IOP). Unlike IOP, CH shows no significant variation ... Full text Cite

Reply

Other American Journal of Ophthalmology · August 1, 2010 Full text Cite

Combined fluocinolone acetonide intravitreal insertion and glaucoma drainage device placement for chronic uveitis and glaucoma.

Journal Article Am J Ophthalmol · May 2010 Featured Publication PURPOSE: To determine whether a fluocinolone acetonide sustained-release intravitreal drug delivery system can be implanted safely at the same time that a glaucoma drainage device is placed for eyes with uveitis and elevated intraocular pressure (IOP) rece ... Full text Link to item Cite

Reply

Journal Article American Journal of Ophthalmology · April 1, 2010 Full text Cite

Review of results from the Tube Versus Trabeculectomy Study.

Journal Article Curr Opin Ophthalmol · March 2010 PURPOSE OF REVIEW: The Tube Versus Trabeculectomy (TVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube-shunt surgery to trabeculectomy with mitomycin (MMC) in eyes with previous cataract and/or unsuccessful glauc ... Full text Link to item Cite

Glaucoma risk factors: The cornea

Chapter · January 1, 2010 It has long been accepted that elevated intraocular pressure (IOP) is a key parameter in the diagnosis of glaucoma. IOP is used in the assessment of disease progression and response to treatment. In fact, it is the only modifiable risk factor for glaucoma. ... Full text Cite

Three-year follow-up of the tube versus trabeculectomy study.

Journal Article Am J Ophthalmol · November 2009 Featured Publication PURPOSE: To report 3-year results of the Tube Versus Trabeculectomy (TVT) Study. DESIGN: Multicenter randomized clinical trial. SETTING: Seventeen clinical centers. STUDY POPULATION: Patients 18 to 85 years of age who had previous trabeculectomy, cataract ... Full text Link to item Cite

Surgical management of hypotony owing to overfiltration in eyes receiving glaucoma drainage devices.

Journal Article J Glaucoma · 2009 Featured Publication PURPOSE: To assess rates of surgical revision of glaucoma drainage devices (GDDs) from hypotony owing to overfiltration and its management. DESIGN: Retrospective case series. METHODS: Demographic characteristics, type of GDD implanted, type of surgical rev ... Full text Link to item Cite

Glaucoma patients' trust in the physician.

Journal Article J Ophthalmol · 2009 Featured Publication Objectives. To describe glaucoma patients' trust in the physician and to test the hypothesis that increased interpersonal trust is associated with increased medication adherence. Methods. One hundred ninety-five subjects with open-angle glaucoma seen by mu ... Full text Link to item Cite

Lack of association between LOXL1 variants and primary open-angle glaucoma in three different populations.

Journal Article Invest Ophthalmol Vis Sci · August 2008 PURPOSE: Significant association has recently been reported between pseudoexfoliation glaucoma (XFG) and two single-nucleotide polymorphisms (SNPs), rs3825942, and rs1048661, in the lysyl oxidase-like 1 gene (LOXL1). The purpose of this study was to invest ... Full text Link to item Cite

DSEK in eyes with double glaucoma tubes.

Other Ophthalmology · August 2008 Featured Publication Full text Link to item Cite

Health literacy and vision-related quality of life.

Journal Article Br J Ophthalmol · June 2008 BACKGROUND: Non-visual factors influence a person's vision-related quality of life (VRQoL). The purpose of this study was to assess the relationship between health literacy and VRQoL in glaucoma patients. METHODS: One hundred and ninety-five subjects with ... Full text Link to item Cite

Phthisis after endoscopic cyclophotocoagulation.

Journal Article Ophthalmic Surg Lasers Imaging · 2008 Featured Publication A 47-year-old man was treated with one session of endoscopic cyclophotocoagulation for uncontrolled, elevated intraocular pressure. Before treatment, the eye was quiet and uninflamed. Pretreatment visual acuity was 4/200 and the intraocular pressure was 24 ... Full text Link to item Cite

Optineurin coding variants in Ghanaian patients with primary open-angle glaucoma.

Journal Article Mol Vis · 2008 PURPOSE: Coding variants in the optineurin gene (OPTN, GLC1E) have been reported to play a role in primary open-angle glaucoma (POAG) in various populations. This study investigated the role of OPTN sequence variants in patients with POAG in Ghana (West Af ... Link to item Cite

Exposure of Ex-PRESS Miniature Glaucoma Devices: case series and technique for tube shunt removal.

Journal Article J Glaucoma · December 2007 Featured Publication PURPOSE: To report a series of cases involving Ex-PRESS Miniature Glaucoma Device exposure and discuss the surgical techniques we used to remove the shunts. METHODS: A retrospective chart review was performed to identify all patients who were referred for ... Full text Link to item Cite

The clinical utility of dynamic contour tonometry and ocular pulse amplitude.

Journal Article J Glaucoma · December 2007 Featured Publication PURPOSE: To determine if ocular pulse amplitude (OPA) as measured by dynamic contour tonometry (DCT) is related to severity of glaucoma, and if intraocular pressure (IOP) as measured by DCT is related to central corneal thickness (CCT). METHODS: Patients w ... Full text Link to item Cite

Management of suprachoroidal hemorrhage.

Journal Article J Glaucoma · September 2007 Full text Link to item Cite

Aqueous humor sCD44 concentration and visual field loss in primary open-angle glaucoma.

Journal Article J Glaucoma · August 2007 PURPOSE: To correlate aqueous humor soluble CD44 (sCD44) concentration, visual field loss, and glaucoma risk factors in primary open-angle glaucoma (POAG) patients. METHODS: Aqueous samples were obtained by paracentesis from normal and glaucoma patients wh ... Full text Link to item Cite

In response [3]

Other Journal of Glaucoma · March 1, 2007 Full text Cite

Surgical complications in the Tube Versus Trabeculectomy Study during the first year of follow-up.

Journal Article Am J Ophthalmol · January 2007 Featured Publication PURPOSE: To describe the intraoperative and postoperative complications encountered during the first year of follow-up in the Tube Versus Trabeculectomy (TVT) Study. DESIGN: Multicenter randomized clinical trial. SETTING: Seventeen clinical centers. STUDY ... Full text Link to item Cite

Treatment outcomes in the tube versus trabeculectomy study after one year of follow-up.

Journal Article Am J Ophthalmol · January 2007 PURPOSE: To report one-year results of the Tube Versus Trabeculectomy (TVT) Study. DESIGN: Multicenter randomized clinical trial. SETTING: 17 Clinical Centers. STUDY POPULATION: Patients 18 to 85 years of age who had previous trabeculectomy and/or cataract ... Full text Link to item Cite

Health literacy and adherence to glaucoma therapy.

Journal Article Am J Ophthalmol · August 2006 PURPOSE: To describe the health literacy of subjects with open angle glaucoma and to investigate the hypothesis that low health literacy is associated with poor glaucoma medication adherence. DESIGN: Cross-sectional patient survey and concomitant chart rev ... Full text Link to item Cite

Longitudinal changes in central corneal thickness and their relation to glaucoma status: an 8 year follow up study.

Journal Article Br J Ophthalmol · June 2006 Featured Publication AIMS: To determine if central corneal thickness (CCT) changes over time and if this change relates to glaucoma progression. METHODS: 39 patients (64 eyes) with open angle glaucoma, ocular hypertension, glaucoma suspect status, or a normal eye examination w ... Full text Link to item Cite

Measuring intraocular pressure-adjustments for corneal thickness and new technologies.

Journal Article Curr Opin Ophthalmol · April 2006 Featured Publication PURPOSE OF REVIEW: Central corneal thickness has become an important biometric factor and is an essential part of the evaluation of glaucoma. Goldmann applanation tonometry is the most widely used method of measuring intraocular pressure, but it is well kn ... Full text Link to item Cite

The glaucoma research foundation patient survey: patient understanding of glaucoma and its treatment.

Journal Article Am J Ophthalmol · January 2006 Featured Publication PURPOSE: Determine patients' understanding of glaucoma and its treatment, their sources of information about glaucoma, their preferences for treatment, their experience with medication side effects, and their reasons for changing eye doctors. DESIGN: Prosp ... Full text Link to item Cite

Racial differences in glaucoma care: the longitudinal pattern of care.

Journal Article Arch Ophthalmol · December 2005 OBJECTIVE: To examine if racial differences exist in longitudinal care patterns for Medicare beneficiaries with glaucoma. METHODS: We analyzed national longitudinal Medicare claims data from January 1, 1991, through December 31, 1999 in 21 644 Medicare ben ... Full text Link to item Cite

High failure rate associated with 180 degrees selective laser trabeculoplasty.

Journal Article J Glaucoma · October 2005 Featured Publication PURPOSE: To determine the efficacy of selective laser trabeculoplasty (SLT) in a tertiary care referral center. PATIENTS AND METHODS: In this retrospective study of selective laser trabeculoplasty performed by five physicians, 94 eyes from 94 patients were ... Full text Link to item Cite

The tube versus trabeculectomy study: design and baseline characteristics of study patients.

Journal Article Am J Ophthalmol · August 2005 PURPOSE: The Tube Versus Trabeculectomy (TVT) Study will compare the safety and efficacy of nonvalved tube shunt surgery to trabeculectomy with mitomycin C in patients with previous intraocular surgery. DESIGN: Multicenter randomized clinical trial. SETTIN ... Full text Link to item Cite

Author reply

Conference American Journal of Ophthalmology · March 2005 Full text Cite

Clinical comparison of the Proview eye pressure monitor with the Goldmann applanation tonometer and the Tonopen.

Journal Article Arch Ophthalmol · August 2004 OBJECTIVE: To compare intraocular pressure (IOP) values obtained by patients using the new Proview eye pressure monitor (Bausch & Lomb, Rochester, NY) with those measured with the Goldmann tonometer and the TonoPen (Mentor, Norwell, Mass). METHODS: Eighty- ... Full text Link to item Cite

Early rapid rise in intraocular pressure after intravitreal triamcinolone acetonide injection.

Journal Article Am J Ophthalmol · August 2004 PURPOSE: To report the occurrences of early rapid increases in intraocular (IOP) after intravitreal glucocorticoid injection. DESIGN: Observational case series. METHODS: We retrospectively reviewed the records of three patients seen and treated at Duke Eye ... Full text Link to item Cite

Central corneal thickness as a risk factor for advanced glaucoma damage.

Journal Article Arch Ophthalmol · January 2004 Featured Publication OBJECTIVE: To determine if central corneal thickness (CCT) is related to the level of glaucoma severity at the initial examination. METHODS: The initial visit to a glaucoma specialist by consecutive patients with primary open-angle glaucoma from 1997 to 20 ... Full text Link to item Cite

Glaucoma in Ghana, West Africa: clinical features and the role of mutations in Myocilin.

Journal Article Ophthalmol Clin North Am · December 2003 Featured Publication POAG is a severely debilitating disease in West Africa. Currently, many patients seem to be misclassified as having POAG who in fact have CACG. Improved examination techniques, including routine gonioscopy, would increase diagnostic accuracy and improve tr ... Full text Link to item Cite

A newer technique for glaucoma tube trimming.

Journal Article Arch Ophthalmol · September 2003 Long silicone glaucoma tubes within the anterior chamber are frequently detrimental to the corneal endothelium and other anterior chamber structures. Tube shortening often involves extensive and potentially complicated surgery that requires tube removal an ... Full text Link to item Cite

Increased periocular pigmentation with ocular hypotensive lipid use in African Americans.

Journal Article Am J Ophthalmol · May 2003 Featured Publication PURPOSE: To report increased eyelid pigmentation as an adverse side effect associated with topical ocular hypotensive lipids in African Americans. DESIGN: Interventional case series. METHODS: Two African-American patients with open-angle glaucoma are descr ... Full text Link to item Cite

Central corneal thickness as a risk factor for advanced glaucoma damage

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · May 1, 2003 Link to item Cite

Correlation among retinal thickness, optic disc, and visual field in glaucoma patients and suspects: a pilot study.

Journal Article J Glaucoma · April 2003 OBJECTIVE: To correlate losses of retinal thickness in the perifoveal area in glaucoma as measured by the Retinal Thickness Analyzer (Talia Technology Ltd, Israel) with optic nerve and visual field changes in glaucoma patients and suspects. METHODS: Observ ... Full text Link to item Cite

Using the arteriolar Pressure Attenuation Index to predict ocular hypertension progression to open-angle glaucoma.

Journal Article Arch Ophthalmol · January 2003 BACKGROUND: Vascular phenomena are considered important to optic nerve and visual field progression in open-angle glaucoma (OAG). A recently described formulation, the Pressure Attenuation Index (PAI), links arteriolar caliber variations to pressure loss a ... Full text Link to item Cite

Prevalence of myocilin mutations in adults with primary open-angle glaucoma in Ghana, West Africa.

Journal Article J Glaucoma · October 2002 PURPOSE: Investigators have noted that primary open-angle glaucoma (POAG) in West Africa has an earlier age of onset and appears to be more clinically severe than in the United States and Europe. Primary open-angle glaucoma patients with mutations in myoci ... Full text Link to item Cite

Survey of glaucoma in an eye clinic in Ghana, West Africa.

Journal Article J Glaucoma · October 2002 Featured Publication PURPOSE: To report the various types of glaucoma among West African patients presenting to an eye clinic in Ghana. METHODS: A complete evaluation was performed in 198 consecutive Ghanaian glaucoma patients. Main outcome measures included intraocular pressu ... Full text Link to item Cite

The effects of drying on central corneal thickness

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · May 1, 2002 Link to item Cite

Novel myocilin mutations in individuals with POAG from West Africa.

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · March 15, 2001 Link to item Cite

Types of glaucoma in a Ghanaian clinic.

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · March 15, 2001 Link to item Cite

Antithrombin III, a serpin family protease inhibitor, is a major heparin binding protein in porcine aqueous humor.

Journal Article Biochem Biophys Res Commun · May 27, 2000 Our hypothesis is that the proteins in aqueous humor may be involved in the regulation of outflow facility through the trabecular meshwork and uveoscleral meshwork. In this study, we analyzed the profile of heparin-binding proteins present in porcine aqueo ... Full text Link to item Cite

Excisional bleb revision to correct overfiltration or leakage.

Journal Article J Glaucoma · April 2000 Featured Publication OBJECTIVES: To evaluate the effectiveness of excisional revision of filtering blebs for hypotony or leakage when more conservative measures have failed. PATIENTS AND METHODS: Retrospective review of all patients who underwent excisional revision of a filte ... Full text Link to item Cite

Who comes to community eye screenings? A survey.

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · March 15, 2000 Link to item Cite

Factors associated with vision loss in glaucoma.

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · March 15, 2000 Link to item Cite

Glaucoma as the initial manifestation of ocular malignancy: Warning signs

Chapter · January 1, 1999 The association between unilaterally elevated IOP and intraocular tumors has been appreciated for years. Although intraocular neoplasms are infrequently encountered in general ophthalmology practice, the ophthalmologist has an excellent opportunity to iden ... Full text Cite

A clinical comparison of transscleral cyclophotocoagulation with neodymium: YAG and semiconductor diode lasers.

Journal Article Am J Ophthalmol · November 1998 PURPOSE: To compare the efficacy of transscleral cyclophotocoagulation using a neodymium: YAG (Nd:YAG) or semiconductor diode laser in controlling intraocular pressure in patients with refractory glaucoma. METHODS: In a prospective study, 95 eyes of 91 pat ... Full text Link to item Cite

Use of latanoprost in the treatment of glaucoma associated with Sturge-Weber syndrome.

Journal Article Am J Ophthalmol · October 1998 PURPOSE: To determine if latanoprost reduces intraocular pressure in eyes with glaucoma associated with Sturge-Weber syndrome. METHODS: We conducted a prospective study in which eyes with uncontrolled intraocular pressure associated with Sturge-Weber syndr ... Full text Link to item Cite

Central corneal thickness.

Other Arch Ophthalmol · September 1998 Link to item Cite

Laser energy reaching the posterior pole during transscleral cyclophotocoagulation.

Journal Article Arch Ophthalmol · April 1998 Featured Publication OBJECTIVE: To measure scattered laser energy reaching the posterior pole during transscleral cyclophotocoagulation. METHODS: Transscleral cyclophotocoagulation was performed on 4 cadaver eyes with Nd:YAG noncontact, Nd:YAG contact, and diode contact lasers ... Full text Link to item Cite

Results of trabeculectomy with 0.3 mg/ml mitomycin C titrating exposure times based on risk factors for failure.

Journal Article J Glaucoma · February 1998 Featured Publication PURPOSE: To examine the efficacy of trabeculectomy with mitomycin C 0.3 mg/ml using titrated exposure times. METHODS: A retrospective chart review of consecutive patients undergoing trabeculectomy in an academic referral glaucoma clinic was performed. All ... Link to item Cite

Adult-onset primary open angle glaucoma does not localize to chromosome 2cen-q13 in North American families.

Journal Article Hum Hered · 1998 Glaucoma is one of the leading causes of irreversible blindness in the world and is characterized by elevated intraocular pressure, optic nerve atrophy, and progressive visual field loss. Primary open angle glaucoma (POAG) is the most common subtype of gla ... Full text Link to item Cite

Diode laser versus contact transscleral ND:YAG cyclophotocoagulation (CPC): A short-term and mid-term follow-up study

Other Investigative Ophthalmology and Visual Science · December 1, 1997 Purpose: To compare the short-term (1 month) and mid-term (6 months) effect of diode and Nd:YAG laser CPC. Methods. We retrospectively studied 60 patients who underwent diode or Nd:YAG laser CPC between 1991 and 1996. Those with at least 6 months follow-up ... Cite

Bleb revision for hypotony and leaks following trabeculectomy

Other Investigative Ophthalmology and Visual Science · December 1, 1997 Purpose: To evaluate the safety and effectiveness of surgical bleb revision, consisting of excision of the bleb and resuturing of the conjunctival wound, in the management of hypotony and bleb leaks following trabeculectomy. Methods: Retrospective chart re ... Cite

Reduction of IOP after PRK.

Other Ophthalmology · October 1997 Full text Link to item Cite

Central corneal thickness in normal, glaucomatous, and ocular hypertensive eyes.

Journal Article Arch Ophthalmol · September 1997 Featured Publication OBJECTIVE: To determine the relationship between central corneal thickness (CCT) and applanation intraocular pressure (IOP) in normal, glaucomatous, and ocular hypertensive eyes. METHODS: One hundred nine subjects (184 eyes) were studied. Forty-eight patie ... Full text Link to item Cite

Efficacy of autologous blood injection for treating overfiltering or leaking blebs after glaucoma surgery.

Journal Article Am J Ophthalmol · April 1997 Featured Publication PURPOSE: To evaluate the efficacy of autologous blood injections for treating overfiltering or leaking blebs after glaucoma surgery. METHOD: Retrospective review of ten eyes of ten patients who received intrableb autologous blood injections for hypotonous ... Full text Link to item Cite

Central corneal thickness in normal, glaucomatous, and ocular hypertensive eyes

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · March 15, 1997 Link to item Cite

Bleb revision for hypotony and leaks following trabeculectomy

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · March 15, 1997 Link to item Cite

Retinal vein occlusion after trabeculectomy with mitomycin C.

Journal Article Am J Ophthalmol · October 1996 PURPOSE: To evaluate acute retinal vein occlusion as a potential complication of trabeculectomy with mitomycin C in cases of advanced glaucoma. METHODS: The records of three patients who developed retinal vein occlusions immediately after uncomplicated tra ... Full text Link to item Cite

Laser scatter reaching the posterior pole during laser cyclophotocoagulation

Other Investigative Ophthalmology and Visual Science · February 15, 1996 Purpose. The reported incidence of visual reduction with transscleral Nd:YAG cyclophotocoagulation (CPC) ranges between one-third and two-thirds of treated patients. One mechanism for visual reduction we propose is that retinal light toxicity from scattere ... Cite

Laser scatter reaching the posterior pole during laser cyclophotocoagulation

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · February 15, 1996 Link to item Cite