Increased Intraocular Pressure in Glaucomatous, Ocular Hypertensive, and Normotensive Space Shuttle Crew

BACKGROUND: Glaucoma and ocular hypertension (OHT) are prevalent diseases with baseline intraocular pressure (IOP) elevations that future astronauts and spaceflight participants may suffer from. Preflight, in-flight, and postflight IOP measurements were collected aboard two U.S. Space Shuttle Program missions in normotensive control, OHT, and glaucomatous crewmembers. METHODS: Five subjects (three controls, one glaucomatous, one OHT) were studied aboard 2-wk Space Shuttle missions. Baseline IOP (triplicate; handheld tonometry) was recorded during training 12 mo preflight, in flight (114 d), and postflight (329 d). Subjective symptoms were recorded via questionnaires. Data were analyzed using a spreadsheet with two-sample t-tests. P-value < 0.05 determined significance. RESULTS: IOP increased for all in-flight vs. preflight measurements for controls (N 3, 48.9, 16.9, 5.85), OHT (N 1, 20.3), and glaucomatous (N 1, 32.2) groups. IOP eventually returned to baseline postflight [Return (R)35 d], except for the astronaut with OHT (R917). Subjective symptoms, likely multifactorial, included blurredvision, decreased visual acuity, and headaches. DISCUSSION: IOP increased during spaceflight and normalized upon return. Astronauts and commercial spaceflight participants may need screening for elevated IOP to potentially prevent sequelae related to glaucoma and OHT, the former which requires treatment in flight and the latter which may need prophylaxis. Previous studies have shown elevated IOP upon entry into microgravity with various normalization timeframes in flight and postflight. It is unclear how increased IOP relates to spaceflight-associated neuro-ocular syndrome (SANS); however, several hypotheses exist. Treatment strategies should be available for acute and chronic ocular pathology during spaceflight despite the unique challenges of eye-drop application in microgravity. Dalal SR, Ramachandran V, Khalid R, Manuel FK, Knowles JR, Jones JA. Increased intraocular pressure in glaucomatous, ocular hypertensive, and normotensive space shuttle crew. Aerosp Med Hum Perform. 2021; 92(9):728733.

The analysis of the results of surgical treatment of macular holes of varying degrees of complexity

Purpose. To provide an analysis of the results of surgical treatment of macular holes, reflecting our own experience of vitreoretinal operations for this pathology of the macular interface. Material and methods. The work was carried out in a private ophthalmological clinic "EyeDoctor" in Almaty, Kazakhstan. The patients were divided into 3 groups, depending on the stage of macular holes and concomitant eye diseases. Results. 1. The macular hole 2-3 stage it is enough to carry out vitrectomy with careful removal of the ILM and PRP technology (the defect is up to 400 microns). 2. The macular hole 4 stage – removal the ILM with PRP technology with obligatory tamponade with silicon oil. Conclusion. To predict the results, it is necessary to take into account the stage of macular hole, its morphological and functional parameters, the duration of the process and the presence of concomitant ocular pathology. Key words: macular hole, J.D. Gass classification, vitrectomy, PRP method.

Risks of the Vision System Lesion during a Long Space Flight

The article describes the factors of a long-term space flight associated with the risk of ocular pathology, including the established risk of space neuroocular syndrome (SANS). The mechanisms of intraocular hydrodynamic disturbance and their potential role in the development of SANS are considered. The results of the studies concerning the hydrodynamics of the eye in the conditions of simulated microgravity are presented.

Clinical Safety and Efficacy of a Preloaded Monofocal Hydrophobic Acrylic Intraocular Lens in a Real-world Population

Background: This study was designed to evaluate visual, refractive and safety outcomes in eyes after they underwent phacoemulsification and implantation of a preloaded monofocal hydrophobic acrylic intraocular lens.Methods: This was a single center prospective study conducted at Ashford and St Peter’s Hospitals NHS Foundation Trust, United Kingdom. Patients were included if they had cataract extraction with in-the-bag implantation of the EyeCee® One preloaded intraocular lens from August to October 2019. Pre-operative, surgery-related and 2 weeks and 3 months post-operative data was collected. Surgeons at this trust were then asked to complete a feedback form to evaluate their experience of implanting the EyeCee® One. Results: 152 eyes were included in the study. 94 (62%) of these eyes had cataract but no concomitant ocular pathology that could potentially affect visual acuity. Three months post-operatively, 98.7% of all eyes had monocular CDVA ≤ 0.3 logMAR. 100% of the eyes without concomitant ocular pathology achieved this target. The mean CDVA of all eyes in this study improved from 0.43 ± 0.43 logMAR pre-operatively, to 0.05 ± 0.11 logMAR post-operatively (p < 0.05). The mean sphere and spherical equivalent values showed significant improvements (p <0.05) and (p < 0.05). There were no intraoperative complications and 1.3% of patients reported complications 2 weeks post-operatively. All of the participating surgeons said they would use the EyeCee® One again with 64% providing an overall rating of ‘excellent’ for their experience of implanting this intraocular lens. Conclusions: This study indicates excellent post-operative visual acuity and refractive outcomes in eyes after EyeCee® One implantation. This is accompanied with very little risk of intraoperative and post-operative complications.