Daniel Laroche - Academia.edu (original) (raw)

Papers by Daniel Laroche

$Research paper thumbnail of How to Stop People from Going Blind from Glaucoma Using Early Cataract Surgery/Refractive Lensectomy and Microinvasive Glaucoma Surgery$

Clinical Ophthalmology, Mar 1, 2022

Glaucoma continues to be a leading cause of blindness worldwide for the same reasons as in the pa... more Glaucoma continues to be a leading cause of blindness worldwide for the same reasons as in the past several decades, including the lack of early detection, improper treatment, and non-adherence to therapy. Medical therapy continues to be the first-line therapy even as surgical techniques are improving in their safety and efficacy. To turn the tide in preventing blindness from glaucoma, attention must be focused on targeted patient education, screening, effective treatment, and addressing health disparities. To achieve this, early safer cataract surgery and microinvasive glaucoma surgery must be considered as a first-line therapy in addition to medical therapy to best lower both intraocular pressure and the medication burden.

$Research paper thumbnail of The Aging Lens and Glaucoma in persons over 50: Why early cataract surgery/refractive lensectomy and microinvasive trabecular bypass can prevent blindness and cure elevated eye pressure$

Journal of the National Medical Association, Aug 1, 2021

Currently, IOP reduction is the only way we can help reduce or even stop glaucoma progression. Du... more Currently, IOP reduction is the only way we can help reduce or even stop glaucoma progression. Due to higher rates of blindness in vulnerable poorer groups with decreased access to expensive medications, safer, uncomplicated cataract extraction/refractive lensectomy and microinvasive trabecular bypass surgery should be considered earlier. We need more studies with randomized controlled clinical trials comparing earlier cataract surgery and trabecular bypass to medical, and laser therapies in order to reassess our algorithm for treating enlarged lens-related glaucoma in adults over the age of 50.

Therapeutic advances in ophthalmology, 2023

$Research paper thumbnail of Combined microinvasive glaucoma surgery in osteogenesis imperfecta patient with refractory open angle glaucoma$

American Journal of Ophthalmology Case Reports, Jun 1, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Journal of Glaucoma, Apr 1, 2018

To describe a new surgical technique for refractory glaucoma with failed XEN gel stent surgery wi... more To describe a new surgical technique for refractory glaucoma with failed XEN gel stent surgery with insertion of the Baerveldt implant. In a patient with a failed XEN gel stent, a gentle conjunctival dissection was performed to expose the XEN and remove subconjunctival obstruction thus restoring patency and flow. A Baerveldt 250 implant was inserted in the superonasal quadrant above the extraocular muscles and sutured to the sclera. The Baerveldt tube was correctly positioned to accept insertion of the present XEN gel stent. The double lumen was sutured to secure the position. Two corneal patches were sutured over the tube to prevent exposure. The usual conjunctival suturing closure was performed. This technique is simple and restores lowering of intraocular pressure in patient with failed XEN and potentially increases the safety of refractory glaucoma surgeries in these patients.

Investigative Ophthalmology & Visual Science, Jun 11, 2015

Journal of Ophthalmology

Introduction. The Hydrus microstent has become a common procedure in glaucoma surgery intended to... more Introduction. The Hydrus microstent has become a common procedure in glaucoma surgery intended to improve outcomes of cataract surgery to lower intraocular pressure. Despite proper placement, this device can subsequently be noted to not be in the proper position. In this case series, we report mispositioned Hydrus microstents in five different patients and use NIDEK GS-1 gonioscopy. Case Report. We report five different patients who had cataract surgery and who were subsequently noted to have mispositioned Hydrus stents. No stents needed to be removed. All patients had improved vision and stable visual fields, and none required secondary surgery. Management and Outcome. In each case of mispositioned stents, vision was significantly improved and there was no inflammation or other complications noted. Discussion. Hydrus stents can be noted to be mispositioned during the post-operative period after successful insertion. This can often be well tolerated requiring no further intervention.

Journal of Racial and Ethnic Health Disparities

Glaucoma is an ophthalmic disorder that affects a significant number of Blacks globally. A leadin... more Glaucoma is an ophthalmic disorder that affects a significant number of Blacks globally. A leading cause of this condition is an age-related enlargement of the lens and increased intraocular pressure. Although Blacks are affected by glaucoma at a higher rate than their Caucasian counterparts, there remains a lack of emphasis placed on the detection, diagnosis, monitoring, and treatment of glaucoma in this population. Education regarding glaucoma in the African and African American populations is essential to reducing rates of glaucoma-related visual impairment and improving treatment success. In this article, we highlight specific issues and limitations to the management of glaucoma, which affects Blacks at a higher rate. In addition, we also review the backgrounds of Blacks globally and examine historical events that have contributed to financial inequality and wealth/health disparities affecting glaucoma management. Lastly, we suggest reparations and solutions that health care pro...

Journal of the National Medical Association

In the United States, more than 3 million Americans suffer from glaucoma. This is the second-lead... more In the United States, more than 3 million Americans suffer from glaucoma. This is the second-leading cause of blindness worldwide.

Journal of Ophthalmology

Glaucoma is a leading cause of preventable blindness globally. Nearly, half of the patients who h... more Glaucoma is a leading cause of preventable blindness globally. Nearly, half of the patients who have glaucoma in the United States are unaware of their diagnosis, and this number is far greater in resource poor areas. The risk of progressive and irreversible loss of vision is decreased with an early diagnosis, and better access to treatment is vital to improve the visual outcome for patients. We therefore postulated that a minimally invasive, low-cost calculator used to predict the risk of glaucoma and inform the course of follow-up care will improve patient prognosis. We retrospectively examined data from 104 eyes of patients who underwent a complete ocular examination, visual field, and corneal pachymetry at Advanced Eye Care of New York (54 with glaucoma and 50 controls). Receiver operating curves (ROC) were utilized to determine the correct glaucoma classification rates of the Laroche glaucoma calculator (Range −3 to 18), a novel tool that combines age, intraocular pressure (IOP...

Journal of the National Medical Association

$Research paper thumbnail of How to Stop People from Going Blind from Glaucoma Using Early Cataract Surgery/Refractive Lensectomy and Microinvasive Glaucoma Surgery$

Clinical Ophthalmology, 2022

Review of Role of minimally invasive glaucoma surgery in the management of chronic open-angle gla... more Review of Role of minimally invasive glaucoma surgery in the management of chronic open-angle glaucoma

Clinical Ophthalmology, 2020

The coronavirus 19 (COVID-19) pandemic has overwhelmed our healthcare systems and caused the deat... more The coronavirus 19 (COVID-19) pandemic has overwhelmed our healthcare systems and caused the deaths of tens of thousands of Americans. Black and Hispanic individuals comprise a disproportionate number of those deaths, primarily because of preexisting health conditions such as hypertension, obesity, and asthma. Health inequities that underlie these disparities also exist within ophthalmology around the world, and more ophthalmologists should advocate for healthcare reform that advances health equity. Immediate actions to reduce health disparities in ophthalmology during the pandemic include taking time to ensure all ophthalmology leadership and industry is diversified with people reflecting the fabric of their countries, embracing telemedicine to increase access to medical care, and advocating for legislation that will increase health insurance coverage during this unprecedented time. Longitudinal actions include recognizing structural racism as a root cause of health inequity and actively rejecting it through addressing modifiable risk factors, increasing cultural competency training, promoting diversity in the workforce, and global leadership.

Journal of the National Medical Association, 2021

The authors report the use of a surgical procedure for the correction of a scleral fistula in a p... more The authors report the use of a surgical procedure for the correction of a scleral fistula in a patient with late hypotony after cataract surgery. Trephination of necrotic tissue lining the scleral fistula with a double scleral patch technique was performed. Four months later, the patient's vision had improved to 20/40, with improvement of the macular folds and an intraocular pressure of 10 mm Hg. The authors conclude that the use of a double-patching technique is effective in the repair of scleral fistulas. The technique allows one to avoid more risky repair procedures that involve a greater area of tissue excision.

Acta Ophthalmologica Scandinavica, 1998

To evaluate the ultrasound biomicroscopic appearance of anterior segment foreign bodies under cli... more To evaluate the ultrasound biomicroscopic appearance of anterior segment foreign bodies under clinical and experimental conditions. Ultrasound biomicroscopy was performed on 4 eyes of 4 patients referred for evaluation of anterior segment trauma and known or suspected intraocular foreign body. Imaging of wood, aluminum, concrete, and glass foreign bodies was performed in the anterior chamber of a human cadaver eye. Ultrasound biomicroscopy verified the location of a foreign body in two patients and identified occult foreign bodies in two others. Under clinical and experimental conditions, intraocular aluminum and glass produced comet tail artifacts. Under experimental conditions intraocular wood and concrete produced shadowing artifacts. Ultrasound biomicroscopy provides useful information in the evaluation of known and occult anterior segment foreign bodies. Ultrasound patterns of shadowing and comet tail may help differentiate foreign body materials.