scholarly journals Hydrus Microstent

2020 ◽  
pp. 59-71
Author(s):  
Panagiotis Laspas ◽  
Norbert Pfeiffer
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Term Treatment ◽  
Open Angle ◽  
Pseudoexfoliation Glaucoma ◽  
Long Term Treatment ◽  
Clinically Significant ◽  
Favorable Safety

Abstract The Hydrus® Microstent (Ivantis Inc., Irvine, CA, USA) is an 8-mm intracanalicular scaffold microinvasive glaucoma surgery (MIGS) device which reduces intraocular pressure (IOP) by bypassing the trabecular meshwork and by dilating and scaffolding the Schlemm’s canal. Indications for Hydrus Microstent implantation include primary open-angle glaucoma and pseudoexfoliation glaucoma and it can be implanted either in combination with cataract surgery or as a solo procedure. Studies have shown that the Hydrus Microstent lowers IOP to the mid-teens and reduces glaucoma medication use for up to 2 years. Hydrus Microstent implantation is associated with a favorable safety profile, with adverse effects being generally mild, transient, and self-resolving. Clinically significant and long-standing hypotony or other potentially sight-threatening complications have not been described so far with Hydrus Microstent implantation. This chapter summarizes the design, mechanism of action, surgical technique, and clinical outcomes of the Hydrus Microstent, which is a promising long-term treatment modality for patients with mild-to-moderate primary open-angle glaucoma.

scholarly journals The Effects of Trabeculectomy on Pseudoexfoliation Glaucoma and Primary Open-Angle Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Fan Li ◽  
Guangxian Tang ◽  
Hengli Zhang ◽  
Xiaowei Yan ◽  
Lihua Ma ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Success Rate ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Success Rates ◽  
Pseudoexfoliation Glaucoma ◽  
Long Term Effects ◽  
Surgical Success

Purpose. To compare long-term effects of trabeculectomy on pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG). Methods. This retrospective case-control study included 53 eyes of PXG and 76 eyes of POAG. Intraocular pressure (IOP), number of antiglaucoma medications used, surgical success rate, and occurrence of complications were observed and statistically analyzed in both groups at 3 and 6 months and at 1, 3, and 5 years after trabeculectomy. Surgical success was defined according to the following 3 criteria: (1) IOP ≤ 21 mmHg; (2) IOP ≤ 18 mmHg; (3) IOP ≤ 15 mmHg. Complete success is defined as patients met these criteria without medical treatment, and qualified success is defined as patients met these criteria with medical treatment (≤3 medications). Cumulative probabilities of success were compared using the Kaplan–Meier survival analysis. Results. For the 3 criteria, there were no statistically significant differences in complete and qualified success rates between the two groups at 3 and 6 months after trabeculectomy (P>0.05). For criterion A, complete success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion B, complete and qualified success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion C, complete and qualified success rates in PXG at 1, 3, and 5 years after surgery were lower than those in POAG, the differences were statistically significant (P<0.05). Conclusions. The short-term success rates of both types of glaucoma were similar; however, the long-term success rate of PXG was significantly lower, and it was difficult to achieve long-term control of IOP at a low target level.

Effectiveness of combined glaucoma and cataract surgery with the use of a modified anti-glaucoma surgery

2021 ◽  
pp. 41-44
Author(s):  
O.I. Orenburkina ◽  
◽  
A.E. Babushkin ◽  
G.Z. Israfilova ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Antihypertensive Drugs ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Functional Results ◽  
Open Angle ◽  
Combined Operation ◽  
Combined Intervention

Purpose. To evaluate the clinical and functional results of a combined intervention – simultaneous cataract phacoemulsification (femtolaser assisted in some cases) and a developed partially fistulizing anti-glaucoma surgery in patients with primary open-angle glaucoma (POAG). Material and methods. 15 patients (45 eyes) aged 65-73 years with stage I-III POAG. The frequency of complications, dynamics of visual acuity's visual functions, and ophthalmotonus were analyzed before, during, and 6 months after surgery. Results. By the end of observation, the level of normalized IOP was defined in all patients, while in 78.6% of cases without drug correction and in 21.4% with the help of antihypertensive drugs (on average, 1.1±0.5). At the day of discharge from the hospital visual acuity after a simultaneous combined operation averaged 0.53±0.05, in the long term-0.77±0.06, while stabilization of glaucoma optical neuropathy after surgery occurred in 92.9%. Conclusion. A simultaneous combined intervention, including cataract phacoemulsification with a developed partially fistulizing anti-glaucoma operation, is an effective way to increase visual acuity, normalize ophthalmotonus and stabilize glaucoma optical neuropathy as well as reduce the drug load. Key words: cataract, glaucoma, surgical treatment, phacoemulsification, anti-glaucoma surgeries.

Results of a new modification of anti-glaucoma surgery in the treatment of primary open-angle glaucoma in combination with cataract

2021 ◽  
pp. 67-70
Author(s):  
M.M. Bikbov ◽  
◽  
O.I. Orenburgkina ◽  
A.E. Babushkin ◽  
G.Z. Israfilova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Visual Functions ◽  
Group 2 ◽  
Group 1

Purpose. To study the effectiveness of the developed partially fistulizing glaucoma surgery in the treatment of primary open-angle glaucoma (POAG) in combination with complicated cataract. Material and methods. 28 patients (28 eyes) were examined, including 13 patients (13 eyes) with I–III stages of POAG, operated according to the method of glaucoma surgery developed by us (group 1), and 15 patients (15 eyes) with a combination of previously unoperated glaucoma with incomplete complicated cataracts, who underwent a combined intervention – simultaneous phacoemulsification of cataracts with the specified variant of partially fistulizing glaucoma intervention (group 2). The analysis of the frequency of complications, the dynamics of visual functions, visual acuity and ophthalmotonus before surgery, at the time of discharge from the hospital, and in the longterm (6–9 months) after surgery was carried out. Results. In group 1, in the long term, the absolute hypotensive effect was recorded in 81.8% of cases, visual functions remained the same – in 90.9%. In group 2, by the end of follow – up, the level of normalized intraocular pressure was recorded in all patients, while in 78.6% of cases without drug correction and in 21.4% – with the help of antihypertensive drugs. Visual acuity in group 2, after a single-stage combined operation by the day of discharge from the hospital, averaged 0.53±0.05, in the long-term – 0.77±0.06, while the stabilization of glaucoma optic neuropathy after surgery occurred in 92.9%. Conclusion. Glaucoma surgery according to the proposed method in the studied long-term periods in patients with POAG provided a sufficiently high hypotensive effect and the preservation of visual functions. Combined single-stage intervention was an effective way to increase visual acuity, normalize ophthalmotonus and stabilize glaucoma optic neuropathy, as well as reduce drug load. Key words: primary open-angle glaucoma, cataract, partially fistulizing glaucoma surgery, cataract phacoemulsification.

scholarly journals Two-Year Outcomes of Ab Interno Trabeculectomy with the Trabectome for Chinese Primary Open Angle Glaucoma: A Retrospective Multicenter Study

2018 ◽  
Author(s):  
Yalong Dang ◽  
Xiao Wang ◽  
Yujie Cen ◽  
Ying Hong ◽  
Ping Huang ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Safe Procedure ◽  
Open Angle ◽  
Trabectome Surgery ◽  
History Of ◽  
Ab Interno Trabeculectomy ◽  
Ab Interno

To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open-angle glaucoma (POAG) patients. This was a multicenter, retrospective study and included POAG patients with or without visually-significant cataracts. The primary outcome was intraocular pressure (IOP) reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2-years. Success was defined as: 1) IOP &lt; 21 mmHg and at least 20% IOP reduction from baseline after 3 months at any two consecutive visits, and 2) no additional glaucoma surgery required. A total of 42 patients were enrolled; thirteen had a history of failed glaucoma surgery. Twelve patients underwent Trabectome surgery combined with phacoemulsification while the remainder underwent Trabectome surgery alone. Overall, the mean preoperative IOP was 21.4&plusmn;1.23 mmHg. The Trabectome lowered IOP to 18.5&plusmn; 0.94 mmHg at 2 years (P&lt;0.05). The number of glaucoma medications also decreased from a baseline of 2.0&plusmn;0.9 to 1.2&plusmn; 0.21 at 2 years (P=0.04). The overall success was 78%, with patients undergoing combined surgery having a higher success than those with Trabectome surgery alone (100% vs. 76%). No major complications were seen. The Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.

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