Semi-permanent transcorneal filter support and in vivo surgical implantation technique for open-angle glaucoma treatment

Purpose. To evaluate thein vivochanges in Schlemm’s canal (SC) and the trabecular meshwork (TM) in patients with primary open-angle glaucoma (POAG) after phacocanaloplasty using anterior segment optical coherence tomography (AS-OCT).Methods. Ten eyes of nine patients with POAG (6 men and 3 women) who underwent phacocanaloplasty. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), and use of glaucoma medications were evaluated. The main outcome measures were the area of SC and TM thickness assessed using AS-OCT before and 12 months after surgery.Results. We found statistically significant reduction in IOP (from 26.4 (8.6) mmHg to 12.9 (2.5) (p<0.05) mmHg), increase in VA from 0.7 (0.4) to 0.9 (0.2), and decrease in glaucoma medication from 2.6 (1.2) to 1.1 (1.3) at 12 months postoperatively. There was a significant increase in the SC area (3081.7 (842.8) μm2versus 5098.8 (1190.5) μm2,p<0.001) and a decrease in mean TM thickness (91.2 (18.6) μm versus 81.3 (15.1) μm,p=0.001) after surgery. We found negative correlations between SC area and IOP before surgery (r=-0.67,p=0.03) and also between SC area before and IOP reduction 12 months after the phacocanaloplasty (r=-0.80,p=0.005).Conclusions. Our results showed statistically significant dilation of SC area and reduction of TM thickness after phacocanaloplasty in POAG patients. The degree of SC expansion was related to the IOP decrease.

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Clinical characteristics of newly diagnosed primary, pigmentary and pseudoexfoliative open-angle glaucoma in the Collaborative Initial Glaucoma Treatment Study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2012-301820 ◽

2012 ◽

Vol 96 (9) ◽

pp. 1180-1184 ◽

Cited By ~ 7

Author(s):

David C Musch ◽

Takayuki Shimizu ◽

Leslie M Niziol ◽

Brenda W Gillespie ◽

L Frank Cashwell ◽

...

Keyword(s):

Clinical Characteristics ◽

Open Angle Glaucoma ◽

Open Angle ◽

Newly Diagnosed ◽

Glaucoma Treatment

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Latanoprost for Open-Angle Glaucoma

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0017 ◽

2020 ◽

pp. 97-102

Author(s):

Alan D. Penman ◽

Kimberly W. Crowder ◽

William M. Watkins

Keyword(s):

United Kingdom ◽

Intraocular Pressure ◽

Visual Field ◽

Open Angle Glaucoma ◽

Controlled Trial ◽

Prostaglandin Analogue ◽

Open Angle ◽

Topical Drugs ◽

The United Kingdom ◽

Glaucoma Treatment

The United Kingdom Glaucoma Treatment Study (UKGTS) was a randomized, triple-masked, placebo-controlled trial comparing topical latanoprost, a prostaglandin analogue, with placebo in patients with newly diagnosed, previously untreated open-angle glaucoma (OAG). Compared to placebo, the latanoprost group showed a large, statistically significant reduction in the rate of glaucomatous visual field deterioration by 24 months. The UKGTS was the first placebo-controlled trial to show visual field preservation through lowering of intraocular pressure with topical drugs in patients with OAG, and the first to show the visual field–preserving effect of a topical prostaglandin analogue.

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Intraocular Pressure Control and Long-Term Visual Field Loss in Open-Angle Glaucoma

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0016 ◽

2020 ◽

pp. 91-96

Author(s):

Alan D. Penman ◽

Kimberly W. Crowder ◽

William M. Watkins

Keyword(s):

Intraocular Pressure ◽

Visual Field ◽

Open Angle Glaucoma ◽

Visual Field Loss ◽

Pressure Control ◽

Open Angle ◽

Aggressive Treatment ◽

Visual Field Progression ◽

Glaucoma Treatment

The Collaborative Initial Glaucoma Treatment Study (CIGTS) was a randomized clinical trial to determine whether patients with newly diagnosed open-angle glaucoma (OAG) were managed better by initial treatment with medications (using a stepped regimen of medications starting initially with a topical beta-blocker) or by immediate filtration surgery (trabeculectomy with or without 5-fluorouracil). Although the surgery group achieved a lower mean intraocular pressure (IOP) than the medication group, both groups had similarly low rates of visual field progression. Three measures of IOP fluctuation over extended time, the range of IOP, the standard deviation of IOP, and the maximum IOP, seem to play an important role in visual field progression The results showed that more aggressive treatment was warranted when undue elevation or variation in IOP measures is observed.

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