scholarly journals Something Old (Trabeculectomy), Something New (Ab Interno Gelatin Microstent): Finally, a Marriage of Innovation and Outcome Data (without Concurrent Cataract Surgery)!

Ophthalmology ◽  
2017 ◽  
Vol 124 (11) ◽  
pp. 1575-1576 ◽  
Author(s):  
Dale K. Heuer ◽  
Gregg A. Heatley
Keyword(s):  
Cataract Surgery ◽  
Outcome Data ◽  
Ab Interno

scholarly journals Corneal Higher-Order Aberrations after Microhook ab Interno Trabeculotomy and Goniotomy with the Kahook Dual Blade: Preliminary Early 3-Month Results

2021 ◽  
Vol 10 (18) ◽  
pp. 4115
Author(s):  
Hiromitsu Onoe ◽  
Kazuyuki Hirooka ◽  
Hideaki Okumichi ◽  
Yumiko Murakami ◽  
Yoshiaki Kiuchi
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Retrospective Study ◽  
Cataract Surgery ◽  
Higher Order ◽  
Higher Order Aberrations ◽  
Postoperative Changes ◽  
The Mean ◽  
Kahook Dual Blade ◽  
Ab Interno

We examined postoperative corneal higher-order aberrations (HOAs) present after combined phacoemulsification with either microhook ab interno trabeculotomy (μLOT-Phaco) or goniotomy, using the Kahook Dual Blade (KDB-Phaco). Retrospective study: A total of 45 eyes underwent μLOT-Phaco and KDB-Phaco (LOT-Phaco) procedures, with 21 eyes that underwent cataract surgery alone used as controls. Visual acuity and corneal HOAs, coma-like aberrations, and spherical-like aberrations were analyzed before and at 1, 2, and 3 months after the surgeries. Risk factors that could potentially influence HOAs were evaluated. No significant postoperative changes were noted for corneal HOAs, coma-like aberrations, and spherical-like aberrations after cataract surgery alone. The mean corneal HOAs, coma-like aberrations, and spherical-like aberrations were 0.222 ± 0.115 μm, 0.203 ± 0.113 μm, and 0.084 ± 0.043 μm at baseline and 0.326 ± 0.195 μm (p < 0.001), 0.302 ± 0.289 μm (p = 0.03), and 0.150 ± 0.115 μm (p < 0.001) at 3 months after LOT-Phaco, respectively. Results of the analysis for risk factors suggested that a longer incision in Schlemm’s canal could influence corneal HOAs, coma-like aberrations, and spherical-like aberrations after LOT-Phaco. Although no significant postoperative changes were observed in corneal HOAs and coma-like or spherical-like aberrations after cataract surgery alone, a significant increase in corneal HOAs and coma-like or spherical-like aberrations remained after the LOT-Phaco procedure.

Combined Surgery in the Treatment of Patients with Cataract and Primary Open-angle Glaucoma

2012 ◽  
Vol 06 (04) ◽  
pp. 218
Author(s):  
Giovanni Taibbi ◽  
Gianmarco Vizzeri ◽  
◽  
Keyword(s):  
Cataract Surgery ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Ageing Population ◽  
Efficacy And Safety ◽  
Combined Surgery ◽  
Operative Complications ◽  
Significant Cataract ◽  
Ab Interno

Cataract and glaucoma are the two leading causes of blindness worldwide and frequently co-exist in the ageing population. No uniform recommendations can be proposed when the two conditions are associated. In the presence of a visually significant cataract and uncontrolled glaucoma, clinicians should consider performing combined cataract surgery and trabeculectomy. Numerous phacotrabeculectomy techniques have been proposed. However, in the absence of strong evidence in support of a specific technique, surgeons’ preference and experience may dictate the choice. Unless contraindicated, mitomycin-C should be considered in all combined procedures. In addition, novel and minimally invasive glaucoma surgical procedures, such as ab interno trabeculotomy, have recently emerged and gained in popularity. In general, these procedures have shown the potential to be combined with phacoemulsification to further lower intraocular pressure (IOP) with relatively few post-operative complications. However, available data suggest that these techniques seem unlikely to be able to achieve a degree of IOP reduction comparable with that of trabeculectomy. Rigorous studies are necessary to better understand the long-term efficacy and safety profile of these novel procedures, when performed alone or in combination with cataract surgery.

scholarly journals Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Laureano A. Rementería-Capelo ◽  
Jorge L. García-Pérez ◽  
Juan Gros-Otero ◽  
Aida Morán ◽  
José M. Sánchez-Pina ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Private Practice ◽  
Outcome Data ◽  
Practice Setting ◽  
Spherical Equivalent ◽  
Refractive Outcomes ◽  
Preoperative Information ◽  
The Difference ◽  
One Year ◽  
Spectrum Of Patients

Introduction. Currently available outcome data for cataract surgery include mostly patients from public health systems. The purpose of this study was to report the visual and refractive outcomes of cataract procedures performed during one year in a private practice center, which may include a different spectrum of patients. Methods. Our center’s database was used to identify all isolated cataract procedures performed during 2017. The electronic records were reviewed to collect the preoperative information, presence of intra- or postsurgical complications, and visual and refractive outcomes one month after surgery. Results. In 2017, 2714 eyes of 1543 patients underwent cataract surgery in our center. Mean patient age was 70.42 years. 775 eyes (28.55%) had prior ophthalmic pathologies, and 113 eyes (4.16%) had undergone previous surgical procedures. Surgical complications developed in 35 eyes (1.29%), including 9 posterior capsule tears (0.33%) and 3 cases of dropped lens fragments (0.11%). A toric or multifocal intraocular lens was implanted in 45.6% of eyes. As regards postoperative complications, 59 eyes (2.17%) required a return to the operating theater, including 29 eyes (1.07%) requiring reinterventions due to an unexpected refractive result. There were no cases of endophthalmitis. Mean LogMAR-corrected distance visual acuity (CDVA) improved from 0.25 (SD 0.34) preoperatively to 0.04 (SD 0.17) postoperatively; 86.5% of eyes achieved a CDVA ≤0.0, with 97.5% achieving ≤0.3. In 86.4% of eyes, the difference between target and residual spherical equivalent difference was of 0.50 D or lower; 88% of eyes had a spherical equivalent ±0.50 D. Conclusions. The visual and refractive outcomes of cataract surgery in a private practice setting were excellent, well over the benchmarks set by the ESCRS. The safety profile was also within expected standards. This study provides information for ophthalmologists in private practice on expected outcomes.

scholarly journals Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent

2021 ◽  
Vol 10 (10) ◽  
pp. 2129
Author(s):  
Yuji Takayanagi ◽  
Sho Ichioka ◽  
Akiko Ishida ◽  
Aika Tsutsui ◽  
Masaki Tanito
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Corneal Endothelial Cell ◽  
Efficacy And Safety ◽  
Fellow Eye ◽  
Corrected Visual Acuity ◽  
Corneal Endothelial Cell Density ◽  
Anterior Chamber Flare ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

The aim of this study is to compare the surgical efficacy and safety between microhook ab-interno trabeculotomy (µLOT) and iStent trabecular micro-bypass stent implantation when both were combined with cataract surgery in both eyes of patients. Sixty-four glaucomatous eyes (32 participants; mean age, 75.9 ± 7.6 years; 15 men, 17 women) were included retrospectively. Intraocular pressure (IOP), number of antiglaucoma medications, best-corrected visual acuity (BCVA), anterior chamber flare (ACF) and corneal endothelial cell density (CECD) were evaluated preoperatively, as well as 2, 3, 6, and 12 months postoperatively. Surgical complications and interventions were compared between the procedures. The preoperative IOP and medications with µLOT (18.8 ± 5.7 mmHg and 3.0 ± 1.2, respectively) were higher than with the iStent (15.5 ± 3.4 mmHg and 2.7 ± 1.2, respectively) (p = 0.0001 and p = 0.0437, respectively). At 12 months, the µLOT values (12.6 ± 2.3 mmHg and 2.3 ± 0.9, respectively) were identical to iStent (12.8 ± 2.5 mmHg and 2.3 ± 0.9, respectively) (p = 0.0934 and p = 0.3251, respectively). At 12 months, the IOP decreased more with µLOT (6.2 mmHg, 29.5%) than iStent (2.7 mmHg, 15.6%) (p = 0.0003). The decrease in medications was greater with µLOT (0.7) than iStent (0.4) (p = 0.0437). Survival rate of IOP control ≤15 mmHg and IOP reduction ≥20% was significantly higher after µLOT (40.6% at 12 months) than iStent (18.8%) (p = 0.0277). The frequency of layered hyphema was significantly greater with µLOT (8 eyes, 25%) than iStent (0 eyes, 0%) (p = 0.0048). The increase in the ACF at 2 weeks postoperatively was significantly greater with µLOT than iStent (p = 0.0156), while changes in the BCVA and CECD were identical between groups. The fellow-eye comparison showed that the IOP reduction was greater with µLOT than iStent when combined with cataract surgery.

scholarly journals Canaloplasty and Trabeculotomy ab interno with the OMNI System Combined with Cataract Surgery in Open-Angle Glaucoma

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Louis Hirsch ◽  
Jeremy Cotliar ◽  
Steven Vold ◽  
Deepan Selvadurai ◽  
Anita G Campbell ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Ab Interno

scholarly journals Refractive Status in Eyes Implanted with Toric and Nontoric Intraocular Lenses during Combined Cataract Surgery and Microhook Ab Interno Trabeculotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yasuyuki Takai ◽  
Kazunobu Sugihara ◽  
Mihoko Mochiji ◽  
Kaoru Manabe ◽  
Aika Tsutsui ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Intraocular Lenses ◽  
Toric Iol ◽  
Absolute Residual ◽  
Refractive Status ◽  
The Mean ◽  
Better Than ◽  
Ab Interno

Purpose. To compare the refractive status between eyes implanted with toric and nontoric intraocular lenses (IOLs) during combined cataract surgery and microhook ab interno trabeculotomy (μLOT), a minimally invasive glaucoma surgery (MIGS). Methods. Twenty eyes of 20 patients who had open-angle glaucoma, cataract, and preexisting regular corneal astigmatism exceeding 1.5 diopters (D) and underwent combined μLOT and phacoemulsification were recruited retrospectively. Ten eyes were implanted with a toric IOL and 10 eyes with a nontoric IOL. The primary outcomes were the uncorrected visual acuity (UCVA) and refractive cylinder at 3 months postoperatively. Results. The mean UCVA of the toric IOL group (logarithm of the minimum angle of resolution (logMAR), 0.23 ± 0.25) was significantly better than that of the nontoric IOL group (logMAR, 0.45 ± 0.26) at 3 months postoperatively ( p < 0.05 ). The mean absolute residual refractive cylinder of the nontoric IOL group (2.25 ± 0.62 D) was significantly greater than that of the toric IOL group (1.30 ± 0.68 D) ( p < 0.05 ). Postoperatively, 60% of eyes in the toric IOL group and 10% in the nontoric IOL group had an absolute refractive astigmatism level of 1.5 D or less. Surgically induced astigmatism (0.77 ± 0.43 D for toric group and 0.60 ± 0.32 D for nontoric group) and IOP reduction (33.9 ± 15.6% for toric group and 29.4 ± 11.7% for nontoric group) were not different between groups. Conclusions. Use of toric IOL during combined cataract surgery and μLOT is possible and better than not, but physician should prevent their patient of persisting residual astigmatism. The study was registered at https://www.umin.ac.jp/, and the clinical trial accession number is https://clinicaltrials.gov/ct2/show/UMIN000043141.

scholarly journals Training strategies and outcomes of ab interno trabeculectomy with the trabectome

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 67 ◽  
Author(s):  
Katherine Fallano ◽  
Igor Bussel ◽  
Larry Kagemann ◽  
Kira L. Lathrop ◽  
Nils A. Loewen
Keyword(s):  
Outcome Data ◽  
Eye Model ◽  
The Us ◽  
Ab Interno Trabeculectomy ◽  
Training Strategies ◽  
And Function ◽  
High Degree ◽  
Outflow Pathway ◽  
Function Testing ◽  
Ab Interno

Plasma-mediated ab interno trabeculectomy with the trabectome was first approved by the US Food and Drug Administration in 2004 for use in adult and pediatric glaucomas. Since then, increased clinical experience and updated outcome data have led to its expanded use, including a range of glaucomas and angle presentations, previously deemed to be relatively contraindicated. The main benefits are a high degree of safety, ease, and speed compared to traditional filtering surgery and tube shunts. The increasing burden of glaucoma and expanding life expectancy has resulted in demand for well-trained surgeons. In this article, we discuss the results of trabectome surgery in standard and nonstandard indications. We present training strategies of the surgical technique that include a pig eye model, and visualization exercises that can be performed before and at the conclusion of standard cataract surgery in patients who do not have glaucoma. We detail the mechanism of enhancing the conventional outflow pathway and describe methods of visualization and function testing.

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