Nine-year follow-up of trabeculectomy with or without low-dosage mitomycin-c in primary open-angle glaucoma

Purpose. To evaluate gel microstent (XEN, Aquesys, Inc) for treatment of primary open angle glaucoma (POAG). Methods. In this prospective interventional study, 13 eyes with POAG underwent XEN implantation with subconjunctival mitomycin-C. Of those eyes, 3 were pseudophakic and 10 underwent simultaneous phacoemulsification and XEN. Patients had uncontrolled IOP, had intolerance to therapy, or had maximal therapy but undergoing cataract extraction. Follow-up visits included IOP, number of medications, vision, and complications and lasted for 1 year. Complete success was defined as IOP reduction ≥20% from preoperative baseline at 1 year without any glaucoma medications while partial success as IOP reduction of ≥20% at 1 year with medications. Results. IOP dropped from 16 ± 4 mmHg pre-op to 9 ± 5, 11 ± 6, 12 ± 5, 12 ± 4, and 12 ± 3 mmHg at 1 week, 1, 3, 6, and 12 months (p=0.004, 0.026, 0.034, 0.01, and 0.01, Wilcoxon Signed Ranks) consecutively. BCVA (LogMAR) was 0.33 ± 0.34 and improved to 0.13 ± 0.11 at 1 year. Mean number of medications dropped from 1.9 ± 1 preoperatively to 0.3 ± 0.49 (p=0.003) at 1 year. 42% of eyes achieved complete success and 66% qualified success. Complications included choroidal detachment in 2 eyes, and implant extrusion in 1 eye, and 2 eyes underwent trabeculectomy. Conclusion. XEN implant is an effective surgical treatment for POAG, with significant reduction in IOP and glaucoma medications at 1 year follow-up.

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Long-term Follow-up of Initial Trabeculectomy With Mitomycin C for Primary Open-angle Glaucoma in Japanese Patients

Journal of Glaucoma ◽

10.1097/01.ijg.0000212202.57029.45 ◽

2006 ◽

Vol 15 (3) ◽

pp. 195-199 ◽

Cited By ~ 57

Author(s):

Takashi Shigeeda ◽

Atsuo Tomidokoro ◽

Yi-Ning Chen ◽

Shiroaki Shirato ◽

Makoto Araie

Keyword(s):

Mitomycin C ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Japanese Patients ◽

Open Angle ◽

Long Term Follow Up

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Biodegradable 3D-Porous Collagen Matrix (Ologen) Compared with Mitomycin C for Treatment of Primary Open-Angle Glaucoma: Results at 5 Years

Journal of Ophthalmology ◽

10.1155/2015/637537 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Fei Yuan ◽

Lei Li ◽

Xiuping Chen ◽

Xiang Yan ◽

Liyang Wang

Keyword(s):

Intraocular Pressure ◽

Mitomycin C ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Collagen Matrix ◽

Open Angle ◽

Significant Difference ◽

The Difference ◽

Rate Of Success

Purpose. To evaluate the effectiveness and safety of the Ologen as an aid for trabeculectomy performed for primary open-angle glaucoma compared with mitomycin C.Methods. In this prospective, randomized, parallel assignment, comparative study, 31 eyes of 21 primary open-angle glaucoma patients were allocated for trabeculectomy with the Ologen implant; another 32 eyes of 23 patients were treated with trabeculectomy augmented with mitomycin C. The patients were followed up for 5 years and evaluated for intraocular pressure, rate of success, status of the bleb, and adverse events.Result. The mean postoperative intraocular pressure was statistically different at 3 m, 6 m, 1 y, 3 y, and 5 y follow-up. The rates of both complete successP=0.017and overall successP=0.031in the Ologen group were significantly higher than those in the mitomycin C group. The difference of the bleb extent and vascularity was statistically significant in both groups. There was no significant difference in postoperative complication.Conclusions. Ologen provides higher rates of surgical success compared with mitomycin C for patients with primary open-angle glaucoma undergoing trabeculectomy. It may be a new, safe, simple, and effective therapeutic approach for treating primary open-angle glaucoma.

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Intraocular Pressure Control after Trabeculectomy with Adjunctive Use of Mitomycin-C versus Bevacizumab: A Hospital Based Study

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v38i1.1335 ◽

2021 ◽

Vol 38 (1) ◽

Author(s):

P S Mahar ◽

Sobia Tabassum ◽

Mujahid Inam ◽

Muhammad Faaz Malik ◽

Tauseef Mahmood

Keyword(s):

Intraocular Pressure ◽

Mitomycin C ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Pressure Control ◽

T Test ◽

P Value ◽

Open Angle ◽

One Year

Purpose: To compare the control of intra ocular pressure (IOP) after trabeculectomy with adjunctive use of Mitomycin–C (MMC) versus Bevacizumab. Study Design: Quasi experimental study. Place and Duration of Study: Al-Ibrahim Eye Hospital, Isra Postgraduate Institute of Ophthalmology, Karachi, from August 2017 to August 2019. Methods: One hundred and six patients of either gender, fulfilling the inclusion criteria were planned for trabeculectomy with adjunctive use of Mitomycin-C (MMC) or Bevacizumab. Each group consisted of 53 patients (53 Eyes). The patients diagnosed with Primary Open Angle Glaucoma (POAG) with IOP ? 21 mm Hg and not controlled with topical anti-glaucoma medication were selected. Data were analyzed by using SPSS Version 22.0. Independent sample t test was used to check significance between two drugs. Paired sample t test was used to check significance of pre and post-operative IOP. Results: Mean age of patients was 56.67±7.34 years. Mean preoperative IOP was 31.51 ± 9.66 mm Hg in MMC group and 29.21 ± 7.69 mm Hg in Bevacizumab group. At first postoperative day, mean IOP after use of MMC was 14.75 ± 9.46 mm Hg and for Bevacizumab was 15.07 ± 6.47 mm Hg (p-value 0.001). Similarly, at one year follow-up, mean IOP for MMC group was 11.26 ± 2.31 mm Hg and for Bevacizumab was 11.73 ± 2.12 mm Hg(p-value 0.001). Conclusion: There was significant reduction in IOP in both MMC and Bevacizumab groups. However, the difference between the two groups was not statistically significant at mean follow-up of one year. Key Words: Primary Open Angle Glaucoma, Mitomycin–C, Intraocular Pressure, Bevacizumab, Trabeculectomy.

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Topical Bimatoprost Insert for Primary Open-Angle Glaucoma and Ocular Hypertension Treatment - A Phase II Controlled Study

Current Drug Delivery ◽

10.2174/1567201818666210101112256 ◽

2021 ◽

Vol 18 ◽

Author(s):

Francine Rubião ◽

Alan Cezar Faria Araújo ◽

João Bernardo Sancio ◽

Bárbara Silva Nogueira ◽

Juçara Ribeiro Franca ◽

...

Keyword(s):

Ocular Hypertension ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

T Test ◽

Controlled Study ◽

Therapeutic Drug ◽

Eye Drops ◽

Open Angle ◽

Drug Concentrations

Background: The most common treatment for primary open-angle glaucoma (POAG) is the daily use of eye drops. Sustained-release drug delivery systems have been developed to improve patient adherence by achieving prolonged therapeutic drug concentrations in ocular target tissues while limiting systemic exposure. The purpose of this study is to compare the efficacy and safety of bimatoprost inserts with bimatoprost eye drops in patients with POAG and ocular hypertension (OH). Methods: We include OH and POAG patients aged between 40 and 75 years-old. Both OH and POAG patients had intraocular pressure (IOP) greater than 21 and ≤30 mmHg at 9:00 am without glaucoma medication and normal biomicroscopy. Five normal patients with IOP≤14 mmHg constitute the control group. A chitosan-based insert of bimatoprost was placed at the upper conjunctival fornix of the right eye. In the left eye, patients used one drop of LumiganTM daily at 10:00 pm. For statistical analysis, we used a two-way analysis of variance (ANOVA), Student t-test, and paired t-test. Results: Sixteen POAG and 13 OH patients with a mean age of 61 years were assessed. In both eyes, IOP reduction was similar during three weeks of follow-up (19.5±2.2 mmHg and 16.9±3.1 mmHg), insert, and eye drop, respectively; P=0.165). The percentage of IOP reduction in the third week was 30% for insert and 35% for eye drops (P=0.165). No intolerance or discomfort with the insert was reported. Among the research participants, 58% preferred the use of the insert while 25% preferred eye drops, and 17% reported no preference. Conclusions: Bimatoprost-loaded inserts showed similar efficacy to daily bimatoprost eye drops during three weeks of follow up, without major side effects. This might suggest a possible change in the daily therapeutic regimen for the treatment of POAG and OH.

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Selective laser trabeculoplasty for primary open angle glaucoma: six-year follow up

10.1117/12.618510 ◽

2005 ◽

Author(s):

Krassimir Koev

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Open Angle ◽

Selective Laser Trabeculoplasty ◽

Laser Trabeculoplasty

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Outcomes of micropulse transscleral cyclophotocoagulation in primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma

European Journal of Ophthalmology ◽

10.1177/1120672120914231 ◽

2020 ◽

pp. 112067212091423 ◽

Cited By ~ 1

Author(s):

Oya Tekeli ◽

Helin Ceren Köse

Keyword(s):

Intraocular Pressure ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Secondary Glaucoma ◽

Open Angle ◽

Pseudoexfoliation Glaucoma ◽

Transscleral Cyclophotocoagulation ◽

The Mean ◽

Glaucoma Group

Purpose: The aim of this study is to compare the outcomes of micropulse transscleral cyclophotocoagulation between primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. Methods: Outcomes of 96 consecutive patients with refractory, end-stage glaucoma treated with micropulse transscleral cyclophotocoagulation were retrospectively reviewed. Follow-up examinations were performed on a regular basis until 12 months postoperatively. Surgical successes were defined as maintaining intraocular pressure ⩽18 mmHg and ⩾20% reduction in intraocular pressure (criteria A), ⩽15 mmHg intraocular pressure and ⩾25% reduction in intraocular pressure (criteria B), and ⩽12 mmHg intraocular pressure and ⩾30% reduction in intraocular pressure from baseline (criteria C). Results: Ninety-six eyes of 96 patients (50 (52%) females, 46 (48%) males) were included. Among all eyes, 32 were primary open-angle glaucoma, 30 were pseudoexfoliation glaucoma, and 34 were other types of secondary glaucoma. The mean age was 59.37 ± 11.45 (range: 20–91) years. The mean follow-up period was 14.2 ± 3.9 (range: 12–16) months. At 12 months, the success rates of primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma group were 68.75%, 66.6%, and 64.7% (p = 0.185) for criteria A; 56.25%, 53.3%, and 50% (p = 0.153) for criteria B; and 43.75%, 43.3%, and 38.2% (p = 0.146) for criteria C. Four patients (12.5%) in primary open-angle glaucoma group, 5 patients (16.6%) in pseudoexfoliation glaucoma group, and 14 (41.2%) patients in other secondary glaucoma group required reoperation during the follow-up (p < 0.05). Conclusion: Micropulse transscleral cyclophotocoagulation is an equally effective method of lowering intraocular pressure in patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. The rate of reoperation was higher in refractory secondary glaucoma patients.

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