scholarly journals Comparison of ExPress Mini-Device Implantation Alone or Combined with Phacoemulsification for the Treatment of Open-Angle Glaucoma

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Łukasz Stawowski ◽  
Joanna Konopińska ◽  
Marta Deniziak ◽  
Emil Saeed ◽  
Renata Zalewska ◽  
...  
Keyword(s):  
Open Angle Glaucoma ◽  
Comparative Assessment ◽  
Open Angle ◽  
Combined Surgery ◽  
Device Implantation ◽  
Corrected Visual Acuity ◽  
Surgical Methods ◽  
Express Group ◽  
Phakic Eyes

We propose comparative assessment of the effectiveness of two surgical methods for the treatment of open-angle glaucoma: (1) ExPress mini-device implantation combined with phacoemulsification and (2) ExPress mini-device implantation alone. In this prospective study, 81 patients (88 phakic eyes) with uncontrolled open-angle glaucoma enrolled for surgery. They were assigned two groups, those with coexisting cataracts (46 eyes; P-ExPress group) and those with glaucoma alone (42 eyes; ExPress group). The follow-up period was 12.9 ± 0.4 months in P-ExPress and 12.2 ± 0.6 months in ExPress group. In both groups the following parameters were measured: best corrected visual acuity (BCVA), intraocular pressure (IOP), number of complications and necessary postoperative interventions, and number of glaucoma medications. The IOP at the end of follow-up was similar in both groups (18.8 ± 5.9 versus 18.1 ± 4.8 mmHg;P=0.814). There were no statistical differences in the average number of glaucoma medications between ExPress and P-ExPress groups (0.9 ± 1.65 versus 1.3 ± 1.7;P=0.419) as well as in the number of postoperative complications (26 versus 21%;P=0.179in the P-ExPress and ExPress groups, resp.). Both methods are safe and effective for the surgical treatment of open-angle glaucoma. Coexistence of cataracts does not constitute a compelling contraindication for combined surgery.

scholarly journals Supraciliary microstent implantation for open-angle glaucoma: multicentre 3-year outcomes

2018 ◽  
Vol 3 (1) ◽  
pp. e000183 ◽  
Author(s):  
Swaantje Grisanti ◽  
Salvatore Grisanti ◽  
Julian Garcia-Feijoo ◽  
H Burkhard Dick ◽  
Francisco Jose Munoz-Negrete ◽  
...  
Keyword(s):  
Adverse Events ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Safety Outcome ◽  
Corrected Visual Acuity ◽  
Lower Baseline ◽  
Iop Elevation ◽  
Retinal Complications

ObjectiveTo describe the safety and effectiveness of CyPass supraciliary microstent implantation alone in eyes with open-angle glaucoma (OAG) followed up for up to 3 years.Methods and analysisThis registry study included subjects with primary or secondary OAG who underwent CyPass Micro-Stent implantation alone at 12 sites in four European countries to reduce intraocular pressure (IOP) and/or use of IOP-lowering medications. The primary safety outcome was the incidence of adverse events. Secondary efficacy outcomes included mean changes from baseline in IOP and IOP-lowering medications. Eyes were subgrouped into those with low (< 21 mm Hg) and high (> 21 mm Hg) baseline IOP.ResultsThis study included 225 eyes of 178 patients, with mean baseline IOP of 22.6 ± 6.7 mm Hg and a mean 2.2 ± 1.2 medications per eye. Common ocular adverse events included device obstruction (10.2%), IOP elevation > 10 mm Hg during follow-up (8.9%), retinal complications (4.4%) and loss of > 2 lines of best-corrected visual acuity (2.7%). Seventy-one eyes (31.6%) required secondary glaucoma surgery, with trabeculectomy (33 eyes) and second microstent implantation (13 eyes) being most common. At months 6–36, mean IOP reductions ranged from 4.4 to 5.1 mm Hg (15.8%–19.5%) and mean medication reductions from 0.2 to 1.2 (9.1%–54.5%). Mean IOP reduction was greater in eyes with higher than lower baseline IOP. Both subgroups showed reductions of 0.5–1.0 medication at 12–18 months.ConclusionCyPass microstent implantation demonstrated a safety profile consistent with other minimally invasive glaucoma surgeries and effectively lowered IOP for up to 3 years in eyes with OAG.

scholarly journals Comparison Efficiency of Combined Trabeculectomy with MMC and Gonioscopy-Assisted Transluminal Trabeculotomy

2021 ◽  
Author(s):  
Ali Olgun ◽  
Hacı Ugur Celik ◽  
Fatih Yenihayat ◽  
Ercument Bozkurt ◽  
İbrahim Sahbaz
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Randomized Study ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Success Rates ◽  
Combined Procedure ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose: To compare the efficacy of gonioscopy-assisted transluminal trabeculotomy combined with cataract surgery (PGATT) and trabeculectomy combined with cataract surgery (PTRAB) in open-angle glaucoma patients.Methods: A multicentered, retrospective, non-randomized study included 67 PGATT patients and 70 PTRAB patients. We compared preoperative intraocular pressure (IOP), best-corrected visual acuity (BCVA) compared with early and final IOP, medication numbers, and BCVA levels. Success was determined as IOP reduction >20% from baseline, IOP between 5-21 mmHg, preoperative IOP of higher than 21 mmHg with medication and postoperative IOP of less than 21 mmHg without medication for surgeries performed for intolerance to medication, postoperative IOP <21 mmHg as well as <18 mmHg separately without medications, and no need for further glaucoma surgery. Results: Preoperative IOP values were 28.61 ± 6.02 mmHg in PTRAB group and 23.99±8.00 mmHg in PGATT group (P<0.0001). Early postoperative IOP values were found lower in PTRAB group as 12.19 ± 3.41 mmHg and as 15.69 ± 4.67 mmHg in PGATT group (P<0.0001). Last follow-up IOP reading were lower in PGATT group (P=0.009). IOP difference values were found higher both in early and last postoperative periods in PTRAB group (respectively, P<0.0001, P=0.018). Success rates were found higher in both at lower than 21 and 18 mmHg levels in PGATT group (respectively, P=0.014, P=0.010).Conclusion: We found the PGATT combined procedure to be a well-tolerated, effective procedure that can lower IOP both early and late in the postoperative period with different rates of IOP success compared with the combined PTRAB procedure.

scholarly journals Prospective Randomized Study Comparing Combined Phaco-ExPress and Phacotrabeculectomy in Open Angle Glaucoma Treatment: 12-Month Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Joanna Konopińska ◽  
Marta Deniziak ◽  
Emil Saeed ◽  
Agnieszka Bartczak ◽  
Renata Zalewska ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Open Angle Glaucoma ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Comparable Efficacy ◽  
Open Angle ◽  
Shunt Implantation ◽  
Express Group ◽  
Study Plan

Purpose of the Study. To compare the efficacy and safety of phacotrabeculectomy (P-Trab) and phacoemulsification with the ExPress (P-ExPress) mini glaucoma shunt implantation.Study Plan. Prospective randomized study.Material and Methods. 85 eyes with cataract and unregulated open angle glaucoma. There were 46 eyes in the P-ExPress and 39 the P-Trab group. Intraocular pressure (IOP), the number of antiglaucoma medications, qualified and complete surgical success (defined as IOP ≤ 18.0 mmHg), visual acuity (CDVA), the number of endothelial cells, and postoperative complications and additional procedures were assessed.Results. After 12 months of observation, the average IOP in the P-Express group went from 26.4 ± 9.3 down to 17.1 ± 5 mmHg (P<0.05) and from 27.9 ± 12.9 down to 15.9 ± 2.7 mmHg in the P-Trab group (P<0.05). No significant differences in the amount of medications used after surgery and CDVA were discovered between the groups. In the P-ExPress group, greater loss of endothelial cells was noted(CDloss%), compared to the P-Trab group.Conclusions. Both P-ExPress and P-Trab have comparable efficacy and similar early postoperative complication profile. The presence of additional implant (as is the case of the ExPress mini glaucoma shunt implantation) may cause progressive loss of endothelial cells.

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

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.

scholarly journals Transpalpebral Electrical Stimulation as a Novel Therapeutic Approach to Decrease Intraocular Pressure for Open-Angle Glaucoma: A Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Félix Gil-Carrasco ◽  
Daniel Ochoa-Contreras ◽  
Marco A. Torres ◽  
Jorge Santiago-Amaya ◽  
Fidel W. Pérez-Tovar ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Intraocular Pressure ◽  
Pilot Study ◽  
Open Angle Glaucoma ◽  
Constant Current ◽  
Open Angle ◽  
Naive Group ◽  
Treatment Naïve ◽  
The Mean

Purpose. To determine the effect on intraocular pressure of transpalpebral specific exogenous voltages in a cohort of open-angle glaucoma patients. Methods. This is a prospective, comparative, and experimental pilot study. The electrical stimuli applied consisted of 10 Hz, biphasic, nonrectangular current pulses (100 μA) delivered from an isolated constant current stimulator. At intake, baseline IOP measurements were obtained from each eye. The measurement was repeated before and after microstimulation until the end of the treatment. Results. Seventy-eight eyes of 46 patients diagnosed with POAG were studied: 58 eyes with maximum tolerated medical treatment and 20 eyes without treatment (naïve). The mean baseline IOP on the treated POAG group was 19.25 mmHg ± 4.71. Baseline IOP on the naïve group was 20.38 mmHg ± 3.28. At the four-month follow-up visit, the mean IOP value on the treatment group was 14.41 mmHg ± 2.06 (P<0.0001). The obtained mean IOP measurement on the treatment-naïve group was 15.29 mmHg ± 2.28 (P<0.0001). Conclusions. The hypotensive response obtained using transpalpebral electrical stimulation on POAG patients, both on treatment-naïve patients and on patients receiving maximum tolerable treatment, was statistically significant when comparing basal IOP measurements to those obtained at the four-month follow-up visit.

Long-Term Follow-up in Preperimetric Open-Angle Glaucoma: Progression Rates and Associated Factors

2015 ◽  
Vol 159 (1) ◽  
pp. 160-168.e2 ◽  
Author(s):  
Ko Eun Kim ◽  
Jin Wook Jeoung ◽  
Dong Myung Kim ◽  
Seong Joon Ahn ◽  
Ki Ho Park ◽  
...  
Keyword(s):  
Associated Factors ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Glaucoma Progression ◽  
Long Term Follow Up

scholarly journals Safety and Efficacy of Two Trabecular Micro-Bypass Stents as the Sole Procedure in Japanese Patients with Medically Uncontrolled Primary Open-Angle Glaucoma: A Pilot Case Series

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Daisuke Shiba ◽  
Shingo Hosoda ◽  
Saori Yaguchi ◽  
Naoki Ozeki ◽  
Kenya Yuki ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Japanese Patients ◽  
Early Postoperative Period ◽  
Open Angle ◽  
Corrected Visual Acuity ◽  
Stent System ◽  
Registration Number ◽  
Favorable Safety

Purpose. To evaluate efficacy and safety of a trabecular micro-bypass stent system when used as the sole procedure in Japanese patients with medically uncontrolled primary open-angle glaucoma (POAG). Design. Prospective nonrandomized interventional pilot study. Methods. Ten eyes of 10 Japanese patients with medically uncontrolled POAG taking three ocular hypotensive medications were treated using only the implantation of two iStent trabecular micro-bypass stents. Each patient continued to take the same ocular hypotensive medications used preoperatively throughout the study. Intraocular pressure (IOP) and endothelial cell density (ECD) were determined at baseline and at 1, 3, and 6 months postoperatively. Best-corrected visual acuity (BCVA) was measured at baseline and 6 months after surgery. Results. Mean IOP was 22.0±3.0 mmHg at baseline and 16.9±3.6 mmHg at 6 months, which represented a mean reduction of 5.1 mmHg or 23.2%. No significant changes were observed in the ECD and BCVA. Complications that occurred during the early postoperative period included hyphema, peripheral anterior synechiae, and occlusion of the stent by the iris. Conclusion. Implantation of two trabecular micro-bypass stents as the sole procedure in Japanese POAG patients effectively reduced IOP and exhibited a favorable safety profile. Clinical Trials Registration number is UMIN000004002.

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