Efficacy and safety of single Ultrasound Cyclo-Plasty to treat refractory glaucoma: Results at 1 year

2020 ◽  
pp. 112067212097360
Author(s):  
Zhou Longfang ◽  
Hu Die ◽  
Lan Jie ◽  
Liu Yameng ◽  
Lv Mingyuan ◽  
...  
Keyword(s):  
Success Rate ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Neovascular Glaucoma ◽  
Angle Closure ◽  
Efficacy And Safety ◽  
Refractory Glaucoma ◽  
Ocular Complications ◽  
The Mean ◽  
Main Complication

Purpose: To evaluate clinical efficacy and safety of single Ultrasound Cyclo-Plasty (UCP) in the treatment of advanced refractory glaucoma. Methods: From January 2018 to August 2018, 25 patients (25 eyes) with refractory glaucoma and intraocular pressure (IOP) not controlled by drugs or conventional filtering surgery were included in the study. All subjects (neovascular glaucoma [ n = 12], secondary glaucoma [ n = 6], angle closure glaucoma [ n = 6], and primary open angle glaucoma [ n = 1]) underwent 8-sector Ultrasound Cyclo-Plasty. Patients were followed-up at Day 1, Week 1, and at 1, 3, 6, and 12 months, during which the IOP, the number of IOP lowering drugs and the occurrence of ocular complications were recorded. Clinical outcomes were IOP reduction, success rate, and ocular complications. According to the glaucoma type, patients were divided into a neovascular group (NVG) and a non-NVG group for sub-analysis. Results: All patients underwent a single UCP procedure and mean IOP reduced significantly from 39.7 ± 6.1 mmHg before UCP to 27.1 ± 11.0 mmHg at 1 year ( p < 0.01) corresponding to a mean IOP reduction of 29.6%. The mean number of IOP-lowering drugs used was 2.4 ± 1.2 at baseline and 2.3 ± 1.0 at 12 months. Success rate after a single UCP procedure was achieved in 41.7% patients at 1 year, with a higher success rate in non-NVG than in the NVG group. No major postoperative complications were reported. The main complication was conjunctival congestion, anterior chamber inflammation, scleral ring congestion, and scleral inprint. Of these, scleral ring congestion and scleral imprint are relatively rare complications, which can still be observed 12 months after UCP treatment. Conclusion: UCP for refractory glaucoma is effective in reducing IOP and has a good safety profile. Success rate is lower after a single UCP in NVG than for other types of glaucoma.

scholarly journals Comparison of the efficacy and safety of bimatoprost (0.03 %) and travoprost (0.004 %) in patients with primary open angle glaucoma

2013 ◽  
Vol 5 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Ashish Chander ◽  
H Kapoor ◽  
S Thomas
Keyword(s):  
Intraocular Pressure ◽  
Side Effect ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Efficacy And Safety ◽  
Once Daily ◽  
The Mean ◽  
To Receive

Purpose: To compare the efficacy and safety of bimatoprost (0.03 %) and travoprost (0.004 %) in patients with primary open angle glaucoma (POAG). Subjects and methods: Patients with POAG were randomized to receive either bimatoprost or travoprost once daily. Detailed ocular examination was done and intraocular pressure (IOP) was measured at 9.00 am, 1.00 pm and 4.00 pm at the baseline and at 1, 2, 4, 6 and 12 weeks of therapy. Results: A total of 31 patients were analysed. The patients were randomly divided into two groups (Bimatoprost group = 16; Travoprost group = 15). Both the groups had a statistically significant reduction from the baseline IOP at all follow up visits at 9.00 am, 1.00 pm and 4.00 pm. The mean IOP decreased from a baseline of 25 ± 2.32 mm Hg to 15.93 ± 1.79 mm Hg after 12 weeks in the bimatoprost group (p < 0.001), and from 24.2 ± 1.60 mm Hg to 16.53 ± 1.56 mm Hg in the travoprost group (p < 0.001). A better mean reduction of IOP was obtained with bimatoprost than with travoprost at the end of the study at 12 weeks (p = 0.03). Mild ocular redness was the commonest side effect in both the groups but was not significant in either group. Conclusion: Both drugs lowered IOP effectively but bimatoprost showed a greater reduction in the mean IOP than did travoprost at 12 weeks and both are safe for ocular use. Nepal J Ophthalmol 2013; 5(9):75-80 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7831

scholarly journals Efficacy and Safety of Timolol-Dorzolamide Fixed-Combination Three Times a Day Versus Two Times a Day in Newly Diagnosed Open Angle Glaucoma

2018 ◽  
Author(s):  
Mohammad Pakravan ◽  
Afsaneh Naderi Beni ◽  
Shahin Yazdani ◽  
Hamed Esfandiari
Keyword(s):  
Blood Pressure ◽  
Primary Open Angle Glaucoma ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Efficacy And Safety ◽  
The Mean

Purpose: To compare the therapeutic efficacy and safety of dorzolamide/timolol fixed-combination in newly diagnosed primary open angle glaucoma patients. Methods: In this prospective, interventional case series, newly diagnosed primary open angle glaucoma (POAG) patients that had not been treated for glaucoma were included. Patients were started on Cosopt twice a day (BID) for 1 month and then switched to three times a day (TDS) for additional 1 month. Patients underwent comprehensive ophthalmic examination, diurnal intraocular pressure (IOP), blood pressure (BP) and 24-hours heart rate (HR) measurements at baseline, month 1( BID), and month 2( TDS). IOP, systolic and diastolic pressures were measured at 8:00 AM,12:00 AM, 4:00 PM, 8:00 PM and 12:00 PM. Throughout the study, all adverse events were recorded and monitored by the investigators. Results: In 31 POAG patients that completed the study ,mean baseline IOP was 23.1&plusmn;3.15 mmHg . IOP was decreased significantly 16.5 &plusmn; 2.21 at 1 month (P &lt; 0.0001) and 13.9 &plusmn; 2.23 mmHg at 1 and 2 month follow up. (P &lt; 0.0001) IOP was significantly lower in month 2 compared to month 1 (P = 0.0004). While Cosopt BID significantly reduced the mean 24-hour systolic BP and mean 24-hour HR from baseline (P &lt; 0.0001), the mean 24-hour systolic BP and HR remained unchanged 2ith Cosopt TDS compared to BID (P = 0.62). Conclusions: Cosopt TDS has a superior IOP-lowering effect than Cosopt BID in POAG patients with comparable safety profile.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;

scholarly journals Efficacy of Selective Laser Trabeculoplasty in Medically Uncontrolled Glaucoma

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Nihat Sayin ◽  
Zeynep Alkin ◽  
Abdullah Ozkaya ◽  
Abdulvahit Demir ◽  
Ahmet Taylan Yazici ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Medical Records ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Efficacy And Safety ◽  
Success Rates ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
The Mean

Purpose. To investigate the efficacy and safety of 360° selective laser trabeculoplasty (SLT) on medically uncontrolled open-angle glaucoma (OAG) and to evaluate the effects of antiglaucomatous medications on the results of therapy. Materials and Methods. The medical records of 62 eyes of 51 patients with OAG, which did not reach the targeted intraocular pressure (IOP) with maximum antiglaucomatous medical therapy, were retrospectively reviewed. Results. A statistically significant decrease was observed in the mean baseline IOP at 1, 3, 6, and 12 months of followup (P<0.01). The success rate was 64.5% in all of the patients. The success rates did not vary significantly by taking 1, 2, 3, or 4 medications with the rates of 63.6%, 71.4%, 64.2%, and 58.3% (P=0.06). The success rate of eyes on medication more or less than 6 months was 62.5% or 66.7%, respectively (P=0.3). There was a positive correlation between mean baseline IOP and mean reduction in IOP from baseline (P<0.001, r=0.8). Conclusion. Application of 360° of SLT provided an effective and safe IOP reduction in medically uncontrolled OAG. Baseline IOP was found to be the most important factor in the efficacy of therapy.

scholarly journals Ultrasound biomicroscopic comparison of primary open-angle glaucoma and primary angle-closure glaucoma eyes in dark and light conditions

2015 ◽  
Vol 14 (1) ◽  
pp. 5-16
Author(s):  
Stephanie Ming Young ◽  
Maria CD Aquino ◽  
Noor Shabana ◽  
Ce Zheng ◽  
Seng Chee Loon ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Light Conditions ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
The Mean ◽  
Inferior Quadrant

Background: With the use of ultrasound biomicroscopy, we aim to look at differences in anterior segment parameters of eyes with primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) in dark and light conditions.Methods: Ultrasound biomicroscopy was performed for 30 subjects with PACG and 30 subjects with POAG at initial presentation before any treatment. Measurements of angle opening distance (AOD-500 and AOD-750) and trabecular-iris space area (TISA-500 and TISA-750) 500 and 750 mm from the scleral spur in both dark and light conditions were made. Anterior chamber depth (ACD) and axial length (AL) were also measured.Results: The mean age of PACG patients was 67.6 ± 9.6 years and POAG patients 62.1 ± 13.9 years. The mean ACD (2.70 ± 0.53mm) in PACG patients was significantly different from that (3.32 ± 0.52mm) of POAG patients (p<0.0001). There were also significant differences (p=0.0004) in the mean AL of PACG (22.91 ± 0.86mm) and POAG (24.47 ± 1.67mm) patients. Significant differences between POAG and PACG eyes were found for TISA-500, TISA-750, AOD-500 and AOD-750 in both light and dark conditions (p<0.001 for all). The light-dark differences in PACG eyes were smaller than that of POAG eyes for all AOD and TISA values in the inferior, superior, nasal and temporal quadrants. However, with the exception of AOD-750 in the inferior quadrant (p=0.0524), there were no significant differences in light-dark changes between POAG and PACG eyes for all parameters in the 4 quadrants.Conclusions: Ultrasound biomicroscopy is a useful tool in the diagnosis and management of glaucoma. We found significant differences in mean AL, ACD, TISA-500, TISA-750, AOD-500 and AOD-750 between PACG and POAG eyes. However, there were no significant differences between PACG and POAG eyes in terms of light-dark difference in anterior segment parameters, except for AOD-750 in the inferior quadrant. Further evaluation of the above findings could be done in future with a larger population.

scholarly journals Efficacy and Safety of Combined Surgeries including Intraocular Direct Cyclophotocoagulation with a 532 nm Laser to Treat Advanced Neovascular Glaucoma

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xiaomin Chen ◽  
Tian Zheng ◽  
Wen Zeng ◽  
Xia Fu ◽  
Shun Wang ◽  
...  
Keyword(s):  
Combined Treatment ◽  
Neovascular Glaucoma ◽  
Angle Closure ◽  
Efficacy And Safety ◽  
Retrospective Case ◽  
The Mean ◽  
Topical Medications ◽  
532 Nm ◽  
Case Note Review

Purpose. The purpose of this study was to assess the efficacy and safety of intraocular direct cyclophotocoagulation (IDCP) using a 532 nm laser with combination treatment in reducing intraocular pressure (IOP) for patients with advanced neovascular glaucoma (NVG) with angle closure. In addition, we sought to determine the success rate and frequency of complications and explore an optimized solution to reduce the number of topical medications and the pain of patients. Methods. A retrospective case note review of all patients undergoing combined treatment including IVR, phaco, PPV, PRP, and IDCP from January 2017 to June 2018. Results. In total, 24 consecutive patients (25 eyes) were reviewed. The mean IOP was significantly decreased from 42.2 ± 8.5 mmHg preoperatively to 15.56 ± 2.0 mmHg ( P < 0.0001 ), and no neovascularization of the iris (NVI) reoccurred at month 18. The number of medications used was reduced from 2.72 ± 0.45 preoperatively to 0.87 ± 0.40 at month 18 ( P < 0.0001 ). Conclusions. During 18 months of follow-up, the combined treatments were safe and had a significant IOP-lowering effect. This study provides a new method of performing IDCP with a 532 nm laser, allowing for the use of internal cyclophotocoagulation without extra equipment.

Micropulse transscleral cyclophotocoagulation in glaucoma treatment. Preliminary results

2021 ◽  
pp. 48-51
Author(s):  
O.Y. Kukleva ◽  
◽  
K.P. Zhukov ◽  
A.K. Drakon ◽  
D.D. Dement'ev ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Neovascular Glaucoma ◽  
Open Angle ◽  
Refractory Glaucoma ◽  
Preliminary Results ◽  
Average Decrease ◽  
Micropulse Laser ◽  
Transscleral Cyclophotocoagulation

Objective. To evaluate the preliminary results after micropulse cyclophotocoagulation in patients with primary open-angle refractory glaucoma (POAG) and neovascular glaucoma. Methods. Retrospective study of adult patients with glaucoma, with at least 6 months follow-up after the only one session of micropulse laser therapy. The study included 16 patients, 17 eyes with refractory primary open-angle glaucoma (POAG) and neovascular glaucoma. Follow up period was 6 months. The same surgical technique was used in all cases. The wavelength of the laser beam was 810 nm, the total exposure was 160 s, the energy was 2000 mJ, 31,3% of active cycle, the pulse duration was 0.5 ms, the period was 1.1 ms. Results. The average decrease in IOP was 26.6%. No complications identified Conclusions: micropulse transscleral cyclophotocoagulation has been shown to be safe and effective in lowering IOP in patients with refractory glaucoma. However, further study of this method is required. Key words: micrоpulse transscleral cyclophotocoagulation, glaucoma, intraocular pressure.

Efficacy and safety data for the XEN45 implant at 2 years: a retrospective analysis

2019 ◽  
Vol 104 (8) ◽  
pp. 1125-1130 ◽  
Author(s):  
Itay Elimelech Gabbay ◽  
Felicity Allen ◽  
Christine Morley ◽  
Tahmina Pearsall ◽  
Oliver Martyn Bowes ◽  
...  
Keyword(s):  
Failure Rate ◽  
Open Angle Glaucoma ◽  
Safety Data ◽  
Angle Closure ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Antihypertensive Medications ◽  
The Mean ◽  
Comparative Audit

AimTo report efficacy and safety measures for XEN45 in a National Health Service setting after 24-month follow-up.MethodsThis is a retrospective, non-comparative audit of records of patients who underwent XEN45 procedure between June 2015 and May 2017. The main outcome measures were intraocular pressure (IOP) reduction and number of antihypertensive medications at each timepoint. Failure was defined as requiring further surgery or removal of XEN. Success was defined as 20% reduction of IOP without additional glaucoma medications or reduction in antihypertensive medications without increase in baseline IOP. Needling rates were assessed and subgroup analysis was performed.ResultsA total of 151 eyes were included in the study. The main diagnoses were primary open angle glaucoma (84.1%), angle closure glaucoma (8.6%) and refractory glaucoma (7.3%). Stand-alone procedure was performed in 62.3% and combined phaco-XEN was done in 37.7%. The mean IOP at baseline was 22.1±6.5 mm Hg, and the mean IOP at 12 and 24 months was 15.4±5.9 mm Hg and 14.5±3.3 mm Hg, respectively (p<0.001). The mean number of medications was 2.77±1.1 at baseline, and 0.3±0.7 and 0.5±1.0 medications at 12 and 24 months, respectively (p<0.001). 25% of patients failed at the 24-month timepoint. Needling was required in 37.7% of patients at 24 months. Non-Caucasian ethnicity was found to be related to higher failure rate. No significant adverse events were noted.ConclusionXEN45 is a viable, effective and safe procedure after 2 years of follow-up. Patients should be advised regarding failure rate as well as possible need for bleb revisions and medication use.

Clinical outcomes of viscocanalostomy and phacoviscoviscocanalostomy in primary open angle glaucoma: Two years follow-up

2021 ◽  
pp. 112067212110640
Author(s):  
Reza Soltani-Moghadam ◽  
Ebrahim Azaripour ◽  
Yousef Alizadeh ◽  
Hassan Behboudi ◽  
Zahra Moravvej ◽  
...  
Keyword(s):  
Success Rate ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Success Rates ◽  
Antiglaucoma Medication ◽  
Prospective Comparative Study ◽  
The Mean ◽  
Effective Procedures

Purpose To compare the outcomes of phacoviscocanalostomy and viscocanalostomy in patients with primary open angle glaucoma. Methods This non randomized, prospective comparative study included 168 eyes of 168 patients with primary open angle glaucoma (POAG). Phacoviscocanalostomy was performed in 94 eyes with POAG and cataract and viscocanalostomy was performed in 74 eyes with POAG. Preoperative and postoperative intraocular pressures (IOP), number of antiglaucoma medication, intraoperative and postoperative complications were recorded throughout the follow-up period. Results The mean follow-up after surgery was 20.13 ± 7.9 months. Mean IOP decreased significantly 1 month after surgery in both groups (p < 0.001) and remained significantly lower from its preoperative value at all follow-up visits. The postoperative mean IOP at the last follow up in phacoviscocanalostomy and viscocanalostomy was 14.98 ± 4.8 mmHg and 16.84 ± 5.0 mmHg, respectively (p = 0.001). Complete success rate in phacoviscocanalostomy and viscocanalostomy groups was 83.1% and 56.8%, respectively (p = 0.008). Qualified success rate was achieved in 89.4% eyes in the phacoviscocanalostomy group and 83.8% of viscocanalostomy group (p = 0.534). The Best corrected visual acuity (BCVA) in phacoviscocanalostomy group improved significantly post-operatively (p = 0.001). Postoperative antiglaucoma medication in both groups were significantly less than the preoperative values (p = 0.001). Conclusions Both Phacoviscocanalostomy and viscocanalostmy are effective procedures in the control of IOP in patients with POAG with and without cataract. Higher complete success rates and BCVA were achieved in phacoviscocanalostomy. Therefore, phacoviscocanalostomy and viscocanalostomy are recommended in eyes with medically uncontrolled primary open-angle glaucoma with and without coexisting cataract.

scholarly journals Micropulse Transscleral Cyclophotocoagulation as Primary Surgical Treatment for Primary Open Angle Glaucoma in Taiwan during the COVID-19 Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1563
Author(s):  
Hsiao-Ling Chang ◽  
Shih-Chun Chao ◽  
Ming-Tsung Lee ◽  
Hung-Yu Lin
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Common Adverse Effect ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Efficacy And Safety ◽  
Primary Procedure ◽  
Transscleral Cyclophotocoagulation ◽  
The Mean ◽  
End Stage

Glaucoma is the leading cause of irreversible blindness worldwide, with primary open angle glaucoma (POAG) accounting for the greatest number of total glaucoma cases. This study aimed to evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) as a primary procedure in POAG during the COVID-19 pandemic. We retrospectively analyzed 60 eyes of 52 patients, who were diagnosed with mild-to-end-stage POAG without previous glaucoma surgery and received MP-TSCPC between 1 January 2020 and 31 August 2020. The mean preoperative intraocular pressure (IOP) significantly decreased from 27.8 mm Hg to 19.8, 20.1, 20.3, 20.4, and 20.2 mm Hg at 1, 3, 6, 9, and 12 months, respectively (all p < 0.05). The mean number of IOP-lowering medications used significantly decreased from 3.3 at the baseline to 1.6, 1.8, 1.8, 1.9, and 1.9 at 1, 3, 6, 9, and 12 months, respectively (all p < 0.001). Total withdrawal of antiglaucoma medications was fulfilled in five patients. The main outcome was achieved in 81.7% at postoperative month 12. The most common adverse effect was transient mydriasis (28.3%). No major complications were encountered. MP-TSCPC seems to be an effective and safe treatment to reduce IOP and the medication burden with minimal vision-threatening complications in mild-to-end-stage POAG patients without previous glaucoma surgery.

scholarly journals Short-Term Observation of Ultrasonic Cyclocoagulation in Chinese Patients with End-Stage Refractory Glaucoma: A Retrospective Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Dongpeng Hu ◽  
Shu Tu ◽  
Chengguo Zuo ◽  
Jian Ge
Keyword(s):  
Success Rate ◽  
Safety Evaluation ◽  
Chinese Patients ◽  
Angle Closure ◽  
Efficacy And Safety ◽  
Refractory Glaucoma ◽  
Clinical Trial Registry ◽  
Promising Alternative ◽  
Significant Difference ◽  
End Stage

Purpose. To assess the efficacy and safety of HIFU-based ultrasonic cyclocoagulation in Chinese patients with end-stage refractory glaucoma. Method. Patients were recruited consecutively from May 2016 to May 2017 in the Zhongshan Ophthalmic Center. Ultrasonic cyclocoagulation was performed on every patient, using the EyeOP1 ultrasound emitting device. Return visits were set at 1 day, 7 days, 1 month, and 3 months after the treatment. An intraocular pressure (IOP) reduction of ≥20% while IOP ≥ 5 mmHg was deemed as success. Mean IOP change was assessed. Efficacy of two modes (6 sectors and 8 sectors) was also compared. Complications were recorded for safety evaluation. Results. 61 eyes were treated in this study. The baseline IOP (mean ± SD) was 41.11 ± 10.65 mmHg. The percentage of IOP reduction after treatment was 29.2%, 43.2%, 34.8%, and 23.1% at 1 day, 7 days, 1 month, and 3 months, respectively. Overall success rate at 3 months was 50.0% (26/52). No significant difference was found between the 6 sectors group and the 8 sectors group in terms of the success rate (48.6% vs. 52.9%, p=0.768) as well as IOP reduction (p=0.417) at 3 months. Primary angle-closure glaucoma (PACG) had the highest success rate (80.0%, 12/15). Scleral thinning existed in 12 eyes, among which 2 developed hypotony (2 mmHg and 3 mmHg). Average pain score decreased massively compared with baseline data. Conclusion. With high percentage of IOP reduction and a good safety profile observed in our study, HIFU-based ultrasonic cyclocoagulation might become a promising alternative to cyclodestructive methods. Long-term efficacy and safety need further assessment. The study was registered with Chinese Clinical Trial Registry (http://www.chictr.org.cn; Registration number: ChiCTR-OOC-17014028).

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