scholarly journals Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Ali Salimi ◽  
Harrison Watt ◽  
Paul Harasymowycz
Keyword(s):  
Cataract Surgery ◽  
First Generation ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Long Term Outcomes ◽  
Surgical Success ◽  
Rnfl Thickness

Abstract Background The short- and medium-term outcomes of iStent have been extensively studied; however, only few studies have investigated its long-term outcomes. Here, we assessed the long-term efficacy and safety of two iStents with concomitant cataract surgery in glaucomatous eyes while also evaluating measures of disease stability using visual field and optical coherence tomography (OCT) of the optic nerve and the macula throughout 8 years of follow-up. Methods This longitudinal, single-center consecutive case series included glaucomatous eyes that underwent implantation of two first-generation trabecular micro-bypass stents (iStent) with concomitant cataract surgery. Eight-year efficacy outcomes included mean intraocular pressure (IOP) and medications, as well as surgical success. Eight-year safety outcomes included best-corrected visual acuity (BCVA), visual field mean deviation (VF-MD), cup-to-disc ratio (CDR), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, and adverse events. Results A total of 62 eyes with primary open-angle glaucoma (POAG) were included. At 8 years postoperative, IOP reduced by 26% from 19.2 ± 3.9 mmHg preoperatively to 14.2 ± 2.4 mmHg (P < 0.001), 91.1% of eyes achieved IOP ≤ 18 mmHg (vs. 51.6% preoperatively), 69.6% of eyes achieved IOP ≤ 15 mmHg (vs. 14.5% preoperatively), and 25% of eyes achieved IOP ≤ 12 mmHg (vs. 1.6% preoperatively). Medication use decreased by 17.9% from 2.8 ± 1.1 preoperatively to 2.3 ± 1.2 (P = 0.018). Surgical success was 90%, as six eyes underwent subsequent glaucoma surgeries. Safety measures of BCVA, CDR, RNFL thickness and GC-IPL thickness remained stable through 8 years postoperative. VF-MD remained stable until postoperative year 5 and subsequently progressed according to the natural history of glaucomatous disease. Conclusions Implantation of two iStents with concomitant cataract surgery is an effective and safe treatment option for surgery-naïve POAG eyes, evidenced by significant IOP and medication reductions, reasonable surgical success, and favorable safety outcomes, throughout the 8-year follow-up. Our data additionally supports the efficacy of this combined procedure in stabilizing or slowing disease progression.

scholarly journals Micro-Bypass Implantation for Primary Open-Angle Glaucoma Combined with Phacoemulsification: 4-Year Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Antonio Maria Fea ◽  
Giulia Consolandi ◽  
Marta Zola ◽  
Giulia Pignata ◽  
Paola Cannizzo ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Control Group ◽  
Open Angle ◽  
Long Term Follow Up ◽  
Baseline Values ◽  
The Mean

Purpose. To report the long-term follow-up results in patients with cataract and primary open-angle glaucoma (POAG) randomly assigned to cataract surgery combined with micro-bypass stent implantation or phacoemulsification alone.Methods. 36 subjects with cataract and POAG were randomized in a 1 : 2 ratio to either iStent implantation and cataract surgery (combined group) or cataract surgery alone (control group). 24 subjects agreed to be evaluated again 48 months after surgery. Patients returned one month later for unmedicated washout assessment.Results. At the long-term follow-up visit we reported a mean IOP of 15,9 ± 2,3 mmHg in the iStent group and 17 ± 2,5 mmHg in the control group (p=NS). After washout, a 14,2% between group difference in favour of the combined group was statistically significant (p=0,02) for mean IOP reduction. A significant reduction in the mean number of medications was observed in both groups compared to baseline values (p=0,005in the combined group andp=0,01in the control group).Conclusion. Patients in the combined group maintained low IOP levels after long-term follow-up. Cataract surgery alone showed a loss of efficacy in controlling IOP over time. Both treatments reduced the number of ocular hypotensive medications prescribed. This trial is registered with:NCT00847158.

scholarly journals The Effects of Trabeculectomy on Pseudoexfoliation Glaucoma and Primary Open-Angle Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Fan Li ◽  
Guangxian Tang ◽  
Hengli Zhang ◽  
Xiaowei Yan ◽  
Lihua Ma ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Success Rate ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Success Rates ◽  
Pseudoexfoliation Glaucoma ◽  
Long Term Effects ◽  
Surgical Success

Purpose. To compare long-term effects of trabeculectomy on pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG). Methods. This retrospective case-control study included 53 eyes of PXG and 76 eyes of POAG. Intraocular pressure (IOP), number of antiglaucoma medications used, surgical success rate, and occurrence of complications were observed and statistically analyzed in both groups at 3 and 6 months and at 1, 3, and 5 years after trabeculectomy. Surgical success was defined according to the following 3 criteria: (1) IOP ≤ 21 mmHg; (2) IOP ≤ 18 mmHg; (3) IOP ≤ 15 mmHg. Complete success is defined as patients met these criteria without medical treatment, and qualified success is defined as patients met these criteria with medical treatment (≤3 medications). Cumulative probabilities of success were compared using the Kaplan–Meier survival analysis. Results. For the 3 criteria, there were no statistically significant differences in complete and qualified success rates between the two groups at 3 and 6 months after trabeculectomy (P>0.05). For criterion A, complete success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion B, complete and qualified success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion C, complete and qualified success rates in PXG at 1, 3, and 5 years after surgery were lower than those in POAG, the differences were statistically significant (P<0.05). Conclusions. The short-term success rates of both types of glaucoma were similar; however, the long-term success rate of PXG was significantly lower, and it was difficult to achieve long-term control of IOP at a low target level.

Long-term Follow-up of Diode Laser Trabeculoplasty for Primary Open-angle Glaucoma and Ocular Hypertension

Ophthalmology ◽  
1993 ◽  
Vol 100 (11) ◽  
pp. 1614-1618 ◽  
Author(s):  
Anthony P. Moriarty ◽  
J. Dominic A. McHugh ◽  
Timothy J. ffytche ◽  
John Marshall ◽  
A.M. Peter Hamilton
Keyword(s):  
Ocular Hypertension ◽  
Diode Laser ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Laser Trabeculoplasty ◽  
Long Term Follow Up

scholarly journals Analysis of changes in structural and hemodynamic parameters of the retina and foveolar avascular zone in patients with primary open-angle glaucoma and diabetes mellitus observed in long-term follow-up

2021 ◽  
Vol 20 (3) ◽  
pp. 59-77
Author(s):  
A. Zh. Fursova ◽  
Y. A. Gamza ◽  
O. G. Gusarevich ◽  
A. S. Derbeneva ◽  
M. V. Vasilyeva ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Stage I ◽  
Hemodynamic Parameters ◽  
Open Angle ◽  
Avascular Zone ◽  
Long Term Follow Up ◽  
Group 3

PURPOSE. To study the changes in structural and hemodynamic parameters of the retina and foveolar avascular zone (FAZ) over time in patients with primary open-angle glaucoma (POAG) and diabetes mellitus (DM) observed in long-term follow-up.MATERIALS AND METHODS. The study included 258 patients (258 eyes) divided into five groups: group 1 — 58 patients (58 eyes) with stage I POAG and DM; group 2 — 50 patients (50 eyes) with stage I POAG; group 3 — 50 patients (50 eyes) with stage III POAG and DM; group 4 — 50 patients (50 eyes) with stage III POAG; group 5 — 50 patients (50 eyes) with DM. Patients underwent comprehensive ophthalmological examination, spectral domain optical coherence tomography (SD-OCT), optical coherence tomo-graphy angiography (OCT-A) of the macular region. The follow-up lasted 24 months.RESULTS. Analysis of the initial parameters in groups of patients with comorbidities showed the lowest values compared to controls, which were progressively worsening. MD in the group with DM + stage I POAG had reliably decreased after 12 months (by 5.05%), after 24 months by 12.12% (p≤0.05). The speed of GCL+IPL loss in groups 1 and 3 during the first year of observation was almost equal for initial and advanced glaucoma — 1.35 (-2.03%) and 1.32 (-2.36%) µm/year, but in group 3 the loss had doubled after two years (2.48 (-4.44%) and 1.41 (2.12%) µm/year). Deterioration of hymodynamic parameters in the macular region in groups 1 and 3 was noted primarily in the inner sectors (whole image vessel density in parafovea (PF wiVD) -0.79% during the first, and -2.57% during the second year in initial glaucoma, -0.6% and -1.24% in advanced, whole image vessel density in parafovea (PF wiVD) -0.2% and -1.22%, -0.66% and -1.56%, respectively). Parameters of FAZ had changed significantly after 2 years in patients with stage I POAG and DM: its area size had increased by 10.2%, perimeter by 4.49%, circularity index had decreased by 3.17%.CONCLUSION. Comorbidity of POAG and DM is accompanied by development and quick progression of significant changes in structural and hemodynamic parameters of the retina as observed by this long-term follow-up.

Long-Term Follow-Up of Argon Laser Trabeculoplasty in Uncontrolled Primary Open-Angle Glaucoma

1990 ◽  
Vol 200 (4) ◽  
pp. 181-188 ◽  
Author(s):  
M. Amon ◽  
R. Menapace ◽  
U. Radax ◽  
A. Wedrich ◽  
Ch. Skorpik
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Argon Laser ◽  
Open Angle ◽  
Argon Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Long Term Follow Up

scholarly journals Surgical stimulation of uveoscleral outflow is an alternative to cyclodestructive procedures

2021 ◽  
Vol 21 (1) ◽  
pp. 9-13
Author(s):  
E.A. Korchuganova ◽  
◽  
A.Yu. Kazantzeva ◽  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Secondary Glaucoma ◽  
Open Angle ◽  
Uveoscleral Outflow ◽  
Surgical Stimulation ◽  
Diode Laser Cyclophotocoagulation ◽  
Stimulation Of

Aim: to assess clinical efficacy and safety of surgical scleral rejection (SSR) vs. transscleral diode laser cyclophotocoagulation (TSCPC) in primary open-angle glaucoma (POAG) and secondary glaucoma (SG). Patients and Methods: study (prospective) group included 84 patients with POAG and SG after SSR. Control (retrospective) group included 80 patients after TSCPC. In addition, the patients were distributed by age and the stage and type of glaucoma, i.e., 128 patients were diagnosed with POAG and 36 patients were diagnosed with secondary thrombotic glaucoma. Follow-up was 24 to 36 months. IOP measurements, tonography (to assess the coefficient outflow facility / COF), ultrasound biomicroscopy of the anterior segment, visual acuity measurement, and visual field testing were performed. Results: no complications after SSR were reported in patients with POAG and SG. In contrast, postoperative complications (choroidal effusion, hyphema, and uveitis) were reported in 14% of patients after TSCPC. Long-term IOP-lowering efficacy of both procedures was similar (87% after SSR and 89% after TSCPC). In POAG, greater IOP reduction was seen after TSCPC (by 39.11%) compared to SSR (by 31.58%) (p<0.05). Meanwhile, in patients with SG, treatment outcomes were similar (IOP reduced by 36.78% after TSCPC and by 35.26% after SSR). In longterm follow-up, PVF reduced by 10.76% vs. baseline after TSCPC but increased by 11.19% vs. baseline after SSR (p≤0.05). Surgery resulted in the improvement or stabilization of visual functions. Ultrasonography has demonstrated that outflow pathways (intrascleral space and filtering bleb) remain functional after SSR in long-term follow-up. Conclusion: SSR is an alternative to cyclodestructive procedures in POAG and SG. Sclera being the final point of the uveoscleral outflow is a perspective entity to develop surgical approaches to glaucoma treatment. Keywords: surgical scleral resection, uveoscleral outflow, sclera, primary open-angle glaucoma, secondary glaucoma, glaucoma surgery, transscleral diode laser cyclophotocoagulation. For citation: Korchuganova E.A., Kazantzeva A.Yu. Surgical stimulation of uveoscleral outflow is an alternative to cyclodestructive procedures. Russian Journal of Clinical Ophthalmology. 2021;21(1):9–13. DOI: 10.32364/2311-7729-2021-21-1-9-13.

Long-term outcomes of primary trabeculectomy in diabetic patients with primary open angle glaucoma

2013 ◽  
Vol 97 (5) ◽  
pp. 561-566 ◽  
Author(s):  
Simon K Law ◽  
Hamid Hosseini ◽  
Elham Saidi ◽  
Nariman Nassiri ◽  
Gundappa Neelakanta ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Diabetic Patients ◽  
Open Angle ◽  
Long Term Outcomes
Sign in / Sign up

Export Citation Format

Share Document