scholarly journals Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 762 ◽  
Author(s):  
Yalong Dang ◽  
Pritha Roy ◽  
Igor I. Bussel ◽  
Ralitsa T. Loewen ◽  
Hardik Parikh ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Age Groups ◽  
Glaucoma Surgery ◽  
Fiber Layer ◽  
Primary Resistance ◽  
Field Function ◽  
Staging Systems ◽  
Significant Difference

Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma. Traditional glaucoma surgeries have a relatively high complication rate and have been reserved for more advanced disease stages. In the analysis presented here we include our data of trabectome combined with cataract surgery. This is a common practice pattern as both occur in the same age group with increasing frequency. For patients in higher glaucoma index (GI) groups, the intraocular pressure (IOP) reduction was 2.34+/-0.19 mmHg more than those in a GI group one level lower while holding everything else constant. Those who had undergone trabectome combined with phacoemulsification had an IOP reduction that was 1.29+/-0.39 mmHg less compared to those with trabectome alone. No statistically significant difference was found between genders and age groups while holding everything else constant. Hispanics had a 3.81+/-1.08 mmHg greater IOP reduction. Pseudoexfoliation and steroid glaucoma patients had an IOP reduction that was greater by 2.91+/-0.56 and 3.86+/-0.81 mmHg, respectively, than those with primary open angle glaucoma. These results suggest a role for trabectome-mediated ab interno trabeculectomy beyond mild forms of glaucoma. Additionally, the multifactorial glaucoma index demonstrates a role in staging patients when comparing glaucoma surgical modalities.

scholarly journals Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 762 ◽  
Author(s):  
Yalong Dang ◽  
Pritha Roy ◽  
Igor I. Bussel ◽  
Ralitsa T. Loewen ◽  
Hardik Parikh ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Age Groups ◽  
Fiber Layer ◽  
Primary Resistance ◽  
Field Function ◽  
Staging Systems ◽  
Significant Difference

Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. In the analysis presented here, we combined data of trabectome alone and trabectome with same session cataract surgery to increase testing power and chances of effect discovery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma. Traditional glaucoma surgeries have a relatively high complication rate and have been reserved for more advanced disease stages. In the analysis presented here we include our data of trabectome combined with cataract surgery. This is a common practice pattern as both occur in the same age group with increasing frequency. For patients in higher glaucoma index (GI) groups, the intraocular pressure (IOP) reduction was 2.34+/-0.19 mmHg more than those in a GI group one level lower while holding everything else constant. Those who had undergone trabectome combined with phacoemulsification had an IOP reduction that was 1.29+/-0.39 mmHg less compared to those with trabectome alone. No statistically significant difference was found between genders and age groups while holding everything else constant. Hispanics had a 3.81+/-1.08 mmHg greater IOP reduction. Pseudoexfoliation and steroid glaucoma patients had an IOP reduction that was greater by 2.91+/-0.56 and 3.86+/-0.81 mmHg, respectively, than those with primary open angle glaucoma. These results suggest a role for trabectome-mediated ab interno trabeculectomy beyond mild forms of glaucoma. Additionally, the multifactorial glaucoma index demonstrates a role in staging patients when comparing glaucoma surgical modalities.

scholarly journals Influence of automated visual field testing on intraocular pressure 

2020 ◽  
Author(s):  
S Bertaud ◽  
E Skarbek Borowski ◽  
R Abbas ◽  
C Baudouin ◽  
A Labbé
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Glaucoma Surgery ◽  
Angle Closure ◽  
Mean Deviation ◽  
Test Duration ◽  
Significant Difference ◽  
The Impact

Abstract Background: To evaluate the influence of automated visual field (VF) testing on intraocular pressure (IOP) in patients with ocular hypertension (OHT) or glaucoma.Methods: We conducted a prospective observational study in the glaucoma department at Quinze-Vingts National Ophthalmology Hospital in Paris. Ninety-five right eyes of 95 patients followed for glaucoma or OHT were included. IOP was measured three times using a Nidek NT-510 non-contact tonometer within a maximum of 5 minutes before and after VF testing. Sub analyses using logistic regression analysis were performed to evaluate the impact of gender, age, central corneal thickness (CCT), mean deviation (MD) of the VF, VF test duration and filtration surgery on IOP fluctuations.Results: There was no significant change in IOP after VF testing, with IOP’s 15.14 ± 4.00 mmHg before and 14.98 ± 3.33 mmHg after the VF (P = 0.4). The average change in IOP was 0.15 ± 1.82 mmHg. Using multivariate analysis, no effect of the VF test on IOP was found (global model fit R²=0.12), whether based on duration of the VF test (P=0.18) or the MD (P=0.7) after adjustment for age, gender, CCT and history of glaucoma surgery. Similarly, there was no significant difference within different types of glaucoma, including open-angle glaucoma (P=0.36), chronic angle closure glaucoma (P=0.85) and OHT (P=0.42). The subgroup of patients with an IOP elevation ≥ 2mmHg had a significantly higher VF test duration (P=0.002).Conclusion: VF testing does not influence IOP as measured with a non-contact tonometer.

scholarly journals Influence of automated visual field testing on intraocular pressure

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Samuel Bertaud ◽  
Elisabeth Skarbek Borowski ◽  
Rachid Abbas ◽  
Christophe Baudouin ◽  
Antoine Labbé
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Glaucoma Surgery ◽  
Angle Closure ◽  
Mean Deviation ◽  
Test Duration ◽  
Significant Difference ◽  
The Impact

Abstract Background To evaluate the influence of automated visual field (VF) testing on intraocular pressure (IOP) in patients with ocular hypertension (OHT) or glaucoma. Methods We conducted a prospective observational study in the glaucoma department at Quinze-Vingts National Ophthalmology Hospital in Paris. Ninety-five right eyes of 95 patients followed for glaucoma or OHT were included. IOP was measured three times using a Nidek NT-510 non-contact tonometer within a maximum of 5 min before and after VF testing. Sub analyses using logistic regression analysis were performed to evaluate the impact of gender, age, central corneal thickness (CCT), mean deviation (MD) of the VF, VF test duration and filtration surgery on IOP fluctuations. Results There was no significant change in IOP after VF testing, with IOP’s 15.14 ± 4.00 mmHg before and 14.98 ± 3.33 mmHg after the VF (P = 0.4). The average change in IOP was 0.15 ± 1.82 mmHg. Using multivariate analysis, no effect of the VF test on IOP was found (global model fit R2 = 0.12), whether based on duration of the VF test (P = 0.18) or the MD (P = 0.7) after adjustment for age, gender, CCT and history of glaucoma surgery. Similarly, there was no significant difference within different types of glaucoma, including open-angle glaucoma (P = 0.36), chronic angle closure glaucoma (P = 0.85) and OHT (P = 0.42). The subgroup of patients with an IOP elevation ≥2 mmHg had a significantly higher VF test duration (P = 0.002). Conclusion VF testing does not influence IOP as measured with a non-contact tonometer.

scholarly journals Influence of automated visual field testing on intraocular pressure

2020 ◽  
Author(s):  
S Bertaud ◽  
E Skarbek Borowski ◽  
R Abbas ◽  
C Baudouin ◽  
A Labbé
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Glaucoma Surgery ◽  
Angle Closure ◽  
Mean Deviation ◽  
Test Duration ◽  
Significant Difference ◽  
The Impact

Abstract Background: To evaluate the influence of automated visual field (VF) testing on intraocular pressure (IOP) in patients with ocular hypertension (OHT) or glaucoma.Methods: We conducted a prospective observational study in the glaucoma department at Quinze-Vingts National Ophthalmology Hospital in Paris. Ninety-five right eyes of 95 patients followed for glaucoma or OHT were included. IOP was measured three times using a Nidek NT-510 non-contact tonometer within a maximum of 5 minutes before and after VF testing. Sub analyses using logistic regression analysis were performed to evaluate the impact of gender, age, central corneal thickness (CCT), mean deviation (MD) of the VF, VF test duration and filtration surgery on IOP fluctuations.Results: There was no significant change in IOP after VF testing, with IOP’s 15.14 ± 4.00 mmHg before and 14.98 ± 3.33 mmHg after the VF (P = 0.4). The average change in IOP was 0.15 ± 1.82 mmHg. Using multivariate analysis, no effect of the VF test on IOP was found (global model fit R²=0.12), whether based on duration of the VF test (P=0.18) or the MD (P=0.7) after adjustment for age, gender, CCT and history of glaucoma surgery. Similarly, there was no significant difference within different types of glaucoma, including open-angle glaucoma (P=0.36), chronic angle closure glaucoma (P=0.85) and OHT (P=0.42). The subgroup of patients with an IOP elevation ≥ 2mmHg had a significantly higher VF test duration (P=0.002).

Comparison of Hypotensive Effect of Endotrabeculoectomy and Selective Laser Trabeculoplasty

2021 ◽  
pp. 19-25
Author(s):  
Olha V. Levytska ◽  
Igor Ya. Novytskyy
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Significant Difference ◽  
The Difference

Hypotensive effect of endotrabeculectomy was compared with that of selective laser trabeculoplasty in patients with primary open-angle glaucoma (POAG). We evaluated 44 patients (44 eyes) with POAG. In the first group (23 patients), endotrabeculectomy (trabecular ablation through the angle of anterior chamber) was performed, and in the second group (21 patients) the patients underwent selective laser trabeculoplasty. When comparing the intraocular pressure (IOP), it was found that the difference between preoperative and postoperative IOP was significant up to 6 months of follow-up in both groups (p < 0.05), however, hypotensive effect in the first group was more pronounced (7.58 vs. 1.55 mmHg, respectively). When comparing the number of hypotensive medications used before and after glaucoma surgery, it was found that the difference in patients of the first group was significant throughout the observation period (p = 0.028), while in patients of the second group there was no significant difference from the 3rd month of observation. The number of topical drugs to reduce IOP decreased by 1.44 in the first group (p < 0.05) and by 0.33 in the second group (p = 0.109). Endotrabeculectomy, as well as selective laser trabeculoplasty, showed significant hypotensive effect in patients with POAG within 6 months of observation, however, hypotensive effect of endotrabeculectomy significantly overweighted that of SLT. Keywords: endotrabeculectomy, selective laser trabeculoplasty, intraocular pressure, primary open-angle glaucoma.

scholarly journals Influence of automated visual field testing on intraocular pressure

2020 ◽  
Author(s):  
Samuel Bertaud ◽  
Elisabeth Skarbek Borowski ◽  
Rachid Abbas ◽  
Christophe Baudouin ◽  
Antoine Labbé
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Angle Closure ◽  
Mean Deviation ◽  
Test Duration ◽  
Automated Perimetry ◽  
Significant Difference ◽  
The Impact

Abstract Background To evaluate the influence of automated visual field (VF) testing on intraocular pressure (IOP) in patients with ocular hypertension (OHT) or glaucoma. Methods We conducted a prospective observational study from October 2015 to July 2016 at Quinze-Vingts National Ophthalmology Hospital in Paris. Ninety-five right eyes of 95 patients followed for glaucoma or OHT with reliable standard automated perimetry (SAP) were included. IOP was measured three times using a Nidek NT-510 non-contact tonometer within a maximum of 5 minutes before and after VF testing. Subanalyses using logistic regression analysis were performed to evaluate the impact of gender, age, central corneal thickness (CCT), mean deviation (MD) of the VF, VF test duration and filtration surgery on IOP fluctuations. Results There was no significant change in IOP after VF testing, with IOP’s 15.14 ± 4.00 mmHg before and 14.98 ± 3.33 mmHg after the VF (P = 0.4). The average change in IOP was 0.15 ± 1.82 mmHg. Using multivariate analysis, no effect of the VF test on IOP was found (global model fit R²=0.12), whether based on duration of the VF test (P = 0.18) or the MD (P = 0.7) after adjustment for age, gender, CCT and history of glaucoma surgery. Similarly, there was no significant difference within different types of glaucoma, including open-angle glaucoma (p = 0.36), chronic angle closure glaucoma (P = 0.85) and OHT (P = 0.42). The subgroup of patients with an IOP elevation > 2 mmHg had a significantly higher SAP test duration (P = 0.002). Conclusion VF testing by SAP does not influence IOP as measured with a non-contact tonometer.

scholarly journals Corneal biomechanics and biomechanically corrected intraocular pressure in primary open-angle glaucoma, ocular hypertension and controls

2019 ◽  
Vol 104 (1) ◽  
pp. 121-126 ◽  
Author(s):  
Riccardo Vinciguerra ◽  
Salwah Rehman ◽  
Neeru A Vallabh ◽  
Mark Batterbury ◽  
Gabriela Czanner ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Ocular Hypertension ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Biomechanics ◽  
Mean Deviation ◽  
Open Angle ◽  
Corvis St ◽  
Significant Difference

AimsTo compare the biomechanically corrected intraocular pressure (IOP) estimate (bIOP) provided by the Corvis-ST with Goldmann applanation tonometry (GAT-IOP) in patients with high-tension and normal-tension primary open-angle glaucoma (POAG; HTG and NTG), ocular hypertension (OHT) and controls. Moreover, we compared dynamic corneal response parameters (DCRs) of the Corvis-ST in POAG, OHT and controls, evaluated the correlation between global visual field parameters mean deviation and pattern SD (MD and PSD) and DCRs in the POAG group.Methods156 eyes of 156 patients were included in this prospective, single-centre, observational study, namely 41 HTG and 33 NTG, 45 OHT cases and 37 controls. Central corneal thickness (CCT), GAT-IOP and bIOP were measured, GAT-IOP was also adjusted for CCT (GATAdj). DCRs provided by Corvis-ST were evaluated, MD and PSD were recorded by 24–2 full-threshold visual field. To evaluate the difference in DCRs between OHT, HTG and NTG, a general linear model was used with sex, medications and group as fixed factors and bIOP and age as covariates.ResultsThere was a significant difference between GAT-IOP, GATAdj and bIOP in NTG and HTG, OHT and controls. NTG corneas were significantly softer and more deformable compared with controls, OHT and HTG as demonstrated by significantly lower values of stiffness parameters A1 and highest concavity and higher values of inverse concave radius (all p<0.05). There was a significant correlation (p<0.05) between MD, PSD and many DCRs with POAG patients with softer or more compliant corneas more likely to show visual field defects.ConclusionsCorneal biomechanics might be a significant confounding factor for IOP measurement that should be considered in clinical decision-making. The abnormality of corneal biomechanics in NTG and the significant correlation with visual field parameters might suggest a new risk factor for the development or progression of NTG.

iStent inject as a reasonable alternative procedure following failed trabeculectomy?

2018 ◽  
Vol 28 (6) ◽  
pp. 735-740 ◽  
Author(s):  
Anja-Maria Davids ◽  
Milena Pahlitzsch ◽  
Alexander Boeker ◽  
Necip Torun ◽  
Eckart Bertelmann ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Wilcoxon Test ◽  
Open Angle ◽  
Istent Inject ◽  
Glaucoma Therapy ◽  
Significant Difference ◽  
Target Pressure

Purpose: The aim of this study is to assess the intraocular pressure lowering effect and the performance of the glaucoma therapy of the iStent inject in glaucoma patients with uncontrolled intraocular pressure after failed trabeculectomy. Methods: In this retrospective study, iStent inject implantation (Glaukos Corporation, Laguna Hills, CA, USA) was performed in 22 eyes of 21 subjects suffering from glaucoma (n = 18 primary open angle glaucoma, n = 3 pseudoexfoliation glaucoma, and n = 1 for secondary glaucoma) with an intraocular pressure above target pressure after failed trabeculectomy (mean = 9.6 ± 8.1 years; range: 1–35 years). The intraocular pressure and the number of antiglaucomatous medication were assessed preoperatively, 1 day, 6 weeks, 3 months, 6 months, and 1 year after surgery and compared to preoperative findings (SPSS v23.0; Shapiro–Wilk test, Wilcoxon test, Friedman test). Results: The results showed a significant intraocular pressure decrease from 22.5 ± 4.6 to 15.5 ± 3.4 mmHg after 1 year follow-up (p = 0.012). The glaucoma therapy was 2.6 ± 1.2 preoperatively and reduced to 2.25 ± 1.5 number of medications after 1 year (p > 0.05). There was no significant difference in the number of medication during the whole follow-up period (1 year, p = 0.012). No significant intra- or postoperative complications were reported. Conclusion: Minimal invasive glaucoma surgery (iStent inject) can offer an effective intraocular pressure reduction in advanced adult primary and secondary open angle glaucoma after failed trabeculectomy in a follow-up period of 1 year. Glaucoma therapy, however, needs to be maintained to achieve an individual target pressure and to prevent glaucoma progression. In addition, a failure rate of 27.3% makes it necessary to select carefully patients for this treatment option.

scholarly journals Comparison of normotensive and glaucoma simplex patients according to age and sex

2012 ◽  
Vol 140 (11-12) ◽  
pp. 699-703
Author(s):  
Milan Stojcic ◽  
Paraskeva Hentova-Sencanic ◽  
Biljana Stojcic ◽  
Ivan Sencanic
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Elderly Population ◽  
Open Angle Glaucoma ◽  
Normal Tension Glaucoma ◽  
Applanation Tonometry ◽  
Open Angle ◽  
Visual Field Examination ◽  
Significant Difference ◽  
Age And Sex

Introduction. According to the level of intraocular pressure (IOP), open angle glaucoma is divided into high tension glaucoma (HTG) and normal tension glaucoma (NTG). Objective. To determine if there are differences in the distribution of patients by age and sex between NTG and HTG. Methods. Our prospective study included 30 patients with NTG and 30 with HTG. A complete eye examination was performed. The examination included measuring of intraocular pressure by Goldmann applanation tonometry, examination of optic disc head by indirect ophthalmoscopy with Volk 90 D lens and visual field examination using the Octopus program. Results. The average damage of visual field in the group of patients with NTG was 8.14?4.43 dB, while in the group with HTG it was 7.40?2.84 dB (p>0.05). The average age of the group of patients with NTG was 66?11.58 years, while among those with HTG the average age was 59.7?11.63 years (p<0.01). Among the patients with NTG there were three times more women than men (?2=9.124; p<0.01), while in the group of patients with HTG there were more men than women, but without statistically significant difference between the tested groups (?2=1.851; p>0.05). Conclusion. Open angle glaucoma is a disease of elderly population. According to our results, risk factors for this disease can be age and sex. NTG is more frequently present than HTG among elderly population and females.

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