scholarly journals Two-Year Outcomes of Ab Interno Trabeculectomy with the Trabectome for Chinese Primary Open Angle Glaucoma: A Retrospective Multicenter Study

2018 ◽  
Author(s):  
Yalong Dang ◽  
Xiao Wang ◽  
Yujie Cen ◽  
Ying Hong ◽  
Ping Huang ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Safe Procedure ◽  
Open Angle ◽  
Trabectome Surgery ◽  
History Of ◽  
Ab Interno Trabeculectomy ◽  
Ab Interno

To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open-angle glaucoma (POAG) patients. This was a multicenter, retrospective study and included POAG patients with or without visually-significant cataracts. The primary outcome was intraocular pressure (IOP) reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2-years. Success was defined as: 1) IOP < 21 mmHg and at least 20% IOP reduction from baseline after 3 months at any two consecutive visits, and 2) no additional glaucoma surgery required. A total of 42 patients were enrolled; thirteen had a history of failed glaucoma surgery. Twelve patients underwent Trabectome surgery combined with phacoemulsification while the remainder underwent Trabectome surgery alone. Overall, the mean preoperative IOP was 21.4±1.23 mmHg. The Trabectome lowered IOP to 18.5± 0.94 mmHg at 2 years (P<0.05). The number of glaucoma medications also decreased from a baseline of 2.0±0.9 to 1.2± 0.21 at 2 years (P=0.04). The overall success was 78%, with patients undergoing combined surgery having a higher success than those with Trabectome surgery alone (100% vs. 76%). No major complications were seen. The Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.

scholarly journals Primary Outcomes of Combined Cataract Extraction Technique with Ab-interno Trabeculectomy  and Endoscopic Cyclophotocoagulation  in Patients with Primary Open Angle Glaucoma

2020 ◽  
Author(s):  
Juan Carlos Izquierdo ◽  
Josefina Mejias ◽  
Laura Cañola ◽  
Natalia Agudelo ◽  
Barbara Rubio
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Surgical Success ◽  
Corrected Visual Acuity ◽  
Ab Interno Trabeculectomy ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

Abstract Background: Glaucoma surgery have been developed to lower intraocular pressure in a less invasive manner than traditional glaucoma surgery. The purpose of this article is to determine the outcome of using combined phacoemulsification technique, ab-interno trabeculectomy dual blade and endoscopic cyclophotocoagulation (ECP) surgeries in patients with primary open angle glaucoma. Methods: A retrospective case series was performed on 27 consecutive eyes with both primary open-angle glaucoma (POAG) and cataract; each eye was treated with combined phacoemulsification, ab-interno trabeculectomy-Kahook Dual Blade and Endocyclophotocoagulation at Instituto de ojos Oftalmosalud, Lima, Peru, between April 2017 and May 2017. Inclusion criteria: 1) Patients with uncontrolled mild to advanced POAG (according to Glaucoma Grading Scale HODAPP) 2) cataract condition 3) treatment with two or more glaucoma medications due to rapid progression in the visual fields (at least two in a short period of time). Intraocular pressure (IOP), best corrected visual acuity (BCVA) logMAR and number of glaucoma medications were recorded prior to the study, at day 1, week 1, and 1,3,6 and 9 months after surgery. Primary outcome measure was surgical success defined in terms of IOP <14 mmHg either with no medications (complete success) or with medications (qualified success). Results: A total of 27 eyes from 27 patients were included. The mean basal IOP was 17.0±3.7 mmHg and postoperatively was 11.6±1.9 mmHg and 11.4±1.8 mmHg (P<0.001) at 6 and 9 months respectively. Glaucoma medications decreased from 1.9±1.4 to 0.56±1.05 at 9 month follow-ups (P<0.001). Preoperative best corrected visual acuity (BCVA) showed and improvement from 0.4± 0.4 LogMAR to 0.2 ± 0.4 logMAR at 9 months. The main complication was blood reflux intra-operatively (66.7%), which resolved without re-operation. The mean IOP was reduced by 32.9% from baseline and the surgical success was 92,6%, (complete success 70,3% and qualified success 29,6%) at 9 months.Conclusions: In patients with POAG, combined treatment with phacoemulsification, ab-interno trabeculectomy and endoscopic cyclophotocoagulation effectively reduced IOP and glaucoma medication dependence.

scholarly journals Coarsened Exact Matching of Excisional to Plasma-Ablative Ab Interno Trabeculectomy

2021 ◽  
Author(s):  
Mohamad Dakroub ◽  
Raoul Verma-Fuehring ◽  
Alicja Strzalkowska ◽  
Jost Hillenkamp ◽  
Yousef Al Yousef ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Group Comparison ◽  
Open Angle ◽  
Exact Matching ◽  
Coarsened Exact Matching ◽  
Ab Interno Trabeculectomy ◽  
One Year ◽  
Ab Interno

Purpose: To compare ab interno trabeculectomy by trabecular meshwork excision to plasma-mediated ablation in primary open-angle glaucoma. Methods: Retrospectively collected data of TrabEx+ (TEx, n=56) and Trabectome (T, n=99) were compared by coarsened exact matching to reduce confounding and matched based on baseline IOP and age. Primary outcomes were IOP and number of glaucoma medications. Complications and need for additional glaucoma surgery were assessed. Patients were followed for up to one year. Results: 53 TEx could be matched to T. Baseline IOP was 16.5&plusmn;4.6 mmHg in both; age was 73.7&plusmn;8.8 and 71.5&plusmn;9.9 years in TEx and T, respectively. TEx were taking more medications than T (p&lt;0.001). IOP was reduced to 14.8&plusmn;4.3 in TEx and to 13.4&plusmn;3.4 in T at 6 months, and to 14.9&plusmn;6.0 (p=0.13) in TEx and to 14.1&plusmn;3.8 mmHg (all p&lt;0.05) in T at 12 months. Medications were reduced at both 6 and 12 months (p&lt; 0.05). No differences were seen between TEx and T at 6 and 12 months. In TEx, only one serious complication occurred, and two patients required further glaucoma surgery. Conclusion: Although both groups had a baseline IOP considered low for ab-interno trabeculectomy, IOP and medications were reduced further at 6 and 12 months. IOP reduction did not reach significance in TEx at 12 months. The inter-group comparison did not reveal any significant differences. Both had a low complication rate.

scholarly journals Primary outcomes of combined cataract extraction technique with Ab-Interno trabeculectomy and endoscopic Cyclophotocoagulation in patients with primary open angle Glaucoma

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Juan Carlos Izquierdo ◽  
Josefina Mejías ◽  
Laura Cañola-R ◽  
Natalia Agudelo ◽  
Bárbara Rubio
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Surgical Success ◽  
Corrected Visual Acuity ◽  
Ab Interno Trabeculectomy ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

Abstract Background Glaucoma surgery have been developed to lower intraocular pressure in a less invasive manner than traditional glaucoma surgery. The purpose of this article is to determine the outcome of using combined phacoemulsification technique, ab-interno trabeculectomy dual blade and endoscopic cyclophotocoagulation (ECP) surgeries in patients with primary open angle glaucoma. Methods A retrospective case series was performed on 27 consecutive eyes with both primary open-angle glaucoma (POAG) and cataract; each eye was treated with combined phacoemulsification, ab-interno trabeculectomy-Kahook Dual Blade and Endocyclophotocoagulation at Instituto de ojos Oftalmosalud, Lima, Peru, between April 2017 and May 2017. Inclusion criteria: 1) Patients with uncontrolled mild to advanced POAG (according to Glaucoma Grading Scale HODAPP) 2) cataract condition 3) treatment with two or more glaucoma medications due to rapid progression in the visual fields (at least two in a short period of time). Intraocular pressure (IOP), best corrected visual acuity (BCVA) logMAR and number of glaucoma medications were recorded prior to the study, at day 1, week 1, and 1,3,6 and 9 months after surgery. Primary outcome measure was surgical success defined in terms of IOP < 14 mmHg either with no medications (complete success) or with medications (qualified success). Results A total of 27 eyes from 27 patients were included. The mean basal IOP was 17.0 ± 3.7 mmHg and postoperatively was 11.6 ± 1.9 mmHg and 11.4 ± 1.8 mmHg (P < 0.001) at 6 and 9 months respectively. Glaucoma medications decreased from 1.9 ± 1.4 to 0.56 ± 1.05 at 9 month follow-ups (P < 0.001). Preoperative best corrected visual acuity (BCVA) showed and improvement from 0.4 ± 0.4 LogMAR to 0.2 ± 0.4 logMAR at 9 months. The main complication was blood reflux intra-operatively (66.7%), which resolved without re-operation. The mean IOP was reduced by 32.9% from baseline and the surgical success was 92,6%, (complete success 70,3% and qualified success 29,6%) at 9 months. Conclusions In patients with POAG, combined treatment with phacoemulsification, ab-interno trabeculectomy and endoscopic cyclophotocoagulation effectively reduced IOP and glaucoma medication dependence.

scholarly journals Primary Outcomes of combined cataract extraction technique with ab-interno trabeculectomy  Dual-Blade and Endoscopic cyclophotocoagulation in patients with primary open angle glaucoma

2019 ◽  
Author(s):  
Juan Carlos Izquierdo ◽  
Josefina Mejias ◽  
Laura Cañola ◽  
Natalia Agudelo ◽  
Barbara Rubio
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Cataract Extraction ◽  
Open Angle ◽  
Corrected Visual Acuity ◽  
Ab Interno Trabeculectomy ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

Abstract Purpose:  To provide an update of primary outcomes of combined phacoemulsification technique with ab-interno trabeculectomy  Dual Blade and Endoscopic cyclophotocoagulation (ECP) in patients with primary open angle glaucoma. Methods: Retrospective case series comprised 27 consecutive eyes, with open-angle glaucoma (POAG) and cataract with combined phacoemulsification, ab-interno trabeculectomy-Kahook Dual Blade and Endocyclophotocoagulation at Instituto de ojos Oftalmosalud, Lima, Perú, between April 2017 and May 2017. Inclusion criteria were Glaucoma patients with POAG from mild to severe, according to Glaucoma Grading Scale (HODAPP), cataract condition, treatment with two or more glaucoma medications and visual field defects continued worsen. Intraocular pressure (IOP), Best corrected visual acuity (BCVA) logMAR, and number of glaucoma medications were recorded before, and 1 day, 1 week, and 1, 3, 6 and 9 months after surgery. Defining succes as IOP <14 mmHg with or without medications. Results:  A total of 27 cases of glaucoma eyes were included. The mean IOP was 17.0±3.7 mmHg preoperatively, 11.6±1.9mmHg at 6 months, and 11.4±1.8 mmHg at 9 months(P<0.001). There was a corresponding drop in glaucoma medications from 1.9±1.41 at mean to 0.56±1.05 at 9 months (P<0.001). Preoperative best corrected visual acuity (BCVA) showed and improvement preoperative value from 0.4± 0.4 LogMAR (p= 0.001) to 0.2 ± 0.4 logMAR at 9 months. The main complication was blood reflux intraoperatively(66.7%), resolved within a few days. The mean IOP was reduce 32.9% from baseline and the qualifed succes was 92.6% at 9 months. Conclusions:  Cataract extraction with phacoemulsification combined with ab-interno trabeculectomy Dual Blade and endoscopic Cyclophotocoagulation effectively lowered IOP and dependence on glaucoma medications.

Effectiveness of combined glaucoma and cataract surgery with the use of a modified anti-glaucoma surgery

2021 ◽  
pp. 41-44
Author(s):  
O.I. Orenburkina ◽  
◽  
A.E. Babushkin ◽  
G.Z. Israfilova ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Antihypertensive Drugs ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Functional Results ◽  
Open Angle ◽  
Combined Operation ◽  
Combined Intervention

Purpose. To evaluate the clinical and functional results of a combined intervention – simultaneous cataract phacoemulsification (femtolaser assisted in some cases) and a developed partially fistulizing anti-glaucoma surgery in patients with primary open-angle glaucoma (POAG). Material and methods. 15 patients (45 eyes) aged 65-73 years with stage I-III POAG. The frequency of complications, dynamics of visual acuity's visual functions, and ophthalmotonus were analyzed before, during, and 6 months after surgery. Results. By the end of observation, the level of normalized IOP was defined in all patients, while in 78.6% of cases without drug correction and in 21.4% with the help of antihypertensive drugs (on average, 1.1±0.5). At the day of discharge from the hospital visual acuity after a simultaneous combined operation averaged 0.53±0.05, in the long term-0.77±0.06, while stabilization of glaucoma optical neuropathy after surgery occurred in 92.9%. Conclusion. A simultaneous combined intervention, including cataract phacoemulsification with a developed partially fistulizing anti-glaucoma operation, is an effective way to increase visual acuity, normalize ophthalmotonus and stabilize glaucoma optical neuropathy as well as reduce the drug load. Key words: cataract, glaucoma, surgical treatment, phacoemulsification, anti-glaucoma surgeries.

Results of a new modification of anti-glaucoma surgery in the treatment of primary open-angle glaucoma in combination with cataract

2021 ◽  
pp. 67-70
Author(s):  
M.M. Bikbov ◽  
◽  
O.I. Orenburgkina ◽  
A.E. Babushkin ◽  
G.Z. Israfilova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Visual Functions ◽  
Group 2 ◽  
Group 1

Purpose. To study the effectiveness of the developed partially fistulizing glaucoma surgery in the treatment of primary open-angle glaucoma (POAG) in combination with complicated cataract. Material and methods. 28 patients (28 eyes) were examined, including 13 patients (13 eyes) with I–III stages of POAG, operated according to the method of glaucoma surgery developed by us (group 1), and 15 patients (15 eyes) with a combination of previously unoperated glaucoma with incomplete complicated cataracts, who underwent a combined intervention – simultaneous phacoemulsification of cataracts with the specified variant of partially fistulizing glaucoma intervention (group 2). The analysis of the frequency of complications, the dynamics of visual functions, visual acuity and ophthalmotonus before surgery, at the time of discharge from the hospital, and in the longterm (6–9 months) after surgery was carried out. Results. In group 1, in the long term, the absolute hypotensive effect was recorded in 81.8% of cases, visual functions remained the same – in 90.9%. In group 2, by the end of follow – up, the level of normalized intraocular pressure was recorded in all patients, while in 78.6% of cases without drug correction and in 21.4% – with the help of antihypertensive drugs. Visual acuity in group 2, after a single-stage combined operation by the day of discharge from the hospital, averaged 0.53±0.05, in the long-term – 0.77±0.06, while the stabilization of glaucoma optic neuropathy after surgery occurred in 92.9%. Conclusion. Glaucoma surgery according to the proposed method in the studied long-term periods in patients with POAG provided a sufficiently high hypotensive effect and the preservation of visual functions. Combined single-stage intervention was an effective way to increase visual acuity, normalize ophthalmotonus and stabilize glaucoma optic neuropathy, as well as reduce drug load. Key words: primary open-angle glaucoma, cataract, partially fistulizing glaucoma surgery, cataract phacoemulsification.

scholarly journals Comprehensive Trabectome Outcomes in Surgery-naive Versus Previously Operated Eyes

2018 ◽  
Vol 12 (1) ◽  
pp. 50
Author(s):  
Sameh Mosaed ◽  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Success Rates ◽  
Medication Usage ◽  
Prospective Data ◽  
Trabectome Surgery ◽  
History Of ◽  
Tube Versus

This study aims to compare the results of trabectome surgery between surgery-naïve eyes and eyes that have previously undergone incisional surgery. Prospective data was collected on the first 20 cases of each new trabectome surgeon. This trabectome dataset was used to create two groups of subjects: surgery-naïve eyes versus eyes with prior incisional surgery. A total of 2,051 eyes were included in the study. These two groups were further broken down into the subtype of glaucoma (primary open angle glaucoma, pigmentary, pseudoexfoliation, uveitic and steroid-induced glaucoma). At 12- and 36-months follow up, success rates, intraocular pressure (IOP) reduction and medication usage were compared between the groups using the Tube versus Trabeculectomy Study criteria for defining success. At 36 months, the IOP of the virgin eyes and the previously operated eyes was 16.3 mmHg versus 15.8 mmHg, respectively. This difference was not statistically significant (p<0.05). Trabectome outcomes are similar in eyes with a history of prior incisional surgery (including failed glaucoma procedures) compared with those that are surgery-naive.

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