scholarly journals Comparison of intraocular pressure fluctuations before and after ab interno trabeculectomy in pseudoexfoliation glaucoma patients

2017 ◽  
Vol Volume 11 ◽  
pp. 1667-1675 ◽  
Author(s):  
Naoki Tojo ◽  
Shinya Abe ◽  
Mari Miyakoshi ◽  
Atsushi Hayashi
Keyword(s):  
Intraocular Pressure ◽  
Pressure Fluctuations ◽  
Pseudoexfoliation Glaucoma ◽  
Before And After ◽  
Ab Interno Trabeculectomy ◽  
Ab Interno

scholarly journals Comparison of a second-generation trabecular bypass (iStent inject) to ab interno trabeculectomy (Trabectome) by exact matching

2020 ◽  
Vol 258 (12) ◽  
pp. 2775-2780 ◽  
Author(s):  
Yousef Al Yousef ◽  
Alicja Strzalkowska ◽  
Jost Hillenkamp ◽  
André Rosentreter ◽  
Nils A. Loewen
Keyword(s):  
Intraocular Pressure ◽  
Second Generation ◽  
Nearest Neighbor ◽  
Exact Matching ◽  
Close Match ◽  
Istent Inject ◽  
Nearest Neighbor Matching ◽  
Ab Interno Trabeculectomy ◽  
Trabecular Bypass ◽  
Ab Interno

Abstract Purpose To achieve a highly balanced comparison of trabecular bypass stenting (IS2, iStent inject) with ab interno trabeculectomy (T, Trabectome) by exact matching. Methods Fifty-three IS2 eyes were matched to 3446 T eyes. Patients were matched using exact matching by baseline intraocular pressure (IOP), the number of glaucoma medications, and glaucoma type, and using nearest neighbor matching by age. Individuals without a close match were excluded. All surgeries were combined with phacoemulsification. Results A total of 78 eyes (39 in each group) could be matched as exact pairs with a baseline IOP of 18.3 ± 5.1 mmHg and glaucoma medications of 2.7 ± 1.2 in each. IOP in IS2 was reduced to 14.6 ± 4.2 mmHg at 3 months and in T to a minimum of 13.1 ± 3.2 mmHg at 1 month. In IS2, IOP began to rise again at 6 months, eventually exceeding baseline. At 24 months, IOP in IS2 was 18.8 ± 9.0 mmHg and in T 14.2 ± 3.5 mmHg. IS2 had a higher average IOP than T at all postoperative visits (p < 0.05 at 1, 12, 18 months). Glaucoma medications decreased to 2.0 ± 1.5 in IS2 and to 1.5 ± 1.4 in T. Conclusion T resulted in a larger and sustained IOP reduction compared with IS2 where a rebound occurred after 6 months to slightly above preoperative values.

Comparison of intraocular pressure fluctuation before and after cataract surgeries in normal-tension glaucoma patients

2018 ◽  
Vol 29 (5) ◽  
pp. 516-523 ◽  
Author(s):  
Naoki Tojo ◽  
Mitsuya Otsuka ◽  
Atsushi Hayashi
Keyword(s):  
Regression Analysis ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Contact Lens ◽  
Pressure Fluctuations ◽  
Normal Tension Glaucoma ◽  
Open Label ◽  
Before And After ◽  
Contact Lens Sensor ◽  
Harmonic Regression

Purpose: Cataract surgeries have been shown to reduce intraocular pressure. We used a Sensimed Triggerfish® contact lens sensor to compare intraocular pressure levels and their fluctuation between before and after cataract surgeries in patients with normal-tension glaucoma. Methods: This was a prospective open-label study. Thirteen patients with normal-tension glaucoma were included. All patients underwent a 1-month washout and discontinued glaucoma medications during this study. In each eye, intraocular pressure fluctuations over 24 h were measured with the contact lens sensor before and at 3 months after the cataract surgery. We compared intraocular pressure levels and their fluctuation between before and after cataract surgeries. We used two approaches to evaluate the amplitude of intraocular pressure fluctuations: dual-harmonic regression analysis, and measurement of the difference between the maximum and the minimum value. Results: The mean pre-operative intraocular pressure was 14.7 ± 2.2 mm Hg and mean post-operative intraocular pressure was 11.4 ± 2.2 mm Hg. Cataract surgery significantly decreased intraocular pressure (p = 0.0005). In both methods, the post-operative fluctuations in intraocular pressure over 24 h were significantly smaller than their pre-operative counterparts (dual-harmonic regression analysis: p = 0.0171; difference between the maximum and the minimum: p = 0.0398). Conclusion: Cataract surgery decreased both intraocular pressure values and intraocular pressure fluctuations in normal-tension glaucoma patients.

Ab interno trabeculectomy with the dual blade in juvenile open-angle glaucoma

2019 ◽  
pp. 112067211989244
Author(s):  
Albert S Khouri ◽  
Yan Zhu ◽  
Hadeel Sadek
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Ab Interno Trabeculectomy ◽  
Kahook Dual Blade ◽  
Ab Interno

Purpose: To introduce the use of the Kahook Dual Blade in the treatment of juvenile open-angle glaucoma. Patients and methods: A 14-year-old male was presented with juvenile open-angle glaucoma in the left eye. Ab interno trabeculectomy was performed using a dual-blade device. Results: Intraocular pressure was reduced from 28 to 15 mmHg in the left eye after 18 months. There were no complications. Conclusion: Dual blade ab interno trabeculectomy is a promising alternate to goniotomy in the treatment of juvenile open-angle glaucoma.

scholarly journals 12-month clinical outcomes of combined phacoemulsification and ab interno trabeculectomy for open-angle glaucoma in the United Kingdom

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252826
Author(s):  
Ejaz Ansari ◽  
Deva Loganathan
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Medication Use ◽  
Retrospective Chart Review ◽  
Mean Deviation ◽  
Open Angle ◽  
Ab Interno Trabeculectomy ◽  
Kahook Dual Blade ◽  
Ab Interno

Background/Objectives To describe intraocular pressure (IOP) and ocular hypotensive medication outcomes of combined phacoemulsification and ab interno trabeculectomy with the Kahook Dual Blade (KDB; New World Medical, Inc, Rancho Cucamonga, CA) in adults with cataract and open-angle glaucoma (OAG). Subjects/Methods Retrospective chart review of existing medical records. Data collected included intraocular pressure (IOP) and IOP-lowering medication use preoperatively and through up to 24 months postoperatively. Paired t-tests were utilized to compare preoperative to postoperative mean IOP and mean medications used. Results Data from 32 eyes of 26 subjects were analyzed. Subjects were predominantly Caucasian (25/26) had mean (standard error) age of 79.3 (1.2) years, and eyes had moderate-advanced OAG (mean visual field mean deviation -8.3 [1.3] dB). Mean IOP was 19.8 (0.8) mmHg at baseline and 15.5 (0.6) mmHg (p<0.0001) after mean follow-up of 11.5 (1.0) months; IOP reductions of ≥20% were achieved in 20/32 eyes (62.5%). Mean medication use declined from 2.4 (0.2) medications per eye at baseline to 0.5 (0.2) at last follow-up (p<0.0001); 23/32 eyes (71.9%) were medication-free at last follow-up. No vision-threatening complications were observed. Conclusions Combined phacoemulsification and ab interno trabeculectomy with the KDB safely provided mean IOP reductions of 21.7% and mean IOP medication reductions of 83% after mean follow-up of 12 months in eyes with moderate to advanced OAG. This procedure provides medication-independence in most eyes with statistically and clinically significant IOP reductions.

scholarly journals Intraocular Pressure Reduction in a Pigmentary Glaucoma Model by Goniotome Ab Interno Trabeculectomy

2018 ◽  
Author(s):  
Chao Wang ◽  
Yalong Dang ◽  
Priyal Shah ◽  
Hamed Esfandiari ◽  
Ying Hong ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Ex Vivo ◽  
Pigmentary Glaucoma ◽  
Pressure Reduction ◽  
Outflow Facility ◽  
Intraocular Pressure Reduction ◽  
Ab Interno Trabeculectomy ◽  
Hematoxylin And Eosin ◽  
Anterior Segments ◽  
Ab Interno

Purpose: To investigate whether microsurgical excision of trabecular meshwork (TM) in an ex vivo pigmentary glaucoma model can normalize the hypertensive phenotype. Methods: Eight eyes of a porcine pigmentary glaucoma model underwent 90&deg; of microsurgical TM excision with an aspirating dual-blade (Goniotome (G)). 24 hours later, an additional 90&deg; of TM were removed. Anterior segments with sham surgeries served as the control (C). Outflow facility and intraocular pressure (IOP) were analyzed. Histology with hematoxylin and eosin (H&amp;E) was obtained. Results: After the first 90&deg; TM excision, IOP was significantly lower in G (10.23&plusmn;2.39 mmHg, n=7) than C (20.04&plusmn;1.97mmHg, n=8, P&lt;0.01). Outflow facility in G (0.38&plusmn;0.07 &micro;l/min/mmHg) was higher than C (0.16&plusmn;0.02 &micro;l/min/mmHg, P&lt;0.01). After the second 90&deg; TM excision, IOP in G (6.46&plusmn;0.81 mmHg, n=7) was significantly lower than C (20.25&plusmn;1.66 mmHg, n=8, P&lt;0.001), while the outflow facility in G (0.50&plusmn;0.05 &micro;l/min/mmHg, n=7) was higher than C (0.16&plusmn;0.01 &micro;l/min/mmHg, n=8, P&lt;0.001). Compared to the first excision, excision of an additional 90&deg; did not change of IOP (P=0.20) or outflow facility (P=0.17) further. Conclusion: Excision of 90&deg; of TM in a pigmentary glaucoma model using an aspirating dual-blade decreased IOP and increased outflow facility. Translational Relevance: Microsurgical TM excision over 90&deg; can effectively restore outflow in pigmentary glaucoma.

scholarly journals Exact matching of trabectome-mediated ab interno trabeculectomy to conventional trabeculectomy with mitomycin C followed for 2 years

2020 ◽  
Author(s):  
A. Strzalkowska ◽  
P. Strzalkowski ◽  
Y. Al Yousef ◽  
F. Grehn ◽  
J. Hillenkamp ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Nearest Neighbor ◽  
Exact Matching ◽  
Surgical Interventions ◽  
Secondary Interventions ◽  
Nearest Neighbor Matching ◽  
Ab Interno Trabeculectomy ◽  
The Mean ◽  
Ab Interno

Abstract Purpose We used exact matching for a highly balanced comparison of ab interno trabeculectomy (AIT) with the trabectome to trabeculectomy with mitomycin C (TRAB). Methods A total of 5485 patients who underwent AIT were exact-matched to 196 TRAB patients by baseline intraocular pressure (IOP), number of glaucoma medications, and glaucoma type. Nearest-neighbor–matching was applied to age. Success was defined as a final IOP of less than 21 mmHg, IOP reduction of at least 20% reduction from baseline, and no secondary surgical interventions. Outcomes were measured at 1, 3, 6, 12, 18, and 24 months. Results A total of 165 AIT could be matched to 165 TRAB. The mean baseline IOP was 22.3 ± 5.6 mmHg, and the baseline number of glaucoma medications was 2.7 ± 1.1 in both groups. At 24 months, IOP was reduced to 15.8 ± 5.2 mmHg in AIT and 12.4 ± 4.7 mmHg in TRAB. IOP was lower than baseline at all visits (p < 0.01) and lower in TRAB than AIT (p < 0.01). Glaucoma medications were reduced to 2.1 ± 1.3 in AIT and 0.2 ± 0.8 in TRAB. Compared to baseline, patients used fewer drops postoperatively (p < 0.01) and more infrequently in TRAB than in AIT (p > 0.01). Secondary surgical interventions had the highest impact on success and became necessary in 15 AIT and 59 TRAB patients. Thirty-two challenging events occurred in TRAB and none in AIT. Conclusion Both AIT and TRAB reduced IOP and medications. This reduction was more significant in TRAB but at the expense of four times as many secondary interventions.

scholarly journals Outflow Enhancement by Three Different ab Interno Trabeculectomy Procedures in a Porcine Anterior Segment Model

2018 ◽  
Author(s):  
Yalong Dang ◽  
Chao Wang ◽  
Priyal Shah ◽  
Susannah Waxman ◽  
Ralitsa T. Loewen ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Segment ◽  
Structure And Function ◽  
Outflow Facility ◽  
Segment Model ◽  
Perfusion Model ◽  
Ab Interno Trabeculectomy ◽  
Anterior Segments ◽  
And Function ◽  
Ab Interno

Objective: To evaluate three different microincisional ab interno trabeculectomy procedures in a porcine eye perfusion model. Methods: In perfused porcine anterior segments, 90 degrees of trabecular meshwork (TM) were ablated using the Trabectome (T; n = 8), Goniotome (G; n = 8), or Kahook device (K; n = 8). After 24 hours, additional 90 degrees of TM were removed. Intraocular pressure (IOP) and outflow facility were measured at 5 &micro;L/min and 10 &micro;L/min perfusion to simulate an elevated IOP. Structure and function were assessed with canalograms and histology. Results: At 5 &micro;L/min infusion rate, T resulted in a greater IOP reduction than G or K from baseline (76.12% decrease versus 48.19% and 47.96%, P = 0.013). IOP reduction between G and K was similar (P = 0.420). Removing another 90 degrees of TM caused an additional IOP reduction only in T and G but not in K. Similarly, T resulted in the largest increase in outflow facility at 5 &micro;L/min compared with G and K (first ablation: 3.41 times increase versus 1.95 and 1.87; second ablation: 4.60 versus 2.50 and 1.74) with similar results at 10 &micro;L/min (first ablation: 3.28 versus 2.29 and 1.90 (P = 0.001); second ablation: 4.10 versus 3.01 and 2.01 (P = 0.001)). Canalograms indicated circumferential flow beyond the ablation endpoints. Conclusions: T, G and K significantly increased the outflow facility. In this model, T had a larger effect than G and K.

scholarly journals Combined ab-interno trabeculectomy and cataract surgery induces comparable intraocular pressure reduction in supine and sitting positions

2021 ◽  
Vol 14 (8) ◽  
pp. 1192-1198
Author(s):  
Caroline Gietzelt ◽  
◽  
Randolf A. Widder ◽  
Ludwig M. Heindl ◽  
Claus Cursiefen ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Relative Reduction ◽  
Sitting Position ◽  
Field Function ◽  
Corrected Visual Acuity ◽  
Ab Interno Trabeculectomy ◽  
Best Corrected Visual Acuity ◽  
Ab Interno ◽  
Fellow Eyes

AIM: To analyze the therapeutic effect of combined ab-interno trabeculectomy and cataract surgery on intraocular pressure (IOP) levels in supine and sitting postures during a 24-hour IOP profile. METHODS: Twenty-six eyes of twenty-six patients receiving ab-interno trabeculectomy using electroablation of the trabecular meshwork combined with cataract surgery or stand-alone were included in this retrospective analysis. IOP change during 24-hour IOP profiles within two years postoperatively were analyzed for eyes receiving surgery (“study eyes”) and compared to fellow eyes, which had not received surgery. Clinical data including mean sitting IOP (siIOP), mean supine IOP (suIOP) and the number of topical antiglaucomatous medications (TAM) were extracted from patients’ files. RESULTS: Preoperatively, siIOP was 17.6±5.3 mm Hg in study and 17.1±4.7 mm Hg in fellow eyes (P=0.347). Patients were treated with an average of 2.8±1.0 TAM. Best corrected visual acuity (BCVA) was significantly worse in study eyes (P<0.001), visual field function was marginally not significantly different (P=0.057). After surgery 9.6±6.8mo, study eyes had a mean siIOP of 14.5±3.6 mm Hg (IOP reduction: -3.2 mm Hg, P=0.009), a mean suIOP of 18.0±3.5 mm Hg, and an average of 1.3±1.34 TAM (P<0.001), while in fellow eyes, mean siIOP was 16.2±3.4 mm Hg and mean suIOP was 20.5±5.1 mm Hg. Postoperatively, the relative IOP increase between sitting and supine postures was approximately 30% in both study and fellow eyes (P=0.99). CONCLUSION: IOP after ab-interno trabeculectomy shows a comparable relative reduction in both supine and sitting position. Classical trabeculectomy is known to lower suIOP overproportionally.

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