Efficacy and safety of Ab interno XEN gel implant after a  failed filtering surgery

Cataract and glaucoma are the two leading causes of blindness worldwide and frequently co-exist in the ageing population. No uniform recommendations can be proposed when the two conditions are associated. In the presence of a visually significant cataract and uncontrolled glaucoma, clinicians should consider performing combined cataract surgery and trabeculectomy. Numerous phacotrabeculectomy techniques have been proposed. However, in the absence of strong evidence in support of a specific technique, surgeons’ preference and experience may dictate the choice. Unless contraindicated, mitomycin-C should be considered in all combined procedures. In addition, novel and minimally invasive glaucoma surgical procedures, such as ab interno trabeculotomy, have recently emerged and gained in popularity. In general, these procedures have shown the potential to be combined with phacoemulsification to further lower intraocular pressure (IOP) with relatively few post-operative complications. However, available data suggest that these techniques seem unlikely to be able to achieve a degree of IOP reduction comparable with that of trabeculectomy. Rigorous studies are necessary to better understand the long-term efficacy and safety profile of these novel procedures, when performed alone or in combination with cataract surgery.

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Ab interno trabeculotomy combined with cataract extraction in eyes with primary open-angle glaucoma

Journal of International Medical Research ◽

10.1177/0300060520957447 ◽

2020 ◽

Vol 48 (9) ◽

pp. 030006052095744

Author(s):

Yuan-Zhi Chen ◽

Ai-Ping Song ◽

Wen-Yan Jin ◽

Xiao Yang ◽

Guang-Fu Dang

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Cataract Extraction ◽

Open Angle ◽

Efficacy And Safety ◽

Corrected Visual Acuity ◽

Postoperative Time ◽

Best Corrected Visual Acuity ◽

Ab Interno ◽

Time Point

Objective To investigate the efficacy and safety of ab interno trabeculotomy using the VISCO360® Viscosurgical System (Sight Sciences, Inc., Menlo Park, CA, USA) combined with cataract extraction in the treatment of primary open-angle glaucoma (POAG). Methods Patients with POAG who underwent ab interno trabeculotomy combined with cataract extraction were retrospectively analyzed. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), the number of antiglaucomatous medications, and complications were recorded preoperatively and 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years postoperatively. Results Thirty-four patients (40 eyes) with POAG were included in this study, including 20 men (22 eyes) and 14 women (18 eyes). Compared with the preoperative IOP, the postoperative IOP was significantly lower at each time point. The greatest reduction in IOP was 60.7% at 1 month after surgery. The BCVA was also significantly improved at each postoperative time point. The number of antiglaucomatous medications used by the patients was significantly lower postoperatively than preoperatively. Conclusion Ab interno trabeculotomy combined with cataract extraction is effective and safe for treatment of POAG.

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Efficacy and Safety of ab interno Excimer Laser Trabeculotomy in Primary Open-Angle Glaucoma: Two Years of Follow-Up

Ophthalmologica ◽

10.1159/000094616 ◽

2006 ◽

Vol 220 (5) ◽

pp. 285-290 ◽

Cited By ~ 15

Author(s):

Silvia Babighian ◽

Emilio Rapizzi ◽

Alessandro Galan

Keyword(s):

Excimer Laser ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Open Angle ◽

Efficacy And Safety ◽

Excimer Laser Trabeculotomy ◽

Ab Interno

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Efficacy and safety of transconjunctival scleral flap resuturing for hypotony after glaucoma filtering surgery

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-008-0924-2 ◽

2008 ◽

Vol 246 (12) ◽

pp. 1751-1756 ◽

Cited By ~ 15

Author(s):

Katsuhiko Maruyama ◽

Shiroaki Shirato

Keyword(s):

Filtering Surgery ◽

Efficacy And Safety ◽

Scleral Flap

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Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent

Journal of Clinical Medicine ◽

10.3390/jcm10102129 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2129

Author(s):

Yuji Takayanagi ◽

Sho Ichioka ◽

Akiko Ishida ◽

Aika Tsutsui ◽

Masaki Tanito

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Corneal Endothelial Cell ◽

Efficacy And Safety ◽

Fellow Eye ◽

Corrected Visual Acuity ◽

Corneal Endothelial Cell Density ◽

Anterior Chamber Flare ◽

Best Corrected Visual Acuity ◽

Ab Interno

The aim of this study is to compare the surgical efficacy and safety between microhook ab-interno trabeculotomy (µLOT) and iStent trabecular micro-bypass stent implantation when both were combined with cataract surgery in both eyes of patients. Sixty-four glaucomatous eyes (32 participants; mean age, 75.9 ± 7.6 years; 15 men, 17 women) were included retrospectively. Intraocular pressure (IOP), number of antiglaucoma medications, best-corrected visual acuity (BCVA), anterior chamber flare (ACF) and corneal endothelial cell density (CECD) were evaluated preoperatively, as well as 2, 3, 6, and 12 months postoperatively. Surgical complications and interventions were compared between the procedures. The preoperative IOP and medications with µLOT (18.8 ± 5.7 mmHg and 3.0 ± 1.2, respectively) were higher than with the iStent (15.5 ± 3.4 mmHg and 2.7 ± 1.2, respectively) (p = 0.0001 and p = 0.0437, respectively). At 12 months, the µLOT values (12.6 ± 2.3 mmHg and 2.3 ± 0.9, respectively) were identical to iStent (12.8 ± 2.5 mmHg and 2.3 ± 0.9, respectively) (p = 0.0934 and p = 0.3251, respectively). At 12 months, the IOP decreased more with µLOT (6.2 mmHg, 29.5%) than iStent (2.7 mmHg, 15.6%) (p = 0.0003). The decrease in medications was greater with µLOT (0.7) than iStent (0.4) (p = 0.0437). Survival rate of IOP control ≤15 mmHg and IOP reduction ≥20% was significantly higher after µLOT (40.6% at 12 months) than iStent (18.8%) (p = 0.0277). The frequency of layered hyphema was significantly greater with µLOT (8 eyes, 25%) than iStent (0 eyes, 0%) (p = 0.0048). The increase in the ACF at 2 weeks postoperatively was significantly greater with µLOT than iStent (p = 0.0156), while changes in the BCVA and CECD were identical between groups. The fellow-eye comparison showed that the IOP reduction was greater with µLOT than iStent when combined with cataract surgery.

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