Comparison of Two Different Vinblastine Dosages for Treatment of Cutaneous Mast Cell Tumor in Dogs

Background: Mast cell tumors (MCT) are among the most common malignant cutaneous neoplasm in dogs with variable biologic behavior and remain a therapeutic challenge in high-grade cases. Surgery remains the primary treatment for canine MCT; however, chemotherapy and radiation therapy are commonly used to treat aggressive cases. The combination of vinblastine (VBL) at a dose of 2 mg/m² and prednisone is the classically described protocol for MCT treatment. Studies have shown the safety of higher VBL doses for dogs with MCT, but there is a lack of information regarding dose intensity and outcome as a goal after chemotherapy. This study aimed to evaluate the impact of a higher dose of VBL on MCT treatment outcome.Materials, Methods & Results: This was an observational and comparative study conducted in two different Veterinary Teaching Hospitals. Client-owned dogs with histopathological diagnosis of grade II or III MCT were selected and underwent at least four chemotherapy sessions with VBL and prednisone. The experimental group (EG) consisted of 18 dogs that received a dose of 3 mg/m² VBL treated in one institution. The control group (CG) included 31 dogs that received a dose of 2 mg/m² VBL treated at the other institution. All dogs treated in both groups had a clinical and complete blood count (CBC) evaluation performed previous the start of chemotherapy (T0) and before each weekly treatment (T1, T2, T3, and T4). After treatment, dogs in both groups were followed-up for the recurrence rate and overall survival time after diagnosis. There was no significant difference in clinical variables between EG and CG. During treatment, dogs of EG showed a significant reduction in erythrocyte, hemoglobin, and hematocrit values between T0 and T1, T2, T3, and T4 (P < 0.001). Comparatively, the CG showed significant reduction in hemoglobin (P = 0.02) and total leucocytes (P = 0.001) values in the same period. Despite these findings, these hematological parameters did not exceed the lower limit for the species in both groups. There was a higher-grade neutropenia one week after the first VBL application (T2) in both groups, with no statistical difference in neutrophil counts at T2 or during the whole treatment. There were discrete and self-limited episodes of anorexia, vomiting, and diarrhea in both groups. After chemotherapy, dogs in EG showed a significantly lower rate of recurrence than dogs in CG (P = 0.02). There was no significant difference in the overall survival time between groups.Discussion: The absence of significant differences in clinical variables (e.g. sex, age, histological grading, and tumor location) between EG and CG suggests that the groups may be similar regarding these parameters. All dogs included in this study had a recommendation for MCT post-operative chemotherapy treatment. VBL action is non-selective and anemia is not a commonly described adverse effect associated with its administration. Despite that, EG dogs exhibited a reduction in erythrocytes, hematocrit, and hemoglobin, and CG dogs in hemoglobin throughout T0 to T4. The highest number of neutropenia episodes occurred during T2, after the first VBL application in both groups with a trend of stabilization after T2, which is compatible with findings described in the literature. Any dog of EG or CG had to interrupt the treatment due to hematological or gastrointestinal toxicity or died during treatment. The role of VBL dose intensity in outcome is still debatable for dogs with MCT, once it is a multifactorial disease with variable presentation. In this study, there was no difference in overall survival time after diagnosis between groups, and EG dogs treated with a higher VBL dose showed significantly less tumor recurrence than CG.

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Comparison between clinical features and prognosis of malignancy- and non-malignancy–associated pediatric hemophagocytic lymphohistiocytosis

BMC Pediatrics ◽

10.1186/s12887-019-1702-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Hua Pan ◽

Yongmin Huo ◽

Lirong Sun

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Survival Time ◽

Clinical Features ◽

Hemophagocytic Lymphohistiocytosis ◽

Clinical Characteristics ◽

Univariate Analysis ◽

Control Group ◽

Survival Times ◽

Overall Survival Time

Abstract Background The differences between the clinical characteristics and survival time in malignancy- and non-malignancy–associated secondary hemophagocytic lymphohistiocytosis (HLH) are unclear. Here, we describe the clinical characteristics, prognostic factors, and survival outcomes of malignancy-associated HLH compared to that of non-malignancy–associated HLH. Methods We retrospectively analyzed 91 pediatric patients with HLH (age < 14 years) at the Affiliated Hospital of Qingdao University Pediatric Department between January 2005 and October 2016. The patients were divided into the malignancy-associated group (n = 22) and non-malignancy–associated group (n = 69, also considered the control group). The clinical features were compared using the Mann–Whitney U and χ2 tests. The overall survival time was compared using log rank and Mann–Whitney U tests. Results Hemoglobin (HGB; p = 0.004), alanine aminotransferase (ALT; p = 0.002), and aspartate aminotransferase (AST; p = 0.001) levels in the malignancy-associated group differed from that in the non-malignancy–associated group. The mean survival times were 26.9 ± 3.82 months (malignancy-associated HLH) and 35.03 ± 2.19 months (non-malignancy–associated HLH). The overall survival time between the two groups was not statistically significantly different (p = 0.055). Univariate analysis showed that disseminated intravascular coagulation (DIC) score > 5 (p = 0.001), albumin < 25 g/L (p = 0.000), HGB < 60 g/L (p = 0.001), and platelet count (PLT) < 30 × 109/L (p = 0.042) correlated with prognosis. Multivariate Cox analysis showed that albumin < 25 g/L (p = 0.017), HGB < 60 g/L (p = 0.027), and bone marrow hemophagocytosis (p = 0.034) correlated with worse prognosis. Conclusions Patients with non-malignancy–associated HLH do not have better survival, although their prognosis is relatively better in clinical practice. A higher DIC score at diagnosis and lower albumin, HGB, and PLT levels are negative prognostic factors in malignancy-associated HLH.

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The Incidence of Corrected Hypercalcemia and Its Relationship with Prognosis for Chinese Multiply Myeloma.

Blood ◽

10.1182/blood.v114.22.4903.4903 ◽

2009 ◽

Vol 114 (22) ◽

pp. 4903-4903

Author(s):

Xi Zhang ◽

Chunkang Chang ◽

Xiao Li ◽

Jiying Su ◽

Lingyun Wu ◽

...

Keyword(s):

Overall Survival ◽

Serum Creatinine ◽

Serum Albumin ◽

Survival Time ◽

Serum Calcium ◽

Staging System ◽

P Value ◽

Overall Survival Time ◽

Significant Difference ◽

Before And After

Abstract Abstract 4903 Purpose This paper is to study and analze the serum calcium level after corrected for serum albumin and its effect on prognosis in Chinese multiple myeloma (MM). Methods Serum calcium levels before and after corrected by serum albumin were retrospectively analyzed in 165 Chinese multiple myeloma patients. Corrected serum calcium (mmol/L)=serum calcium (mmol/L) – 0.025 x serum albumin (g/L)+1.0 (mmol/L). We also analyzed the relationship of serum calcium, serum creatinine and disease categories in Durie-Salmon (DS) staging system with patients' long-term overall survival rate. Results In 165 patients, the incidences of before and after corrected hypercalcemia were 8.7% and 40.6%, which were statistically significantly different (p=0.0245). Based on DS staging, the before and after corrected serum calcium levels of sixteen MM patients in I stage were 2.316±0.082 mmol/L and 2.344±0.073 mmol/L with a p value equal to 0.3236; the before and after correccted serum calcium levels of fifty MM patients in II stage were 2.314±0.17 and 2.407±0.235 mmol/L with a p value equal to 0.0251; the before and after corrected serum calcium levels of ninety-nine MM patients in II stage were 2.428±0.32 and 2.671±0.309 mmol/L with a p value equal to 0.0000. There is no significant difference in overall survival time between normal serum calcium group and elevated serum calcium group, p=0.8929. There is significant difference in overall survival time between normal serum creatinine patients and raised serum calcium patients with a p value equal to 0.0170. Patients in I stage in DS staging system have statistically significant longer overall survival time than those patients in II/III stage in DS staging system, p=0.0382. Conclusion The incidence of corrected hypercalcemia in Chinese MM is similar to foreign reports. Hypercalcemia has smaller or limit impact on patients' long-term overall survival compared to serum creatinine and DS staging. Disclosures No relevant conflicts of interest to declare.

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Is Renal Impairment Still a Poor Prognostic Marker in Myeloma Care?: A Population Based Study Including 1542 Patients

Blood ◽

10.1182/blood.v120.21.5033.5033 ◽

2012 ◽

Vol 120 (21) ◽

pp. 5033-5033

Author(s):

Katarina Uttervall ◽

Johan Andreasson ◽

Johan Liwing ◽

Per Näsman ◽

Johan Aschan ◽

...

Keyword(s):

Overall Survival ◽

Renal Impairment ◽

Prognostic Marker ◽

Control Group ◽

Line Treatment ◽

Employment Equity ◽

Significant Difference ◽

Study Population ◽

Equity Ownership ◽

The Impact

Abstract Abstract 5033 Background: Renal impairment (RI) is a relatively common feature of multiple myeloma (MM) and it has been shown in several studies that RI at diagnosis correlates to inferior survival, significant morbidity and increased early death rate. Aims: To understand the impact of RI on survival in the era of novel agents and to evaluate the efficacy of bortezomib-based treatment in patients presenting with RI. The primary endpoint of the study was overall survival (OS) in the whole population and renal response (RR) in 1st, 2nd and 3rd line treatment in a selected center (Karolinska). Time to progression (TTP), time to next treatment (TTNT), overall survival (OS) and MM response were the secondary endpoints. Methods: The study population included all patients diagnosed with MM since earliest January 2000 until latest June 2011 at 6 university clinics, 3 regional centers and 4 local hospitals in Sweden. A S-Creatinine limit of 177 μmol/L was chosen as cutoff for OS calculations. For a detailed analysis on RR all patients with MM with a S-Creatinine >=130 μmol/L that were diagnosed in clinical practice between January 2000 and July 2010 at Karolinska Huddinge and between January 2005 and July 2010 at Karolinska Solna were selected. This S-Creatinine limit was selected in an attempt to cover all MM patients with GFR <50 mL/min. The study population was divided into those receiving bortezomib and those receiving other drug combinations (control group). Results: The population consisted of 1642 patients, but S-Creatinine values were missing for 100 patients resulting in a study population of 1542 patients. Patients with S-Creatinine >=177 μmol/L (n=267) had a significantly worse median OS of 1. 9 years 95% CI[1. 5;2. 6] compared to S-Creatinine <177 μmol/L (n=1275), with a median OS of 4. 1 years 95% CI[3. 8;4. 4]; (p=<0. 001). Patients with >=177 in S-Creatinine receiving bortezomib (n=60) had a median OS of 2. 6 years compared to 1. 7 years in the control group (n=206) (p=0. 05). Of the 1542 patients, 556 were diagnosed and treated at our center. Ninety-five of these patients had a S-Creatinine >=130 μmol/L at diagnosis. Of the 95 patients 52 also had RI in 2nd line and 25 in 3rd line treatment resulting in a total of 172 treatment occasions where anti-myeloma treatment was given to patients with RI. There was no significant difference regarding age, sex, hemoglobin, β2-microglobulin, calcium, or albumin between the bortezomib-group and the control group. In the bortezomib-group, in 1st line treatment, 11 of 12 patients (92%) improved their GFR compared to 57 of 83 (69%) in the control group (p=0. 049). In the 2nd and 3rd treatment line the overall RR was 19% and 43% in the bortezomib treated compared to 23% and 28% in the control group (p=0. 749, and p=0. 257). When analyzing all treatment lines together the MM response was better in the bortezomib-group with significantly higher overall response rate of 80%, compared to 55% (p=0. 026). Median TTP in 1st, 2nd and 3rd line in the bortezomib-group was 18, 6 and 10 months and in the control group 11, 10 and 8 months. Median survival time was 3. 4 years for the control group, whereas 62% of the bortezomib treated patients still were alive at median time of follow up. Conclusion: RI is still an important prognostic marker in MM despite modern treatment with a proteasome inhibitor. Bortezomib-based regimens can partly overcome the negative impact of RI by a higher frequency of RR and MM responses, as well as an improved median OS in comparison to other treatment regimens for MM patients with RI. Disclosures: Liwing: Janssen-Cilag: Employment, Equity Ownership. Näsman:Janssen-Cilag: Consultancy. Aschan:Janssen-Cilag: Employment, Equity Ownership.

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Evaluating survival in subjects with astrocytic brain tumors by dynamic susceptibility-weighted perfusion MR imaging

PLoS ONE ◽

10.1371/journal.pone.0244275 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244275

Author(s):

Matthew L. White ◽

Yan Zhang ◽

Syed A. Jaffar Kazmi ◽

Michele Aizenberg ◽

Nicole Shonka ◽

...

Keyword(s):

Overall Survival ◽

Brain Tumors ◽

Survival Time ◽

Dynamic Susceptibility ◽

Clinical Factors ◽

Chi Square ◽

Overall Survival Time ◽

Initial Surgery ◽

Perfusion Mr ◽

The Impact

Purpose Studies have evaluated the application of perfusion MR for predicting survival in patients with astrocytic brain tumors, but few of them statistically adjust their results to reflect the impact of the variability of treatment administered in the patients. Our aim was to analyze the association between the perfusion values and overall survival time, with adjustment for various clinical factors, including initial treatments and follow-up treatments. Materials and methods This study consisted of 51 patients with astrocytic brain tumors who underwent perfusion-weighted MRI with MultiHance® at a dose of 0.1 mmol/kg prior to initial surgery. We measured the mean rCBV, the 5% & 10% maximum rCBV, and the variation of rCBV in the tumors. Comparisons were made between patients with and without 2-year survival using two-sample t-test or Wilcoxon rank-sum test for the continuous data, or chi-square and Fisher exact tests for categorical data. The multivariate cox-proportional hazard regression was fit to evaluate the association between rCBV and overall survival time, with adjustment for clinical factors. Results Patients who survived less than 2 years after diagnosis had a higher mean and maximum rCBV and a larger variation of rCBV. After adjusting for clinical factors including therapeutic measures, we found no significant association of overall survival time within 2 years with any of these rCBV values. Conclusions Although patients who survived less than 2 years had a higher mean and maximum rCBV and a larger variation of rCBV, rCBV itself may not be used independently for predicting 2-year survival of patients with astrocytic brain tumors.

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Contribution of intraoperative stimulation mapping to glioblastoma surgery within or adjacent to descending motor pathways: survival analysis and functional outcome comparison between two series in a single institution

10.21203/rs.3.rs-302485/v1 ◽

2021 ◽

Author(s):

Jimmy Ming-Jung Chuang ◽

Li-Han Lin ◽

Meng-Hsiang Chen ◽

Wei-Che Lin ◽

Cheng-Hsien Lu ◽

...

Keyword(s):

Overall Survival ◽

Survival Time ◽

Neurological Outcome ◽

Median Overall Survival ◽

Extent Of Resection ◽

Rank Test ◽

Positive Effects ◽

Overall Survival Time ◽

Significant Difference ◽

Median Overall Survival Time

Abstract Purpose Extensive resection probably confers a modest survival advantage in patients with glioblastoma. Studies have revealed the positive effects of intraoperative stimulation mapping (ISM) on the extent of resection, but no consensus for contribution of intraoperative stimulation mapping is reached. Methods This retrospective study enrolled two groups of patients who underwent surgery for motor-eloquent glioblastoma: the non-ISM group of 57 patients (surgery in 2008–2013) and ISM group of 13 patients (surgery in 2014–2015). The two groups and subgroups based on resection extent and postoperative additional neurological deficit were compared using Kaplan–Meier analysis and the log-rank test. Results Gross or near total resection (≥ 90% resection quality) was significantly more common in the ISM group than the non-ISM group (76.9% versus 24.6%; p = 0.001). The extent of resection was also significantly greater (90.5% ± 15.6% versus 64.6% ± 29.2%; p = 0.002). The neurological outcome in the ISM group was thus superior, but the two differences were not significant. The median progression-free survival time was significantly longer in the ISM group (22.0 ± 5.1 months vs 8.0 ± 1.0 months; p = 0.037) but a significant difference was not indicated in median overall survival time (22.0 ± 8.4 months vs 16.0 ± 2.2 months; p = 0.167). Conclusion ISM was discovered to lead to higher quality of resection and delayed recurrence. The neurological outcome and median overall survival time in the ISM group was thus superior, but the two differences were not significant. Trial registration number (for clinical trials) Nil

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Analysis of Nuclear Factor Kappa B in Mantle Cell Lymphoma.

Blood ◽

10.1182/blood.v106.11.4712.4712 ◽

2005 ◽

Vol 106 (11) ◽

pp. 4712-4712

Author(s):

Carsten Schrader ◽

Wolfram Klapper ◽

Dirk Janssen ◽

Paul Riis ◽

Peter Meusers ◽

...

Keyword(s):

Overall Survival ◽

Mantle Cell Lymphoma ◽

Survival Time ◽

Survival Data ◽

Cell Lymphoma ◽

Expression Profiles ◽

High Power Field ◽

Overall Survival Time ◽

Significant Difference ◽

Mantle Cell

Abstract Gene expression profiles revealed that proliferation associated genes are important prognostic factors in the clinical outcome in mantle cell lymphoma (MCL). Beside this well accepted markers also analysis of apoptotic proteins are now under investigation. We investigated immunohistochemically the expression of the apoptotic marker NF-kB in relation to the clinical course in 89 patients enrolled in two multicenter prospective trials. Biopsies were recut and stained with mandatory antibodies (CD20, CD5, CD3, CD23, cyclin D1) and NF-kB. The NF-kB expression was analyzed in three groups: negative, cytoplasmatic positive and nuclear positive (more than 1/HPF). The expression was compared with the overall survival data analyzed according to Kaplan and Meier. In 13 cases a negative NF-kB staining was detected. Fifty-seven cases were positive only in the cytoplasma and in 17 cases more than 1 cell per high power field showed nuclear activity. Patients with mantle cell lymphoma that had negative and cytoplasmatic positive expression had a median overall survival time of 35.7 months compared to 22.4 months for patients with a nuclear NF-kB expression. The Kaplan-Meier analysis showed a significant difference in the overall survival time (p=0.0121). The immunohistochemical detection of NF-kB in mantle cell lymphoma is possible and a tool to identify patients with a poor prognosis.

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Reducing the Social Stigma Associated with Obsessive Compulsive Disorder: A Controlled Trial of an Intervention Program in a Turkish Community Sample

Journal of Evidence-Based Psychotherapies ◽

10.24193/jebp.2020.2.14 ◽

2020 ◽

Vol 20 (2) ◽

pp. 101-120

Author(s):

Ayça Aktaç Gürbüz ◽

Orçun YORULMAZ ◽

Gülşah DURNA

Keyword(s):

Obsessive Compulsive Disorder ◽

Intervention Program ◽

Controlled Trial ◽

Community Sample ◽

Case Vignette ◽

Control Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Significant Difference ◽

The Impact

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.

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Association of Genetic Polymorphisms and Serum Levels of IL-6 and IL-8 with the Prognosis in Children with Neuroblastoma

Cancers ◽

10.3390/cancers13030529 ◽

2021 ◽

Vol 13 (3) ◽

pp. 529

Author(s):

Silvia Selene Moreno-Guerrero ◽

Arturo Ramírez-Pacheco ◽

Luz María Rocha-Ramírez ◽

Gabriela Hernández-Pliego ◽

Pilar Eguía-Aguilar ◽

...

Keyword(s):

Overall Survival ◽

Genetic Polymorphisms ◽

Poor Prognosis ◽

Serum Levels ◽

Control Group ◽

Mexican Children ◽

Genotype Frequencies ◽

Pcr Rflp ◽

The Impact ◽

Circulating Levels

There is evidence that high circulating levels of IL-6 and IL-8 are markers of a poor prognosis in various types of cancer, including NB. The participation of these cytokines in the tumor microenvironment has been described to promote progression and metastasis. Our objective was to evaluate the prognostic role of genetic polymorphisms and serum levels of IL-6 and IL-8 in a cohort of Mexican pediatric patients with NB. The detection of the SNPs rs1800795 IL-6 and rs4073 and rs2227306 IL-8 was carried out by PCR-RFLP and the levels of cytokines were determined by the ELISA method. We found elevated circulating levels of IL-8 and IL-6 in NB patients compared to the control group. The genotype frequencies of the rs1800795 IL-6 and rs4073 IL-8 variants were different between the patients with NB and the control group. Likewise, the survival analysis showed that the GG genotypes of rs1800795 IL-6 (p = 0.014) and AA genotypes of rs4073 IL-8 (p = 0.002), as well as high levels of IL-6 (p = 0.009) and IL-8 (p = 0.046), were associated with lower overall survival. We confirmed the impact on an adverse prognosis in a multivariate model. This study suggests that the SNPs rs1800795 IL-6 and rs4073 IL-8 and their serum levels could be promising biomarkers of a poor prognosis, associated with overall survival, metastasis, and a high risk in Mexican children with NB.

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The Antioxidant Effect of Curcumin and Rutin on Oxidative Stress Biomarkers in Experimentally Induced Periodontitis in Hyperglycemic Wistar Rats

Molecules ◽

10.3390/molecules26051332 ◽

2021 ◽

Vol 26 (5) ◽

pp. 1332

Author(s):

Gilda M. Iova ◽

Horia Calniceanu ◽

Adelina Popa ◽

Camelia A. Szuhanek ◽

Olivia Marcu ◽

...

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Diabetic Rats ◽

Gingival Tissue ◽

Control Group ◽

Albino Rats ◽

Oxidative Stress Biomarkers ◽

Significant Difference ◽

The Impact ◽

Experimentally Induced

Background: There is a growing interest in the correlation between antioxidants and periodontal disease. In this study, we aimed to investigate the effect of oxidative stress and the impact of two antioxidants, curcumin and rutin, respectively, in the etiopathology of experimentally induced periodontitis in diabetic rats. Methods: Fifty Wistar albino rats were randomly divided into five groups and were induced with diabetes mellitus and periodontitis: (1) (CONTROL)—control group, (2) (DPP)—experimentally induced diabetes mellitus and periodontitis, (3) (DPC)—experimentally induced diabetes mellitus and periodontitis treated with curcumin (C), (4) (DPR)—experimentally induced diabetes mellitus and periodontitis treated with rutin (R) and (5) (DPCR)—experimentally induced diabetes mellitus and periodontitis treated with C and R. We evaluated malondialdehyde (MDA) as a biomarker of oxidative stress and reduced glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG and catalase (CAT) as biomarkers of the antioxidant capacity in blood harvested from the animals we tested. The MDA levels and CAT activities were also evaluated in the gingival tissue. Results: The control group effect was statistically significantly different from any other groups, regardless of whether or not the treatment was applied. There was also a significant difference between the untreated group and the three treatment groups for variables MDA, GSH, GSSG, GSH/GSSG and CAT. There was no significant difference in the mean effect for the MDA, GSH, GSSG, GSH/GSSG and CAT variables in the treated groups of rats with curcumin, rutin and the combination of curcumin and rutin. Conclusions: The oral administration of curcumin and rutin, single or combined, could reduce the oxidative stress and enhance the antioxidant status in hyperglycemic periodontitis rats.

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Impact of failed ab-interno trabeculectomy (trabectome) on subsequent XEN45 gel stent implantation in pseudophakic eyes

International Ophthalmology ◽

10.1007/s10792-021-01977-w ◽

2021 ◽

Author(s):

D. Kiessling ◽

C. Rennings ◽

M. Hild ◽

A. Lappas ◽

T. S. Dietlein ◽

...

Keyword(s):

Stent Implantation ◽

Open Angle Glaucoma ◽

Control Group ◽

Repeat Surgery ◽

Medication Score ◽

Significant Difference ◽

Ab Interno Trabeculectomy ◽

The Impact ◽

Ab Interno

Abstract Purpose To determine the impact of failed ab-interno trabeculectomy on the postoperative outcome of subsequent XEN45 gel stent (Allergan, CA, USA) implantation in pseudophakic eyes. Methods In this retrospective single-center study, we included 60 pseudophakic eyes from 60 participants who underwent XEN45 gel stent implantation. Thirty eyes each underwent primary stent implantation (control group) or had previously undergone a failed ab-interno trabeculectomy (trabectome group). The groups were matched at a 1:1 ratio based on the following criteria: preoperative and maximum Intraocular pressure (IOP), preoperative medication score, cup/disk-ratio, follow-up time, best-corrected visual acuity at baseline, age, and the proportion of patients classified as primary open angle glaucoma or exfoliation glaucoma. We defined a successful surgery by the following three scores: an IOP reduction > 20% and IOP at the longest follow-up < 21 mmHg (Score A) or < 18 mmHg (Score B) or IOP ≤ 15 mmHg and an IOP reduction ≥ 40% (Score C). One open conjunctival revision was allowed in all scores, and a repeat surgery was considered a failure. Results Following an average follow-up period of 22 ± 12 months, we observed a mean IOP reduction of 38%, from 23.5 ± 5.2–14.5 ± 5.0 mmHg. Comparative analyses between the groups did not reveal a significant difference in the postoperative IOP, postoperative medication score, side effects, revision rate, repeat surgery rate, or success rate. Conclusions Trabectome is a viable first-line procedure for medically uncontrolled glaucoma before filtering ab-interno microstent surgery is considered.

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