The Results of Ab Interno Laser Thermal Sclerostomy Combined With Cataract Surgery Versus Trabeculectomy Combined With Cataract Surgery 6 to 12 Months Postoperatively

We examined postoperative corneal higher-order aberrations (HOAs) present after combined phacoemulsification with either microhook ab interno trabeculotomy (μLOT-Phaco) or goniotomy, using the Kahook Dual Blade (KDB-Phaco). Retrospective study: A total of 45 eyes underwent μLOT-Phaco and KDB-Phaco (LOT-Phaco) procedures, with 21 eyes that underwent cataract surgery alone used as controls. Visual acuity and corneal HOAs, coma-like aberrations, and spherical-like aberrations were analyzed before and at 1, 2, and 3 months after the surgeries. Risk factors that could potentially influence HOAs were evaluated. No significant postoperative changes were noted for corneal HOAs, coma-like aberrations, and spherical-like aberrations after cataract surgery alone. The mean corneal HOAs, coma-like aberrations, and spherical-like aberrations were 0.222 ± 0.115 μm, 0.203 ± 0.113 μm, and 0.084 ± 0.043 μm at baseline and 0.326 ± 0.195 μm (p < 0.001), 0.302 ± 0.289 μm (p = 0.03), and 0.150 ± 0.115 μm (p < 0.001) at 3 months after LOT-Phaco, respectively. Results of the analysis for risk factors suggested that a longer incision in Schlemm’s canal could influence corneal HOAs, coma-like aberrations, and spherical-like aberrations after LOT-Phaco. Although no significant postoperative changes were observed in corneal HOAs and coma-like or spherical-like aberrations after cataract surgery alone, a significant increase in corneal HOAs and coma-like or spherical-like aberrations remained after the LOT-Phaco procedure.

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Something Old (Trabeculectomy), Something New (Ab Interno Gelatin Microstent): Finally, a Marriage of Innovation and Outcome Data (without Concurrent Cataract Surgery)!

Ophthalmology ◽

10.1016/j.ophtha.2017.08.018 ◽

2017 ◽

Vol 124 (11) ◽

pp. 1575-1576 ◽

Cited By ~ 1

Author(s):

Dale K. Heuer ◽

Gregg A. Heatley

Keyword(s):

Cataract Surgery ◽

Outcome Data ◽

Ab Interno

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Twelve-month outcomes of an ab interno gelatin stent combined with cataract surgery or as a standalone procedure in pseudophakic eyes with open-angle glaucoma

Journal of Cataract & Refractive Surgery ◽

10.1097/j.jcrs.0000000000000286 ◽

2020 ◽

Vol 46 (8) ◽

pp. 1172-1177

Author(s):

Peyton A. Rather ◽

Steven Vold ◽

Michael McFarland

Keyword(s):

Cataract Surgery ◽

Open Angle Glaucoma ◽

Open Angle ◽

Ab Interno

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Combined Surgery in the Treatment of Patients with Cataract and Primary Open-angle Glaucoma

European Ophthalmic Review ◽

10.17925/eor.2012.06.04.218 ◽

2012 ◽

Vol 06 (04) ◽

pp. 218

Author(s):

Giovanni Taibbi ◽

Gianmarco Vizzeri ◽

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Keyword(s):

Cataract Surgery ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Ageing Population ◽

Efficacy And Safety ◽

Combined Surgery ◽

Operative Complications ◽

Significant Cataract ◽

Ab Interno

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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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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Canaloplasty and Trabeculotomy ab interno with the OMNI System Combined with Cataract Surgery in Open-Angle Glaucoma

Journal of Cataract & Refractive Surgery ◽

10.1097/j.jcrs.0000000000000552 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Louis Hirsch ◽

Jeremy Cotliar ◽

Steven Vold ◽

Deepan Selvadurai ◽

Anita G Campbell ◽

...

Keyword(s):

Cataract Surgery ◽

Open Angle Glaucoma ◽

Open Angle ◽

Ab Interno

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Refractive Status in Eyes Implanted with Toric and Nontoric Intraocular Lenses during Combined Cataract Surgery and Microhook Ab Interno Trabeculotomy

Journal of Ophthalmology ◽

10.1155/2021/5545007 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Yasuyuki Takai ◽

Kazunobu Sugihara ◽

Mihoko Mochiji ◽

Kaoru Manabe ◽

Aika Tsutsui ◽

...

Keyword(s):

Cataract Surgery ◽

Open Angle Glaucoma ◽

Glaucoma Surgery ◽

Intraocular Lenses ◽

Toric Iol ◽

Absolute Residual ◽

Refractive Status ◽

The Mean ◽

Better Than ◽

Ab Interno

Purpose. To compare the refractive status between eyes implanted with toric and nontoric intraocular lenses (IOLs) during combined cataract surgery and microhook ab interno trabeculotomy (μLOT), a minimally invasive glaucoma surgery (MIGS). Methods. Twenty eyes of 20 patients who had open-angle glaucoma, cataract, and preexisting regular corneal astigmatism exceeding 1.5 diopters (D) and underwent combined μLOT and phacoemulsification were recruited retrospectively. Ten eyes were implanted with a toric IOL and 10 eyes with a nontoric IOL. The primary outcomes were the uncorrected visual acuity (UCVA) and refractive cylinder at 3 months postoperatively. Results. The mean UCVA of the toric IOL group (logarithm of the minimum angle of resolution (logMAR), 0.23 ± 0.25) was significantly better than that of the nontoric IOL group (logMAR, 0.45 ± 0.26) at 3 months postoperatively ( p < 0.05 ). The mean absolute residual refractive cylinder of the nontoric IOL group (2.25 ± 0.62 D) was significantly greater than that of the toric IOL group (1.30 ± 0.68 D) ( p < 0.05 ). Postoperatively, 60% of eyes in the toric IOL group and 10% in the nontoric IOL group had an absolute refractive astigmatism level of 1.5 D or less. Surgically induced astigmatism (0.77 ± 0.43 D for toric group and 0.60 ± 0.32 D for nontoric group) and IOP reduction (33.9 ± 15.6% for toric group and 29.4 ± 11.7% for nontoric group) were not different between groups. Conclusions. Use of toric IOL during combined cataract surgery and μLOT is possible and better than not, but physician should prevent their patient of persisting residual astigmatism. The study was registered at https://www.umin.ac.jp/, and the clinical trial accession number is https://clinicaltrials.gov/ct2/show/UMIN000043141.

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