Cataract Surgery Combined with Trabecular MIGS (Minimally Invasive Glaucoma Surgery)

Cataract surgery decreases significantly and with maintained effect intraocular pressure (IOP) in both normal eyes as in eyes with glaucoma. In patients with cataracts and glaucoma, it can be performed, isolated or in combination with other techniques, such as the following: minimally invasive glaucoma surgery (MIGS) in patients with mild/moderate glaucoma that do not require a high tensional decrease; and conventional glaucoma surgery techniques in patients with advanced glaucoma. Although lower than with conventional techniques, MIGS trabecular surgery has a good IOP lowering effect and provides some of the following advantages: a more physiological approach; little traumatic; without bleb; and it does not limit other techniques in the future. Different techniques that combinated or not with cataract surgery facilitate the exit of aqueous humor through the trabecular meshwork (TM) have been described. Our aim in this chapter is to review the newest of them, such as the following: iStent; ELT (Excimer Laser Trabeculostomy); kahook; ABiC; and OMNI.

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Triggerfish Recording of IOP Patterns in Combined HFDS Minimally Invasive Glaucoma and Cataract Surgery: A Prospective Study

Journal of Clinical Medicine ◽

10.3390/jcm10163472 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3472

Author(s):

Bojan Pajic ◽

Mirko Resan ◽

Brigitte Pajic-Eggspuehler ◽

Horace Massa ◽

Zeljka Cvejic

Keyword(s):

Circadian Rhythm ◽

Intraocular Pressure ◽

Minimally Invasive ◽

Prospective Study ◽

Cataract Surgery ◽

High Frequency ◽

Glaucoma Surgery ◽

Before And After ◽

Contact Lens Sensor ◽

A Prospective Study

Background: The aim of the study is to investigate whether the circadian IOP rhythm can be influenced by combined cataract surgery with high frequency deep sclerotomy (HFDS) and whether intraocular pressure (IOP) can be significantly reduced by HFDS. Methods: In our study 10 patients were included, in whom 24 h IOP monitoring was installed before and after HFDS/cataract surgery using a Triggerfish. HFDS is a minimally invasive glaucoma surgery (MIGS). Results: After performed HFDS combined with cataract surgery, the IOP was reduced from 27.7 ± 2.11 mmHg to 14.4 ± 2.59 mmHg, which is highly significant (p < 0.001). The contact lens sensor (CLS) cosinor analysis pre- and postoperatively showed that the circadian rhythm is not influenced by the surgery, i.e., the circadian IOP rhythm did not show significant differences before and after surgery. Conclusions: HFDS combined with cataract surgery is a potent surgical method that can significantly reduce the IOP. However, the circadian rhythm cannot be changed by the surgery. The acrophase remained during the night in all patients.

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Faculty Opinions recommendation of Visual outcomes of combined cataract surgery and minimally invasive glaucoma surgery.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.739461975.793582429 ◽

2021 ◽

Author(s):

Eric C Amesbury

Keyword(s):

Minimally Invasive ◽

Cataract Surgery ◽

Glaucoma Surgery ◽

Minimally Invasive Glaucoma Surgery ◽

Visual Outcomes

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Erratum to: Visual outcomes of combined cataract surgery and minimally invasive glaucoma surgery

Journal of Cataract & Refractive Surgery ◽

10.1097/j.jcrs.0000000000000505 ◽

2021 ◽

Vol 47 (2) ◽

pp. 286-286

Author(s):

Steven R. Sarkisian ◽

Nathan Radcliffe ◽

Paul Harasymowycz ◽

Steven Vold ◽

Thomas Patrianakos ◽

...

Keyword(s):

Minimally Invasive ◽

Cataract Surgery ◽

Glaucoma Surgery ◽

Minimally Invasive Glaucoma Surgery ◽

Visual Outcomes

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Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-020-05029-4 ◽

2020 ◽

Author(s):

C. Deubel ◽

D. Böhringer ◽

A. Anton ◽

T. Reinhard ◽

J. Lübke

Keyword(s):

Intraocular Pressure ◽

Minimally Invasive ◽

Cataract Surgery ◽

Excimer Laser ◽

Invasive Procedure ◽

Minimally Invasive Procedure ◽

Long Term Follow Up ◽

Excimer Laser Trabeculotomy

Abstract Background Excimer laser trabeculotomy (ELT) is a minimally invasive procedure to lower the intraocular pressure (IOP) via a photo-ablative laser that is applied to the trabecular meshwork. With this procedure, it is possible to improve the outflow of the aqueous humor. Until now, a limited number of studies examining mostly relatively small sample sizes with midterm follow-up exist. We therefore present the analysis of a large ELT cohort in a long-term follow-up. Methods We recorded data from 580 patients who underwent ELT or combined ELT with cataract surgery at our institution from November 2000 until March 2011. A total of 512 patients with primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PEX), and ocular hypertension (OHT) were included in the analysis. At every follow-up examination, the usage of IOP-lowering medication and the IOP were recorded. Failure criteria were defined as the need for another surgical glaucoma procedure, when the IOP was not 21 mmHg or less and a reduction of 20% from the baseline was not achieved with (qualified success) or without (absolute success) additional medication. Statistical analysis was done using Kaplan-Meier analysis and Cox regression. Results Four hundred twenty-eight patients underwent combined cataract and ELT surgery, and 84 underwent solitary ELT surgery. After a median follow-up time of 656 days, 87% (combined surgery) and 66% (ELT) of the patients did not have to undergo another IOP-lowering intervention; 47/31% were classified as a qualified success and 31/11% as a complete success. The IOP-lowering medication, however, could not be significantly reduced within that time period. Conclusion Especially when combined with cataract surgery, ELT is a feasible minimally invasive procedure to lower the IOP on a mid- to long-term basis. Over the long term, however, IOP-lowering medication could not be reduced.

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