360-Degree Trabeculotomy for Medically Refractory Glaucoma Following Cataract Surgery and Juvenile Open-Angle Glaucoma

Lim, Maria E.; Dao, Jennifer B.; Freedman, Sharon F.

doi:10.1016/j.ajo.2016.11.011

Cited by 34 publications

(20 citation statements)

References 45 publications

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“…2,3 More recently, a novel ab interno conjunctival sparing surgery, gonioscopy-assisted transluminal trabeculotomy (GATT) has been shown to be reasonably safe and effective in JOAG. [4][5][6][7] Long-term outcomes regarding GATT outcomes in JOAG are not well-described, as most studies are retrospective, or JOAG patients were mixed with POAG patients or patients with secondary glaucoma. 5,6,[7][8][9] Early studies have identified several risk factors affecting success following GATT, including postoperative IOP spikes (defined as IOP >30 mmHg), 7,9 African-American race, 9 primary (as opposed to secondary) open angle glaucoma, 10 pseudophakia, 10 and noncircumferential trabeculotomy.…”

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confidence: 99%

A Prospective Study of Intraocular Pressure Spike and Failure After Gonioscopy-Assisted Transluminal Trabeculotomy in Juvenile Open-Angle Glaucoma

Shi

Wang

Oatts

et al. 2022

American Journal of Ophthalmology

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confidence: 99%

A Prospective Study of Intraocular Pressure Spike and Failure After Gonioscopy-Assisted Transluminal Trabeculotomy in Juvenile Open-Angle Glaucoma

Shi

Wang

Oatts

et al. 2022

American Journal of Ophthalmology

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“… 51 55 However, angle surgery has a lower success rate which is likely due to the different pathologies in eyes with congenital cataracts compared with primary congenital glaucoma. 56 57 In our cohort, 20% (9/46) eyes were diagnosed with glaucoma, with the rate higher in the PFV surgery cohort (25%, 8/32 eyes). This rate of glaucoma is higher than many of the previously published studies ( table 5 ).…”

Section: Discussionmentioning

confidence: 59%

Outcomes and surgical management of persistent fetal vasculature

2021

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ObjectiveTo analyse outcomes in different forms of persistent fetal vasculature (PFV).Methods and analysisRetrospective cohort study at a university-based practice of children presenting with PFV between 2011 and 2020. Exclusion criteria was surgical management outside of our institution and follow-up less than 1 month. Wilcoxon and Student’s t-tests were used for statistical analysis.ResultsForty-six eyes of 45 patients presented with PFV at 16.7±31.3 (median 2.8) months old with 32.6±29.8 (median 22.5) months of follow-up. Types of PFV included: mild combined anterior-posterior (23 eyes, 50%), severe combined anterior-posterior (18 eyes, 39%), severe anterior (3 eyes, 7%), mild anterior (1 eye, 2%) and posterior (1 eye, 2%). Thirty-two eyes (70%) underwent PFV surgical correction; lensectomy (13 mild combined), vitrectomy (3 mild combined), sequential lensectomy then vitrectomy (3 severe combined), combined lensectomy-vitrectomy (11 severe anterior or severe combined), laser retinopexy (1 mild combined). Five eyes required additional vitrectomy surgery for retinal detachment, fold or cyclitic membrane. Nine eyes developed glaucoma, six requiring Intraocular pressure (IOP)-lowering surgery. At final follow-up, 32 eyes had at least form vision and 6 eyes were aversive to light. Eight eyes, all which were severe combined, and four that did not undergo PFV surgery, were unable to detect light due to phthisis bulbi (7) and optic nerve hypoplasia (1).ConclusionsClassification of PFV is important in determining surgical approach with severe cases often requiring both lensectomy and vitrectomy for optimal anatomic and functional outcomes.

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“…Trabeculotomy in its various forms has demonstrated success in the surgical management of GFCS since as early as 1970 [12]. It is maintained as the initial surgery of choice in GFCS due to the favorable success rates demonstrated previously (with most common complication remaining vitreous hemorrhage), as well as the improved safety profile compared to traditional surgical modalities used for GFCS [12,53,54,56,63]. Many patients in the aforementioned studies have been well-controlled at the defined study follow-up without the use of IOP-lowering medication [53,56,57].…”

Section: Discussionmentioning

confidence: 99%

“…It is maintained as the initial surgery of choice in GFCS due to the favorable success rates demonstrated previously (with most common complication remaining vitreous hemorrhage), as well as the improved safety profile compared to traditional surgical modalities used for GFCS [12,53,54,56,63]. Many patients in the aforementioned studies have been well-controlled at the defined study follow-up without the use of IOP-lowering medication [53,56,57]. Circumferential (360 • trabeculotomy) has been shown to have the highest rates of success, whether by two-site rigid probe or via microcatheter assisted suture placement [55,57,58].…”

Section: Discussionmentioning

confidence: 99%

“…A larger retrospective chart review on 360 • trabeculotomy in medically refractory pediatric glaucomatous eyes was subsequently conducted by Lim et al in 2017, including 25 GFCS eyes, of which, 21 were aphakic and 4 were pseudophakic [56]. Patients with prior surgery, prior suture trabeculotomy, coexisting ocular or systemic syndromes, and insufficient follow-up time were excluded.…”

Section: Microcatheter Trabeculotomymentioning

confidence: 99%

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Angle Surgery in Pediatric Glaucoma Following Cataract Surgery

Jamerson

Solyman

Yacoub

et al. 2021

Vision

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Glaucoma is a common and sight-threatening complication of pediatric cataract surgery Reported incidence varies due to variability in study designs and length of follow-up. Consistent and replicable risk factors for developing glaucoma following cataract surgery (GFCS) are early age at the time of surgery, microcornea, and additional surgical interventions. The exact mechanism for GFCS has yet to be completely elucidated. While medical therapy is the first line for treatment of GFCS, many eyes require surgical intervention, with various surgical modalities each posing a unique host of risks and benefits. Angle surgical techniques include goniotomy and trabeculotomy, with trabeculotomy demonstrating increased success over goniotomy as an initial procedure in pediatric eyes with GFCS given the success demonstrated throughout the literature in reducing IOP and number of IOP-lowering medications required post-operatively. The advent of microcatheter facilitated circumferential trabeculotomies lead to increased success compared to traditional <180° rigid probe trabeculotomy in GFCS. The advent of two-site rigid-probe trabeculotomy indicated that similar results could be attained without the use of the more expensive microcatheter system. Further studies of larger scale, with increased follow-up, and utilizing randomization would be beneficial in determining optimum surgical management of pediatric GFCS.

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360-Degree Trabeculotomy for Medically Refractory Glaucoma Following Cataract Surgery and Juvenile Open-Angle Glaucoma

Cited by 34 publications

References 45 publications

A Prospective Study of Intraocular Pressure Spike and Failure After Gonioscopy-Assisted Transluminal Trabeculotomy in Juvenile Open-Angle Glaucoma

A Prospective Study of Intraocular Pressure Spike and Failure After Gonioscopy-Assisted Transluminal Trabeculotomy in Juvenile Open-Angle Glaucoma

Outcomes and surgical management of persistent fetal vasculature

Angle Surgery in Pediatric Glaucoma Following Cataract Surgery

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