A Novel Low Cost Effective Technique in Using a 23 Gauge Straight Cystotome to Perform Goniotomy: Making Micro-invasive Glaucoma Surgery (MIGS) Accessible to the Africans and the Diaspora

Laroche, Daniel; Okaka, Yvonne; Ng, Chester

doi:10.1016/j.jnma.2018.09.006

Cited by 11 publications

(7 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clear lens extraction is an option 35 ; however, it imposes a greater financial burden on patients due to intraocular lens (IOL) insertion. Microinvasive glaucoma surgery (MIGS) is a possibility 36 , but it is beyond the reach of our institute. We intend to collaborate with other institutions in order to acquire MIGS skills.…”

Section: Discussionmentioning

confidence: 99%

“…We intend to collaborate with other institutions in order to acquire MIGS skills. Also, exploring the use of a 23-gauge cystotome to perform goniotomy in a glaucoma patient is an intriguing idea 36 . It has been demonstrated that cystotome can make MIGS more accessible to Africa, African Diaspora countries, and low-income developing countries 36 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A 5-year retrospective study of intraocular pressure control after trabeculectomy: a retrospective cohort study

Mayor¹,

Ugbede²,

Oyeronke³

et al. 2023

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Background: Glaucoma is a group of diseases that damage the optic nerve in the eye, resulting in vision loss and, in severe cases, blindness. The prevalence of glaucoma and glaucoma blindness is highest in West Africans. Objective: The study presents a 5-year retrospective analysis of intraocular pressure (IOP) and complications after trabeculectomy. Materials and methods: Trabeculectomy was performed using 5 mg/ml of 5-fluorouracil. A gentle diathermy was performed to secure hemostasis. Using a blade fragment of the scleral thickness, a 4×3 mm rectangular scleral flap was dissected. The central part of the flap was dissected 1 mm into the clear cornea. Before being tailed down, the patient was given topical 0.05% dexamethasone qid, 1% atropine tid, and 0.3% ciprofloxacin qid for 4–6 weeks. Patients with pain were given pain relievers, and all patients with photophobia were given sun protection. A successful surgical outcome was defined as a postoperative IOP of 20 mmHg or less. Results: There were 161 patients over the 5-year period under review, with men constituting 70.2% of the total. Out of 275 eyes operated on, 82.9% were bilateral cases, while 17.1% were unilateral. Glaucoma was found in both children and adults aged 11–82 years. However, it was observed to predominate between the ages of 51 and 60, with males having the highest incidence. The average preoperative IOP was 24.37 mmHg, while it was 15.24 mmHg postoperatively. The complication with the highest ranking was shallow anterior chamber (24; 8.73%) due to overfiltration, followed by leaking bleb (8; 2.91%). The most common late complications were cataract (32; 11.64%) and fibrotic bleb (8; 2.91%). Bilateral cataracts developed at an average of 25 months after trabeculectomy. It was seen in patients aged 2–3 with a frequency of 9, whereas 5 years after, 77 patients had improved vision, with a postoperative visual acuity of 6/18-6/6. Conclusion: Postoperatively, the patients had satisfying surgical outcomes as a result of the decrease in preoperative IOP. Although postoperative complications occurred, they had no effect on the surgical outcomes because they were temporary and not optically threatening. In our experience, trabeculectomy is an effective and safe procedure for achieving IOP control.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A 5-year retrospective study of intraocular pressure control after trabeculectomy: a retrospective cohort study

Mayor¹,

Ugbede²,

Oyeronke³

et al. 2023

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

show abstract

“… 3 Omni goniotomy works well, and Sinskey hook, or needle goniotomy, is very affordable. 58 Kahook goniotomy and 23 or 25 gauge needle goniotomy can also be used, but their sharper tips can lead to increased bleeding. IStent leads to the least bleeding but may not always be as efficacious if it is not inserted into the canal properly.…”

Section: Introductionmentioning

confidence: 99%

Preventing Blindness with Early Cataract Surgery and Micro-Invasive Glaucoma Surgery in Patients Over 50: Guidance for Patients, Physicians and World Governments in Dealing with Glaucoma

Laroche,

Madu

2023

OPTH

Self Cite

View full text Add to dashboard Cite

Purpose To offer clinical guidance and address safety and efficacy concerns regarding the growing use of micro-invasive glaucoma surgery (MIGS) as an initial treatment for glaucoma in adult patients. Design Narrative literature review. Methods A review was conducted to assess outcomes and complications of MIGS in the treatment of glaucoma, both alone and in combination with lens replacement. These outcomes were compared with those of standard glaucoma surgery and/or glaucoma management with medication. Results MIGS are effective at lowering intraocular pressure (IOP) over long periods of follow-up. These techniques share a similarly high safety profile between one another. MIGS were found to have lower complication rates and to be more effective in reducing the total amount of medication needed to maintain control of intraocular pressure than standard surgery approaches. Conclusion MIGS techniques are growing in popularity and have been demonstrated to be a safe and effective alternative to standard glaucoma surgery. Guidance in the implementation of these procedures has been outlined.

show abstract

“…Alternative, low-cost methods for goniotomy have been described, but these tend to incise or lacerate rather than completely excise a segment of TM. [ 21 , 22 ] Without excision, leaflet scarring could lead to loss of effect over time. The authors developed a procedure for ab interno TM excision (goniectomy) utilizing a disposable 25-gauge hypodermic needle—termed bent ab interno needle goniectomy (BANG)—for the treatment of glaucoma.…”

Section: Introductionmentioning

confidence: 99%

An Alternate Technique for Goniotomy: Description of Procedure and Preliminary Results

Shute

Green

Liu

et al. 2022

JOVR

View full text Add to dashboard Cite

Purpose: Multiple glaucoma treatment modalities seek to lower IOP by bypassing or removing a portion of the juxtacanalicular trabecular meshwork. These procedures often require expensive implants or specialized surgical instruments. The authors developed a technique for ab interno goniectomy utilizing a standard disposable 25-gauge hypodermic needle. The surgical procedure—termed bent ab interno needle goniectomy (BANG)—and preliminary results are presented here. Methods: A retrospective chart review was performed for all patients who underwent goniotomy using a modified hypodermic needle by one of the three authors between July 2017 and June 2018. The mean and standard deviation pre- and postoperative IOP and the number of glaucoma medications were calculated. The student paired t-test was used to compare pre- and postoperative data. A P-value of <0.05 was considered statistically significant. Results: At postoperative month six, the mean IOP was 13.3 ± 2.5 mmHg (P = 3.6 × 10−7) on 0.5 ± 0.8 topical glaucoma medications (P = 0.01). A ≥20% reduction in IOP was achieved in 73% of patients. Seventy-three percent of patients required ≥1 fewer medication, while 73% of patients required no medications for IOP control. Forty-one percent of those treated achieved IOP ≤12 mmHg. Conclusion: The BANG procedure is a low-cost MIGS technique available to surgeons around the world with preliminary outcomes similar to more expensive alternatives.

show abstract

A Novel Low Cost Effective Technique in Using a 23 Gauge Straight Cystotome to Perform Goniotomy: Making Micro-invasive Glaucoma Surgery (MIGS) Accessible to the Africans and the Diaspora

Cited by 11 publications

References 17 publications

A 5-year retrospective study of intraocular pressure control after trabeculectomy: a retrospective cohort study

A 5-year retrospective study of intraocular pressure control after trabeculectomy: a retrospective cohort study

Preventing Blindness with Early Cataract Surgery and Micro-Invasive Glaucoma Surgery in Patients Over 50: Guidance for Patients, Physicians and World Governments in Dealing with Glaucoma

An Alternate Technique for Goniotomy: Description of Procedure and Preliminary Results

Contact Info

Product

Resources

About