Ab interno trabecular bypass surgery with Schlemm´s Canal Microstent (Hydrus) for open angle glaucoma

Otárola, Francisco Jiménez; Hu, Kuang; Gazzard, Gus; Bunce, Catey

doi:10.1002/14651858.cd012740

Cited by 15 publications

(13 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this review, we plan specifically to examine the evidence for efficacy of one type of MIGS devices - the iStent and iStent inject - in people with mild to moderate OAG of any type. This Cochrane review will be conducted in parallel with other reviews currently undertaken by the Cochrane Eyes and Vision MIGS Consortium, which includes MIGS techniques and devices such as the Trabectome (NeoMedix, Tustin, California), Hydrus Microstent (Invantis, Irvine, California) (Otarola 2017), endoscopic cytophotocoagulation (ECP) (Endo Optiks, Waltham, Massachusetts) (Tóth 2017), and XEN Glaucoma Implant (Aque-Sys Implant, Aliso Viejo, California) (King 2017). …”

Section: Introductionmentioning

confidence: 99%

Ab interno trabecular bypass surgery with Trabectome for open angle glaucoma

Gazzard

Bunce

et al. 2016

Cochrane Database of Systematic Reviews

Self Cite

View full text Add to dashboard Cite

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The primary objective is to assess the comparative effectiveness and safety of ab interno trabecular bypass surgery with iStent or iStent inject for OAG in comparison to conventional medical, laser, or surgical treatment. A secondary objective is to examine the effectiveness and safety of iStent or iStent Inject surgery in people who have concomitant phacoemulsification.

show abstract

Section: Introductionmentioning

confidence: 99%

Ab interno trabecular bypass surgery with Trabectome for open angle glaucoma

Gazzard

Bunce

et al. 2016

Cochrane Database of Systematic Reviews

Self Cite

View full text Add to dashboard Cite

show abstract

“…Glaucoma caused by high IOP is an optic nerve disease that can ultimately result in blindness. Currently, treatments for this disease include drugs (28) and surgery (29,30) to control IOP and limit optic nerve damage. However, prognosis remains to be improved, due to the various unwanted side effects of these treatments (31).…”

Section: Discussionmentioning

confidence: 99%

Neuroprotective role of epigallocatechin‑3‑gallate in acute glaucoma via the nuclear factor‑κB signalling pathway

et al. 2021

View full text Add to dashboard Cite

Glaucoma is a disease involving impaired visual function accompanied by degeneration and necrosis of the optic nerve. Epigallocatechin-3-gallate (EGCG) exerts a neuroprotective effect against the degeneration of retinal ganglion cells. However, whether EGCG can relieve glaucoma and the possible mechanisms remain unclear. In order to determine the function of EGCG in glaucoma, an acute glaucoma rat model was established. Optic neuropathology was examined by haematoxylin-eosin staining and immunofluorescence staining for class III-β tubulin. The levels of inflammation-associated cytokines, such as interleukin (IL)-4, IL-6, TNF-α, IL-1β, IL-13 and IFN-γ were measured by flow cytometry. T cell proliferation was assessed by the carboxyfluorescein diacetate succinimidyl ester method. Finally, the functional role of EGCG in glaucoma was explored. The levels of the inflammation-associated proteins p-IκBα and p-p65 were measured by western blot analysis. The results showed that optic nerve injury occurred, and elevated levels of the inflammatory cytokines IL-4, IL-6, TNF-α, IL-1β, IL-13 and IFN-γ were observed in the rat model of acute glaucoma. In addition, an increased T lymphocyte proliferation rate and imbalance of Th1/Th2 cytokines were present in the models. Importantly, treatment with EGCG significantly alleviated optic nerve injury. At the molecular level, EGCG decreased the levels of inflammation-associated cytokines, decreased the proliferation rate of T lymphocyte cells, and repaired the imbalance of Th1/Th2 cytokines. Moreover, EGCG inhibited the increase in the phosphorylation of IκBα and p65 caused by modelling and thus suppressed the activation of the nuclear factor (NF)-κB signalling pathway. The findings of the present study indicate that EGCG could attenuate the symptoms of glaucoma and inhibit inflammatory responses by suppressing the NF-κB signalling pathway in a rat glaucoma model.

show abstract

“…HMS was shown to reduce medication use by an additional 0.41 drops at 24 months compared with cataract surgery alone, based on a Cochrane systematic review of studies comparing HMS plus cataract surgery to cataract surgery alone in patients with mild to moderate glaucoma at the time of screening. 21 A compliance rate of 0.65 was applied to medication use, determined from the mean of 7 studies assessing adherence to glaucoma medications. 9,10,[27][28][29][30][31] This compliance rate had a direct impact on mean medicated IOP reduction and thus progression rate in our model.…”

Section: Model Overviewmentioning

confidence: 99%

“…20 DOI: 10.1097/IJG.0000000000001993 MIGS procedures were designed with the intention of safe and effective long-term reduction of IOP, reduced medication dependence, higher likelihood of being medication-free and lower risk of future incisional surgery. 21 Medicare Part B data in the United States shows that overall spending on glaucoma procedures have increased from USD 52 million in 2007 to USD 180 million in 2017. 22 However, proportional spending on gold-standard incisional procedures (trabeculectomy and glaucoma drainage device) have decreased dramatically from 92.3% to 21.2%, as they are replaced by MIGS.…”

mentioning

confidence: 99%

Cost Utility of Schlemm’s Canal Microstent Injection With Cataract Surgery for Open-angle Glaucoma in the US Medicare System

Atik

Rhodes

Samuels

et al. 2022

Journal of Glaucoma

View full text Add to dashboard Cite

Précis: Hydrus microstent (HMS) implantation at the time of cataract surgery appears to be cost-effective in mild-to-moderate glaucoma. However, long-term follow-up is essential for a full assessment of device performance, safety and cost-effectiveness. Purpose: The aim was to assess the societal cost-utility to the US Medicare system of implanting HMS with cataract surgery versus cataract surgery alone in patients with open-angle glaucoma. Patients: Markov model cohort of patients with mild-to-moderate open-angle glaucoma and visually significant cataract. Methods: Patients received HMS during cataract surgery versus cataract surgery alone, in a deterministic model over a 2-year horizon using TreeAge software. Both arms received additional ocular hypotensive agents to control intraocular pressure. Treatment effect of HMS was measured as mean number of ocular hypotensive medications and intraocular pressure, which directly impacted transition probabilities. Health states included the Hodapp-Parrish-Anderson glaucoma stages (mild, moderate, advanced, blind) and death. One-way sensitivity and probabilistic sensitivity analyses were conducted on device efficacy and longer time horizons. Results: At 2 years, HMS with cataract surgery in mild glaucoma had an incremental cost-utility ratio of USD 38,346.43 per utility gained, compared with cataract surgery alone. Probabilistic sensitivity analysis was cost-effective in 61.4% of iterations for HMS+cataract surgery. The probability of side-effects with eye drops, utility decrement with side-effects, cost of the HMS and real-world efficacy rate had the greatest impact on model outcomes. HMS must be 85.60% as effective as published data to maintain cost-effectiveness at a willingness-to-pay threshold of USD 50,000. The incremental cost-utility ratio of HMS with cataract surgery in moderate glaucoma was USD 42,895.38. Conclusions: HMS implantation during cataract surgery appears to be cost-effective for patients with mild-to-moderate glaucoma. Nevertheless, more long-term safety and efficacy data are required.

show abstract

Ab interno trabecular bypass surgery with Schlemm´s Canal Microstent (Hydrus) for open angle glaucoma

Abstract: Ab interno trabecular bypass surgery with Schlemm´s Canal Microstent (Hydrus) for open angle glaucoma.

Cited by 15 publications

References 22 publications

Ab interno trabecular bypass surgery with Trabectome for open angle glaucoma

Ab interno trabecular bypass surgery with Trabectome for open angle glaucoma

Neuroprotective role of epigallocatechin‑3‑gallate in acute glaucoma via the nuclear factor‑κB signalling pathway

Cost Utility of Schlemm’s Canal Microstent Injection With Cataract Surgery for Open-angle Glaucoma in the US Medicare System

Contact Info

Product

Resources

About