Ab interno trabeculectomy: patient selection and perspectives

Vinod, Kateki; Gedde, Steven J.

doi:10.2147/opth.s99746

Cited by 6 publications

(2 citation statements)

References 43 publications

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“…According to a previous study,[ 15 ] patients with primary or various secondary open-angle glaucomas as well as narrow angles were included, except neovascular glaucoma and those with postoperative follow-ups <3 months. All patients received either Trabectome alone or Trabectome with phacoemulsification/intraocular lens implantation.…”

Section: Ethodsmentioning

confidence: 99%

Safety and Efficiency of Trabectome-mediated Trabecular Meshwork Ablation for Chinese Glaucoma Patients

Dang

Cen

Hong

et al. 2018

Chinese Medical Journal

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Background:The aim of the study was to evaluate the long-term safety and efficacy of the Trabectome for Chinese glaucoma patients.Methods:This was a multicenter, retrospective, observational study. Glaucoma patients, except those with neovascular glaucoma, with/without a visually significant cataract were enrolled. The patients received Trabectome or a combined surgery with phacoemulsification and intraocular lens implantation. The primary outcome evaluation was a reduction in intraocular pressure (IOP), and the secondary outcomes were a reduction in glaucoma medication, the 2-year success percentages, and complications. Success was defined as an IOP <21 mmHg and at least a 20% IOP reduction from baseline after 3 months for any two consecutive visits, without additional glaucoma surgery. The data were processed using the R Stats Package version 3.0.0. The Wilcoxon test was used to compare the postoperative IOP and the number of glaucoma medications with baselines. The Kaplan–Meier test was used to calculate the 2-year success percentage. The risk factors related to Trabectome failure were determined by logistic regression.Results:A total of 120 glaucoma patients were enrolled. The Trabectome efficiently reduced the IOP from a baseline of 22.8 ± 1.34 mmHg to 17.6 ± 0.96 mmHg, and the use of glaucoma medications from 2.2 ± 0.17 mmHg to 1.4 ± 0.21 in a 2-year follow-up (both, P < 0.01). The overall success percentage was 80%. No risk factor related to Trabectome failure was identified. No vision-threatening complication was observed. Ten patients, who required secondary glaucoma surgery, all reached the target IOP.Conclusions:In a 2-year follow-up, Trabectome was an efficient and safe procedure for Chinese glaucoma patients.

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Section: Ethodsmentioning

confidence: 99%

Safety and Efficiency of Trabectome-mediated Trabecular Meshwork Ablation for Chinese Glaucoma Patients

Dang

Cen

Hong

et al. 2018

Chinese Medical Journal

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“…There are many clinical scenarios where MIGS may be appropriate for a patient and may offer advantages over traditional glaucoma therapies. 3 Decisions on which clinical scenarios to perform MIGS will be aided by a better understanding of the relative safety and efficacy of the MIGS procedures.…”

Section: Introductionmentioning

confidence: 99%

<p>Prospective Studies of Minimally Invasive Glaucoma Surgeries: Systematic Review and Quality Assessment</p>

Rosdahl¹,

Gupta²

2020

OPTH

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Glaucoma is a common blinding disease; while there is no cure, effective treatments include medications, laser, and incisional surgery. There is significant interest from patients and doctors to develop safer surgical options throughout the spectrum of disease, to minimize treatment burden in mild glaucoma patients and to minimize risk of complications in patients needing more aggressive treatment. Surgical procedures called Minimally or Micro-Invasive Glaucoma Surgery (MIGS) are growing in popularity. Eightyseven prospective studies on MIGS were identified and assessed for quality. Most (74%) did not have a control group. Twelve of the highest quality were reviewed. MIGS procedures appeared to have fewer complications, and lowered intraocular pressure, and reduced medication use. Studies were limited by small sample size, narrow spectrum of glaucomatous disease, and/or conflicts of interest. There is a need for high quality, independently funded and performed, comparative studies on the MIGS to help make treatment decisions.

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Which Patients Would Most Likely to Benefit: MIGS or MEGS, Which One Is It?

Sheheitli

Tirpack

Parrish

2019

Asia-Pacific Journal of Ophthalmology

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The availability of ab interno minimally invasive glaucoma surgery (MIGS) has promoted an international interest in this procedure. Our purpose is to define the role of MIGS in the constant evolving glaucoma treatment algorithm. Current MIGS approaches to lowering intraocular pressure (IOP) include increasing trabecular outflow (iStent trabecular microbypass stent, iStent inject, Hydrus Microstent, Kahook Dual Blade goniotomy, Trabectome ab interno trabeculectomy, Excimer laser trabeculotomy, and goniotomy-assisted transluminal trabeculotomy), increasing uveoscleral outflow with suprachoroidal shunts (Cypass microstent), and developing subconjunctival filtration (XEN gel stent and InnFocus microshunt). The efficacy of each depends on the achievement of desired target IOP reduction in a specific patient. The determination of whether a procedure is either a MIGS or minimally effective glaucoma surgery (MEGS) procedure is based on their efficacy and complications. Aqueous humor angiography suggests that success of trabecular bypass MIGS may not be patient-dependent only, but it may be affected by the location and flow of aqueous through collector channels. The future use of aqueous angiography may permit customized treatment of trabecular meshwork dependent MIGS procedures.

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Ab interno trabeculectomy: patient selection and perspectives

Cited by 6 publications

References 43 publications

Safety and Efficiency of Trabectome-mediated Trabecular Meshwork Ablation for Chinese Glaucoma Patients

Safety and Efficiency of Trabectome-mediated Trabecular Meshwork Ablation for Chinese Glaucoma Patients

<p>Prospective Studies of Minimally Invasive Glaucoma Surgeries: Systematic Review and Quality Assessment</p>

Which Patients Would Most Likely to Benefit: MIGS or MEGS, Which One Is It?

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