Additive Effect of Risk Factors for Trabeculectomy Failure in Glaucoma Patients: A Risk-group From a Cohort Study

Fendi, Lígia Issa De; Oliveira, Tiago Cena de; Pereira, Carolina Bigheti; Bigheti, Carina Pereira; Viani, Gustavo Arruda

doi:10.1097/ijg.0000000000000490

Cited by 23 publications

(24 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Issa de Fendi et al reported that the use of >4 preoperative glaucoma medications is a risk factor for trabeculectomy failure. 15 In our study, the number of preoperative medications did not affect the volume of the blebs. In our study, most of the patients were using 4 or more glaucoma medications (81.8%).…”

Section: Discussionmentioning

confidence: 41%

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Tojo

Hayashi

Otsuka

2018

OPTH

View full text Add to dashboard Cite

PurposeThe aim of this study was to investigate the factors influencing the volume of the filtration bleb after Ex-PRESS® surgery.MethodsThis was a retrospective non-randomized study. After excluding patients who had undergone an additional glaucoma surgery, 99 glaucoma patients who underwent Ex-PRESS® surgeries and were followed up for >2 years were analyzed. We used anterior segment optical coherence tomography to measure the bleb volume, and compared the volume at 1 year with that at 2 years after surgery. We also examined potential influencing factors, including age, number of medications, central corneal thickness, type of glaucoma, preoperative intraocular pressure (IOP), postoperative IOP, reduction ratio of IOP, history of trabeculotomy, and operation method (Ex-PRESS® surgery only or simultaneous cataract surgery).ResultsEx-PRESS® surgeries significantly decreased the IOP from 26.3±9.7 mmHg to 11.6±3.7 mmHg after 24 months (P<0.001). The success rate at 2 years was 81.2% (IOP ≥21 mmHg or ≥20% reduction from the baseline IOP). The results showed that age, postoperative IOP, glaucoma type, and simultaneous cataract surgeries influenced the filtration-bleb volume.ConclusionAdvanced age, higher postoperative IOP, pseudo-exfoliation glaucoma, and simultaneous cataract surgeries were all found to decrease the volume of the filtration bleb.

show abstract

Section: Discussionmentioning

confidence: 41%

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Tojo

Hayashi

Otsuka

2018

OPTH

View full text Add to dashboard Cite

show abstract

“…First, the prolonged inflammation induced by chronic exposure to benzalkonium chloride (BAK) and other substances in glaucoma eye drops may damage the conventional aqueous humour drainage pathway through the Schlemm's canal. High preoperative glaucoma drug scores and long-term history of drug use have been identified as risk factors for the surgical failure of trabeculectomy (Broadway et al 1994;Landers et al 2012;Issa de Fendi et al 2016). Previous studies claimed that BAK increases the number of conjunctival fibroblasts, macrophages and lymphocytes and decreases the number of conjunctival goblet cells, resulting in prolonged asymptomatic inflammation in the conjunctiva (Broadway et al 1994;Landers et al 2012;Issa de Fendi et al 2016).…”

Section: Discussionmentioning

confidence: 99%

Association of the prolonged use of anti‐glaucoma medications with the surgical failure of ab interno microhook trabeculotomy

Okuda

Mori

Takano

et al. 2022

Acta Ophthalmologica

View full text Add to dashboard Cite

Purpose: This study examined the perioperative factors affecting surgical success in ab interno microhook trabeculotomy (lTLO). Methods: A total of 146 consecutive patients who underwent lTLO were included in this retrospective study. We performed Cox proportional hazard modelling by setting surgical success at 1 year as an objective variable. The explanatory variables included age, sex, glaucoma type, preoperative intraocular pressure (IOP), glaucoma drug score, mean deviation (MD) of the Humphrey visual field test, duration of glaucoma drug use, antithrombotic drug use, combined cataract surgery, incision range and diabetes mellitus. Additionally, we performed 1:1 matching using propensity score analysis and compared the perioperative parameters between durations of glaucoma drug use of <4.5 years and ≥ 4.5 years (50 patients each). We defined surgical success as satisfaction of all three criteria: IOP 5-21 mmHg, IOP reduction of ≥20% from the preoperative IOP and no additional glaucoma surgery. Results:The Cox proportional hazard model revealed that a longer duration of anti-glaucoma medication was significantly associated with surgical failure. Propensity score matching analysis showed that the <4.5-year users of antiglaucoma drugs had significantly higher success rates than the ≥4.5-year users (72% versus 52%; p = 0.04). Conclusions: The prolonged use of multiple glaucoma drugs adversely affected the outcome of lTLO at least at 1 year postoperatively.

show abstract

“…The main cause of filtering surgery failure is excessive conjunctival scarring with the appearance of subconjunctival fibrosis due to surgery‐induced tissue trauma with attraction of fibroblasts and myofibroblasts secreting high extracellular matrix contents. Any situation leading to excessive conjunctival scarring resulting in filtering surgery failure therefore represents a risk factor for progression to refractory glaucoma (Issa de Fendi et al 2016).…”

Section: Cw‐tscpc and Ecpmentioning

confidence: 99%

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Souissi¹,

Mer²,

Metge³

et al. 2020

Acta Ophthalmologica

View full text Add to dashboard Cite

Purpose Continuous‐wave cyclophotocoagulation (CW‐CPC) is often preferred to medical and surgical treatments for managing refractory glaucoma. This review summarizes diode CW‐CPC indications, history, histopathology, methods, efficacy and safety. It also provides an overview of the latest data available on micropulse transscleral laser treatment (MP‐TLT) that uses repetitive micropulses of diode laser energy in an off‐and‐on cyclical fashion. Methods A literature review was conducted on transscleral CW‐CPC (CW‐TSCPC), endoscopic CPC (ECP) and MP‐TLT. Relevant series of adult and paediatric patients were included for assessing the procedures. Results Regarding CW‐TCPC, highly variable success rates are reported in the literature, depending on the definition of success, type of underlying glaucoma, energy settings, follow‐up duration and retreatment rates. CW‐CPC often needs to be repeated, especially in paediatric patients. CW‐CPC exposes to risks of inflammation and chronic ocular hypotony or phthisis with irreversible visual loss. CW‐TSCPC has mainly been used in very severe forms of glaucoma, in painful eyes with limited visual potential or after filtering surgery failure. Published data on ECP are more limited but overall good success rates have been reported. Through the direct visualization of the targeted ciliary body in anatomically abnormal eyes, ECP is the preferred surgical procedure in paediatric refractory glaucoma. Complication rates are relatively low after ECP; however, large studies with long‐term follow‐up are needed. ECP may be used in difficult, refractory cases, but it is often used earlier when combined with cataract surgery. Despite limited data on the exact mechanism of action of MP‐TLT and a lack of standardization of laser settings, the first data from heterogeneous case series shows that it has a similar efficacy and a better safety profile compared to CW‐TSCPC in the medium term. Conclusion Although they may lead to sight‐threatening complications, both CW‐TSCPC and ECP seem effective. ECP appears to be superior to CW‐TSCPC in paediatric refractory glaucoma. Unlike ECP combined with cataract surgery, evidence supporting a wider use of CW‐TSCPC and MP‐TLT in earlier stages of neuropathy is lacking. While it now appears that the safety profile of MP‐TLT is superior to that of CW‐CPC, robust prospective comparative studies including homogeneous and well‐defined cohorts of patients are still needed to confirm an at least comparable efficacy in the long term.

show abstract

Additive Effect of Risk Factors for Trabeculectomy Failure in Glaucoma Patients: A Risk-group From a Cohort Study

Abstract: Trab with mitomycin produces satisfactory intraocular pressure control over time. However, several risk factors influence the efficacy of the surgical procedure. Our data show that there seems to exist an additive effect among risk factors with similar pathophysiology.

Cited by 23 publications

References 15 publications

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Association of the prolonged use of anti‐glaucoma medications with the surgical failure of ab interno microhook trabeculotomy

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Contact Info

Product

Resources

About

Additive Effect of Risk Factors for Trabeculectomy Failure in Glaucoma Patients: A Risk-group From a Cohort Study

Abstract: Trab with mitomycin produces satisfactory intraocular pressure control over time. However, several risk factors influence the efficacy of the surgical procedure. Our data show that there seems to exist an additive effect among risk factors with similar pathophysiology.

Cited by 23 publications

References 15 publications

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>&reg;</sup> surgery

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>&reg;</sup> surgery

Association of the prolonged use of anti‐glaucoma medications with the surgical failure of ab interno microhook trabeculotomy

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Contact Info

Product

Resources

About

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery