An Update on Implants for Minimally Invasive Glaucoma Surgery (MIGS)

Ansari, Ejaz

doi:10.1007/s40123-017-0098-2

Cited by 82 publications

(95 citation statements)

References 25 publications

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“…As of 2020, more than 10 million people around the world have suffered from binocular blindness due to glaucoma. The success rate of filtering operation of refractory glaucoma is only 11–52%, which is much lower than that of conventional glaucoma operation (70–90%) ( 1 – 4 ).…”

Section: Introductionmentioning

confidence: 87%

Observation of curative effects of Ex-PRESS and AGV implantation in the treatment of refractory glaucoma

2018

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The curative effects of Ex-PRESS implantation and Ahmed glaucoma valve (AGV) implantation in the treatment of refractory glaucoma were compared. A total of 68 patients (76 eyes) with refractory glaucoma treated were randomly divided into Ex-PRESS group and AGV group. Results showed that the intraocular pressure IOP in both Ex-PRESS group and AGV group after operation was significantly decreased compared with that before operation (P<0.001). At 3, 6 and 9 months after operation, IOP in Ex-PRESS group was significantly lower than that in AGV group (P<0.05). At the end of follow-up, BCVA of patients in both groups after operation was slightly decreased compared with that before operation (P>0.05). There was no statistically significant difference in BCVA between the two groups of patients (P>0.05). Moreover, the corneal endothelial cell counts of patients in both groups after operation were obviously decreased compared with those before operation (P<0.05). The number of anti-glaucoma drugs applied was decreased from 3.53±0.86 to 0.55±0.60 in Ex-PRESS, and from 3.24±0.88 to 0.89±0.73 in AGV group. At the end of follow-up, the number of anti-glaucoma drugs applied in Ex-PRESS group was smaller than that in AGV group (P<0.05). There was no statistically significant difference in success rate of operation between the two groups at the end of follow-up (log-rank test; P>0.05). Finally, the incidence rates of postoperative complications and surgical intervention rates had no statistically significant differences between the two groups. Ex-PRESS implantation is a safe and effective treatment for refractory glaucoma, characterized by simple operation, small trauma and less pain, which has an equivalent curative effect to AGV implantation; but its control effect on IOP after operation is superior to that of AGV, and the number of anti-glaucoma drugs applied after operation is small.

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Section: Introductionmentioning

confidence: 87%

Observation of curative effects of Ex-PRESS and AGV implantation in the treatment of refractory glaucoma

2018

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“…Glaucoma surgery has significantly evolved in recent years with the advent of new MIGS (minimally-invasive glaucoma surgery) devices. ese devices have been introduced so as to have another alternative to decrease elevated IOP and to minimize the use of topical medication, while being a technically less invasive approach than traditional glaucoma filtration surgery (trabeculectomy) [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Comparing Medium-Term Clinical Outcomes following XEN® 45 and XEN® 63 Device Implantation

Fernández-García¹,

Zhou²,

García-Alonso

et al. 2020

Journal of Ophthalmology

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Purpose. To evaluate medium-term clinical outcomes with XEN® 45 or XEN® 63 Gel Stent (Allergan, Dublin, Ireland) for treatment of primary open angle glaucoma (POAG). Materials and Methods. Retrospective, descriptive, and observational study involving 40 patients implanted with a XEN® 45 Gel Stent and 34 implanted with a XEN® 63 Gel Stent who had undergone POAG surgery and had been followed up and controlled between 12 and 36 months. Results. IOP dropped from 18.02 ± 5.23 mmHg preop to 13.81 ± 1.88, 14.80 ± 2.23, and 14.62 ± 1.90 at 1, 2, and 3 years after surgery (p<0.001) consecutively with XEN® 45 and from 19.00 ± 6.11 mmHg preop to 15.47 ± 2.45, 14.66 ± 2.45, and 15.46 ± 2.48 at 1, 2, and 3 years after surgery (p<0.001) with XEN® 63. The number of drugs used by patients to treat their glaucoma decreased after undergoing surgery in both groups. Within the XEN® 45 group, mean changes at 1 year, 2 years, and 3 years amounted to 70%, 74.3%, and 37.5%, respectively, whereas within the XEN® 63 group, the mean reduction was 75%, 79.8%, and 71.9%. When comparing the outcomes for two groups, the differences did not prove to be statistically significant. More than 90% of the procedures included in the study (using either gel-stent device) were completed without any noteworthy complications. Conclusion. POAG surgical procedures with either XEN® 45 or XEN® 63 Gel Stent implantation could be a safe and effective treatment approach.

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“…To our knowledge, no foreign body reaction following minimal invasive glaucoma surgery has yet been described in the literature, either after CyPass® Micro-Stent implantation or after any other implant (iStent®, Hydrus TM , XEN®, or InnFocus MicroShunt®) [11]. Two of those implants, i.e., the iStent®, which consists of heparin-coated nonferromagnetic titanium, and the Hydrus TM , made of nitinol (nickel-titanium alloy), are metal based.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Chronic Granulomatous Inflammation after CyPass® Implantation

2020

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• Polyimide material is described as having excellent in vivo biocompatibility. • No prolonged inflammation was described after CyPass ® implantation in several studies. • The reason for CyPass ® withdrawal in August 2018 was a marked endothelial cell loss 5 years following its implantation. Novel Insights • Persisting clinical inflammation in association with an intense foreign body reaction is described 19 months after CyPass ® implantation. • Previous multiple glaucoma surgeries could have been discussed as a contraindication prior to CyPass ® Micro-Stent implantation. • Histopathological evaluation of explanted stents provides better insight into possible therapy failure and should therefore be performed routinely.

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An Update on Implants for Minimally Invasive Glaucoma Surgery (MIGS)

Cited by 82 publications

References 25 publications

Observation of curative effects of Ex-PRESS and AGV implantation in the treatment of refractory glaucoma

Observation of curative effects of Ex-PRESS and AGV implantation in the treatment of refractory glaucoma

Comparing Medium-Term Clinical Outcomes following XEN® 45 and XEN® 63 Device Implantation

Chronic Granulomatous Inflammation after CyPass® Implantation

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