Assessing Efficacy of Canaloplasty Using Continuous 24-Hour Monitoring of Ocular Dimensional Changes

Rękas, Marek; Danielewska, Monika E.; Byszewska, Anna; Petz, Katarzyna; Wierzbowska, Joanna; Wierzbowski, Robert; Iskander, D. Robert

doi:10.1167/iovs.16-19185

Cited by 24 publications

(16 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study found that VAR and â were decreased 3 and 12 months after surgery compared with the washout time, and there was a statistically significant difference between preoperative and postoperative values. Post-surgery IOP reduction was in agreement with previous studies on the effect of canaloplasty on glaucoma, indicating that VAR and â could reliably assess the effectiveness of canaloplasty [50].…”

Section: The Associations Between Different Interventions and 24-h Iosupporting

confidence: 89%

Outcome, influence factor and development of CLS measurement in continuous IOP monitoring: A narrative review

Chen

Lin

et al. 2021

Contact Lens and Anterior Eye

View full text Add to dashboard Cite

A large fluctuation in intraocular pressure (IOP) and a high peak IOP remain the risk factors for progressive visual field loss in patients with glaucoma, which is a leading cause of irreversible blindness. However, IOP measurements during working time cannot provide sufficient information on IOP to guide clinicians in setting IOP target values. Contact lenses are extensively used in ophthalmology to correct the refractive error, and recently, they are serving as platforms for detection and drug delivery. Contact lens sensor (CLS) is a feasible and promising approach to continuously monitor IOP, with superior tolerance, non-invasiveness, and without sleep disturbance. The present work reviewed the associations between progressive course and Triggerfish® CLS outputs as well as the relationship between treatments and Triggerfish® CLS outputs. Moreover, it further summarized state-of-the-art CLS devices of the past decade.

show abstract

Section: The Associations Between Different Interventions and 24-h Iosupporting

confidence: 89%

Outcome, influence factor and development of CLS measurement in continuous IOP monitoring: A narrative review

Chen

Lin

et al. 2021

Contact Lens and Anterior Eye

View full text Add to dashboard Cite

show abstract

“…In one of these studies, introduction of a PG analogue monotherapy on open-angle glaucoma and OHT eyes in which medication was previously washed out did reduce IOP measured with Goldmann tonometry, but did not modify the CLS curves [ 205 ]. Decrease of IOP fluctuation measured with CLS was reported in a small number of eyes after combined canaloplasty and phacoemulsification [ 213 ], while both decreased and unchanged IOP fluctuation was reported after SLT [ 155 , 207 ]. Considering the currently available peer-reviewed information published on the usefulness of the CLS [ 214 ] for clinical glaucoma care, no final conclusion can be drawn.…”

Section: Current and Future Options For 24-h Iop Monitoringmentioning

confidence: 99%

Diurnal and 24-h Intraocular Pressures in Glaucoma: Monitoring Strategies and Impact on Prognosis and Treatment

et al. 2018

View full text Add to dashboard Cite

The present review casts a critical eye on intraocular pressure (IOP) monitoring and its value in current and future glaucoma care. Crucially, IOP is not fixed, but varies considerably during the 24-h cycle and between one visit and another. Consequently, a single IOP measurement during so-called office hours is insufficient to characterize the real IOP pathology of a patient with glaucoma. To date IOP remains the principal and only modifiable risk factor for the development and progression of glaucoma. Only by evaluating IOP characteristics (mean, peak and fluctuation of IOP) at diagnosis and after IOP-lowering interventions can we appreciate the true efficacy of therapy. Unfortunately, a major limiting factor in glaucoma management is lack of robust IOP data collection. Treatment decisions, advancement of therapy and even surgery are often reached on the basis of limited IOP evidence. Clearly, there is much room to enhance our decision-making and to develop new algorithms for everyday practice. The precise way in which daytime IOP readings can be used as predictors of night-time or 24-h IOP characteristics remains to be determined. In practice it is important to identify those at-risk glaucoma patients for whom a complete 24-h curve is necessary and to distinguish them from those for whom a daytime curve consisting of three IOP measurements (at 10:00, 14:00 and 18:00) would suffice. By employing a staged approach in determining the amount of IOP evidence needed and the rigour required for our monitoring approach for the individual patient, our decisions will be based on more comprehensive data, while at the same time this will optimize use of resources. The patient’s clinical picture should be the main factor that determines which method of IOP monitoring is most appropriate. A diurnal or ideally a 24-h IOP curve will positively impact the management of glaucoma patients who show functional/anatomical progression, despite an apparently acceptable IOP in the clinic. The potential impact of nocturnal IOP elevation remains poorly investigated. The ideal solution in the future is the development of non-invasive methods for obtaining continuous, Goldmann equivalent IOP data on all patients prior to key treatment decisions. Moreover, an important area of future research is to establish the precise relationship between 24-h IOP characteristics and glaucoma progression.

show abstract

“…Recently, more attention has been paid to finding parameters complementary to IOP for better assessing the outcome of glaucoma surgery, particularly the parameters describing the aforementioned dynamic nature of the eye. Rękas and colleagues [13] were first to report that 24-h fluctuations pattern of corneoscleral limbus area (CSLA), measured with the Sensimed Triggerfish contact lens sensor in glaucoma patients, can be clinically useful for assessing mid-term efficacy of canaloplasty. Those findings emphasize the significance of characteristics of the eye dynamics in monitoring glaucomatous eyes after surgeries aiming at IOP reduction.…”

Section: Introductionmentioning

confidence: 99%

Changes in spectral parameters of corneal pulse following canaloplasty

Danielewska

Kicińska

Plaček

et al. 2019

Graefes Arch Clin Exp Ophthalmol

Self Cite

View full text Add to dashboard Cite

Purpose To ascertain whether changes in the spectral content of the corneal pulse (CP) signal, measured in vivo in primary openangle glaucoma (POAG) patients, indirectly reflect changes in corneal biomechanics after canaloplasty. Methods Fifteen eyes of 15 POAG patients who underwent canaloplasty combined with phacoemulsification were enrolled. Standard ophthalmic examinations were conducted before washout, pre-operatively, at days 1, 7, and 1, 3, 6, and 12 months after surgery. Non-contact measurements of the CP signal were performed at pre-washout, pre-operatively, and at 3, 6, and 12 months post-operatively. Then, amplitudes of the CP first five harmonics associated with the heart rate were estimated. Temporal changes of all considered parameters were tested at a Bonferroni-adjusted significance level set to 0.005. Results A decrease in the amplitude of the first harmonic and an increase in the normalized amplitude of the third harmonic (A CP3n) of the CP signal were noticed between the pre-washout and the pre-operative stages (p = 0.003 and p = 0.004, respectively). This corresponds to an increase in median intraocular pressure (IOP) values by 6.0 mmHg (p = 0.0045). After surgery, A CP3n reached the highest value at 3 months post-operatively, compared with pre-washout level (p = 0.0045). Conclusions Alterations in corneoscleral stiffness caused by surgery are reflected in changes in the A CP3n value. Hence, postoperative corneal biomechanics could be monitored indirectly by this supporting indicator that can be used to estimate the time at which measures of IOP are no longer biased by the changed cornea boundary conditions caused by canaloplasty. Clinical Trials Registration NCT02908633

show abstract

Assessing Efficacy of Canaloplasty Using Continuous 24-Hour Monitoring of Ocular Dimensional Changes

Abstract: Canaloplasty alone or combined with cataract surgery is a successful surgical method of lowering IOP in glaucoma patients. Canaloplasty decreases 24-hour CSLA fluctuation pattern measured with CLS.

Cited by 24 publications

References 72 publications

Outcome, influence factor and development of CLS measurement in continuous IOP monitoring: A narrative review

Outcome, influence factor and development of CLS measurement in continuous IOP monitoring: A narrative review

Diurnal and 24-h Intraocular Pressures in Glaucoma: Monitoring Strategies and Impact on Prognosis and Treatment

Changes in spectral parameters of corneal pulse following canaloplasty

Contact Info

Product

Resources

About