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

Okuda, Mina; Mori, Sotaro; Takano, Fumio; Murai, Yusuke; Ueda, Kaori; Sakamoto, Mari; Kurimoto, Takuji; Yamada-Nakanishi, Yuko; Nakamura, Makoto

doi:10.1111/aos.15090

Cited by 14 publications

(34 citation statements)

References 38 publications

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“…Mori et al compared the effectiveness and safety of µLOT for all types of glaucoma between 1-quadrant and 2-quadrant incision groups and concluded that the 1-year success rate was not significantly different, but 2-quadrant incision groups showed a significantly higher rate of transient IOP rise post-operatively [24]. Further, the relationship between the prolonged use of anti-glaucoma medications and surgical outcomes should be investigated in the future because Okuda et al recently reported that the prolonged use of anti-glaucoma drugs was significantly associated with surgical failure after µLOT for all types of glaucoma [25].…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Microhook ab Interno Trabeculotomy in Consecutive 36 Eyes with Uveitic Glaucoma

Sotani

Kusuhara

Matsumiya

et al. 2022

JCM

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Microhook trabeculotomy (μLOT), recently developed by Tanito belongs to minimally invasive glaucoma surgery and contributes to intraocular pressure (IOP) control in eyes with glaucoma resistant to medical therapy. In this study, we aimed to investigate the effectiveness and safety of μLOT for uveitic glaucoma. The medical records of consecutive 36 eyes from 30 patients who underwent μLOT and were followed up over post-operative 1 year were reviewed. The surgical success (IOP = 5–20 mmHg and ΔIOP ≥ 20% with additional anti-glaucoma drugs) was achieved in 67% of eyes at post-operative 12 months. The median IOP significantly decreased from 30.5 mmHg pre-operatively to 15 mmHg at 12 months post-operatively (p = 0.001), and the median glaucoma drug score changed from 5 pre-operatively to 2.5 at 12 months post-operatively (p = 0.301). Intraocular inflammation scores at post-operative 6 weeks did not show a significant worsening as compared to pre-operatively, and 8 (22%) eyes exhibited exacerbation of inflammation during the 12-month follow-up period. Post-operative complications were confirmed in 58% of eyes, but most of them were mild and transient or successfully managed. With its favorable benefit–risk profile, μLOT would be an option worth considering as the first glaucoma surgery for uveitic glaucoma.

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Section: Discussionmentioning

confidence: 99%

“…µLOT was performed according to an original procedure devised by Tanito et al [21] with a minor modification as previously described [24,25]. In brief, for eyes undergoing 1quadrant µLOT, after a corneal paracentesis was created, the aqueous humor was replaced by cohesive viscoelastic.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Outcomes of Microhook ab Interno Trabeculotomy in Consecutive 36 Eyes with Uveitic Glaucoma

Sotani

Kusuhara

Matsumiya

et al. 2022

JCM

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“…A long-term history of topical glaucoma medication use and high preoperative glaucoma drug scores have been recognized as a risk factors for surgical failure of trabeculotomy [25][26][27][28]. In a recent study conducted by Okuda et al, researchers examined the perioperative factors that affected the surgical success of ab-interno microhook trabeculotomy.…”

Section: Topical Glaucoma Medicationsmentioning

confidence: 99%

“…In a recent study conducted by Okuda et al, researchers examined the perioperative factors that affected the surgical success of ab-interno microhook trabeculotomy. The findings revealed that patients taking anti-glaucoma eye drop medications for more than 4.5 years had a lower success rate of cataract surgery and microinvasive trabeculectomy [25]. These findings may be attributed to the substances found within glaucoma eye drops, such as benzalkonium chloride (BAK), that can cause prolonged inflammation and damage to the drainage of the aqueous humor through Schlemm's canal.…”

Section: Topical Glaucoma Medicationsmentioning

confidence: 99%

“…Other studies have found that BAK may affect aqueous outflow by increasing oxidative stress in the cells of the trabecular meshwork and endothelium, leading to apoptosis and an eventual increase in IOP [30,31]. Therefore, the effects of chronic inflammation caused by prolonged glaucoma medication use can lead to remodeling of the aqueous humor outflow pathway, and eventually antagonize the opening of the trabecular meshwork during a trabeculectomy or distal outflow after a Schlemm's canal procedure [25].…”

Section: Topical Glaucoma Medicationsmentioning

confidence: 99%

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Refractive Lensectomy and Microinvasive Glaucoma Surgery (MIGS): An Initial Approach in Glaucoma Patients over 50 Years of Age

Laroche¹,

Rickford²

2022

Refractive Surgery - Types of Procedures, Risks, and Benefits

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Glaucoma is a common cause of blindness worldwide, affecting patients at an average age of 57 years old. This is a disease of ocular anatomy commonly caused by a blockage of trabecular meshwork leading to an increase in intraocular pressure and glaucomatous optic neuropathy. The lens enlarges in width with age, often contributing to this, with obstruction of the angle due to pupillary block in angle-closure glaucoma. In open-angle glaucoma, there is often increased pigment liberation and obstruction of the trabecular meshwork due to increased iridolenticular and zonular contact. Recent studies looking at cataract extraction, refractive lensectomy, and the Hydrus stent have demonstrated adequate safety and efficacy for the treatment of glaucoma. We review the latest glaucoma treatment algorithm and results with early cataract surgery/refractive lensectomy and microinvasive glaucoma surgery to be considered as initial treatment for patients with glaucoma over 50 years of age.

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Favorable effect of ripasudil use on surgical outcomes of microhook ab interno trabeculotomy

Okuda

Mori

Ueda

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose We have previously demonstrated that prolonged use of glaucoma medications was associated with a poor surgical outcome of ab interno trabeculotomy (µTLO). Given that almost all types of glaucoma eye drop either enhance the drainage through the uveoscleral pathway or reduce aqueous humor production, we hypothesized that prolonged use of these medications might cause disuse atrophy of the conventional pathway. In contrast, ripasudil increases the conventional outflow and eventually shows a favorable outcome of µTLO. This study aimed to evaluate the effect of ripasudil use on µTLO outcomes. Method The medical charts of 218 patients who underwent µTLO were analyzed retrospectively. We compared the 1-year outcome between ripasudil users versus nonusers by using propensity score matching. We set the covariates as age, sex, glaucoma types, preoperative intraocular pressure (IOP), the mean deviation values of visual field tests, the presence or absence of concomitant cataract surgery, trabecular meshwork incision range, the presence or absence of any glaucoma medication except ripasudil and duration of glaucoma medical therapy. Success was defined as a postoperative IOP between 5 and 21 mmHg, a ≥ 20% IOP reduction from baseline, and no additional glaucoma surgery at postoperative 1 year. Result Fifty-seven patients each were allocated to the ripasudil users or nonusers. The 1-year success rates were 74% in ripasudil users and 51% in nonusers (p = 0.01). Kaplan‒Meier survival curves also showed that the ripasudil users had a higher survival distribution (p = 0.01). Conclusion The patients who took ripasudil showed a favorable 1-year outcome of µTLO.

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

Cited by 14 publications

References 38 publications

Outcomes of Microhook ab Interno Trabeculotomy in Consecutive 36 Eyes with Uveitic Glaucoma

Outcomes of Microhook ab Interno Trabeculotomy in Consecutive 36 Eyes with Uveitic Glaucoma

Refractive Lensectomy and Microinvasive Glaucoma Surgery (MIGS): An Initial Approach in Glaucoma Patients over 50 Years of Age

Favorable effect of ripasudil use on surgical outcomes of microhook ab interno trabeculotomy

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