Comparison between the Express Implant and Transscleral Diode Laser in Neovascular Glaucoma

Wagdy, Faried M; Zaky, Adel Galal

doi:10.1155/2020/3781249

Cited by 6 publications

(15 citation statements)

References 19 publications

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“…Two RCTs investigated TDL against other surgical interventions, Express Implant [ 22 ] and AGV [ 23 ]. Tokumo et al (2021) compared Trab vs the Baerveldt shunt [ 24 ] and Elwehidy et al (2019) compared IVR + PRP + Trab with IVR + PRP + visco-trabeculectomy (Vtrab) [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…Four studies had a low risk of bias [ 16 , 19 , 20 , 27 ]. From the remaining 10 studies, 6 had some concerns [ 17 , 18 , 21 , 23 , 26 , 28 ] and 4 had a high risk of bias [ 22 , 24 , 25 , 29 ] (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…The definition of success was IOP < 21 mmHg with the same or improved BCVA on one study [ 23 ] and the definition of complete success was IOP < 22 mmHg and no further treatment in the second study [ 22 ]. Choy et al (2018) showed a non-significant success rate of 63% in the TDL group and 42% in the Ahmed valve group, whereas Wagdy et al (2020) showed a complete success rate in the TDL group compared with Express Implant group of 44.4 vs 50%, respectively.…”

Section: Transcleral Diode Laser Vs Other Surgical Interventionsmentioning

confidence: 99%

“…These complications comprised 8% intraoperative haemorrhage, 8% corneal decompensation, 17% over-filtration, 8% encapsulated bleb, 17% implant exposure, 8% rapid cataract progression and 25% phthisis bulbi (Table 6 ). In the other study, the TDL group had a total of 5 complications and the Express Implant group had a total of 6 [ 22 ]. The TDL group reported 5.5% of hyphema, 11.1% increased IOP and 11.1% hypotony whereas the Express group reported 8.3% for hyphema, 16.66% for increased IOP and 25% for hypotony (Table 6 ).…”

Section: Transcleral Diode Laser Vs Other Surgical Interventionsmentioning

confidence: 99%

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A systematic review and meta-analysis of randomised controlled trials in the management of neovascular glaucoma: absence of consensus and variability in practice

Ramji

Nagi

Ansari

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose Neovascular glaucoma (NVG) is characterised by neovascularisation of the angle and therefore elevated intraocular pressure (IOP). This results in progressive optic neuropathy and loss of visual acuity. Treatment aims to reduce IOP in order to prevent optic nerve damage. A systematic review was completed synthesising results from randomised control trials (RCTs) comparing interventions for the management of NVG and their efficacy and safety. Methods Data was sourced from Web of Science, Embase and Medline after 1st January 2000. The primary outcome measures were mean IOP at follow-up and success rate. The secondary outcomes included mean IOP lowering medications and total complications. A meta-analysis was completed on comparative studies using Revman (version 5.4). Results For the two studies comparing Ahmed glaucoma valve (AGV) + pan-retinal photocoagulation (PRP) vs AGV + PRP + intra-vitreal bevacizumab (IVB), there was no difference in mean IOP or odds of success from the meta-analysis. From the 4 studies examining the utilisation of anti-vascular endothelial growth factor (anti-VEGF), one study showed lower mean IOP at 1 (p = 0.002) and 3 months (p = 0.033) for IVB vs sham injection. In the 2 studies studying transcleral diode laser (TDL), there were no significant findings. From the 4 studies looking at trabeculectomy (trab), lower mean IOP at 6 (p = 0.001), 9 (p = 0.01), 12 (p = 0.02) and 18 months (p = 0.004) was shown for intra-vitreal ranibizumab (IVR) + PRP + visco-trabeculectomy vs IVR + PRP + trab, and a significantly lower mean IOP was present in the Baerveldt group vs trab at 6 months (p = 0.03). In the 2 studies investigating the AGV, there was a lower mean IOP at 1 month (p = 0.01) in the AGV + triamcinolone (TCA) group. The risk of bias was low for 4 studies, high for 4 studies and 6 studies had some concerns. Conclusion This is the first meta-analysis of RCTs in the management of neovascular glaucoma. The lack of high-quality evidence contributes to the lack of consensus in managing NVG. Our results highlight modern treatment strategies and the need for better powered RCTs with long-term follow-up in order to establish optimal treatment modalities and true patient outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Transcleral Diode Laser Vs Other Surgical Interventionsmentioning

confidence: 99%

Section: Transcleral Diode Laser Vs Other Surgical Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review and meta-analysis of randomised controlled trials in the management of neovascular glaucoma: absence of consensus and variability in practice

Ramji

Nagi

Ansari

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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“…Ex-PRESS shunt was indicated initially for open-angle glaucoma but has been implanted in other types of glaucomas, including neovascular glaucoma, uveitic glaucoma and post-penetrating keratoplasty glaucoma with satisfactory results. 6 …”

Section: Introductionmentioning

confidence: 99%

The Role of Automated Peripheral Iridectomy Combined with Phacoemulsification and Mini Ex-PRESS Shunt Implantation in Patients with Chronic Angle Closure Glaucoma

Samir¹,

Elsayed²,

Deiaeldin³

et al. 2022

OPTH

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Purpose To evaluate the role of automated peripheral iridectomy as an adjunctive tool combined with phacoemulsification and ExPRESS shunt implantation in management of cases with chronic angle closure glaucoma. Setting Magrabi eye hospital. Methods This prospective study included 22 eyes of 22 patients with chronic angle closure glaucoma and cataract who underwent Ex-PRESS shunt implantation, cataract extraction and surgical peripheral iridectomy at the site of shunt implantation in the period between January 2018 and April 2020. Results After surgery, the mean IOP was 11.3±1.2 mm Hg, 14.5±1.6 mm Hg, 14.8±2.1 mm Hg, 15.3±1.9 mm Hg and 17.4±1.8 mm Hg at 7 days, 1 month, 3 months, 6 months and 12 months, respectively. All postoperative IOP was significantly lower compared with preoperative IOP (P = 0.001). There was a significant decrease in the number of medications required after surgery. The baseline mean number of medications was 3.4±0.02 (range from 1 to 4), while postoperatively the mean number of medications decreased to 0.7±0.01 at 12 months (P < 0.01). The qualified success rate was 6/22 eyes, and the complete success rate was 16/22 (72.7%) at 12 months, respectively. Conclusion The combined phacoemulsification and Ex-PRESS shunt implantation with automated peripheral iridectomy is an effective and safe procedure to treat chronic angle closure glaucoma.

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Cyclophotocoagulation for Neovascular Glaucoma

Krause

Eisengart

2022

Essentials in Ophthalmology

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Comparison between the Express Implant and Transscleral Diode Laser in Neovascular Glaucoma

Cited by 6 publications

References 19 publications

A systematic review and meta-analysis of randomised controlled trials in the management of neovascular glaucoma: absence of consensus and variability in practice

A systematic review and meta-analysis of randomised controlled trials in the management of neovascular glaucoma: absence of consensus and variability in practice

The Role of Automated Peripheral Iridectomy Combined with Phacoemulsification and Mini Ex-PRESS Shunt Implantation in Patients with Chronic Angle Closure Glaucoma

Cyclophotocoagulation for Neovascular Glaucoma

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