Delayed-Onset Symptomatic Hyphema After Ab Interno Trabeculotomy Surgery

Ahuja, Yachna; Malihi, Mehrdad; Sit, Arthur J.

doi:10.1016/j.ajo.2012.03.027

Cited by 47 publications

(37 citation statements)

References 8 publications

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“…The most common complication is hyphema. Twelve patients presented with transient vision loss 2–31 months following AIT from a spontaneous rebleed associated with a mean IOP 12 mm Hg higher than the preceding visit 37. This may be under-reported: a case report using continuous IOP monitoring showed nocturnal IOP spikes ascribed to transient microhyphemas 38.…”

Section: Resultsmentioning

confidence: 99%

“…Six cyclodialysis clefts were reported (0.06%), with only one reporting further intervention (closure by laser) 11 41. There are three cases of a postoperative IOP spike associated with hyphema35 37 requiring surgical intervention (0.03%). Finally there is a single case of choroidal haemorrhage (0.01%) with no details given15 and a single case (0.01%) of endophthalmitis after phaco-AIT where the culture grew Enterococcus faecalis 9.…”

Section: Resultsmentioning

confidence: 99%

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Review and meta-analysis of ab-interno trabeculectomy outcomes

et al. 2016

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We analysed all of the PubMed publications on ab-interno trabeculectomy (AIT) with the Trabectome (Neomedix, Irvine, California, USA) to determine the reduction in intraocular pressure (IOP) and medications following the procedure. For IOP outcomes, PubMed was searched for 'trabectome', 'ab interno trabeculotomy' and 'ab interno trabeculectomy' and all available papers retrieved. The meta-analysis used a random-effects model to achieve conservative estimates and assess statistical heterogeneity. To investigate complications, we included all abstracts from the American Glaucoma Society, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery and the Association for Research in Vision and Ophthalmology. The overall arithmetic mean baseline IOP for standalone Trabectome was 26.71±1.34 mm Hg and decreased by 10.5±1.9 mm Hg (39% decrease) on 0.99±0.54 fewer medications. Defining success as IOP ≤21 with a 20% decrease while avoiding reoperation, the overall average success rate after 2 years was 46±34%. For combined phacoemulsification-Trabectome, the baseline IOP of 21±1.31 mm Hg decreased by 6.24±1.98 mm Hg (27% decrease) on 0.76±0.35 fewer medications. The success rate using the same definition at 2 years was 85±7%. The weighted mean IOP difference from baseline to study endpoint was 9.77 mm Hg (95% CI 8.90 to 10.64) standalone and 6.04 mm Hg (95% CI 4.95 to 7.13) for combined cases. Despite heterogeneity, meta-analysis showed significant and consistent decrease in IOP and medications from baseline to end point in AIT and phaco-AIT. The rate of visually threatening complications was <1%. On average, trabectome lowers the IOP by approximately 31% to a final IOP near 15 mm Hg while decreasing the number of medications by less than one, with a low rate of serious complications. After 2 years, the overall average success rate is 66%.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Review and meta-analysis of ab-interno trabeculectomy outcomes

et al. 2016

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“…A common postoperative observation is reflux of blood from the collector channels indicating free communication with the drainage system,64 but only one case needing a surgical intervention for hyphema has been reported 66. PAS may occur in 24%67 and can be lysed with photocoagulation or with the Nd:YAG laser 56.…”

Section: Resultsmentioning

confidence: 99%

Techniques and outcomes of minimally invasive trabecular ablation and bypass surgery

2013

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Minimally invasive glaucoma surgeries (MIGS) can improve the conventional, pressure dependent outflow by bypassing or ablating the trabecular meshwork or create alternative drainage routes into the suprachoroidal or subconjunctival space. They have a highly favorable risk profile compared to penetrating surgeries and lower intraocular pressure with variable efficacy that may depend on the extent of outflow segments accessed. Since they are highly standardized procedures that use clear corneal incisions, they can elegantly be combined with cataract and refractive procedures to improve vision in the same session. There is a growing need for surgeons to become proficient in MIGS to address the increasing prevalence of glaucoma and cataracts in a well-informed, aging population. Techniques of visualization and instrumentation in an anatomically highly confined space with semi-transparent tissues are fundamentally different from other anterior segment surgeries and present even experienced surgeons with a substantial learning curve. Here, we provide practical tips and review techniques and outcomes of TM bypass and ablation MIGS.

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“…6). arbeiter zeigten [37]. Auch diese späten Refluxblutungen sind mit dem Risiko eines passageren Augeninnendruckanstiegs verbunden, der meist medikamentös überbrückt werden konnte, in Ausnahmefällen aber auch operativ behoben werden musste.…”

Section: Schwierigkeiten Und Komplikationenunclassified

Minimalinvasive Kammerwinkelchirurgie mit dem Trabektom

Wecker

Jordan

2014

Klin Monatsbl Augenheilkd

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The main barrier reducing outflow of aqueous humor in open angle glaucomas is the juxtacanalicular trabecular meshwork. The trabectome removes this pathophysiologically altered tissue by electroablation, thus allowing for the collector channels draining Schlemm's canal to directly communicate with the anterior chamber. In studies published so far, about 30% decrease of intraocular pressure and a simultaneous 42% reduction of pressure-lowering eyedrops could be achieved in primary and secondary open angle glaucomas. A clear cornea tunnel is used to advance the trabectome to the trabecular meshwork, leaving the conjunctiva unaffected. Hence minimally invasive chamber angle surgery using this device is in particular suitable for patients with an altered ocular surface. Lowering of intraocular pressure and reduction of needed topical medication seems to be distinct in pseudoexfoliative glaucoma. Surgery with the trabectome and phacoemulsification can easily be combined in one procedure. Using a minimally invasive approach, the complication profile of the trabectome is rather advantageous, not exceeding the general risks of globe-opening surgery. Ab-interno trabeculotomy is a safe and effective method for treatment of patients with primary or secondary open angle glaucomas and moderate target pressures.

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Delayed-Onset Symptomatic Hyphema After Ab Interno Trabeculotomy Surgery

Cited by 47 publications

References 8 publications

Review and meta-analysis of ab-interno trabeculectomy outcomes

Review and meta-analysis of ab-interno trabeculectomy outcomes

Techniques and outcomes of minimally invasive trabecular ablation and bypass surgery

Minimalinvasive Kammerwinkelchirurgie mit dem Trabektom

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