Different modes of intraocular pressure reduction after three different nonfiltering surgeries and trabeculectomy

Chihara, Etsuo; Hayashi, Ken

doi:10.1007/s10384-010-0923-9

Cited by 10 publications

(3 citation statements)

References 19 publications

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“…31 These characteristics are in accordance with previous results of the external trabeculotomy study. 32 If the pathogenesis of IOP elevation was attributed to increased resistance at the trabecular meshwork, it is reasonable that magnitude of IOP reduction by the canal opening is proportional to the height of presurgical IOP. However, there are some reports concerning positive association between presurgical IOP level and postsurgical IOP level.…”

Section: Discussionmentioning

confidence: 99%

<p>Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery</p>

Chihara¹,

Chihara

2020

OPTH

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Purpose To evaluate the surgical outcome of internal trabeculectomy by Kahook dual blade (KDB) with that of external trabeculotomy, each combined with phaco-lensectomy and intraocular lens implantation (Phaco). Patients and Methods This is a retrospective comparative study. The primary and secondary outcome measures are postsurgical intraocular pressure and postsurgical hyphema. One eye each of 76 primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PEG) and ocular hypertension (OH) patients underwent external phaco-trabeculotomy, and that of 40 POAG, PEG and OH patients underwent phaco-KDB surgery. Results Reduction of the intraocular pressure (IOP) by phaco-KDB at one and two years was 28.4 and 27.8%, respectively, and was not significantly different from that by external phaco-trabeculotomy of 32.7% ( P =0.256) and 31.5% ( P =0.468), respectively. Three months postsurgical IOP after phaco-KDB and external phaco-trabeculotomy was 16.1 and 15.9 mmHg, respectively. There was a significant turn back elevation of once reduced IOP to 17.1 ( P =0.0207) and 17.0 mmHg ( P =0.0096) at 24 months, respectively. There were no differences in success probability to achieve IOP below 17 mmHg ( P =0.120), 21 mmHg ( P =0.719) and >20% IOP reduction ( P =0.309) with medication(s) at two years between the phaco-KDB and external phaco-trabeculotomy cohorts. Younger age was a significant ( P <0.001) risk factor for failure; however, presurgical IOP ( P =0.466), the type of surgery ( P =0.219) and presence of postsurgical IOP spike ( P =0.737) were not significant risk factors by the Cox proportional hazard model. Hyphema and spike of the IOP in phaco-KDB and external phaco-trabeculotomy cohorts were 40% and 88% ( P <0.001), and 53% and 41% ( P =0.238), respectively. Conclusion The IOP reduction by the phaco-KDB was equivalent to that by external phaco-trabeculotomy up to two years. In both cohorts, once reduced postsurgical IOP tend to increase up to 24 months.

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Section: Discussionmentioning

confidence: 99%

<p>Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery</p>

Chihara¹,

Chihara

2020

OPTH

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“…In this study both the T-hook and KDB were combined with cataract surgery. Cataract surgery alone can decrease post-surgical IOP, 15 thus, the effects of the T-hook alone on post-surgical IOP is a subject for future studies. In this study we analyzed the outcomes in eyes with high pre-surgical IOP exceeding 21 mmHg.…”

Section: Limitations Of This Studymentioning

confidence: 99%

Development and Application of a New T-shaped Internal Trabeculotomy Hook (T-hook)

Chihara¹,

Chihara²

2022

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Purpose We introduce a newly designed T-shaped internal trabeculotomy hook and compare its surgical outcomes with those of Kahook dual blade (KDB) surgery. Patients and Methods One eye each of seventeen and sixty-one patients underwent T-hook and KDB surgeries, respectively. Post-surgical intraocular pressure (IOP), medications, visual acuity, and prevalence of IOP spikes and hyphema were compared between the two cohorts. Results The utility of the T-hook was excellent and enabled the easy opening of the Schlemm’s canal. The pre-surgical IOP of 25.6 ±7.5 mmHg in the T-hook cohort decreased to 14.1 ± 4.3 (−41.2% reduction) and 15.0 ± 3.1mmHg (−39.3% reduction) at 3 (P<0.001) and 6 months (P=0.003), respectively. Pre-surgical medications of 2.8 decreased to 2.3 and 2.0 medications, respectively, at 3 and 6 months. The best-corrected visual acuity (BCVA) improved from the pre-surgical logarithm of the minimum angle resolution (logMAR) of 0.148 to −0.012 at three months (P=0.036,). While the pre-surgical IOP of 24.9±4.3 mmHg in the KDB cohort decreased to 16.5±5.7 mmHg (−35.5%, P<0.001) and 16.1±3.4 mmHg (−33.5%, P<0.001) at 3 and 6 months, respectively. Reduction in medications at 3- and 12-month timepoints (from 2.8 to 1.7 and 1.7, respectively; P<0.001) and improvement in BCVA at three months (from 0.106 to −0.025 logMAR, P<0.001) were also significant. There was no difference between the T-hook and KDB cohorts in terms of the pre-surgical IOP (P=0.15) and post-surgical IOP at 1 (P=0.27), 3 (P=0.17), 6 (P=0.47), and 12 months (P=0.11, Mann–Whitney U -test). The prevalence of a post-surgical IOP spike in the T-hook and KDB cohorts was 41.2% and 47.5%, and that of post-surgical hyphema was 17.6% and 26.2%, respectively. Conclusion The novel T-hook was easy to use and was as useful as the KDB device in performing internal trabeculotomy.

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“…Intraocular pressure (IOP) measurement (tonometry) is a common test included by eye‐care practitioners in eye examinations particularly for patients diagnosed with, or at risk for, glaucoma,2003 and in care after eye surgery (for example, intraocular lens implantation,2016 vitrectomy,2016 and trabeculectomy2011). An increase in IOP can cause irreversible optic nerve damage and visual field loss, and IOP is one of the parameters used as an indicator of glaucoma progression 2009…”

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confidence: 99%

Repeatability and agreement of intraocular pressure measurement among three tonometers

Pavón

Cañadas

Martín

2020

Clinical and Experimental Optometry

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Background: Elevated intraocular pressure (IOP) is one of the causes of irreversible optic nerve head damage and visual field loss. It is often measured with applanation tonometers but the use of rebound tonometry devices has been proposed as an alternative to assess IOP. Rebound tonometers have also been proposed as a method for patients to measure their own intraocular pressure (that is, self-tonometry). The purpose of this study was to determine the intrasession repeatability and the agreement of the IOP measurement with two rebound measuring principle tonometers, ICare ic100 and ICare Home with Perkins tonometer. Methods: This study involved 27 healthy volunteers (18 to 30 years old). We performed three consecutive IOP measurements with ICare Home, ICare ic100, and Perkins. The means of the three measurements from each device were calculated. Repeatability and agreement were defined according to the British Standards Institute and the International Organization for Standardization. The agreement was assessed using the method described by Bland and Altman, where 95 per cent of the differences or limits of agreement were between 1.96 standard deviations of the mean difference. Results: All tonometers showed close measurements (Perkins 15.34 AE 3.45 mmHg, range 10.00-24.00; ICare ic100 15.40 AE 4.06 mmHg, range 9.67-23.33; and ICare Home 14.22 AE 4.72 mmHg, range 7.33-24.00). The coefficient of variation (CV) and within-subject standard deviation (Sw) was low for ICare ic100 and Perkins (close to 6.30 per cent and one) with higher values for ICare Home (CV = 9.55% and Sw = 1.33). The intraclass correlation coefficient showed values higher than 0.96 for all tonometers. The difference between both rebound tonometers was statistically significant (p = 0.03). Conclusion: The ICare ic100 tonometer provides repeatable IOP measurements close to the measurements of the Perkins IOP (good agreement); however, ICare Home provides less repeatable values, showing worse agreement with the Perkins tonometer in healthy subjects.

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Different modes of intraocular pressure reduction after three different nonfiltering surgeries and trabeculectomy

Cited by 10 publications

References 19 publications

<p>Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery</p>

<p>Turn Back Elevation of Once Reduced IOP After Trabeculotomy Ab Externo and Kahook Dual Blade Surgeries Combined with Cataract Surgery</p>

Development and Application of a New T-shaped Internal Trabeculotomy Hook (T-hook)

Repeatability and agreement of intraocular pressure measurement among three tonometers

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