Early Results of Irrigating Goniectomy With TrabEx+: A Novel Device for the Treatment of Open-angle Glaucoma

Gosling, Daniel; Wang, Haoyu; Auger, Graham

doi:10.1097/ijg.0000000000001994

Cited by 8 publications

(10 citation statements)

References 29 publications

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“…Kaplowitz et al alternatively de ned surgical success as an IOP of ≤ 21 with a 20% postoperative decrease in IOP while avoiding reoperation; using this de nition, the success rate for trabeculotomy using the Trabecutome procedure was 46 ± 3.4% two years postoperatively [21]. In addition, Gosling et al de ned surgical success as an IOP reduction of > 20% (IOP < 21 mm); these researchers showed that, given this de nition, the success rate for trabeculotomy using TrabEX® was 54% at 25 months postoperatively [22]. The success rate of non-HM with OAG in the present study has good agreement with these previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…According to the ndings of previous studies, the level of surgical success for this procedure (typically de ned as an IOP of ≤ 21 with a 20% decrease in IOP following standalone trabeculotomy surgery using MIGS) ranges from 45-60% [21][22][23][24][25]. Kaplowitz et al alternatively de ned surgical success as an IOP of ≤ 21 with a 20% postoperative decrease in IOP while avoiding reoperation; using this de nition, the success rate for trabeculotomy using the Trabecutome procedure was 46 ± 3.4% two years postoperatively [21].…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Standalone Ab Interno Trabeculotomy in the Treatment of Open-Angle Glaucoma in Eyes with High Myopia

Yoshida

Nomura

Yoshimoto

et al. 2023

Preprint

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Background We retrospectively evaluate the long-term efficacy and safety of trabeculotomy glaucoma surgery in treating open-angle glaucoma (OAG) in eyes with high myopia (HM). Methods This study included 20 eyes with HM (axial length ≥ 26.5 mm) and OAG; age, preoperative IOP (intraocular pressure), and sex-matched 20 non-HM eyes (axial length < 26.5 mm) served as controls. Each eye underwent standalone ab interno trabeculotomy using a Kahook dual blade. A follow-up examination was performed 36 months after surgery. The main outcome measure was the operative success rate (i.e., a ≥ 20% pre- to post-operative reduction in IOP with or without IOP-lowering medication). Kaplan-Meier analysis was employed as a measure of surgical success. The secondary outcome measures were postoperative IOP, the number of glaucoma medications, and postoperative complications. Results IOP and the number of glaucoma medications were statistically significantly reduced at all postoperative follow-up examinations. The Kaplan-Meier analysis demonstrated that the probability of postoperative success at 36 months was 45% and 65% for HM and non-HM eyes, respectively. In the HM group, the presence of pathological myopia (PM) was statistically significant risk factor for surgical failure. No critical postoperative complications were detected. Conclusions In our study, the long-term efficacy of ab interno trabeculotomy in HM eyes with OAG was inferior to that in non-HM eyes with OAG. Our findings suggest that surgical indications for trabeculotomy in HM should be determined based on the presence of PM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcomes of Standalone Ab Interno Trabeculotomy in the Treatment of Open-Angle Glaucoma in Eyes with High Myopia

Yoshida

Nomura

Yoshimoto

et al. 2023

Preprint

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“…For the first time in 2004, Trabectome ® offered irrigation when opening the trabecular apparatus through a tip that forms plasma and vaporizes the tissue. In this way, direct access is provided for draining the intraocular fluid to the Schlemm’s canal and the intrascleral venous plexuses [ 15 , 16 ]. In 2016 Kaplowitz et al [ 13 ] published results of a two-year study that indicated a 36% reduction in baseline intraocular pressure and a significant reduction in topical therapy to one agent.…”

Section: Discussionmentioning

confidence: 99%

“…The stable anterior chamber also relies on an adaptive viscoelastic substance. Gosling [ 15 ] reported in a study that irrigating goniectomy with the TrabEx+ device in combination with, or without cataract surgery, effectively decreased IOP and glaucoma medications in the postoperative period between 3 months to 2 years.…”

Section: Discussionmentioning

confidence: 99%

“Ab Interno” Surgery of the Schlemm’s Canal in Postuveitic Glaucoma Patients

Tanev¹,

Kirkova

2023

JPM

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Background: Patients with uveitis have a higher risk of developing glaucoma not only because of the disease by itself, but also because of the ongoing corticosteroid therapy. The pathogenesis of uveitic glaucoma is characterized by a complex of biochemical and cellular processes, as well as morphological changes in the trabecular meshwork. Treatment of secondary chronic glaucoma is challenging and often requires different approaches and solutions. Purpose: To present the “ab interno” procedure of the Schlemm‘s canal (SC) performed with the help of TrabEx+ (MST, Redmond, WA, USA) in postuveitic glaucoma patients. Methods: The observed group included patients with postuveitic secondary glaucoma, which consisted of 12 pseudophakic patients (12 eyes). Patients are with intraocular pressure higher than 25 mmHg and on maximal local therapy. Due to insufficient conservative control on IOP, surgical solutions are needed. We describe a new, minimally invasive surgical procedure–the technique of the operation, the postoperative results and complications. Results: We present the achieved intraocular pressure (on the first day, 2 weeks, 1 month, 6, 8 12 and 18 months). The morphology of the trabecular area was demonstrated by gonioscopy. The effects of the therapy on the glaucoma progression, was evaluated with perimetry and OCT. Discussion: The following procedure is a minimally invasive procedure and provides good control of intraocular pressure. Aqueous veins in the conjunctiva are significantly preserved compared to conventional filtration trabeculectomy. This potentially modulates the physiological outflow pathways by ablating trabeculum strip the cause of increased outflow resistance-the inner wall of the SC. Conclusion: Removal of the inner wall of the SC, using Trabex+ (MST, Redmond, WA, USA), demonstrates promising results in the selected patients with a minimally invasive nature.

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“…Kaplowitz et al alternatively defined surgical success as an IOP of ≤ 21 with a 20% postoperative decrease in IOP while avoiding reoperation; using this definition, the success rate for trabeculotomy using the Trabectome procedure was 46 ± 3.4% two years postoperatively [ 22 ]. In addition, Gosling et al defined surgical success as an IOP reduction of > 20% (IOP < 21 mm); these researchers showed that, given this definition, the success rate for trabeculotomy using TrabEX® was 54% at 25 months postoperatively [ 23 ]. The success rate of non-HM with OAG in the present study has good agreement with these previous studies.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of standalone ab interno trabeculotomy in the treatment of open-angle glaucoma in eyes with high myopia

et al. 2023

View full text Add to dashboard Cite

Background We retrospectively evaluate the long-term efficacy and safety of trabeculotomy glaucoma surgery in treating open-angle glaucoma (OAG) in eyes with high myopia (HM). Methods This study included 20 eyes with HM (axial length ≥ 26.5 mm) and OAG; age, preoperative IOP (intraocular pressure), and sex-matched 20 non-HM eyes (axial length < 26.5 mm) served as controls. Each eye underwent standalone ab interno trabeculotomy using a Kahook dual blade. A follow-up examination was performed 36 months after surgery. The main outcome measure was the operative success rate (i.e., a ≥ 20% pre- to post-operative reduction in IOP with or without IOP-lowering medication). Kaplan–Meier analysis was employed as a measure of surgical success. The secondary outcome measures were postoperative IOP, the number of glaucoma medications, and postoperative complications. Results IOP and the number of glaucoma medications were statistically significantly reduced at all postoperative follow-up examinations. The Kaplan–Meier analysis demonstrated that the probability of postoperative success at 36 months was 45% and 65% for HM and non-HM eyes, respectively. In the HM group, the presence of pathological myopia was statistically significant risk factor for surgical failure. No critical postoperative complications were detected. Conclusions In our study, the long-term efficacy of ab interno trabeculotomy in HM eyes with OAG was inferior to that in non-HM eyes with OAG. Our findings suggest that surgical indications for trabeculotomy in HM should be determined based on the presence of pathological myopia.

show abstract

Early Results of Irrigating Goniectomy With TrabEx+: A Novel Device for the Treatment of Open-angle Glaucoma

Cited by 8 publications

References 29 publications

Outcomes of Standalone Ab Interno Trabeculotomy in the Treatment of Open-Angle Glaucoma in Eyes with High Myopia

Outcomes of Standalone Ab Interno Trabeculotomy in the Treatment of Open-Angle Glaucoma in Eyes with High Myopia

“Ab Interno” Surgery of the Schlemm’s Canal in Postuveitic Glaucoma Patients

Outcomes of standalone ab interno trabeculotomy in the treatment of open-angle glaucoma in eyes with high myopia

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