Effect of glaucoma implant surgery on intraocular pressure reduction, flare count, anterior chamber depth, and corneal endothelium in primary open-angle glaucoma

Ishida, Kyoko; Moroto, Naoya; Murata, Kouichi; Yamamoto, Tetsuya

doi:10.1007/s10384-017-0512-2

Cited by 31 publications

(34 citation statements)

References 51 publications

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“…Although combined phacoemulsification might have enhanced corneal ECD loss after filtering surgery, the data is consistent with our present study. A single arm case series for eyes treated with Ex-PRESS implantation also showed a significant reduction in the corneal ECD 27 . The mechanism underlying the damage to the corneal endothelial cells following Ex-PRESS implantation remains unknown.…”

Section: Discussionmentioning

confidence: 85%

Randomised Clinical Trial for Postoperative Complications after Ex-PRESS Implantation versus Trabeculectomy with 2-Year Follow-Up

Arimura

Miyake

Iwasaki

et al. 2018

Sci Rep

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We compared complications between Ex-PRESS implantation and trabeculectomy for 2 years after surgery. Sixty-four open-angle glaucoma eyes were randomly assigned to treatment with trabeculectomy (n = 32) or Ex-PRESS implantation (n = 32). The primary outcomes were postoperative complications, including reduction of the endothelial cell density (ECD) of the cornea, cataract progression and the frequency of other late postoperative complications. The Ex-PRESS group had significantly greater reduction of postoperative corneal ECD than the trabeculectomy group did at 2 years after surgery (P = 0.026). Among the corneal areas measured using specular microscopy, the superior area, where the Ex-PRESS tube was inserted, had significantly more severe corneal ECD reduction than the inferior area after 2 years (−17.6% in superior area and −11.7% in inferior area, P = 0.04). More cataract progression occurred in the trabeculectomy group than in the Ex-PRESS group (P = 0.04). Twelve eyes (37.5%) in the trabeculectomy group and 4 eyes (12.5%) in the Ex-PRESS group underwent cataract surgery (P = 0.019). The total number of other postoperative complications between 3 months and 2 years was significantly higher in the trabeculectomy group than in the Ex-PRESS group (P = 0.02). Although Ex-PRESS implantation might be associated with an increased rate of corneal endothelial cell loss compared with trabeculectomy, it is beneficial for preventing cataract progression after filtering surgery.

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Section: Discussionmentioning

confidence: 85%

Randomised Clinical Trial for Postoperative Complications after Ex-PRESS Implantation versus Trabeculectomy with 2-Year Follow-Up

Arimura

Miyake

Iwasaki

et al. 2018

Sci Rep

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“…To ensure maintenance of the corneal integrity and transparency, the corneal endothelium is essential [ 15 ]. Aging, surgery, and trauma have been reported by several studies to be able to reduce the CECD [ 2 , 4 , 12 – 14 ]. Our current study showed that while there were no changes in the CECD after the EX-PRESS implantation, there were significant decreases observed in the CECD after the trabeculectomies.…”

Section: Discussionmentioning

confidence: 99%

“…Casini et al also found that there were no changes in the CECD at 1 or 3 months after the EX-PRESS shunt implantation surgery [ 12 ]. In contrast, Ishida et al showed that there was a significant decreased in the CECD at 24 months after the EX-PRESS shunt implantation [ 14 ]. The authors speculated that the reason for the differences seen in these studies is that the decreases in the CECD are only observed after a specific length of time.…”

Section: Discussionmentioning

confidence: 99%

“…Although it has been previously shown that trabeculectomy can damage corneal endothelial cells [ 10 – 13 ], no changes have been observed in the CECD at either 1 or 3 months after EX-PRESS implantation surgery [ 12 ]. In contrast, Ishida et al reported finding significant decreases in the CECD at 24 months after EX-PRESS implantation [ 14 ]. Even so, it should be noted that this previous study did not compare eyes undergoing implantation to a control group of eyes undergoing trabeculectomy.…”

Section: Introductionmentioning

confidence: 99%

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Changes in corneal endothelial cells after trabeculectomy and EX-PRESS shunt: 2-year follow-up

et al. 2018

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BackgroundTo compare trabeculectomy and EX-PRESS device implantation procedures for treating glaucoma and evaluate changes in corneal endothelial cell density (CECD).MethodsThis study prospectively evaluated changes in the CECD in 60 eyes of 60 patients who underwent trabeculectomy and 50 eyes of 45 patients who underwent EX-PRESS device implantation. Baseline patient data recorded included age at surgery, sex, type of glaucoma medications, and lens status. Using a noncontact specular microscope, corneal specular microscopy was performed preoperatively at the central cornea and then at 6, 12, 18 and 24 months after surgery. CECD before and after surgery was compared using a paired t-test.ResultsThere was a significant decrease in the IOP and number of antiglaucoma medications in both groups after the surgery. The mean CECD in the trabeculectomy group was 2505 ± 280 cells/mm2 at baseline, while it was 2398 ± 274 cells/mm2 (P < 0.001), 2349 ± 323 cells/mm2 (P < 0.001), 2293 ± 325 cells/mm2 (P < 0.001), and 2277 ± 385 cells/mm2 (P = 0.003) at 6, 12, 18, and 24 months, respectively. However, the CECD in the EX-PRESS group was 2377 ± 389 cells/mm2 at baseline, while it was 2267 ± 409 cells/mm2 (P = 0.007), 2292 ± 452 cells/mm2 (P = 0.043), 2379 ± 375 cells/mm2 (P = 0.318), and 2317 ± 449 cells/mm2 (P = 0.274) at 6, 12, 18, and 24 months, respectively.ConclusionsAs compared to trabeculectomy, EX-PRESS device implantation appears to be a safer procedure with regard to the endothelial cell loss risk.

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“…Evaluation of the anterior aqueous flare in patients with glaucoma has also been addressed recently [ 27 – 29 , 32 ]. Many groups have assessed the anterior chamber aqueous flare in glaucomatous eyes after treatment with antiglaucomatous drugs.…”

Section: Discussionmentioning

confidence: 99%

Anterior Chamber Flare as an Objective and Quantitative Noninvasive Method for Oculopathy in Transthyretin V30M Amyloidosis Patients

Beirão

Miranda

Pinheiro-Torres

et al. 2018

Journal of Ophthalmology

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Purpose Assess the aqueous humor flare in transthyretin V30M amyloidosis patients (ATTRV30M). Materials and Methods This is a retrospective, cross-sectional, noninterventional comparative study including 28 ATTRV30M patients with a unilateral scalloped iris. For comparative analysis, the fellow eye, the nonscalloped iris eye, from each patient was used as control. All patients underwent aqueous humor flare meter and intraocular pressure (IOP) measurements. Results Mean aqueous humor flare was significantly higher in the eyes with the scalloped iris than the control group with the nonscalloped iris (14.1 ± 2.2 versus 6.5 ± 0.9 pc/ms, respectively). No significant differences in IOP were found in the scalloped iris eyes than those in the nonscalloped iris control group (17.1 ± 0.8 versus 16.8 ± 0.7 mmHg, respectively). No significant correlation was not found between the flare and the IOP value within groups. Conclusions In this study, aqueous humor flare values in the scalloped iris eyes may be a valid marker for controlling the stage of the oculopathy in ATTRV30M patients.

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Effect of glaucoma implant surgery on intraocular pressure reduction, flare count, anterior chamber depth, and corneal endothelium in primary open-angle glaucoma

Abstract: The advantage of filtering surgery using the EX-PRESS device includes reduced inflammation, and the disadvantages include loss of the CE and reduced effectiveness of NTG.

Cited by 31 publications

References 51 publications

Randomised Clinical Trial for Postoperative Complications after Ex-PRESS Implantation versus Trabeculectomy with 2-Year Follow-Up

Randomised Clinical Trial for Postoperative Complications after Ex-PRESS Implantation versus Trabeculectomy with 2-Year Follow-Up

Changes in corneal endothelial cells after trabeculectomy and EX-PRESS shunt: 2-year follow-up

Anterior Chamber Flare as an Objective and Quantitative Noninvasive Method for Oculopathy in Transthyretin V30M Amyloidosis Patients

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