Endoscopic ophthalmic surgery of the anterior segment

Francis, Brian A.; Kwon, Julie; Fellman, Ronald L.; Noecker, Robert J.; Samuelson, Thomas W.; Uram, Martin; Jampel, Henry D.

doi:10.1016/j.survophthal.2013.03.010

Cited by 33 publications

(20 citation statements)

References 35 publications

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“…It has been suggested that excessive exfoliation material on the zonules can hinder laser uptake in endoscopic cyclophotocoagulation (Francis et al. ). It remains unclear if such a hindrance may also be the case in TCP.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of transscleral cyclophotocoagulation in Swedish glaucoma patients

Rasmuson

Lindén

Lundberg

et al. 2019

Acta Ophthalmologica

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Purpose: To retrospectively evaluate the efficacy and safety of all transscleral cyclophotocoagulation (TCP) treatments performed during a 5-year period. Methods: Medical records of all patients, who had undergone TCP treatment between 2010 and 2014 at Ume a University Hospital, Sweden, were evaluated. Clinical data including intraocular pressure (IOP), visual acuity (VA), number of topical glaucoma medications, use of oral acetazolamide, retreatments and complications during a 2-year follow-up were registered. Global success was defined as IOP 6-18 mmHg with or without glaucoma medication. Results: Three hundred patients underwent TCP during the time period. Mean IOP at baseline was 29.3 AE 11.0 (mean AE standard deviation) mmHg (n = 297) with a mean reduction of 11.5 (AE12.0) mmHg at 1 year (n = 258; p < 0.001) and 12.6 (AE12.0) mmHg at 2-year follow-up (n = 245; p < 0.001). Global success at 2 years was 64%, achieved by a mean of 1.2 treatments (n = 257). The number of topical glaucoma medications at baseline was 3.1 (AE1.0; n = 296) and was reduced by 0.9 (AE1.0) medications at 2 years (n = 244; p < 0.001). Use of oral acetazolamide decreased from 30% (n = 90) at baseline to 5.3% (n = 13) at 2 years. In eyes with Snellen VA ≥ 0.1, the mean VA at baseline was 0.55 (AE0.3) logarithm of the minimum angle of resolution (logMAR; n = 132) and 1.1 (AE0.9) logMAR (n = 76) at 2 years (p < 0.001). No cases of phthisis bulbi were found. Conclusion: This study displays a substantial and long-term reduction of IOP following TCP with a decrease in topical and oral glaucoma medications. The treatment appears to be safe but the decrease in VA during follow-up is a concern that needs further evaluation.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of transscleral cyclophotocoagulation in Swedish glaucoma patients

Rasmuson

Lindén

Lundberg

et al. 2019

Acta Ophthalmologica

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“…After filling the anterior chamber and ciliary sulcus with OVD, the endoscope probe (Endo Optiks, Little Silver, New Jersey, US) is inserted through the incision, and the anterior ciliary processes are visualized and treated with the laser. The power of the laser can range from 0.25 to 0.4 W and ablate anywhere from 270 to 360 degrees[58]. Characteristic whitening and contraction of the ciliary processes are observed, signifying the endpoint for treatment.…”

Section: 0 Reducing Aqueous Production (Endocyclophotocoagulation)mentioning

confidence: 99%

Microinvasive glaucoma surgery: an evidence-based assessment

Schehlein

Kaleem

Swamy

et al. 2017

Expert Review of Ophthalmology

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Introduction The advent of Microinvasive Glaucoma Surgery (MIGS) offers a novel approach in the treatment of glaucoma with the number of procedures developing at an exciting pace. Areas Covered MIGS procedures aim to lower intraocular pressure (IOP) via four mechanisms: (1) increasing trabecular outflow, (2) increasing outflow via suprachoroidal shunts, (3) reducing aqueous production, and (4) subconjunctival filtration. A comprehensive search for published studies for each Microinvasive Glaucoma Surgery (MIGS) device or procedure was undertaken using the electronic database PubMed. Search terms included ‘minimally invasive glaucoma surgery’, ‘microincisional glaucoma surgery’, and ‘microinvasive glaucoma surgery’. A manual search for each device or procedure was also performed. After review, randomized control trials and prospective studies were preferentially included. Expert Opinion These procedures offer several benefits: an improved safety profile allowing for intervention in earlier stages of glaucoma, combination with cataract surgery, and decreased dependence on patient compliance with topical agents. Established MIGS procedures have proven efficacy and more recent devices and procedures show promising results. Despite this, further study is needed to assess the long term IOP-lowering effectiveness of these procedures. Particularly, rigorous study with more randomized control trials and head-to-head comparisons would allow for better informed clinical and surgical decision-making. MIGS offers new solutions for glaucoma treatment.

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“…At the internal lip of a sclerotomy, vitreous incarceration can be uniquely visualized as vitreous folds (Fig. It is typically done from the anterior segment, with or without cataract surgery [35][36][37]. Endoscope-directed complete vitreous release with a vitrector can be performed.…”

Section: Difficult-to-access Diseasesmentioning

confidence: 99%