Evaluating CO2 laser-assisted sclerectomy surgery with mitomycin C combined with or without phacoemulsification in adult Asian glaucoma subjects

Ho, Dawn; Perera, Shamira; Hla, Myint Htoon; Ho, Ching Lin

doi:10.1007/s10792-021-01707-2

Cited by 4 publications

(7 citation statements)

References 18 publications

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“…Comparing CLASS alone and Class ? Phaco, the success rate in standalone group was significantly higher than in combination group in our current study, which was consistent with a previous Singapore study [22]. The 1-year success rate of combination surgery varied significantly among previous studies.…”

Section: Discussionsupporting

confidence: 91%

“…Phaco (45.2% vs 37.7%)[21]. However, only 6.7% IOP reduction in combination group was reported by Ho et al in 2021, which was significantly lower than in CLASS group (40.6%)[22]. In our study, a greater IOP reduction was…”

contrasting

confidence: 65%

“…Statistical analyses were performed with the GraphPad Prism version 9.0 software (GraphPad Software Incorporation, San Diego, CA, USA). The sample size was calculated based on a power calculation (power = 0.80; P = 0.05) using IOP reduction% at 1 year after surgery obtained in a previous study [22], and 21 eyes per group were considered well suited for the purpose of this study. Quantitative data were expressed as mean values ± standard deviation (mean ± SD).…”

Section: Discussionmentioning

confidence: 99%

“…Phaco [24]. In contrast, only 46.4% qualified success was reported by Ho et al in Asian glaucoma patients from Singapore [22]. However, Yu et al reported an overall LGP, Nd:YAG laser goniopuncture; CS, complete success; QS, qualified success success rate of 88.0% in a Chinese population [20].…”

Section: Discussionmentioning

confidence: 99%

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CO2 Laser-Assisted Sclerectomy Surgery Alone or Combined with Phacoemulsification in Primary Open-Angle Glaucoma: Comparison of 1-Year Outcomes

Chen

Huang

et al. 2022

Ophthalmol Ther

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Introduction:To compare 1-year outcomes of CO 2 laser-assisted sclerectomy surgery (CLASS) alone or combined with phacoemulsification (CLASS ? Phaco) in eyes with primary openangle glaucoma (POAG). Methods: This was a prospective, comparative, case series study. A total of 46 eyes with POAG underwent CLASS or CLASS ? Phaco were followed up for 1 year. The primary outcomes included changes in intraocular pressure (IOP), medication and best corrected visual acuity (BCVA). The secondary outcomes were success rate, functional bleb, postoperative laser intervention and complications. Results: CLASS alone resulted in a greater IOP reduction compared with CLASS ? Phaco. BCVA improved remarkably in CLASS ? Phaco group, but there was no difference in BCVA before and after CLASS. The number of antiglaucoma medications significantly decreased at 12 months postoperatively in both groups. Functional blebs were more commonly seen in the CLASS than combination group. The overall success rate was higher in the CLASS than CLASS ? Phaco group at 1 year after surgery. The incidence of peripheral anterior synechiae (PAS) in CLASS ? Phaco group was significantly lower than that of CLASS alone. Conclusion: CLASS alone achieved a greater IOP reduction, more common functional bleb formation and a higher success rate compared to CLASS combined with Phaco, while combination surgery yielded a better BCVA improvement and a lower PAS incidence than CLASS alone. Both surgical strategies have favorable safety and efficacy among POAG patients. Combined surgery could be a viable option for patients with co-existing POAG and cataract.

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Section: Discussionsupporting

confidence: 91%

contrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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CO2 Laser-Assisted Sclerectomy Surgery Alone or Combined with Phacoemulsification in Primary Open-Angle Glaucoma: Comparison of 1-Year Outcomes

Chen

Huang

et al. 2022

Ophthalmol Ther

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“…During the process, the energy can be accurately controlled and the depth and size of the ablating area can be adjusted (8). It has been successfully used to treat primary open-angle glaucoma (POAG) during the recent years, both in the Caucasian and in Chinese patients (9)(10)(11). Compared with other filtering surgeries, CLASS requires a shorter learning curve and less technical challenge and also achieves higher safety (12).…”

Section: Introductionmentioning

confidence: 99%

Management of Intraocular Pressure Elevation After CO2 Laser-Assisted Sclerectomy Surgery in Patients With Primary Open-Angle Glaucoma

Chen

Yang

et al. 2021

Front. Med.

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Purpose: To report the safety and efficiency of carbon dioxide (CO2) laser-assisted sclerectomy surgery (CLASS) in Chinese patients with primary open-angle glaucoma (POAG) and the management of unexpected postoperative intraocular pressure (IOP) elevation.Methods: This was a prospective case series study. A total of 23 eyes from 23 patients with POAG who underwent CLASS were involved and followed-up for 12 months. The primary outcomes included the changes in best corrected visual acuity (BCVA), IOP, and medications before and after CLASS. The secondary outcomes were success rate and postoperative laser interventions.Results: The mean age of the patient was 42.6 ± 16.0 years. There was no significant change in BCVA and visual field at baseline and 12 months after CLASS. The number of medications was significantly reduced after CLASS. The IOP was also significantly decreased and remained well controlled during the follow-up period, except for a transient elevation at 1 month postoperatively, due to the occurrence of peripheral anterior synechiae (PAS). Generally, 17 patients (73.9%) were treated with neodymium-doped yttrium aluminum garnet (Nd:YAG) laser synechiolysis to remove iris obstruction in the filtration site and seven patients (30.4%) underwent Nd:YAG laser goniopuncture to deal with scleral reservoir reduction. Only one patient (4.3%) received surgical repositioning due to iris incarceration. The complete success rate and total success rate at 12 months were 69.6 and 95.7%, respectively.Conclusion: CLASS was a safe and effective approach for Chinese patients with POAG. Peripheral anterior synechiae (PAS), iris incarceration, and scleral reservoir reduction were common causes of unexpected postoperative IOP elevation. Individualized Nd:YAG laser intervention helps to improve the long-term outcomes after CLASS.

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CO2 laser-assisted sclerectomy surgery for secondary open-angle glaucoma after vitrectomy

Li,

Wang,

Zhu

et al. 2024

Front. Med.

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PurposeTo explore the efficiency and safety of carbon dioxide (CO2) laser-assisted sclerectomy surgery (CLASS) in Chinese patients with glaucoma secondary to vitrectomy.MethodsThis retrospective study consisted of 16 eyes from 16 patients with glaucoma secondary to vitrectomy who underwent CLASS and were followed up for 12 months. Main outcome measures included preoperative and postoperative intraocular pressure, best corrected visual acuity (BCVA), number of anti-glaucoma medications, and postoperative surgical success rate and complications.ResultsThe postoperative IOP and number of anti-glaucoma medications used at all follow-up time point were significantly lower than those preoperatively. The difference in BCVA was not significant before and after surgery. The main complicatios were peripheral anterior synechiae (PAS) and scleral reservoir reduction, which were controlled after neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, 2 (12.50%) patients underwent re-operation. The complete and total success rates at 12 months were 68.75% and 87.50%, respectively.ConclusionCLASS is a safe and effective procedure for Chinese patients with glaucoma secondary to vitrectomy. PAS and scleral reservoir reduction is a major contributor to postoperative IOP elevation, and trabecular minimally invasive perforation with the Nd:YAG laser is effective in lowering IOP and increasing scleral cistern volume.

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Evaluating CO2 laser-assisted sclerectomy surgery with mitomycin C combined with or without phacoemulsification in adult Asian glaucoma subjects

Cited by 4 publications

References 18 publications

CO2 Laser-Assisted Sclerectomy Surgery Alone or Combined with Phacoemulsification in Primary Open-Angle Glaucoma: Comparison of 1-Year Outcomes

CO2 Laser-Assisted Sclerectomy Surgery Alone or Combined with Phacoemulsification in Primary Open-Angle Glaucoma: Comparison of 1-Year Outcomes

Management of Intraocular Pressure Elevation After CO2 Laser-Assisted Sclerectomy Surgery in Patients With Primary Open-Angle Glaucoma

CO2 laser-assisted sclerectomy surgery for secondary open-angle glaucoma after vitrectomy

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