Five-Year Visual Field Outcomes of the HORIZON Trial

Montesano, Giovanni; Ometto, Giovanni; Ahmed, Iqbal Ike K.; Ramulu, Pradeep Y.; Chang, David F.; Crabb, David P.; Gazzard, Gus

doi:10.1016/j.ajo.2023.02.008

Cited by 25 publications

(16 citation statements)

References 78 publications

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“…42 Recently, Montesano et al demonstrated that when evaluating the visual field (VF) data from the HORIZON trial, the phaco/Hydrus procedure exerts a protective effect in VF preservation compared with cataract surgery alone at 5 years, significantly reducing the proportion of fast progressors. 43 These key findings demonstrate not only IOP reduction with the use of this MIGS device but also stabilization of perimetric loss due to glaucoma. Such work is a notable contribution to the literature on MIGS, as there is a growing interest in evaluating the impact of MIGS procedures on VF outcomes.…”

Section: Hydrus Microstentmentioning

confidence: 72%

“…The average postoperative IOP was also lower in the phaco/Hydrus group 42 . Recently, Montesano et al demonstrated that when evaluating the visual field (VF) data from the HORIZON trial, the phaco/Hydrus procedure exerts a protective effect in VF preservation compared with cataract surgery alone at 5 years, significantly reducing the proportion of fast progressors 43 . These key findings demonstrate not only IOP reduction with the use of this MIGS device but also stabilization of perimetric loss due to glaucoma.…”

Section: Non-bleb Forming Trabecular Meshwork Canal Implantsmentioning

confidence: 99%

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Minimally Invasive Glaucoma Surgery

Gallo Afflitto,

Swaminathan

2023

International Ophthalmology Clinics

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Section: Hydrus Microstentmentioning

confidence: 72%

Section: Non-bleb Forming Trabecular Meshwork Canal Implantsmentioning

confidence: 99%

Minimally Invasive Glaucoma Surgery

Gallo Afflitto,

Swaminathan

2023

International Ophthalmology Clinics

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“…Additional data on visual field progression monitored over 5 years favor Hydrus compared with cataract surgery alone; the rate of progression was –0.49 dB/y in cataract surgery alone and improved to –0.26 dB/y with the addition of Hydrus. This result is incompletely explained by the average IOP over the course of follow-up that authors postulate, similar to the LiGHT, which may be evidence of more consistent IOP control with Hydrus 21 . Overall, Hydrus represents a safe, efficacious method to improve IOP control when combined with cataract surgery, reduces the incidence of major glaucoma surgery, and slows visual field progression.…”

Section: Bypassing Trabecular Meshwork By Implantable Devicesmentioning

confidence: 91%

“…This result is incompletely explained by the average IOP over the course of follow-up that authors postulate, similar to the LiGHT, which may be evidence of more consistent IOP control with Hydrus. 21 Overall, Hydrus represents a safe, efficacious method to improve IOP control when combined with cataract surgery, reduces the incidence of major glaucoma surgery, and slows visual field progression.…”

Section: Hydrus Microstentmentioning

confidence: 99%

Minimally Invasive Glaucoma Surgery: Latest Developments and Future Challenges

Chan,

Larson,

Dickerson

et al. 2023

Asia-Pacific Journal of Ophthalmology

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The development of minimally invasive glaucoma surgeries (MIGSs) was intended to provide safe and modestly efficacious modalities for early intervention of mild-to-moderate glaucoma, with minimal trauma and rapid recovery. They were mainly ab interno procedures that reduce intraocular pressure by facilitating the aqueous outflow by bypassing the trabecular meshwork resistance, reinforcing the uveoscleral flow via the supraciliary space, and reducing aqueous production by the ciliary body. While the cumulating evidence helps shape the role of the available MIGS, the exponential new development and advancement in this field has expanded the territory of MIGS. Apart from developing subconjunctival MIGS filtration devices (Xen gel stent and PRESERFLO MicroShunt), there is a tendency to revisit the “traditional” MIGS for alternative use and to modify the procedures with consideration of the fundamental aqueous outflow physiology. Combined MIGS has also been suggested, based on the theory that their different mechanisms may provide additive or synergistic effects. The advancement of laser procedures is also promising and could supplement unmet needs along the glaucoma treatment algorithm. This review examines the broad array of MIGS, updates the recent findings, discusses their potential alternative applications, and explores future challenges.

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“…Patients with worse baseline visual field testing and higher postoperative IOP peak were more likely to worsen. Notably, recent evidence from the HORIZON trial has suggested less pointwise VF progression in patients undergoing cataract surgery with Hydrus stent implantation compared to cataract surgery alone, despite both groups showing similar measured IOP during clinic hours [24]. These data suggest that measured IOP may be an insufficient metric of disease control, either due to its inability to gauge medication compliance or because of the importance of IOP fluctuation, particularly outside of clinical hours [25].…”

Section: Open Angle Glaucoma and Ocular Hypertensionmentioning

confidence: 98%

How much does cataract surgery contribute to intraocular pressure lowering?

Sabharwal,

Garg,

Ramulu

2023

Current Opinion in Ophthalmology

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Purpose of review To review the literature evaluating the effect of cataract surgery on intraocular pressure (IOP) in patients with glaucoma. Recent Findings Recent high-quality secondary analyses of large and primary trials continue to show IOP lowering following cataract surgery. Likewise, cataract surgery remains a key treatment for angle closure glaucoma. Some micro-invasive glaucoma surgeries (MIGS) have strong evidence to be performed at the time of cataract surgery. Data clarifying when these surgeries should be combined with cataract surgery is emerging. The mechanism underlying IOP lowering after cataract surgery remains unclear. Summary Patients who are glaucoma suspects with visually significant cataracts would benefit from cataract surgery alone. Those with mild-moderate damage on 1–2 classes of medications would most likely benefit from additional MIGS. Patients with advanced disease would benefit from cataract surgery and a choice of additional surgery, which depends on disease status and patient factors. Clear lens extraction is becoming a more accepted practice as a primary procedure for patients with angle closure and high IOP or glaucoma. The role of additional MIGS in angle closure needs further study.

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Five-Year Visual Field Outcomes of the HORIZON Trial

Cited by 25 publications

References 78 publications

Minimally Invasive Glaucoma Surgery

Minimally Invasive Glaucoma Surgery

Minimally Invasive Glaucoma Surgery: Latest Developments and Future Challenges

How much does cataract surgery contribute to intraocular pressure lowering?

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