Incidence of steroid response in microinvasive glaucoma surgery with trabecular microbypass stent and ab interno trabeculectomy

Abtahi, M; Rudnisky, Christopher J.; Nazarali, Samir; Damji, Karim F.

doi:10.1016/j.jcjo.2021.04.008

Cited by 6 publications

(6 citation statements)

References 51 publications

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“…The definition of steroid responders in the general population varies among studies. Yamamoto et al [21] and Abtahi et al [22] define steroid responders as individuals with an IOP rise of 5 mmHg from baseline, whereas Chang et al describe steroid responsiveness as an IOP increase of at least 25% when on topical prednisolone, and up to 28 mmHg, followed by a drop of at least 25%, when the medication is withdrawn [23]. Steroid response may be divided into three categories: approximately 2/3 are low responders, with a pressure increase <6 mmHg and an IOP < 20 mmHg; approximately 1/3 are intermediate responders, with IOPs between 20 and 31 mmHg or a pressure increase of 6-15 mmHg; and 4-6% are high responders, with an IOP above 31 mm Hg or an increase of more than 15 mm Hg above baseline [24].…”

Section: Discussionmentioning

confidence: 98%

“…Thomas et al studied 87 eyes of 52 participants with POAG and found a significant steroidinduced increase in 23% of the eyes with a mean pressure of 25.1 mmHg; Wilensky et al reported an IOP between 25 to 42 mmHg following trabeculectomy during postoperative steroid prophylaxis [10,11]. The incidence of steroid response after combined phacoemulsification with either Trabectome or iStent is reported to be 12.7% [22]. Several studies have assessed the efficacy of steroids and NSAIDs in controlling early postoperative inflammation.…”

Section: Discussionmentioning

confidence: 99%

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Steroid Response after Trabeculectomy—A Randomized Controlled Trial Comparing Dexamethasone to Diclofenac Eye Drops

Ahmadzadeh

Kessel

Schmidt

et al. 2022

JCM

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This prospective randomized controlled trial aimed to compare changes in intraocular pressure in three different anti-inflammatory regimens following trabeculectomy. Sixty-nine patients were randomized to receive either postoperative prophylaxis with topical preservative-free dexamethasone (DEX), diclofenac (DICLO), or their combination (DEX+DICLO). Our main outcome measure was an intraocular pressure (IOP) change of a minimum 4 mmHg following the withdrawal of anti-inflammatory prophylaxis 9 weeks after trabeculectomy. We found that the IOP decreased ≥ 4 mmHg in 18.6% of eyes after cessation of the topical steroid DEX (n = 3/22) and DEX+DICLO (n = 5/21), whereas a decrease in IOP was not observed in the DICLO group. In conclusion, IOP decreased in nearly 1/5 of patients after cessation of topical steroidal anti-inflammatory prophylaxis after trabeculectomy. This points toward a steroid-induced increase in IOP even after trabeculectomy. Thus, increased postoperative IOP may be related to steroid use, and the success or failure of a trabeculectomy cannot be fully evaluated before anti-inflammatory prophylaxis with steroids is stopped or changed to non-steroidal eye drops.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Steroid Response after Trabeculectomy—A Randomized Controlled Trial Comparing Dexamethasone to Diclofenac Eye Drops

Ahmadzadeh

Kessel

Schmidt

et al. 2022

JCM

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“… 141 Chowdhury and colleague developed an approach to culture vascular distal outflow cells and showed that these cells are biologically different from TM cells. 142 More importantly, a recent clinical study reported that one-eighth of the minimally invasive glaucoma surgery (surgical procedures that partially/completely remove the TM or open the TM from inside the eye) patients may still develop GIOHT, 143 suggesting that the distal outflow tissue may also contribute to GIOHT/GIG.…”

Section: Basic Science Review Of Gig/giohtmentioning

confidence: 99%

Glucocorticoid-Induced Ocular Hypertension and Glaucoma

Harvey,

Sugali,

Mao

2024

OPTH

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Glucocorticoid (GC) therapy is indicated in many diseases, including ocular diseases. An important side-effect of GC therapy is GC-induced ocular hypertension (GIOHT), which may cause irreversible blindness known as GC-induced glaucoma (GIG). Here, we reviewed the pathological changes that contribute to GIOHT including in the trabecular meshwork and Schlemm’s canal at cellular and molecular levels. We also discussed the clinical aspects of GIOHT/GIG including disease prevalence, risk factors, the type of GCs, the route of GC administration, and management strategies.

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“…153,159 Steroid response is seen in about 13.6%. 162 Reports of recurrent hyphaema, 163 malposition, occlusion, peripheral anterior synechiae (PAS) and low grade chronic inflammation have been reported. 164…”

Section: With a Device Istent G1 And Istent Injectmentioning

confidence: 99%

The surgical management of glaucoma: A review

Lim

2022

Clinical Exper Ophthalmology

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After a long period of little change, glaucoma surgery has experienced a dramatic rise in the number of possible procedures in the last two decades. Glaucoma filtering surgeries with mitomycin C and glaucoma drainage devices remain the standard of surgical care. Other newer surgeries, some of which are minimally or microinvasive glaucoma surgeries, target existing trabecular outflow, enhance suprachoroidal outflow, create subconjunctival blebs, or reduce aqueous production. Some require the implantation of a device such as the iStent, Hydrus, Ex-PRESS, XEN and PRESERFLO, whilst others do not-Trabectome, Kahook dual blade, Ab interno canaloplasty, gonioscopy-assisted transluminal trabeculotomy, OMNI and excimer laser trabeculotomy. Others are a less destructive variation of an established procedure, such as micropulse transscleral cyclophotocoagulation, endoscopic cyclophotocoagulation and ultrasound cycloplasty. Cataract surgery alone can be a significant glaucoma operation. These older and newer glaucoma surgeries, their mechanism of action, efficacy and complications are the subject of this review.

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Incidence of steroid response in microinvasive glaucoma surgery with trabecular microbypass stent and ab interno trabeculectomy

Cited by 6 publications

References 51 publications

Steroid Response after Trabeculectomy—A Randomized Controlled Trial Comparing Dexamethasone to Diclofenac Eye Drops

Steroid Response after Trabeculectomy—A Randomized Controlled Trial Comparing Dexamethasone to Diclofenac Eye Drops

Glucocorticoid-Induced Ocular Hypertension and Glaucoma

The surgical management of glaucoma: A review

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