Intraocular Pressure Peaks After Suprachoroidal Stent Implantation

Kuusniemi, Arvi-Matti; Lindbohm, Nina; Allinen, Pasi; Harju, Mika

doi:10.1097/ijg.0000000000001608

Cited by 3 publications

(2 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a result, this device was withdrawn from the market by the manufacturer [ 15 ]. Its implantation may result in a high incidence of sudden IOP peaks with a low success rate [ 55 ]. Several other devices have been proposed but are still under study [ 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Optical Coherence Tomography Evidence of Aqueous Humor Flow from the Suprachoroidal Space to Conjunctival Lymphatics

Kumar,

Bezzabotnov,

Rustamova

et al. 2023

Vision

View full text Add to dashboard Cite

A surgical technique was developed to enhance aqueous humor (AH) flow through the non-trabecular outflow pathway by rerouting it from the anterior chamber (AC) to the suprachoroidal space (SCS) without detaching the ciliary body from the scleral spur. Medium- and long-term surgical outcomes were retrospectively analyzed in a case series of 58 glaucoma patients. At 6, 12, and 24 months, the mean IOP decreased from 27.8 ± 8.3 to 14.9 ± 5.0 mmHg, median 15.0 (25th percentile (p25)13.0; 75th percentile (p75) 18.0) and 15.2 ± 3.3 mmHg, and hypotensive medication use reduced from a median (p25; p75) of 3 (2; 3) to 0 (0; 2), 0 (0; 2), and 0 (0; 1.5), respectively. Intra- and postoperative complications were few and manageable. Following surgery, no bleb formation occurred in any of the cases (as confirmed by optical coherence tomography). Conjunctival lymphatic vessels (CLVs) developed in 50% of eyes (29/58). Clinically, they developed directly from sclera and had no connection to the surgical site. Analysis further showed that the development of CLVs and their longer visibility period had poor prognostic value for IOP control. If the fluid flow from the SCS to CLVs was resistance-free, no CLV development was evident. However, if any resistance existed in the flow, the fluid accumulated in lymphatics, resulting in their engorgement. The proposed technique was safe and effective in decreasing IOP in glaucoma patients by enhancing AH flow from the SCS to CLVs via connecting intrascleral microchannels.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical and Optical Coherence Tomography Evidence of Aqueous Humor Flow from the Suprachoroidal Space to Conjunctival Lymphatics

Kumar,

Bezzabotnov,

Rustamova

et al. 2023

Vision

View full text Add to dashboard Cite

show abstract

“…104 Occlusive events with sudden peaks of IOP have been recorded in as many as 37% in one series, with 43% asymptomatic. 110 They postulated that the rise was due to a sudden cleft closure with increased trabecular resistance.…”

Section: Ab Externo Suprachoroidal Devicesmentioning

confidence: 99%

Minimally Invasive Glaucoma Surgery: Latest Developments and Future Challenges

Chan,

Larson,

Dickerson

et al. 2023

Asia-Pacific Journal of Ophthalmology

View full text Add to dashboard Cite

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.

show abstract