IOP-lowering and drug-sparing effects of trabectome surgery with or without cyclodialysis ab interno

Garweg, Richard A.; Pfister, Isabel B.; Gerhardt, Christin; Halberstadt, Markus; Straessle, Kim; Anastasi, Stefano; Garweg, Justus G.

doi:10.1007/s00417-023-06063-8

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…There are few reports of complications of hypotony caused by an ab interno trabeculotomy, and there are also few reports on its treatment. 2 Shue et al described a case in which cyclodialysis caused by a Kahook dual blade goniotomy was successfully treated with multiple sessions of argon laser photocoagulation. 3 If we had chosen cycloplegic drops or laser treatment, the results might have been different.…”

Section: Discussionmentioning

confidence: 99%

“…7 There are few reports of treatment methods for post-MIGS ciliary body detachment. 2 , 3 Treatment for ciliary body detachment after trabeculectomy includes methods to increase IOP, such as suturing a scleral flap. On the other hand, there is no consensus regarding the best treatment for ciliary body detachment due to MIGS such as microhooks.…”

Section: Introductionmentioning

confidence: 99%

“…1 MIGS has some complications, one of which is ciliary detachment. 2,3 Some cases of ciliary body detachment may improve naturally. 4,5 If ciliary detachment continues over a long period of time, it might lead to hypotensive maculopathy due to low IOP.…”

Section: Introductionmentioning

confidence: 99%

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Gas Tamponade Improved Cilio-Choroidal Effusion Induced by an Ab Interno Trabeculotomy with a Microhook: Two Cases

Otsuka,

Tojo,

Yanagisawa

et al. 2024

IMCRJ

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Purpose We treated two patients with ciliary detachment due to an ab interno trabeculotomy. The ciliary detachment was improved by the use of sulfur hexafluoride (SF 6 ) gas or octafluoro propane (C 3 F 8 ) tamponade. Patients and Methods Patient 1 was a 52-year-old Brazilian man with primary open angle glaucoma (POAG). His preoperative intraocular pressure (IOP) was 29 mmHg. Patient 2 was a 57-year-old Japanese woman with POAG. Her preoperative IOP was 35 mmHg. Both patients underwent an ab interno trabeculotomy with a microhook. They caused ciliary detachment as a postoperative complication. We could observe their ciliary detachment with anterior segment optical coherence tomography (AS-OCT). Hypotony persisted for 2 months and the patients’ ciliary detachment had not improved. They each underwent a pars plana vitrectomy (PPV) with simultaneous 20% SF 6 filling. Results In Patient 1, the use of the SF 6 gas tamponade successfully attached the ciliary body. His IOP was increased to 30 mmHg after this resolution of the ciliary detachment. He underwent additional tube shunt surgery. For Patient 2, the SF 6 gas tamponade improved the ciliary detachment but the ciliary body could not be attached. We injected 0.6 cc of 100% C 3 F 8 gas into the vitreous cavity, and this gas tamponade was able to attach the ciliary body. Conclusion AS-OCT is very useful to evaluate ciliary detachment. PPV+Gas tamponade can be a treatment option for ciliary detachment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gas Tamponade Improved Cilio-Choroidal Effusion Induced by an Ab Interno Trabeculotomy with a Microhook: Two Cases

Otsuka,

Tojo,

Yanagisawa

et al. 2024

IMCRJ

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Surgical Outcomes, Ocular Safety and Tolerability of Bio-Interventional Cyclodialysis with Allograft Scleral Reinforcement: Clinical Experience of More than 240 Cases

Chaya,

Herndon,

Lince

et al. 2024

JCM

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Background: To report the surgical safety of reinforced bio-interventional cyclodialysis with scleral allograft reinforcement. Methods: This was a consecutive case series of 243 eyes with open-angle glaucoma who underwent a bio-scaffolded cyclodialysis (BSC) procedure for uveoscleral outflow enhancement using allogeneic bio-spacers to maintain patency of the internal filtration conduit. Results: 79% of the eyes underwent concomitant phacoemulsification cataract surgery prior to BSC intervention, while the remaining eyes underwent stand-alone BSC surgery. All patients had a postoperative surgical safety period of at least 30 days. There were no sight-threatening or serious ocular adverse events. There was one case of prolonged iritis beyond 30 days, which resolved with topical treatment. Two cases (0.8%) of intraoperative and five (2%) of postoperative non-sight-threatening hyphema were without clinical sequelae, which resolved with conservative management. There were 11 cases of IOP elevation and one case of numeric hypotony without maculopathy, which resolved within the study period. The rate of secondary surgical intervention for IOP control was low, and overall, IOP for the cohort improved in the postoperative period, with 78.6% of eyes achieving IOP ≤ 18 mmHg without an increase in medications. Conclusions: Allogeneic biotissue for cyclodialysis intervention demonstrates a biocompatible ocular profile as an implantable material for internal scleral reinforcement during uveoscleral outflow enhancement surgery.

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Historical and Contemporary Debates in Schlemm’s Canal-Based MIGS

Chihara,

Hamanaka

2024

JCM

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Glaucoma is one of the primary causes of blindness worldwide. Canal opening surgery, a type of minimally invasive glaucoma surgery (MIGS) applied in cases of mild to moderate glaucoma, has gained increasing popularity in recent years due to its efficacy in reducing the intraocular pressure, its safety profile, the simplicity of its technique, and the reduced likelihood of compromised vision. Nevertheless, the existing body of histopathological studies remains insufficient for a comprehensive understanding of post-surgical wound healing. Consequently, debates persist among researchers regarding the mechanism through which Schlemm’s canal opening surgery reduces the intraocular pressure, as well as the surgical techniques that may impact the outcomes and the factors influencing surgical success. As the history of MIGS is relatively short and lacks sufficient systemic reviews or meta-analyses evaluating the influence of individual factors, this review was conducted to illuminate the disparities in researchers’ opinions at the current stage of research.

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IOP-lowering and drug-sparing effects of trabectome surgery with or without cyclodialysis ab interno

Cited by 3 publications

References 35 publications

Gas Tamponade Improved Cilio-Choroidal Effusion Induced by an Ab Interno Trabeculotomy with a Microhook: Two Cases

Gas Tamponade Improved Cilio-Choroidal Effusion Induced by an Ab Interno Trabeculotomy with a Microhook: Two Cases

Surgical Outcomes, Ocular Safety and Tolerability of Bio-Interventional Cyclodialysis with Allograft Scleral Reinforcement: Clinical Experience of More than 240 Cases

Historical and Contemporary Debates in Schlemm’s Canal-Based MIGS

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