Longer-term Baerveldt to Trabectome glaucoma surgery comparison using propensity score matching

Kostanyan, Tigran; Shazly, Tarek A.; Kaplowitz, Kevin; Wang, Steven Z.; Kola, Sushma; Brown, Eric N.; Loewen, Nils A.

doi:10.1007/s00417-017-3804-9

Cited by 15 publications

(16 citation statements)

References 30 publications

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“…This sequence was first described for the Molteno device and was addressed by a complete intraoperative tube ligation to prevent aqueous from negatively impacting the bleb maturation [25] . More recent studies of these devices do not describe a significant hypertensive phase [9,[26][27][28] . Aqueous humor of patients with glaucoma contains a high concentration of tissue growth factor b (TGF-b ), which has a substantial regulatory effect on the extracellular matrix macromolecules and synthesis of matrix protein as well as an inhibitory effect on degradative proteolytic enzymes [15] .…”

Section: Discussionmentioning

confidence: 99%

“…Due to its retrospective nature, patients were not randomized to each treatment group. Although applying different matching methods like coarsened exact [23,30,31] and propensity score matching [28] that we used in our previous studies could reduce the bias due to confounding variables, we were unable to use them here due to relatively small sample size. Additionally, this study was conducted at a single tertiary academic center and cannot easily be generalized to other practices.…”

Section: Discussionmentioning

confidence: 99%

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Impact of same-session trabectome surgery on Ahmed glaucoma valve outcomes

Esfandiari

Shazly

Shah

et al. 2018

Graefes Arch Clin Exp Ophthalmol

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Purpose: To evaluate the efficacy and survival rates of same session ab interno trabeculectomy with the trabectome and Ahmed glaucoma valve implant (AT) in comparison to the Ahmed glaucoma valve alone (A).Method : A total of 107 eyes undergoing primary glaucoma surgery were enrolled in this retrospective comparative case series, including 48 eyes which underwent AT and 59 eyes which received A alone . Participants were identified using the procedural terminology codes, and their medical records were reviewed. The primary outcome measure was surgical success, defined as intraocular pressure (IOP) > 5 mmHg, ≤ 21 mmHg, and IOP reduction ≥ 20% from baseline at two consecutive visits after three months, no reoperation for glaucoma. Secondary outcome measures were IOP, the number of glaucoma medications, incidence of a hypertensive phase, and best corrected visual acuity (BCVA). Results:The cumulative probability of success at one year was 70% in AT, and 65% in A (p=0.85). IOP decreased significantly from 26.6 ± 10.1 mmHg at baseline to 14.7 ± 3.3 mmHg at the final follow-up in AT (p= 0.001). The corresponding numbers for A were 28.8 ± 10.2 and 16.7 ± 4.9, respectively (p= 0.001). The final IOP was significantly lower in AT (p= 0.022). The number of medications at baseline was comparable in both groups (2.6 ± 1.2 in AT and 2.5 ± 1.3 in A, p=0.851). Corresponding number at 1 year visit was 1.2±2 in AT and 2.8±1.8 in A (p=0.001).The incidence of a hypertensive phase was 18.7% in AT and 35.5% in A (p=0.05). HP resolved in only 30% of eyes. The criteria for HP resolution were fulfilled in 9 eyes (30%). There was no difference in the rate of resolution of the hypertensive phase between AT and A (33.3% and 28.5%, respectively, p=0.67).Conclusion : Ahmed glaucoma valve implant with same session trabectome surgery significantly decreased the rate of the hypertensive phase and postoperative IOP as well as the number of glaucoma medications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of same-session trabectome surgery on Ahmed glaucoma valve outcomes

Esfandiari

Shazly

Shah

et al. 2018

Graefes Arch Clin Exp Ophthalmol

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“…Kostanyan et al [31] published a comparison study of 29 matched Baerveldt glaucoma drainage implant cases to 30 cases after ab interno trabeculectomy with the trabectome [31]. The primary outcome measures were IOP, number of glaucoma medications, and a Glaucoma Index score, which reflected glaucoma severity based on visual field, the number of preoperative medications, and preoperative IOP [31]. Success, defined as an IOP less than 21 mmHg, more than 20% reduction, and no reoperation, was achieved in 50% in the ab interno trabeculectomy with the trabectome group versus 52% in the Baerveldt glaucoma drainage implant group at 2.5 years [31].…”

Section: Ab Interno Trabeculotomy With the Trabectomementioning

confidence: 99%

Section: Ab Interno Trabeculotomy With the Trabectomementioning

confidence: 99%

“…The primary outcome measures were IOP, number of glaucoma medications, and a Glaucoma Index score, which reflected glaucoma severity based on visual field, the number of preoperative medications, and preoperative IOP [31]. Success, defined as an IOP less than 21 mmHg, more than 20% reduction, and no reoperation, was achieved in 50% in the ab interno trabeculectomy with the trabectome group versus 52% in the Baerveldt glaucoma drainage implant group at 2.5 years [31]. Both groups had similar IOP after 30 months (15 mmHg) [31].…”

Section: Ab Interno Trabeculotomy With the Trabectomementioning

confidence: 99%

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Influence of new treatment modalities on adherence in glaucoma

Meier-Gibbons

Berlin

Töteberg‐Harms

2019

Current Opinion in Ophthalmology

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PURPOSE OF REVIEW It is well known that glaucoma patients are not adherent to their therapeutic regimens. The issue of nonadherence is multifactorial and includes inadequate communication between doctors and patients, resulting in significant costs associated with enhanced disease progression. Therapeutic regimens are risk factors which often influences adherence rates. Thus, alternative treatment modalities, especially those risk factors that do not rely on patients' cooperation, may enable improvements in long-term outcomes of glaucoma in patient. RECENT FINDINGS The studies selected for this review were divided into new medications, especially advancements in pharmaceutical approaches to treat glaucoma and new ways of delivering the medication, new surgical methods, especially minimally invasive surgery methods for glaucoma, and new studies about adherence in glaucoma. SUMMARY Surprisingly, a very few studies on glaucoma medication or surgery addressed the concept of adherence. However, adherence is discussed in studies which consider psychological aspects of patients or communication issues between doctors and patients. Although these studies were performed in clinical settings, the issue of adherence is not addressed; despite it has significant effect on long-term outpatient care. A combination of both aspects, adherence and miscommunication, should be considered in studies.

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Exact matching of trabectome-mediated ab interno trabeculectomy to conventional trabeculectomy with mitomycin C followed for 2 years

Strzalkowska

Strzalkowski

Yousef

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose We used exact matching for a highly balanced comparison of ab interno trabeculectomy (AIT) with the trabectome to trabeculectomy with mitomycin C (TRAB). Methods A total of 5485 patients who underwent AIT were exact-matched to 196 TRAB patients by baseline intraocular pressure (IOP), number of glaucoma medications, and glaucoma type. Nearest-neighbor–matching was applied to age. Success was defined as a final IOP of less than 21 mmHg, IOP reduction of at least 20% reduction from baseline, and no secondary surgical interventions. Outcomes were measured at 1, 3, 6, 12, 18, and 24 months. Results A total of 165 AIT could be matched to 165 TRAB. The mean baseline IOP was 22.3 ± 5.6 mmHg, and the baseline number of glaucoma medications was 2.7 ± 1.1 in both groups. At 24 months, IOP was reduced to 15.8 ± 5.2 mmHg in AIT and 12.4 ± 4.7 mmHg in TRAB. IOP was lower than baseline at all visits (p < 0.01) and lower in TRAB than AIT (p < 0.01). Glaucoma medications were reduced to 2.1 ± 1.3 in AIT and 0.2 ± 0.8 in TRAB. Compared to baseline, patients used fewer drops postoperatively (p < 0.01) and more infrequently in TRAB than in AIT (p > 0.01). Secondary surgical interventions had the highest impact on success and became necessary in 15 AIT and 59 TRAB patients. Thirty-two challenging events occurred in TRAB and none in AIT. Conclusion Both AIT and TRAB reduced IOP and medications. This reduction was more significant in TRAB but at the expense of four times as many secondary interventions.

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Longer-term Baerveldt to Trabectome glaucoma surgery comparison using propensity score matching

Cited by 15 publications

References 30 publications

Impact of same-session trabectome surgery on Ahmed glaucoma valve outcomes

Impact of same-session trabectome surgery on Ahmed glaucoma valve outcomes

Influence of new treatment modalities on adherence in glaucoma

Exact matching of trabectome-mediated ab interno trabeculectomy to conventional trabeculectomy with mitomycin C followed for 2 years

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