Non-penetrating filtration surgery versus trabeculectomy for open-angle glaucoma

Eldaly, Mohamed A.; Bunce, Catey; ELSHEIKHA, OLA ZAKARIA; Wormald, Richard

doi:10.1002/14651858.cd007059.pub2

Cited by 66 publications

(32 citation statements)

References 35 publications

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“…However, it should be mentioned that it might be hard to draw a comparison from previous studies, as the criteria for success are frequently different and, as the patients treated are in some of the studies performed with the diode laser cyclophotocoagulation, most have secondary and refractory glaucoma (Kaplowitz et al 2014). Similarly, systematic review or meta-analysis has described the ability of the filtering surgeries -particularly the trabeculectomy -to decrease IOP (Eldaly et al 2014;Zhou et al 2014). Even if for the same reasons it may be hard to draw a comparison with other studies conducted in different patients, the efficacy of the trabeculectomy, both evaluated using the absolute IOP reduction, the relative IOP reduction, the proportion of patients with surgical success or the reduction in number of medical hypotensive treatment, seems to be higher that the efficacy of the ultrasonic cyclocoagulation.…”

Section: Retreatmentmentioning

confidence: 99%

Multicenter clinical trial of high‐intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery

Aptel

Denis

Rouland

et al. 2015

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate the efficacy and safety of the ultrasonic circular cyclocoagulation procedure in patients with open-angle glaucoma na€ ıve of previous filtering surgery. Methods: Prospective non-comparative interventional clinical study conducted in five French University Hospitals. Thirty eyes of 30 patients with open-angle glaucoma, intra-ocular pressure (IOP) > 21 mmHg and with no previous filtering glaucoma surgeries were sonicated with a probe comprising six piezoelectric transducers. The six transducers were activated with a 6-s exposure time. Complete ophthalmic examinations were performed before the procedure and at 1 day, 1 week, 1, 2, 3, 6 and 12 months after the procedure. Primary outcomes were qualified surgical success (defined as IOP reduction from baseline ≥20% and IOP > 5 mmHg with possible re-intervention and without hypotensive medication adjunction) and complete surgical success (defined as IOP reduction from baseline ≥20%, IOP > 5 mmHg and IOP < 21 mmHg with possible re-intervention and without hypotensive medication adjunction) at the last follow-up visit and vision-threatening complications. Secondary outcomes were mean IOP at each follow-up visit compared with baseline, medication use, complications and re-interventions. Results: Intra-ocular pressure was significantly reduced (p < 0.05) from a mean pre-operative value of 28.2 AE 7.2 mmHg (n = 3.6 hypotensive medications) to 19.6 AE 7.9 mmHg at 12 months (n = 3.1 hypotensive medications and n = 1.1 procedures) (mean IOP reduction of 30%). Qualified success was achieved in 63% of eyes (19/30) (mean IOP reduction of 37% in these eyes) and complete success in 46.7% of eyes (14/30) (mean IOP reduction of 37% in these eyes) at the last follow-up. No major intra-or post-operative complications occurred. Conclusions: The UC 3 procedure seems to be an effective and well-tolerated method to reduce IOP in patients with open-angle glaucoma without previous filtering surgery.

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Section: Retreatmentmentioning

confidence: 99%

Multicenter clinical trial of high‐intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery

Aptel

Denis

Rouland

et al. 2015

Acta Ophthalmologica

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“…In contrast to trabeculectomy, it enhances aqueous humor outflow acting on the major resistance site without entering the anterior chamber, thus reducing the incidence of intra and postoperative overfiltration, hypotony and its potential sequelae. 1 - 8 Moreover, the incidence of cataract, 8 - 10 hyphema, 5 endothelial damage 11 and macular edema is lower 5 with DS. Although it is widely accepted that the DS is safer, remains some controversy about the intraocular pressure (IOP)-lowering effects.…”

Section: Introductionmentioning

confidence: 99%

Anterior Segment Optical Coherence Tomography Imaging of Filtering Blebs after Deep Sclerectomy with Esnoper-Clip Implant: One-year Follow-up

Vieira¹,

Noronha²,

Lemos³

et al. 2014

Journal of Current Glaucoma Practice

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Purpose: To describe the technique of deep sclerectomy with the new Esnoper-Clip® implant, the clinical outcome and the anatomic characteristics of filtering blebs, using anterior segment optical coherence tomography (AS-OCT).Methods: A prospective case-series study was conducted in five eyes (5 patients) with open angle glaucoma. The fornix-based deep sclerectomy with Esnoper-Clip® implant was done by the same surgeon. In one case, mitomycin C was used during surgery. All participants underwent a complete ophthalmic examination and AS-OCT (Visante®) preoperatively, then at each follow-up visit, at 1 day, 1 week, 1 month, 6 months and 1 year postoperatively. Scans were obtained through sagittal and transversal plans to the implant.Results: Intraocular pressure (IOP) was significantly reduced (p < 0.05) from a mean preoperative value of 23.4 ± 8.6 mm Hg (n = 3.8 glaucoma medications) to a postoperative value of 6.0 ± 2.5 (n = 0), 10.6 ± 5.4 (n = 0), 13 ± 1.6 (n = 0.4), 12.4 ± 2.1 (n = 0.2) and 14.4 ± 1.5 (n = 0.2) at 1 day, 1 week, 1 month, 6 months and 1 year respectively. AS-OCT allowed the visualization of the two plates of the implant (scleral and suprasciliary), the trabeculodescemetic membrane and the hyporeflective spaces in the bleb wall thickness and in suprascleral and suprachoroidal localizations. An immediate postoperative hypotony and an anteriorization of the implant associated to trabeculodescemetic membrane rupture, were detected, although without significant clinical repercussions.Conclusion: Our first five deep sclerectomy with Esnoper-Clip implantation analysis suggest an effective and well-tolerated method to reduce IOP. AS-OCT is a noninvasive imaging technique that allows the anatomic analysis of the drainage mechanisms after glaucoma surgery.How to cite this article: Vieira L, Noronha M, Lemos V, Reina M, Gomes T. Anterior Segment Optical Coherence Tomography Imaging of Filtering Blebs after Deep Sclerectomy with Esnoper-Clip Implant: One-year Follow-up. J Curr Glaucoma Pract 2014;8(3):91-95.

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“…Emiatt minden olyan intra-és posztoperatív szövőd-mény, amely ezek jelenléte miatt alakul ki, itt nem tapasztalható. Így ilyen műtétek során a trabeculectomiá-hoz viszonyítva lényegesen kisebb mértékben kell számolnunk túlzott filtráció, tartós hypotonia, chorioidealeválás, fokozódó cataractaképződés, tartós hyphaema, valamint progresszív látótérkiesés kialakulásával [11,12]. Habár a mélysclerectomiával elérhető szemnyomás-csökkenés mértéke hosszú távon nem haladja meg a trabeculectomiával elérhető mértéket, azonban a műtét az előbbiek alapján a modern glaucomasebészetben kiemelt jelentőséggel bír [13,14].…”

Section: Következtetésekunclassified

CO₂-lézerrel végzett mélysclerectomiával szerzett tapasztalatok

Sohajda¹,

Káldi²,

Facskó

2017

Orvosi Hetilap

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Bevezetés: A CO 2 -lézeres mélysclerectomia (CLASS) a nyitott zugú glaucomás betegek sebészi kezelésében alkalmazható. Célkitűzés: A CLASS-műtéttel szerzett tapasztalataink ismertetése. Módszer: 21 CLASS-műtétet végeztünk OT-134-IOPtiMate (IOPtima Ltd, Ramat-Gan, Izrael) készülékkel. A betegeket a posztoperatív első napon, majd 1, 3, 6, 9 és 12 hónap múlva kontrolláltuk. Retrospektíven értékeltük a szemnyomás, antiglaucomás terápia és a visus alakulását, az intra-és posztoperatív szövődményeket. Eredmények: Az átlagéletkor 65,6 év volt. A teljes siker (szemcsepp nélkül elért célszemnyomás) a hatodik hónapra (18 beteg) 61,1%, míg a 12. hónapnál (10 beteg) 50% volt. A minősített siker (szemcseppel elért célszemnyomás) 72,2% és 70%, a preoperatív átlagos 29,2 ± 9,4 Hgmm-es szemnyomás rendre 17,7 ± 4,9 Hgmm és 17,3 ± 4,3 Hgmm volt. Jelentősen csökkent az antiglaucomás cseppek átlagos száma: 2,90 ± 0,83-ról 2,05 ± 1,46 értékre. Egy makroperforáción túl a műtét eredményességét befolyásoló egyéb lényeges szövődmény nem volt. Következtetések: CLASS-műtéttel tapasztalataink szerint hatékonyan csökkent-hető a szemnyomás nyitott zugú glaucomában. Orv Hetil. 2017; 158(18): 701-705. Kulcsszavak: CLASS, nyitott zugú glaucoma Experiences with CO 2 laser-assisted sclerectomy surgeryIntroduction: CO 2 laser-assisted sclerectomy surgery (CLASS) can be used for the surgical treatment of open-angle glaucoma. Aim: To introduce our results with CLASS. Method: We performed 21 CLASS operations using OT-134-IOPtiMate (IOPtima Ltd, Ramat-Gan, Israel). Patients were examined on the 1st day, and in the 1st, 3rd, 6th, 9th and 12th months postoperatively. We evaluated intraocular pressure (IOP), antiglaucomatous medication-use, visual acuity, complications. Results: Mean age was 65.6 yrs. Complete success (no hypotensive medication required to target IOP) was achieved in 61.1% (18 patients) at 6 months, whereas in 50% (10 patients) at 12 months. Qualified success (hypotensive medication required to target IOP) was achieved in 72.2% and in 70%, preoperative mean IOP was 29.2 ± 9.4 Hgmm, which falled to 17.7 ± 4.9 Hgmm and 17.3 ± 4.3 Hgmm, respectively. Antiglaucomatous medication use falled significantly from 2.90 ± 0.83 to 2.05 ± 1.46. Apart from 1 macroperforation, no serious complication occurred. Conclusions: With CLASS it is possible to effectively lower intraocular pressure in open-angle glaucoma.

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Non-penetrating filtration surgery versus trabeculectomy for open-angle glaucoma

Cited by 66 publications

References 35 publications

Multicenter clinical trial of high‐intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery

Multicenter clinical trial of high‐intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery

Anterior Segment Optical Coherence Tomography Imaging of Filtering Blebs after Deep Sclerectomy with Esnoper-Clip Implant: One-year Follow-up

CO₂-lézerrel végzett mélysclerectomiával szerzett tapasztalatok

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Non-penetrating filtration surgery versus trabeculectomy for open-angle glaucoma

Cited by 66 publications

References 35 publications

Multicenter clinical trial of high‐intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery

Multicenter clinical trial of high‐intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery

Anterior Segment Optical Coherence Tomography Imaging of Filtering Blebs after Deep Sclerectomy with Esnoper-Clip Implant: One-year Follow-up

CO2-lézerrel végzett mélysclerectomiával szerzett tapasztalatok

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CO₂-lézerrel végzett mélysclerectomiával szerzett tapasztalatok