Referral for first glaucoma surgery in Europe, the ReF-GS study

Holló, Gábor; Schmidl, Doreen; Hommer, Anton

doi:10.1177/1120672118791937

Cited by 11 publications

(5 citation statements)

References 15 publications

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“…Nevertheless, no significant difference in the other parameters of glaucoma severity was found in this study (PSD, visual field index, C/D). Patients referred for their first glaucoma surgery in Europe had a mean MD of − 13.8 dB, consistent with that found in our two groups [29]. The difference in MD could be explained by the surgeon's caution regarding the new PKE + XEN technique and its unfamiliar outcomes, which led to the selection of patients with a less impaired visual field to prevent the potential risk of sudden visual loss ("wipe-out").…”

Section: Discussionsupporting

confidence: 82%

Cataract and glaucoma combined surgery: XEN® gel stent versus nonpenetrating deep sclerectomy, a pilot study

et al. 2020

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Background: To compare the efficacy of phacoemulsification (PKE) combined with nonpenetrating deep sclerectomy (NPDS) with mitomycin C (MMC) versus XEN® gel stent with MMC. Methods: In this nonrandomized, retrospective, comparative, single-center pilot study, 105 consecutive eyes of 75 patients with uncontrolled primary open-angle glaucoma (POAG) and cataract who underwent PKE combined with either XEN implantation (n = 47) or NPDS (n = 58) between May 2013 and November 2018 were included. The primary outcome was complete success at 9 months, which was defined as intraocular pressure (IOP) ≤18, 15 or 12 mmHg without treatment; qualified success was IOP ≤18, 15 or 12 mmHg with antiglaucoma medications. Secondary outcome measures included the number of antiglaucoma medications, visual acuity (VA), and postoperative adverse events. Results: Using the 18 mmHg threshold, complete or qualified success was achieved in 69.6 and 89.1% in the PKE + XEN group, and 63.8 and 89.7% in the PKE + NPDS group (p = .54 and p = .93), respectively, at 9 months. The mean IOP decreased from 20.8 ± 6.8 mmHg to 16.2 ± 2.8 mmHg in the PKE + XEN group (p < .001, 18.9% mean drop), and from 21.5 ± 8.9 mmHg to 14.9 ± 3.9 mmHg in the PKE + NPDS group (p < .001, 25.6% mean drop). Best-corrected VA significantly improved (p < .001) in both groups. The mean number of antiglaucoma medications was significantly reduced from 2.66 ± 1.1 to 0.49 ± 1.0 in the PKE + XEN group (p < .001) and from 2.93 ± 0.9 to 0.69 ± 1.2 in the PKE + NPDS group (p < .001). Conclusions: The XEN stent combined with PKE seemed to be as effective and safe as PKE + NPDS at 9 months in this pilot study.

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Section: Discussionsupporting

confidence: 82%

Cataract and glaucoma combined surgery: XEN® gel stent versus nonpenetrating deep sclerectomy, a pilot study

et al. 2020

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“…The mean delay between first prescription of glaucoma eye drop and surgery was 2.3 years. This was shorter than the 7.7 years of delay found in another French study (Hollo, Schmidl & Hommer 2018); however, this short delay could be due to the study design, an open cohort, leading to an underrepresentation of individuals with long follow-up and subsequent long treatment period before surgery. Our statistical analysis using Cox model and censored data take into account various delay.…”

Section: Discussioncontrasting

confidence: 52%

Preservative‐free versus preserved glaucoma eye drops and occurrence of glaucoma surgery. A retrospective study based on the French national health insurance information system, 2008‐2016

Chamard

Larrieu

Baudouin³

et al. 2020

Acta Ophthalmologica

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Purpose: Preservatives contained in glaucoma eye drops have been shown to have a deleterious impact on the ocular surface. We aimed to assess the association between preservative exposure and the occurrence of further glaucoma surgery among patients with glaucoma or ocular hypertension in France. Methods: The study concerned all patients who first received glaucoma eye drop treatments in a French medical-administrative database (EGB) between 2008 and 2015. Three groups were created according to the level of preservative exposure during the whole follow-up: '0% preservatives', 'mixed' and '100% preservatives'. The occurrence of glaucoma surgery was estimated according to preservative exposure indicators in Cox multivariate models adjusted on age, sex, number of glaucoma eye drops simultaneously used, systemic antihypertensive treatment and duration of treatment. Results: The sample consisted of 12 454 patients. The median (interquartile range) follow-up was 4.1 (1.7-6.1) years. A total of 231 (1.9%) patients underwent glaucoma surgery during follow-up. On multivariable analysis, the risk of glaucoma surgery was increased for the 'mixed' group (hazard ratio [HR] = 3.94 [95% CI, 1.54-10.05]) and for the '100% preservative' group (HR = 7.97 [95% CI, 3.07-20.67]) when compared with the 0% preservative group. Conclusion: We found an association between exposure to glaucoma eye drop preservatives and the prevalence of further glaucoma surgery. While these data might be used to support the consideration of routine use of preservative-free drops, in the absence of a randomized clinical trial, they cannot prove a direct cause-and-effect relationship between preservative-free glaucoma eye drops and further glaucoma surgery.

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“…13,14,28 Lower mean baseline RNFLT score of our candidates indicates that patients in Hungary are assigned for glaucoma surgery at a more advanced stage of glaucomatous damage. 27 Rebolleda found RNFLT-change to be higher in patients with a preoperative RNFLT smaller than 62 µm than in patients with a preoperative RNFLT higher than 62 µm. 14 When evaluating RNFLT-changes measured with spectral-domain OCT, we must take into account the fact that the average RNFLT-reduction per year might be as high as 0.33 µm in healthy eyes whereas 0.69 µm in glaucomatous eyes being on maximal medical therapy.…”

Section: Discussionmentioning

confidence: 97%

<p>Retinal Nerve Fibre Layer Thickness Change After CO2 Laser-Assisted Deep Sclerectomy Surgery</p>

Sohajda¹,

Széll²,

Revák³

et al. 2020

OPTH

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The goal of our study was to investigate changes in intraocular pressure (IOP), best-corrected visual acuity (BCVA), and retinal nerve fibre layer thickness (RNFLT) after CO2 laser-assisted deep sclerectomy (CLASS). Methods: We carried out uncomplicated CLASS surgeries and a 12-month follow-up on 22 open-angle glaucomatous (OAG) eyes of 22 patients. IOP, BCVA, and RNFLT with spectraldomain optical coherence tomography (SD OCT) were recorded before and 1, 3, 6, 12 months after surgery. Results: Mean age of patients was 68.1 years. IOP decreased from preoperative 28.45±5.99 SD mmHg (mean±standard deviation) to 15.09±2.40 mmHg (p=0.00039) at 12 months after surgery. BCVA-change from preoperative 0.34±0.38 SD (LogMAR) to 0.37±0.41 SD (LogMAR) was not significant (p=0.2456). RNFLT-change from preoperative 60.50 ±18.15µm to 59.63±17.52 µm at 12 months postoperatively was not significant (p=0.056). Qualified success rate of CLASS surgery was 72.7%, whereas complete success rate was 64% at 1 year postoperatively. Conclusion: Successful CLASS surgery efficiently reduced IOP. At postoperative 12 months, RNFLT and BCVA were not reduced significantly. There was no significant glaucomatous progression after surgery encountered in respect of investigated parameters.

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Referral for first glaucoma surgery in Europe, the ReF-GS study

Abstract: Of 294 European open-angle glaucoma referrals for first glaucoma-surgery, 41.5% were completely satisfactory. The damage was typically advanced, and the care varied considerably among the countries. This suggests that further efforts are necessary to improve glaucoma care in Europe.

Cited by 11 publications

References 15 publications

Cataract and glaucoma combined surgery: XEN® gel stent versus nonpenetrating deep sclerectomy, a pilot study

Cataract and glaucoma combined surgery: XEN® gel stent versus nonpenetrating deep sclerectomy, a pilot study

Preservative‐free versus preserved glaucoma eye drops and occurrence of glaucoma surgery. A retrospective study based on the French national health insurance information system, 2008‐2016

<p>Retinal Nerve Fibre Layer Thickness Change After CO2 Laser-Assisted Deep Sclerectomy Surgery</p>

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