Risk Factors and Long-Term Outcomes in Patients with Low Intraocular Pressure after Trabeculectomy

Tseng, Victoria L.; Kim, Carole H; Romero, Pablo; Yu, Fei; Robertson-Brown, Kenneth W; Phung, Lam; Raygoza, Daniel; Caprioli, Joseph; Coleman, Anne L.

doi:10.1016/j.ophtha.2017.05.014

Cited by 41 publications

(28 citation statements)

References 14 publications

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“…Medications and laser or incisional surgeries are conventional methods for reducing IOP. Trabeculectomy is the most common incisional surgical procedure, commonly performed in patients with medically uncontrolled glaucoma [ 4 , 5 ]. However, postoperative fibrosis that most commonly occurs at the episclera leading to bleb failure months or years after filtering glaucoma surgery has limited the success rate of the treatment [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and Safety of Trabeculectomy along with Amniotic Membrane Transplantation on Glaucoma: A Systematic Review

Shen

Cai

et al. 2020

Journal of Ophthalmology

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Purpose. To determine the effectiveness and safety of trabeculectomy along with amniotic membrane transplantation (AMT) for glaucoma. Methods. This systematic review was performed using RevMan 5.3. We searched PubMed, EMBASE, and the Cochrane Library and included studies published until September 2019. The treatment group included patients with AMT and trabeculectomy (group A), and the control group had only trabeculectomy (group B). We only included randomized controlled trials. The outcomes were intraocular pressure (IOP), complete success rate, number of antiglaucoma medications, and complications. Results. Five studies, including 174 eyes (87 eyes in the AMT group and 87 eyes in the control group), were eligible in this review. The parameters had no significant difference in heterogeneity between the AMT and control groups preoperatively. In the AMT group, the mean IOP was significantly lower at 3 and 12 months after operation (P < 0.0001 and P = 0.02, respectively), while the number of complete successes in the AMT group was significantly higher at 6 and 12 months (P = 0.02 and P = 0.003, respectively) compared with the control group. Complications, including a flat anterior chamber and hyphema, appeared to be decreased in the AMT group compared to the control group (P = 0.02 and P = 0.02, respectively). No differences were observed in the number of antiglaucoma medications, hypotony, encapsulated bleb, or choroidal detachment. Conclusion. Compared with only trabeculectomy, it is more efficient and safer to add AMT to trabeculectomy during glaucoma filtering surgery.

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Section: Introductionmentioning

confidence: 99%

Effectiveness and Safety of Trabeculectomy along with Amniotic Membrane Transplantation on Glaucoma: A Systematic Review

Shen

Cai

et al. 2020

Journal of Ophthalmology

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“…SCPT, as a conventional filtering surgery, have some unavoidable early complications such as postoperative anterior chamber inflammation [21] , bleb leaks [22] , intraocular hypotony [23] , and choroidal effusion etc [24] all may threaten the VA. In the current study, both surgery procedures had similar effects on the improvement of postoperative VA, even though the postoperative complications were different between them.…”

Section: Discussionmentioning

confidence: 99%

Scleral Concave Pool Trabeculectomy Combined Phacoemulsification in Primary Open-Angle Glaucoma with Cataract.

Deng

et al. 2020

Preprint

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Background: To investigate the safety and efficacy of scleral concave pool trabeculectomy (SCPT) combined phacoemulsification for eyes with coexisting cataract and primary open-angle glaucoma (POAG).Methods: This was a retrospective, controlled, interventional case series. Thirty patients (30 eyes) were diagnosed with coexisting cataract and POAG between May 2015 and April 2018. Fourteen eyes underwent SCPT combined phacoemulsification were set as the study group, and 16 eyes received conventional phacotrabeculectomy were set as the control group. All patients were followed up for at least 6 months. The preoperative to postoperative changes in IOP, glaucoma medication requirements, BCVA, blebs functions, and adverse events were recorded. Results: The groups were matched for baseline age, BCVA, IOP and types of IOP-lowering medications (all P>0.05). At 6-month visit, there were no significant difference between control and study group in the improvement of BCVA (0.22±0.24 versus 0.18±0.26, P=0.718), reduction of IOP (-11.21±8.61mmHg versus -9.19±9.18mmHg, P=0.540) and the number of eyes that needed IOP-lowering medications (2 versus 3, P=0.743). At the last visit, the rate of forming functioning blebs was significantly different between the study and control groups, (92.9% versus 68.7% respectively, P=0.007). In the study group, 5 eyes developed hypotony，and 1 eye showed limited choroidal detachment, whereas in the control group 1 eye developed malignant glaucoma. All adverse events were successfully managed. Conclusion: The SCPT combined phacoemulsification is a safe and effective alternative to conventional phacotrabeculectomy for patients with POAG and visually significant cataract.

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“…37 Laser suture lysis is necessary for lowering IOP, but we need to take care not to cause hypotony. 38,39 In fact, the timing of laser suture lysis varies depending on each case.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Early Postoperative Intraocular Pressure for Success after Ex-Press Surgery

Tojo

Hayashi

Otsuka

2019

Journal of Current Glaucoma Practice

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AimThe aim of this study is to identify target levels of early postoperative intraocular pressure (IOP) associated with successful trabeculectomy using an Ex-Press glaucoma shunt.Materials and methodsThis was a retrospective single-facility study. We enrolled 158 glaucoma patients who underwent trabeculectomy with Ex-Press and were followed for >1 year, and investigated risk factors for the failure of Ex-Press surgery. We examined age, sex, central corneal thickness (CCT), number of preoperative glaucoma medications, simultaneous performance of cataract surgery, history of trabeculotomy, hypertension (HT), diabetes mellitus (DM), subtype of glaucoma, and early postoperative IOP (minimum, 2 weeks, 1 month, and 3 months).ResultsEx-Press surgery could significantly decrease IOP. Success rates at 1, 2, 3, and 4 years were 91.1, 86.1, 82.5, and 78.1%, respectively. Factors significantly affecting the success rate included age, the number of preoperative glaucoma medications, and early postoperative IOP. The IOP cutoff values of minimum IOP for the success of Ex-Press surgery was 5 mm Hg.ConclusionsYounger age, a high number of preoperative glaucoma medications, and high IOPs in the early postoperative period were found to be the risk factors for failure of Ex-Press surgery. Considering hypotonic complications, it is desirable to control the minimum IOP from 3–5 mm Hg within 2 weeks after surgery. According to our calculations, target IOPs at 2 weeks, 1 month, and 3 months after Ex-Press surgery should be 8 mm Hg, 10 mm Hg, and 14 mm Hg, respectively.Clinical significanceWe thought that Ex-Press surgery might require lower IOP in the early postoperative period than conventional trabeculectomy.How to cite this articleTojo N, Hayashi A, et al. Evaluation of Early Postoperative Intraocular Pressure for Success after Ex-Press Surgery. J Curr Glaucoma Pract 2019;13(2):55–61.

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Risk Factors and Long-Term Outcomes in Patients with Low Intraocular Pressure after Trabeculectomy

Cited by 41 publications

References 14 publications

Effectiveness and Safety of Trabeculectomy along with Amniotic Membrane Transplantation on Glaucoma: A Systematic Review

Effectiveness and Safety of Trabeculectomy along with Amniotic Membrane Transplantation on Glaucoma: A Systematic Review

Scleral Concave Pool Trabeculectomy Combined Phacoemulsification in Primary Open-Angle Glaucoma with Cataract.

Evaluation of Early Postoperative Intraocular Pressure for Success after Ex-Press Surgery

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