Supraciliary versus intrascleral implantation with hema implant (Esnoper V‐2000) in deep sclerectomy: a multicenter randomized controlled trial

Belda, José I; Loscos-Arenas, Jordi; Mermoud, André; Lozano, Ester; D’Alessandro, Elisa; Rebolleda, Gema; Rodríguez-Agirretxe, Iñaki; Canut, Maribel; Rodríguez-Calvo, Pedro Pablo

doi:10.1111/aos.13749

Cited by 5 publications

(10 citation statements)

References 20 publications

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“…The relative reductions in IOP and treatments observed in the present study are similar to that reported in prospective studies of DS. 19,20,21 In this study, the only significant difference between first-operated eyes and second-operated eyes was the mean baseline BCVA (p = 0. 045).…”

Section: Discussionmentioning

confidence: 58%

“…The relative reductions in IOP and treatments observed in the present study are similar to those reported in prospective studies of DS. [19][20][21] In this study, the only significant difference between first-operated and second-operated eyes was the mean baseline BCVA (P = 0.045). Such a difference had already been described in several studies comparing the outcomes of trabeculectomies in fellow eyes, 10,11 and can be accounted for by the fact that eyes with more advanced glaucoma are usually operated on first, thus leading to poorer central vision in this group.…”

Section: Discussionmentioning

confidence: 58%

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Bilateral Nonpenetrating Deep Sclerectomy: Difference in Outcomes Between First- and Second-Operated Eyes at 24 Months

Gillmann¹,

Meduri²,

Paillard³

et al. 2021

Journal of Glaucoma

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Background/AimsThe purpose of this study was to assess the difference in outcome between the first-operated eye and the second-operated eye following non-penetrating deep sclerectomy (DS), and to identify potential success predictors for the second eye. MethodsThis single-surgeon, retrospective study analyzed the outcomes of all bilateral nonsimultaneous DS with at least 24 months of follow-up. Its main outcome measure was surgical success, defined as unmedicated intraocular pressure (IOP) ≤ 15 mmHg associated with a relative reduction ≥20%. ResultsIn all, 104 eyes of 52 patients who underwent bilateral (standalone or combined) DS, within a mean of 344.3 ± 526.3 days of each other, were analysed. Post-operatively, mean medicated IOP decreased from 20.7 ± 7.9 (first-operated) and 19.3 ± 6.6 mmHg (second) at baseline (p = 0.107) to 13.8 ± 4.8 ([-33.3%; p < 0.001] first-operated eyes) and 12.7 ± 3.8 mmHg ([-34.2%; p < 0.001] second eyes) after 2 years (p = 0.619). Post-operative IOP and treatments reduction respectively showed fair (r = 0.53) and good (r = 0.71) levels of correlation between fellow eyes. Rates of complete success were comparable between first-operated and second-operated eyes (32.7% and 40.4%, respectively; p = 0.364). At 2 years, among patients whose firstoperated eyes were considered a success, 82.4% of surgeries in second eyes were successful (p=0.001). The odd ratio of a second-operated eye experiencing complete success were 6.32 (p = 0.011) if the first operated eye experienced complete success. ConclusionThe present study demonstrated a strong association between first-operated eyes and secondoperated eyes following DS, in terms of surgical outcomes and IOP reduction. In effect, surgical success in the first-operated eye increases the odds of success in the second eye by 6 folds.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 58%

Bilateral Nonpenetrating Deep Sclerectomy: Difference in Outcomes Between First- and Second-Operated Eyes at 24 Months

Gillmann¹,

Meduri²,

Paillard³

et al. 2021

Journal of Glaucoma

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“…Among the first nonabsorbable drainage devices marketed were the rigid implant Homdec (Homdec SA) made of polymethyl methacrylate and the highly hydrophilic, flexible acrylic implant T-flux (IOLTECH Laboratoires) 19,21–24. Another implant that belongs to the new generation of nonabsorbable devices is the Esnoper V2000 (AJL Ophthalmic) which is made of 2-hydroxyethyl methacrylate (HEMA) 25,35,36. The Esnoper V2000 represents the second generation of this model and has been improved with internal channels to facilitate aqueous humor flow through the device and also with lateral notches for nonsuture supraciliary placement 35.…”

mentioning

confidence: 99%

“…19,[21][22][23][24] Another implant that belongs to the new generation of nonabsorbable devices is the Esnoper V2000 (AJL Ophthalmic) which is made of 2-hydroxyethyl methacrylate (HEMA). 25,35,36 The Esnoper V2000 represents the second generation of this model and has been improved with internal channels to facilitate aqueous humor flow through the device and also with lateral notches for nonsuture supraciliary placement. 35 A related nonabsorbable drainage device specially designed for supraciliary implantation is the foldable HEMA implant Esnoper Clip (AJL Ophthalmic).…”

mentioning

confidence: 99%

“… 25 , 35 , 36 The Esnoper V2000 represents the second generation of this model and has been improved with internal channels to facilitate aqueous humor flow through the device and also with lateral notches for nonsuture supraciliary placement. 35 A related nonabsorbable drainage device specially designed for supraciliary implantation is the foldable HEMA implant Esnoper Clip (AJL Ophthalmic). It was first implanted by Dr Loscos-Arenas at the Hospital Germans Trias i Pujol, Barcelona, Spain in 2011.…”

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confidence: 99%

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Efficacy and Safety of Deep Sclerectomy With the Esnoper Clip Implant for Uncontrolled Primary Open Angle Glaucoma: A 1 Year Prospective Study

Baxant

Klimesova

Holubová

et al. 2022

Journal of Glaucoma

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Précis: Deep sclerectomy (DS) with the Esnoper Clip drainage implant in patients with uncontrolled primary open angle glaucoma (POAG) achieved a complete success rate of 87.2% at the 1-year follow-up.Purpose: To investigate the efficacy and safety of DS followed by Esnoper Clip implantation in patients with uncontrolled POAG. Materials and Methods:In a prospective, consecutive, interventional study, we investigated 39 eyes of 35 patients with uncontrolled POAG who underwent DS with Esnoper Clip implantation. Complete ophthalmologic examinations including corrected visual acuity and intraocular pressure (IOP), were performed preoperatively, and at 1 day, at 1 week as well as at 1, 3, 6, 9, and 12 months postoperatively. Moreover, any goniopunctures and glaucoma medications required postoperatively were noted. Results:The mean preoperative IOP was 20.8 ± 5.2 mm Hg and it decreased to 13.9 ± 3.1 mm Hg at 1 year postoperatively (P < 0.001). The number of glaucoma medications decreased from 2.9 ± 0.7 preoperatively to 0.3 ± 0.8 after 1 year (P < 0.001). The complete success rate (IOP ≤ 21 mm Hg without glaucoma medication) and the qualified success rate (IOP ≤ 21 mm Hg with or without glaucoma medication) were 87.2% and 94.9%, respectively. Goniopuncture was performed in 33.3% of cases. No significant corrected visual acuity changes were registered at the final follow-up. Perioperative complications consisted of 3 micro-perforations of the trabeculo-descemet membrane. Postoperative complications included: hyphema (6 eyes), hypotony (6 eyes), shallow anterior chamber (3 eyes), choroidal detachment (4 eyes)-all of which were resolved without surgical intervention during the first postoperative month-and conjunctival dehiscence, which required resuture (2 eyes). Conclusion:Deep sclerectomy with the Esnoper Clip implant was safe and effectively lowered IOP in patients with uncontrolled POAG.

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Biomaterials for Glaucoma Surgery

Ramachandran,

Court,

et al. 2023

Curr Ophthalmol Rep

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Supraciliary versus intrascleral implantation with hema implant (Esnoper V‐2000) in deep sclerectomy: a multicenter randomized controlled trial

Cited by 5 publications

References 20 publications

Bilateral Nonpenetrating Deep Sclerectomy: Difference in Outcomes Between First- and Second-Operated Eyes at 24 Months

Bilateral Nonpenetrating Deep Sclerectomy: Difference in Outcomes Between First- and Second-Operated Eyes at 24 Months

Efficacy and Safety of Deep Sclerectomy With the Esnoper Clip Implant for Uncontrolled Primary Open Angle Glaucoma: A 1 Year Prospective Study

Biomaterials for Glaucoma Surgery

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