Trabeculectomy ab interno with the Trabectome® as a therapeutic option for uveitic secondary glaucoma

Anton, Alexandra; Heinzelmann, Sonja; Neß, Thomas; Lübke, Jan; Neuburger, M.; Jordan, Jens; Wecker, Thomas

doi:10.1007/s00417-015-3102-3

Cited by 39 publications

(30 citation statements)

References 38 publications

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“…12 This study found similar results to ours, patients presented with elevated IOP at presentation 31 ± 6.7 mmHg and had a 40% lowering of IOP on average. 12 This study found similar results to ours, patients presented with elevated IOP at presentation 31 ± 6.7 mmHg and had a 40% lowering of IOP on average.…”

Section: Discussionsupporting

confidence: 91%

Clinical results of ab interno trabeculotomy using the trabectome in patients with uveitic glaucoma

Swamy

Francis

Akıl

et al. 2019

Clinical Exper Ophthalmology

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Importance: To evaluate the safety and efficacy of ab interno trabeculotomy (AIT) (trabecular ablation) with the trabectome in patients with uveitic glaucoma. Background: Traditional glaucoma filtration surgeries in the uveitic patient population come with a higher risk of complications such as failure and hypotony. Design: Retrospective observational cohort study.Participants: All patients diagnosed with uveitic glaucoma were included in this study. Patients were excluded if they have less than 12 months of follow-up. Methods: All patients who received AIT alone or combined with phacoemulsification. Main Outcome Measures: Major outcomes include intraocular pressure (IOP), number of glaucoma medications and secondary glaucoma surgery, if any. Kaplan-Meier method was used for survival analysis and success was defined as IOP ≤21 mmHg, at least 20% IOP reduction from baseline for any two consecutive visits after 3 months, no additional glaucoma medications, and no secondary glaucoma surgery. Results: A total of 45 eyes, 45 patients, with an average age of 52 years were included in the study. The majority were Japanese (40%) and underwent AIT alone (71%). IOP was reduced from 29.2 ± 8.0 to 16.7 ± 4.6 mmHg at 12 months (P < .01*), while the number of glaucoma medications was reduced from 4.0 ± 1.0 to 2.5 ± 1.6 (P < .01*). Survival rate at 12 months was 91%. Six cases required secondary glaucoma surgery and no other serious complication were reported. Conclusions and Relevance: The trabectome AIT procedure appears to be effective in reducing IOP in uveitic glaucoma patients. Although no statistically significant difference was found in the number of glaucoma medications, a decreasing trend was found. K E Y W O R D Sab interno trabeculotomy, glaucoma treatment, trabectome, uveitis

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Section: Discussionsupporting

confidence: 91%

Clinical results of ab interno trabeculotomy using the trabectome in patients with uveitic glaucoma

Swamy

Francis

Akıl

et al. 2019

Clinical Exper Ophthalmology

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“…Notably, these serious complications have not been reported after XEN‐45 implantation in eyes with primary open angle glaucoma . In comparison, ab interno trabeculectomy with the Trabectome was found to be effective for the treatment of uveitic glaucoma but was not associated with persistent hypotony or ocular infections . In our study, there was a high rate of transient postoperative hypotony associated with a shallow anterior chamber, with approximately 20% of patients requiring anterior chamber reformation with viscoelastic.…”

Section: Discussionmentioning

confidence: 51%

XEN‐45 collagen implant for the treatment of uveitic glaucoma

Sng

Wang

Hau

et al. 2017

Clinical Exper Ophthalmology

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“…It is one of the most difficult forms of glaucoma to manage, because the ophthalmologist must simultaneously address inflammation and elevated IOP. Among the current surgical treatment options are trabeculectomy, deep sclerectomy, minimally invasive glaucoma surgery (MIGS; e.g., trabectome), cyclodestructive procedures, and several types of glaucoma drainage devices (GDD), with comparable efficacy [5–7]. However, the long-term role of trabeculectomy in patients with uveitis is compromised by young age, inflammation-induced fibrosis and conjunctival scarring, and scleral thinning, making trabeculectomy in many cases not the optimal choice.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of glaucoma drainage devices in uveitic glaucoma and a meta-analysis of the literature

Ramdas

Pals

Rothová

et al. 2018

Graefes Arch Clin Exp Ophthalmol

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PurposeTo assess the efficacy of glaucoma drainage devices (GDD) in uveitic glaucoma and non-uveitic glaucoma, and to perform a meta-analysis of previously published results to compare with our data.MethodsRetrospective case-control study, in which all eyes that underwent GDD surgery were included from 2015 onwards. Cases were defined as patients with uveitic glaucoma. Patients with non-uveitic glaucoma served as controls. To compare our results, a review of the literature was performed using PubMed database.ResultsA total of 99 eyes were included (38 with uveitic glaucoma). The preoperative IOP was 25.9 ± 7.7 mmHg and 27.9 ± 9.6 mmHg for patients with and without uveitis (p = 0.277). No significant differences were found between patients with and without uveitis in the final IOP or reduction in IOP (44.9% vs. 42.8%, respectively). Within the first year after surgery, 13.2% of cases developed macular edema (vs. 6.6%; p = 0.267) and 15.8% a transient hypotony (vs. 8.2%; p = 0.242). A meta-analysis of 24 studies showed a postoperative weighted mean difference of − 17.8 mmHg and 2.2 lower number of IOP-lowering medications in uveitic glaucoma (compared to − 13.2 mmHg and 3.5 in the current study, respectively).ConclusionGDD surgery in patients with uveitis has a similar effect on IOP as in patients without uveitis. The risks of developing macular edema and hypotony were slightly higher in patients with uveitis, but the results were not statistically significant. These findings are in line with previous reports, though data on the efficacy of GDD surgery and macular edema in uveitic glaucoma is scarce.Electronic supplementary materialThe online version of this article (10.1007/s00417-018-4156-9) contains supplementary material, which is available to authorized users.

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Trabeculectomy ab interno with the Trabectome® as a therapeutic option for uveitic secondary glaucoma

Abstract: Trabeculectomy ab interno with the Trabectome® is a minimally invasive and effective method for controlling IOP in uveitic secondary glaucoma.

Cited by 39 publications

References 38 publications

Clinical results of ab interno trabeculotomy using the trabectome in patients with uveitic glaucoma

Clinical results of ab interno trabeculotomy using the trabectome in patients with uveitic glaucoma

XEN‐45 collagen implant for the treatment of uveitic glaucoma

Efficacy of glaucoma drainage devices in uveitic glaucoma and a meta-analysis of the literature

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