scholarly journals Minimally invasive glaucoma surgery: Comparison of iStent with iStent inject in primary open angle glaucoma

2019 ◽  
Vol 47 (7) ◽  
pp. 898-903 ◽  
Author(s):  
Joobin Hooshmand ◽  
Philip Rothschild ◽  
Penny Allen ◽  
Nathan M. Kerr ◽  
Brendan J. Vote ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Istent Inject ◽  
Minimally Invasive Glaucoma Surgery

scholarly journals Modern view of using gonioassociated trabeculotomy

2021 ◽  
pp. 77-82
Author(s):  
R.R. Fayzrakhmanov ◽  
◽  
M.E. Kalinin ◽  
M.M. Shishkin ◽  
O.A. Pavlovskiy ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Review Literature ◽  
Secondary Glaucoma ◽  
Maximum Effect ◽  
Open Angle ◽  
Minimally Invasive Glaucoma Surgery ◽  
Minimal Trauma

Purpose. Provide data on the use of gonioscopy-assisted transluminal trabeculotomy (GATT), reflecting its effectiveness and safety when using this technique in various patient models. Material and methods. To perform the review, literature sources which were searched through the PubMed and Scopus databases up to and including 2021, using the keywords "gonioassociated trabeculotomy", "minimally invasive glaucoma surgery", "primary open-angle glaucoma", "glaucoma", "secondary glaucoma". A total of 19 articles related to the topic of the review were selected. The beginning of publications on this topic dates back to 2013. Results. GATT can be used at various stages of glaucoma, but at the same time, the maximum effect of lowering intraocular pressure (IOP) is achieved in patients with an early or middle stage of glaucoma. There are also good results of using the GATT technique after vitreoretinal surgery, with the development of secondary glaucoma or ophthalmic hypertension. One of the advantages of GATT is that all manipulations are performed in the anterior chamber, which in turn makes it possible, if necessary, to perform reoperation after an unsuccessful ad-externo trabeculotomy without re-traumatizing the sclera and conjunctiva. It should be noted that the main complication in all studies is the hyphema, which is completely absorbed within a few days. Conclusion. Based on these studies, it can be concluded that the proposed GATT technique is relevant, and meets all modern standards of minimally invasive glaucoma surgery (MIGS): micro-incision, minimal trauma, is able to effectively reduce IOP, has a high level of safety and quick recovery. Key words: glaucoma, primary open-angle glaucoma, secondary glaucoma, gonioassociated trabeculotomy, minimally invasive glaucoma surgery, surgical treatment of glaucoma

scholarly journals Neuroinflammation in Primary Open-Angle Glaucoma

2020 ◽  
Vol 9 (10) ◽  
pp. 3172 ◽  
Author(s):  
Stefania Vernazza ◽  
Sara Tirendi ◽  
Anna Maria Bassi ◽  
Carlo Enrico Traverso ◽  
Sergio Claudio Saccà
Keyword(s):  
Oxidative Stress ◽  
Immune Response ◽  
Trabecular Meshwork ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Antioxidant Defences ◽  
Age Related ◽  
Wide Range

Primary open-angle glaucoma (POAG) is the second leading cause of irreversible blindness worldwide. Increasing evidence suggests oxidative damage and immune response defects are key factors contributing to glaucoma onset. Indeed, both the failure of the trabecular meshwork tissue in the conventional outflow pathway and the neuroinflammation process, which drives the neurodegeneration, seem to be linked to the age-related over-production of free radicals (i.e., mitochondrial dysfunction) and to oxidative stress-linked immunostimulatory signaling. Several previous studies have described a wide range of oxidative stress-related makers which are found in glaucomatous patients, including low levels of antioxidant defences, dysfunction/activation of glial cells, the activation of the NF-κB pathway and the up-regulation of pro-inflammatory cytokines, and so on. However, the intraocular pressure is still currently the only risk factor modifiable by medication or glaucoma surgery. This present review aims to summarize the multiple cellular processes, which promote different risk factors in glaucoma including aging, oxidative stress, trabecular meshwork defects, glial activation response, neurodegenerative insults, and the altered regulation of immune response.

scholarly journals Ab externo implantation of the MicroShunt, a poly (styrene-block-isobutylene-block-styrene) surgical device for the treatment of primary open-angle glaucoma: a review

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Omar Sadruddin ◽  
Leonard Pinchuk ◽  
Raymund Angeles ◽  
Paul Palmberg
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Operative Management ◽  
Glaucoma Drainage Device ◽  
Outer Diameter ◽  
Open Angle ◽  
Less Invasive ◽  
Randomized Clinical Study ◽  
Suture Tension

AbstractTrabeculectomy remains the ‘gold standard’ intraocular pressure (IOP)-lowering procedure for moderate-to-severe glaucoma; however, this approach is associated with the need for substantial post-operative management. Micro-invasive glaucoma surgery (MIGS) procedures aim to reduce the need for intra- and post-operative management and provide a less invasive means of lowering IOP. Generally, MIGS procedures are associated with only modest reductions in IOP and are targeted at patients with mild-to-moderate glaucoma, highlighting an unmet need for a less invasive treatment of advanced and refractory glaucoma. The PRESERFLO® MicroShunt (formerly known as InnFocus MicroShunt) is an 8.5 mm-long (outer diameter 350 μm; internal lumen diameter 70 μm) glaucoma drainage device made from a highly biocompatible, bioinert material called poly (styrene-block-isobutylene-block-styrene), or SIBS. The lumen size is sufficiently small that at normal aqueous flow hypotony is avoided, but large enough to avoid being blocked by sloughed cells or pigment. The MicroShunt achieves the desired pressure range in the eye by draining aqueous humor from the anterior chamber to a bleb formed under the conjunctiva and Tenon’s capsule. The device is implanted ab externo with intraoperative Mitomycin C via a minimally invasive (relative to incisional surgery) surgical procedure, enabling precise control of placement without the need for gonioscopy, suture tension control, or suture lysis. The implantation procedure can be performed in combination with cataract surgery or as a standalone procedure. The MicroShunt received Conformité Européenne (CE) marking in 2012 and is intended for the reduction of IOP in eyes of patients with primary open-angle glaucoma in which IOP remains uncontrolled while on maximum tolerated medical therapy and/or in which glaucoma progression warrants surgery. Three clinical studies assessing the long-term safety and efficacy of the MicroShunt have been completed; a Phase 3 multicenter, randomized clinical study comparing the MicroShunt to primary trabeculectomy is underway. In preliminary studies, the MicroShunt effectively reduced IOP and use of glaucoma medications up to 3 years after implantation, with an acceptable safety profile. This article summarizes current literature on the unique properties of the MicroShunt, the preliminary efficacy and safety findings, and discusses its potential use as an alternative to trabeculectomy for glaucoma surgery.

scholarly journals Primary Outcomes of Combined Cataract Extraction Technique with Ab-interno Trabeculectomy  and Endoscopic Cyclophotocoagulation  in Patients with Primary Open Angle Glaucoma

2020 ◽  
Author(s):  
Juan Carlos Izquierdo ◽  
Josefina Mejias ◽  
Laura Cañola ◽  
Natalia Agudelo ◽  
Barbara Rubio
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Surgical Success ◽  
Corrected Visual Acuity ◽  
Ab Interno Trabeculectomy ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

Abstract Background: Glaucoma surgery have been developed to lower intraocular pressure in a less invasive manner than traditional glaucoma surgery. The purpose of this article is to determine the outcome of using combined phacoemulsification technique, ab-interno trabeculectomy dual blade and endoscopic cyclophotocoagulation (ECP) surgeries in patients with primary open angle glaucoma. Methods: A retrospective case series was performed on 27 consecutive eyes with both primary open-angle glaucoma (POAG) and cataract; each eye was treated with combined phacoemulsification, ab-interno trabeculectomy-Kahook Dual Blade and Endocyclophotocoagulation at Instituto de ojos Oftalmosalud, Lima, Peru, between April 2017 and May 2017. Inclusion criteria: 1) Patients with uncontrolled mild to advanced POAG (according to Glaucoma Grading Scale HODAPP) 2) cataract condition 3) treatment with two or more glaucoma medications due to rapid progression in the visual fields (at least two in a short period of time). Intraocular pressure (IOP), best corrected visual acuity (BCVA) logMAR and number of glaucoma medications were recorded prior to the study, at day 1, week 1, and 1,3,6 and 9 months after surgery. Primary outcome measure was surgical success defined in terms of IOP <14 mmHg either with no medications (complete success) or with medications (qualified success). Results: A total of 27 eyes from 27 patients were included. The mean basal IOP was 17.0±3.7 mmHg and postoperatively was 11.6±1.9 mmHg and 11.4±1.8 mmHg (P<0.001) at 6 and 9 months respectively. Glaucoma medications decreased from 1.9±1.4 to 0.56±1.05 at 9 month follow-ups (P<0.001). Preoperative best corrected visual acuity (BCVA) showed and improvement from 0.4± 0.4 LogMAR to 0.2 ± 0.4 logMAR at 9 months. The main complication was blood reflux intra-operatively (66.7%), which resolved without re-operation. The mean IOP was reduced by 32.9% from baseline and the surgical success was 92,6%, (complete success 70,3% and qualified success 29,6%) at 9 months.Conclusions: In patients with POAG, combined treatment with phacoemulsification, ab-interno trabeculectomy and endoscopic cyclophotocoagulation effectively reduced IOP and glaucoma medication dependence.

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