scholarly journals Changes in Flow Density Measured Using Optical Coherence Tomography Angiography after iStent Insertion in Combination with Phacoemulsification in Patients with Open-Angle Glaucoma

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Maged Alnawaiseh ◽  
Viktoria Müller ◽  
Larissa Lahme ◽  
Ralph Laurent Merté ◽  
Nicole Eter
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Flow Density ◽  
En Face ◽  
Before And After ◽  
Quantitative Analyses ◽  
The Mean ◽  
Therapy Success

Purpose. To evaluate changes in flow density after the implantation of a trabecular microbypass stent (iStent) in combination with cataract surgery. Methods. A total of 48 eyes of 48 patients, who underwent either cataract surgery alone (cataract group) or cataract surgery with implantation of two iStent inject devices (iStent group), were prospectively included in this study. Intraocular pressure (IOP) and flow density data before and after surgery were extracted and analyzed. Results. In the iStent group, the mean IOP was 18.2 ± 3.3 mmHg prior to surgery and 13.2 ± 2.3 at follow-up, and this difference was statistically significant (p<0.001). The mean IOP in the cataract group also improved significantly after surgery (before: 17.1 ± 2.4; after: 15.1 ± 2.7 p=0.003). The flow density (whole en face) in the superficial and deep retinal OCT angiogram of the macula (superficial: p=0.002; deep: p=0.034) and in the ONH (p=0.011) improved significantly after surgery in the iStent group. The differences in the cataract group were not significant. Conclusions. Flow density of the macula and ONH, as measured by OCTA, improved significantly after cataract surgery with iStent. Noninvasive quantitative analyses of flow density provide a new parameter, which can help for the monitoring of therapy success after glaucoma surgery.

scholarly journals CENTRAL MACULAR THICKNESS AFTER CATARACT SURGERY IN NON-DIABETICS AND DIABETICS WITHOUT RETINOPATHY

2021 ◽  
Vol 71 (6) ◽  
pp. 1993-96
Author(s):  
Marrium Shafi ◽  
Muhammad Akmal Khan ◽  
Yaseen Lodhi ◽  
Asma Aftab ◽  
Muhammad Haroon Sarfraz
Keyword(s):  
Cataract Surgery ◽  
Thickness Measurement ◽  
Case Control ◽  
Macular Thickness ◽  
P Value ◽  
Central Macular Thickness ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Objective: To determine the mean change in central macular thickness after cataract surgery and to compare the mean change in central macular thickness after cataract surgery in non-diabetics and diabetics without diabetic retinopathy Study design: Case control   Study settings and duration: A case control study was carried out at Ophthalmology department, POF hospital, Wah Cantt. Study duration was 6 months (April 2019-September 2019)   Material and methods: A sample size of 60 patients was calculated by using Open Epi Software. We used non probability consecutive sampling. Patients were divided into two groups; Cases (Diabetic) and controls (non-Diabetic). All patients underwent phacoemulsification and observed after 4 weeks for macular thickness measurement using optical coherence tomography before and after surgery. Data analysis was done with SPSS version 20. Post stratification t test was applied. P value ≤0.05 was considered significant.   Results: Total 60 patients were included. Mean age of patients was 65.31 ±7. 63SD.There were 35 (58.3%) males and 25 (41.7%) female patients in the study. We found a significant increase in central macular thickness in cases and controls [(223.100±15.86SD vs 227.2667±17.9SD, p=0.000) and (221.200±12.16SD vs 226.289±16.7861SD, p =0.001)] before and after phacoemulsification in cases and controls respectively. However, no significant difference was found between the groups (p=0.486).   Conclusion: Central macular thickness was increased after uncomplicated phacoemulsification in both diabetics and non-diabetics without retinopathy for up to a follow-up period of 4 weeks but the thickness did not differ between the two groups.

scholarly journals A Comparison of Endothelial Cell Loss in Combined Cataract and MIGS (Hydrus) Procedure to Phacoemulsification Alone: 6-Month Results

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Antonio M. Fea ◽  
Giulia Consolandi ◽  
Giulia Pignata ◽  
Paola Maria Loredana Cannizzo ◽  
Carlo Lavia ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Cell Loss ◽  
Endothelial Cell Loss ◽  
Age Related ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Purpose. To compare the corneal endothelial cell loss after phacoemulsification, alone or combined with microinvasive glaucoma surgery (MIGS), in nonglaucomatous versus primary open angle glaucoma (POAG) eyes affected by age-related cataract.Methods. 62 eyes of 62 patients were divided into group 1 (n=25, affected by age-related cataract) and group 2 (n=37, affected by age-related cataract and POAG). All patients underwent cataract surgery. Group 2 was divided into subgroups A (n=19, cataract surgery alone) and B (n=18, cataract surgery and MIGS). Prior to and 6 months after surgery the patients’ endothelium was studied. Main outcomes were CD (cell density), SD (standard deviation), CV (coefficient of variation), and 6A (hexagonality coefficient) variations after surgeries.Results. There were no significant differences among the groups concerning preoperative endothelial parameters. The differences in CD before and after surgery were significant in all groups: 9.1% in group 1, 17.24% in group 2A, and 11.71% in group 2B. All endothelial parameters did not significantly change after surgery.Conclusions. Phacoemulsification determined a loss of endothelial cells in all groups. After surgery the change in endothelial parameters after MIGS was comparable to the ones of patients who underwent cataract surgery alone.

scholarly journals Refractive Status in Eyes Implanted with Toric and Nontoric Intraocular Lenses during Combined Cataract Surgery and Microhook Ab Interno Trabeculotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yasuyuki Takai ◽  
Kazunobu Sugihara ◽  
Mihoko Mochiji ◽  
Kaoru Manabe ◽  
Aika Tsutsui ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Intraocular Lenses ◽  
Toric Iol ◽  
Absolute Residual ◽  
Refractive Status ◽  
The Mean ◽  
Better Than ◽  
Ab Interno

Purpose. To compare the refractive status between eyes implanted with toric and nontoric intraocular lenses (IOLs) during combined cataract surgery and microhook ab interno trabeculotomy (μLOT), a minimally invasive glaucoma surgery (MIGS). Methods. Twenty eyes of 20 patients who had open-angle glaucoma, cataract, and preexisting regular corneal astigmatism exceeding 1.5 diopters (D) and underwent combined μLOT and phacoemulsification were recruited retrospectively. Ten eyes were implanted with a toric IOL and 10 eyes with a nontoric IOL. The primary outcomes were the uncorrected visual acuity (UCVA) and refractive cylinder at 3 months postoperatively. Results. The mean UCVA of the toric IOL group (logarithm of the minimum angle of resolution (logMAR), 0.23 ± 0.25) was significantly better than that of the nontoric IOL group (logMAR, 0.45 ± 0.26) at 3 months postoperatively ( p < 0.05 ). The mean absolute residual refractive cylinder of the nontoric IOL group (2.25 ± 0.62 D) was significantly greater than that of the toric IOL group (1.30 ± 0.68 D) ( p < 0.05 ). Postoperatively, 60% of eyes in the toric IOL group and 10% in the nontoric IOL group had an absolute refractive astigmatism level of 1.5 D or less. Surgically induced astigmatism (0.77 ± 0.43 D for toric group and 0.60 ± 0.32 D for nontoric group) and IOP reduction (33.9 ± 15.6% for toric group and 29.4 ± 11.7% for nontoric group) were not different between groups. Conclusions. Use of toric IOL during combined cataract surgery and μLOT is possible and better than not, but physician should prevent their patient of persisting residual astigmatism. The study was registered at https://www.umin.ac.jp/, and the clinical trial accession number is https://clinicaltrials.gov/ct2/show/UMIN000043141.

The Efficacy of Ab Externo Canaloplasty by Using a Nonabsorbable Suture and No Viscoelastics; IOP Results, Intraoperative and Early Complication Rates within 6-Month Follow-Up Period

2021 ◽  
Author(s):  
Iraklis Vastardis ◽  
Sofia Fili ◽  
Georgios Perdikakis ◽  
Kalliopi Kontopoulou ◽  
Zisis Gatzioufas ◽  
...  
Keyword(s):  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Complication Rates ◽  
Success Rates ◽  
Intraoperative Complication ◽  
Nonabsorbable Suture ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background To report the efficacy of ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification in terms of mean intraocular pressure (IOP), medication reduction, and intra- and postoperative complication rates as well as additional glaucoma surgery. Patients and Methods Forty-eight patients with primary open-angle glaucoma (POAG) and 50 eyes were divided into two groups according to the operation performed (Group A canaloplasty, n = 34 and Group B canaloplasty combined with phaco, n = 16), respectively. The success criteria were evaluated between three IOP ranges: a) IOP ≤ 16 mmHg, b) ≤ 18 mmHg, and c) ≤ 21 mmHg. Complete success was considered the percentage of eyes reaching these goals with no medication and qualified success with or without medication. Groups A and B were compared with the Kaplan-Meier test. Mean IOP and medication reduction as well as additional glaucoma surgery were also evaluated. The follow-up time was 6 months. Statistical importance was given at p < 0.05. Results Fail rate and intraoperative conversion of canaloplasty to other surgery (trabeculotomy due to extensive cheese-wiring) accounted for 12% (6 eyes), while a mandatory usage of the iTrack 250A microcatheter to successfully overcome intracanalicular bridging of the Schlemmʼs canal accounted for 20% (10 eyes). The most common early postoperative complications in both groups were hyphema, cheese wiring, and transient IOP rising. The mean IOP in Group A reduced from 23.67 ± 6.06 mmHg to 13.35 ± 4.23 mmHg and in Group B, it reduced from 23.55 ± 6.19 mmHg to 12.75 ± 1.5 mmHg at 6 months (p < 0.001). Group Aʼs absolute success rates accounted for a) 44%, b) 47.1%, and c) 52.9% in comparison to Group B [a) 50%, b) 50%, and c) 56.3%] at 6 months (p < 0.05). Qualified success with or without medication showed no statistical differences between the groups. The mean medication reduction was significantly lower (p < 0.001) in both groups (Group A from baseline 3.2 ± 1.23 to 0.95 ± 1.35 and Group B from 3.12 ± 0.88 to 1.12 ± 0.75 at 6 months, respectively). Five eyes (10%) required additional glaucoma surgery. Conclusions Ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification seems to lower the mean IOP and medication sufficiently. However, they pose a greater surgical challenge and intraoperative complication rate. Additional glaucoma surgery or medication following both procedures may be necessary to achieve an optimal target IOP.

scholarly journals The Effectiveness of First-Generation iStent Microbypass Implantation Depends on Initial Intraocular Pressure: 24-Month Follow-Up—Prospective Clinical Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Joanna Konopińska ◽  
Milena Kozera ◽  
Paweł Kraśnicki ◽  
Zofia Mariak ◽  
Marek Rękas
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Observation Time ◽  
Open Angle ◽  
Group I ◽  
Before And After ◽  
The Mean ◽  
Group Ii

Background. Evaluation of efficacy of the iStent trabecular bypass implant in reducing intraocular pressure (IOP) depending on the value pretreatment IOP and number of medications used before surgery in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PXG) and coexisting cataract. Methods. A prospective, uncontrolled, interventional case series. 72 patients, on a mean age of 72.42 ± 9.17, were divided into two groups depending on baseline IOP: group I < 26 mmHg and group II ≥ 26 mmHg. All subjects underwent ab interno implantation of a single iStent together with cataract surgery. Best-corrected visual acuity (BCVA), IOP, number of antiglaucoma medications, visual field, and number and type of complications were examined before and after surgery. Postoperative patients were followed up at 1, 7, and 30 days and 3, 6, 12, and 24 months. All the patients were washed out preoperatively as well as postoperatively. Results. The mean observation time was 20 months. The mean preoperative IOP was 21.03 ± 1.44 mmHg in group I and reduced to mean 15.60 ± 2.12 mmHg after operation. In group II, mean IOP reduced from 26.00 ± 0.00 to 18.56 ± 1.81 (p=0.003). Mean glaucoma medications decreased from 1.35 ± 0.65 to 0.29 ± 0.52 in group I (p<0.001) and from 2.89 ± 1.18 to 1.33 ± 1.50 in group II (p<0.001). At 24 months, medication reduction was significantly greater in group I than group II (p=0.026). Conclusions. Combined cataract surgery with implantation of iStent seems to be an effective procedure in patients with mild-to-moderate open-angle glaucoma and cataract. In patients with baseline IOP < 26 mmHg, surgery reduced IOP and medication use significantly declined to 2 years, with greater reductions achieved versus patients with baseline IOP ≥ 26 mmHg. This trial is registered with NCT03807869.

Canaloplasty with mitomycin C after previous combined cataract surgery and Schlemm’s canal microstent implantation

2021 ◽  
pp. 112067212110002
Author(s):  
Eva Elksne ◽  
Karl Mercieca ◽  
Verena Prokosch-Willing
Keyword(s):  
Cataract Surgery ◽  
Mitomycin C ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Glaucomatous Optic Neuropathy ◽  
Schlemm’S Canal ◽  
Schlemm's Canal ◽  
The Right

We report on a 56-year-old male with primary open-angle glaucoma who underwent mitomycin C augmented canaloplasty enabling filtration in the right eye after cataract surgery combined with a Schlemm’s canal microstent 3 years previously. He showed progressive glaucomatous optic neuropathy and was highly myopic (axial length 32.05 mm, spherical equivalent −18.75 dioptres in the right eye). Augmented canaloplasty was performed uneventfully and 360° catheterisation was achieved followed by the placement of a 10-0 polypropylene suture in Schlemm’s canal. Intraocular pressure (IOP) in the first post-operative day was reduced from 19 to 6 mmHg. At 1-month follow-up IOP was 12 mmHg off glaucoma medications. The presence of a minimally invasive glaucoma surgery (MIGS) device did not hinder successful catheterisation of Schlemm’s canal. Significant reduction of IOP was obtained in the early post-surgical period. No intra-operative complications were registered and only transient hyphema in early post-operative period was reported. This augmented canaloplasty could be an effective alternative to trabeculectomy even after Schlemm’s canal microstent implantation.

scholarly journals Comparison Efficiency of Combined Trabeculectomy with MMC and Gonioscopy-Assisted Transluminal Trabeculotomy

2021 ◽  
Author(s):  
Ali Olgun ◽  
Hacı Ugur Celik ◽  
Fatih Yenihayat ◽  
Ercument Bozkurt ◽  
İbrahim Sahbaz
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Randomized Study ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Success Rates ◽  
Combined Procedure ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose: To compare the efficacy of gonioscopy-assisted transluminal trabeculotomy combined with cataract surgery (PGATT) and trabeculectomy combined with cataract surgery (PTRAB) in open-angle glaucoma patients.Methods: A multicentered, retrospective, non-randomized study included 67 PGATT patients and 70 PTRAB patients. We compared preoperative intraocular pressure (IOP), best-corrected visual acuity (BCVA) compared with early and final IOP, medication numbers, and BCVA levels. Success was determined as IOP reduction >20% from baseline, IOP between 5-21 mmHg, preoperative IOP of higher than 21 mmHg with medication and postoperative IOP of less than 21 mmHg without medication for surgeries performed for intolerance to medication, postoperative IOP <21 mmHg as well as <18 mmHg separately without medications, and no need for further glaucoma surgery. Results: Preoperative IOP values were 28.61 ± 6.02 mmHg in PTRAB group and 23.99±8.00 mmHg in PGATT group (P<0.0001). Early postoperative IOP values were found lower in PTRAB group as 12.19 ± 3.41 mmHg and as 15.69 ± 4.67 mmHg in PGATT group (P<0.0001). Last follow-up IOP reading were lower in PGATT group (P=0.009). IOP difference values were found higher both in early and last postoperative periods in PTRAB group (respectively, P<0.0001, P=0.018). Success rates were found higher in both at lower than 21 and 18 mmHg levels in PGATT group (respectively, P=0.014, P=0.010).Conclusion: We found the PGATT combined procedure to be a well-tolerated, effective procedure that can lower IOP both early and late in the postoperative period with different rates of IOP success compared with the combined PTRAB procedure.

scholarly journals Molteno3 Implantation as Primary Glaucoma Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Juha O. Välimäki ◽  
Ari-Pekka A. Ylilehto
Keyword(s):  
Cataract Surgery ◽  
Detrimental Effect ◽  
Glaucoma Surgery ◽  
Success Rates ◽  
Laser Trabeculoplasty ◽  
Retrospective Clinical Study ◽  
Surgical Failure ◽  
The Mean ◽  
Primary Glaucoma

Purpose. To determine the outcome of Molteno3 implantation as primary glaucoma surgery and to analyze the factors influencing the surgical outcome.Methods. This is a retrospective clinical study of 106 consecutive eyes (97 patients) with no previous glaucoma surgery. Surgical failure was defined as an IOP > 21 mmHg or less than a 20% reduction below baseline, or IOP ≤ 5 mmHg, on two consecutive visits after 3 months follow-up, or reoperation for glaucoma or loss of light perception.Results. At the end of the follow-up (mean, 35 months; range, 12–71 months), the mean postoperative IOP (14.2 ± 4.4 mmHg) was statistically significantly lower than the preoperative IOP (35.2 ± 9.7 mmHg) (P<0.001). Life-table success rates were 97%, 94%, and 91% after follow-up of 12, 24, and 36 months, respectively. Success rate for an IOP ≤ 18 mmHg was 77% at the last visit. Success was not influenced by previous cataract surgery, sex, age, laser trabeculoplasty (LTP), preoperative IOP, or number of antiglaucoma medications. Forty-seven eyes had 66 postoperative complications.Conclusions. The primary Molteno3 implant provided significant IOP lowering with minimal and manageable complications in uncontrolled glaucoma. Neither previous cataract surgery nor LTP had any detrimental effect on surgical success.

scholarly journals Micro-Bypass Implantation for Primary Open-Angle Glaucoma Combined with Phacoemulsification: 4-Year Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Antonio Maria Fea ◽  
Giulia Consolandi ◽  
Marta Zola ◽  
Giulia Pignata ◽  
Paola Cannizzo ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Control Group ◽  
Open Angle ◽  
Long Term Follow Up ◽  
Baseline Values ◽  
The Mean

Purpose. To report the long-term follow-up results in patients with cataract and primary open-angle glaucoma (POAG) randomly assigned to cataract surgery combined with micro-bypass stent implantation or phacoemulsification alone.Methods. 36 subjects with cataract and POAG were randomized in a 1 : 2 ratio to either iStent implantation and cataract surgery (combined group) or cataract surgery alone (control group). 24 subjects agreed to be evaluated again 48 months after surgery. Patients returned one month later for unmedicated washout assessment.Results. At the long-term follow-up visit we reported a mean IOP of 15,9 ± 2,3 mmHg in the iStent group and 17 ± 2,5 mmHg in the control group (p=NS). After washout, a 14,2% between group difference in favour of the combined group was statistically significant (p=0,02) for mean IOP reduction. A significant reduction in the mean number of medications was observed in both groups compared to baseline values (p=0,005in the combined group andp=0,01in the control group).Conclusion. Patients in the combined group maintained low IOP levels after long-term follow-up. Cataract surgery alone showed a loss of efficacy in controlling IOP over time. Both treatments reduced the number of ocular hypotensive medications prescribed. This trial is registered with:NCT00847158.

Canaloplasty ab interno (AbiC) – 2-Year-Results of a Novel Minimally Invasive Glaucoma Surgery (MIGS) Technique

2020 ◽  
Author(s):  
Sara Kazerounian ◽  
Michael Zimbelmann ◽  
Martin Lörtscher ◽  
Sufian Hommayda ◽  
Irene Tsirkinidou ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Eye Drops ◽  
Medication Usage ◽  
Minimally Invasive Glaucoma Surgery ◽  
The Mean ◽  
Ab Interno

Abstract Purpose The aim of this study is to evaluate the long-term efficacy of a novel minimally invasive glaucoma surgery technique (MIGS), Ab interno Canaloplasty (AbiC). Material and Methods For this retrospective cohort study, we analysed the data of 25 eyes of 23 patients with open angle glaucoma who underwent an AbiC (6 eyes) or in case of an additional cataract, a combined cataract-AbiC procedure (“phacocanaloplasty ab interno”, 19 eyes), respectively. Postoperatively, we investigated the intraocular pressure (IOP) and the number of still required IOP-lowering medication, as well as surgery-related complications. Results Overall, the mean baseline IOP of 20.24 mmHg ± 5.92 (n = 25) was reduced to 10.64 mmHg ± 2.77 (n = 25, p < 0.001), 12.55 mmHg ± 3.33 (n = 22, p < 0.001) and 13.67 mmHg ± 2.15 (n = 21, p < 0.001) at 1 day, 1 year and 2 year follow-up visit, respectively. Compared to baseline, this implies a reduction in IOP of 47.4, 37.9 and 32.5%. An average glaucoma medication usage of 1.92 ± 1.04 was registered at baseline visit and was reduced to 0,05 ± 0,23 after 2 years of follow-up. 80% of patients were off medication. In 5 eyes (20%) further antiglaucomatous eye drops or surgical treatment were administered. The only surgical complications were hyphema in 5 eyes (20%) and a localized peripheral detachment of the Descemetʼs membrane in one eye (4%) with no late sequelae. Conclusion AbiC performed independently or combined with cataract surgery seems to be a safe and effective MIGS-technique with good long-term regulation of IOP and low risk profile.

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