Ab externo 240-degree trabeculotomy versus trabeculotomy–trabeculectomy in primary congenital glaucoma

Wagdy, Faried M

doi:10.1007/s10792-020-01453-x

Cited by 6 publications

(6 citation statements)

References 17 publications

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“…One patient with uveitis and 1 with Peter's anomaly developed posterior synechia of the pupil, which indicated that uveitis and abnormal development of the anterior segment might be risk factors of post-operative pupillary synechia. The occurrence of hyphema (1/26, 3.85%) was substantially lower than that of other surgeries (6.66-45.4%) [2,26,27]. In traditional combined surgeries sight-threatening complications such as bleb leakage, blebitis, endophthalmitis and phthisis bulbi were more common [21,26], while no such severe complications were observed in our multi-pathway surgeries.…”

Section: Discussionmentioning

confidence: 69%

The safety and efficacy of CO 2 laser-assisted sclerectomy surgery-based multi- pathway glaucoma surgery in intractable pediatric glaucoma

Liang

Song

Cheng

et al. 2022

Preprint

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Background To evaluate the safety and efficacy of CO2 laser-assisted sclerectomy surgery (CLASS)-based multi-pathway glaucoma surgeries in intractable pediatric glaucoma. Methods Retrospective, self-controlled, interventional case series. Twenty-three intractable pediatric glaucoma patients (26 eyes) who underwent CLASS-based multi-pathway surgeries were enrolled, including CLASS combined with trabeculectomy and CLASS combined with combined trabeculectomy and trabeculotomy. Complete examinations were performed before and after surgery. Intraocular pressure (IOP) change, complete and qualified success rates (CSR, QSR), best-corrected visual acuity (BCVA), number of IOP-lowering eyedrops and adverse events were recorded. Results The mean age at surgery was 8.72 ± 5.46 years and the mean follow-up time was 25.49 ± 10.87 months. Baseline IOP, number of IOP-lowering eyedrops and logMAR BCVA were 32.00 ± 4.83 mmHg, 3.21 ± 0.71 and 1.31 ± 0.90 respectively. The mean IOP was 12.05 ± 5.02, 11.71 ± 3.25 and 12.67 ± 3.38 mmHg at 6 months, 1 year and 2 years after surgery, which were significantly lower than baseline (all p < 0.05). The reduction in number of medications was statistically significant at all post-operative timepoints within 3 years (all p < 0.005). CSR and QSR were 82.2% and 91.7% respectively at 1 year, and were 68.5% and 81.5% respectively at 2 years. Majority of the early and late-onset complications including shallow anterior chamber, extensive peripheral anterior synechia, scarring of blebs and cataract were mild and reversible. Conclusion CLASS-based multi-pathway surgery was safe and effective for the treatment of intractable pediatric glaucoma. It is promising to become an alternative and safer surgical management for intractable pediatric glaucoma.

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Section: Discussionmentioning

confidence: 69%

The safety and efficacy of CO 2 laser-assisted sclerectomy surgery-based multi- pathway glaucoma surgery in intractable pediatric glaucoma

Liang

Song

Cheng

et al. 2022

Preprint

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“…follow-up duration) ranged from 6 to 60 months, and the baseline mean IOP ranged from 16.4 to 34.0 mmHg. Nine studies had been conducted in Egypt 9 – 13 , 15 , 17 , 19 , 20 , three in India 16 , 18 , 21 , and one each in Brazil 14 , Lebanon 22 , Saudi Arabia 23 , and the USA 24 . Twelve studies 9 – 12 , 15 – 18 , 20 – 22 , 24 included only patients lacking any surgical history, whereas four 13 , 14 , 19 , 23 also included such patients.…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies had been conducted in Egypt 9 – 13 , 15 , 17 , 19 , 20 , three in India 16 , 18 , 21 , and one each in Brazil 14 , Lebanon 22 , Saudi Arabia 23 , and the USA 24 . Twelve studies 9 – 12 , 15 – 18 , 20 – 22 , 24 included only patients lacking any surgical history, whereas four 13 , 14 , 19 , 23 also included such patients. A schematic of the ROB assessment across all of the studies included in our analysis is provided in Supplementary Appendix 3, Supplemental Digital Content 4, http://links.lww.com/JS9/A166 .…”

Section: Resultsmentioning

confidence: 99%

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Comparative efficacies of 13 surgical interventions for primary congenital glaucoma in children: a network meta-analysis of randomized clinical trials

Lee

Kang

et al. 2023

International Journal of Surgery

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Background: Timely and proper intraocular pressure (IOP) management is vital to the prevention of visual impairment in children with primary congenital glaucoma (PCG). Although various surgical interventions have been proposed, no well-founded evidence exists on their comparative efficacies. We aimed to compare the efficacies of surgical interventions for PCG. Methods: We searched relevant sources up to 4 April 2022. Randomized controlled trials (RCTs) entailing surgical interventions for PCG in children were identified. A network meta-analysis (NMA) was performed, comparing 13 surgical interventions: Conventional partial trabeculotomy ([CPT] control), 240-degree trabeculotomy, Illuminated microcatheter-assisted circumferential trabeculotomy (IMCT), Viscocanalostomy, Visco-circumferential-suture-trabeculotomy, Goniotomy, Laser goniotomy, Kahook dual blade ab-interno trabeculectomy, Trabeculectomy with mitomycin C, Trabeculectomy with modified scleral bed, Deep sclerectomy, Combined trabeculectomy-trabeculotomy with mitomycin C, and Baerveldt implant. The main outcomes were mean IOP reduction and surgical success rate at postoperative 6 months. The mean differences (MDs) or odds ratios (ORs) were analyzed by a random-effects model, and the efficacies were ranked by P-score. We appraised the RCTs using the Cochrane risk-of-bias (ROB) tool (PROSPERO: CRD42022313954). Results: Sixteen RCTs were eligible for NMA, including 710 eyes of 485 participants and 13 surgical interventions, which formed a network of 14 nodes comprising both single interventions and intervention combinations. IMCT was superior to CPT in both IOP reduction [MD (95% CI): −3.10 (−5.50 to −0.69)] and surgical success rate [OR (95% CI): 4.38 (1.61–11.96)]. The MD and OR comparing the other surgical interventions and intervention combinations with CPT were not statistically significant. The P-scores ranked IMCT as the most efficacious surgical intervention in terms of success rate (P-score =0.777). Overall, the trials had a low-to-moderate ROB. Conclusion: This NMA indicated that IMCT is more effective than CPT and might be the most efficacious of the 13 surgical interventions for management of PCG.

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“…Additionally, the [7] Trab 360 device/OMNI (comprised of a stainless steel needle with internal 4/0 nylon blue filament) is handy and effective in producing desirable outcomes. In terms of intraocular pressure (IOP) reduction, viscotrabeculotomy has been shown to be somewhat more successful than traditional trabeculotomy.…”

Section: Introductionmentioning

confidence: 99%

Trabeculectomy with Mitomycin C and Intra-Ocular Pressure in Congenital Glaucoma Patients

Khan¹,

Bhatti²,

Tahir³

et al. 2022

PJMHS

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Objective: The purpose of this study is to evaluate the mean change in intraocular pressure following trabeculectomy with Mitomycin C in patients who present with congenital glaucoma. Study Design: Observational/ Cross-sectional Place and Duration: Data was collected from different hospitals of Pakistan, including Jinnah International Hospital, Abbottabad and Department of Ophthalmology, Sahara Medical College, Narowal from December 2021 to May 2022. Methods: The study included 62 patients, both male and female, with primary congenital glaucoma, ranging in age from birth to five years. After receiving signed permission from patients' legal guardians, we were able to record their demographic information. Trabeculectomy using 0.4mg/ml Mitomycin C was performed on all of the patients. Mitomycin C was placed for 2 minutes under the scleral flap. The intraocular pressure was measured before surgery and again 12 days later. Statistical analysis was performed using SPSS 22.0. Results: Included children had mean age 1.9±3.16 years. We found that, majority of the patients 39 (62.9%) were males and 23 (37.1%) cases were females. The mean intraocular pressure before and after surgery was significantly different, with a p-value of 0.002 (29.41±5.22 Vs 15.17±1.73). Conclusion: It has been determined that doing a trabeculectomy while administering mitomycin C results in a significant decrease in intraocular pressure. Following surgery, a substantial reduction in intraocular pressure was noted by the attending physician. Keywords: Intra-ocular Pressure, Primary Congenital Glaucoma, Mitomycin C, Trabeculectomy

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Ab externo 240-degree trabeculotomy versus trabeculotomy–trabeculectomy in primary congenital glaucoma

Cited by 6 publications

References 17 publications

The safety and efficacy of CO 2 laser-assisted sclerectomy surgery-based multi- pathway glaucoma surgery in intractable pediatric glaucoma

The safety and efficacy of CO 2 laser-assisted sclerectomy surgery-based multi- pathway glaucoma surgery in intractable pediatric glaucoma

Comparative efficacies of 13 surgical interventions for primary congenital glaucoma in children: a network meta-analysis of randomized clinical trials

Trabeculectomy with Mitomycin C and Intra-Ocular Pressure in Congenital Glaucoma Patients

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