Aqueous shunts for glaucoma

Tseng, Victoria L.; Coleman, Anne L.; Chang, Melinda Y.

doi:10.1002/14651858.cd004918.pub3

Cited by 46 publications

(44 citation statements)

References 113 publications

(410 reference statements)

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“…AT and A were both effective in reducing IOP. The IOP reduction of 40% at the 1-year follow-up was similar to previous reports [2,7,8,17] . Adding trabectome surgery led to a significantly lower IOP with fewer glaucoma medications throughout the postoperative follow-up visits.…”

Section: Discussionsupporting

confidence: 90%

“…Trabeculectomy and glaucoma drainage devices (GDD) are common surgical interventions for advanced glaucomas [1][2][3] . Concerns about bleb-related complications along with studies that indicated an equal or even higher success rate of glaucoma drainage devices have contributed to their increased use [2,4] .…”

Section: Introductionmentioning

confidence: 99%

“…Concerns about bleb-related complications along with studies that indicated an equal or even higher success rate of glaucoma drainage devices have contributed to their increased use [2,4] . The shift in practice pattern from trabeculectomy to GDDs in severe glaucoma is evidenced by a 43% decrease in the number of trabeculectomies and a 184% increase in GDDs in the United States between 1995 and 2004 [5,6] .…”

Section: Introductionmentioning

confidence: 99%

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Impact of same-session trabectome surgery on Ahmed glaucoma valve outcomes

Esfandiari

Shazly

Shah

et al. 2018

Graefes Arch Clin Exp Ophthalmol

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Purpose: To evaluate the efficacy and survival rates of same session ab interno trabeculectomy with the trabectome and Ahmed glaucoma valve implant (AT) in comparison to the Ahmed glaucoma valve alone (A).Method : A total of 107 eyes undergoing primary glaucoma surgery were enrolled in this retrospective comparative case series, including 48 eyes which underwent AT and 59 eyes which received A alone . Participants were identified using the procedural terminology codes, and their medical records were reviewed. The primary outcome measure was surgical success, defined as intraocular pressure (IOP) > 5 mmHg, ≤ 21 mmHg, and IOP reduction ≥ 20% from baseline at two consecutive visits after three months, no reoperation for glaucoma. Secondary outcome measures were IOP, the number of glaucoma medications, incidence of a hypertensive phase, and best corrected visual acuity (BCVA). Results:The cumulative probability of success at one year was 70% in AT, and 65% in A (p=0.85). IOP decreased significantly from 26.6 ± 10.1 mmHg at baseline to 14.7 ± 3.3 mmHg at the final follow-up in AT (p= 0.001). The corresponding numbers for A were 28.8 ± 10.2 and 16.7 ± 4.9, respectively (p= 0.001). The final IOP was significantly lower in AT (p= 0.022). The number of medications at baseline was comparable in both groups (2.6 ± 1.2 in AT and 2.5 ± 1.3 in A, p=0.851). Corresponding number at 1 year visit was 1.2±2 in AT and 2.8±1.8 in A (p=0.001).The incidence of a hypertensive phase was 18.7% in AT and 35.5% in A (p=0.05). HP resolved in only 30% of eyes. The criteria for HP resolution were fulfilled in 9 eyes (30%). There was no difference in the rate of resolution of the hypertensive phase between AT and A (33.3% and 28.5%, respectively, p=0.67).Conclusion : Ahmed glaucoma valve implant with same session trabectome surgery significantly decreased the rate of the hypertensive phase and postoperative IOP as well as the number of glaucoma medications.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of same-session trabectome surgery on Ahmed glaucoma valve outcomes

Esfandiari

Shazly

Shah

et al. 2018

Graefes Arch Clin Exp Ophthalmol

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“…The Molteno implant was the first commercially available tube shunt; currently, the Ahmed glaucoma valve (AGV) (New World Medical Inc., Rancho Cucamonga, CA, USA) and Baerveldt glaucoma implant (BGI) (Abbott Medical Optics, Abbott Park, IL, USA) are the most commonly used. 23 …”

Section: Methodsmentioning

confidence: 99%

Evolution of Glaucoma Surgery in the Last 25 Years

Bar-David¹,

Blumenthal²

2018

Rambam Maimonides Med J

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Glaucoma is a chronic neurodegenerative optic nerve disease. Treatment is intended to prevent the development and progression of optic nerve damage by lowering intraocular pressure (IOP). Current therapy options include topical/systemic drugs that increase aqueous humor outflow or decrease its production, laser therapy that targets the trabecular meshwork and ciliary body, and incisional surgery. Trabeculectomy as well as glaucoma drainage devices are often performed, given their high efficacy in lowering IOP. However, the significant risk profile with potential sight-threatening complications has motivated glaucoma experts to create alternative surgeries to treat glaucoma. Minimally invasive glaucoma surgery (MIGS) is defined by: micro-invasive approach, minimal tissue trauma, high safety profile, and rapid recovery. The new devices might promote an earlier transition from medical/laser therapy to surgery, and therefore decrease the side effects associated with long-term use of topical medications as well as deal with the limited adherence of patients to their regimens. This review presents the surgical options available for glaucoma patients and their evolution over the past 25 years.

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“…Trabeculectomy is associated with a relatively high rate of failure and potentially sight-threatening complications [1][2][3][4]. Recent studies indicate glaucoma drainage devices have the same or higher success rate than trabeculectomy in the management of end-stage glaucoma with a better safety profile [1,2,5].…”

Section: Introductionmentioning

confidence: 99%

Coarsened Exact Matching of Trabectome Surgery Combined with Baerveldt to Baerveldt: Same Session Trabectome Negates Tube Fenestration

Esfandiari¹,

Hassanpour²,

Knowlton³

et al. 2018

Preprint

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Purpose: To evaluate the efficacy and survival rates of trabectome-mediated ab interno trabeculectomy combined with non-fenestrated Baerveldt glaucoma implants (BT) in comparison to Baerveldt glaucoma implant alone (B).Method: A total of 175 eyes undergoing primary glaucoma surgery (60 eyes BT and 115 B) were enrolled in this retrospective comparative case series. Participants were identified using the procedural terminology codes. Groups were then matched using Coarsened Exact Matching (51 eyes in each group). The primary outcome measure was surgical success, defined as 5 mmHg < IOP ≤ 21 mmHg, and IOP reduction ≥ 20% from baseline, and no reoperation for glaucoma. Secondary outcome measures were intraocular pressure, the number of glaucoma medications, and best corrected visual acuity (BCVA).Results: The cumulative probability of success at one year was 61% in BT, and 50% in B. IOP decreased significantly from 23.5±2.4 mmHg at baseline to 14.1±2.7 mmHg at the final follow up in BT (P= 0.001). The corresponding numbers for B were 23.2± 2.0 and 13.9± 1.6, respectively (P= 0.001). There was no significant difference in IOP at the final follow-up (P=0.56). The number of medications at baseline was 2.3±0.3 in both groups. However, BT needed significantly fewer drops at all postoperative time intervals and used 1.1±0.3 (BT) and 2.0±0.4 eye drops (B) at the final follow-up visit (P= 0.004). No dangerous hypotony or hypertension occurred in BT.Conclusion: Similar rates of success and IOP reduction were observed in BT and B. BT needed significantly fewer glaucoma medications. Tube fenestration was not necessary in BT resulting in less postoperative hypotony and hypertension.

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Aqueous shunts for glaucoma

Cited by 46 publications

References 113 publications

Impact of same-session trabectome surgery on Ahmed glaucoma valve outcomes

Impact of same-session trabectome surgery on Ahmed glaucoma valve outcomes

Evolution of Glaucoma Surgery in the Last 25 Years

Coarsened Exact Matching of Trabectome Surgery Combined with Baerveldt to Baerveldt: Same Session Trabectome Negates Tube Fenestration

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