Comparative outcomes of trabeculotomy ab externo versus trabecular ablation ab interno for open angle glaucoma

Kinoshita-Nakano, Eri; Nakanishi, Hideo; Ikeda, Hanako Ohashi; Morooka, Shigenori; Akagi, Tadamichi

doi:10.1007/s10384-017-0559-0

Cited by 21 publications

(20 citation statements)

References 22 publications

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“…Recent trends for micro-invasive glaucoma surgery (MIGS) has prompted the reappraisal of the utility and significance of TLO. Many devices, including trabectome,6–10 the Kahook dual blade11 and iStent,12 have been developed with the aim of reconstructing the physiological aqueous outflow facility. Recently, Dr Masaki Tanito also developed a microhook for ab interno TLO 13–15.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of the 1-year surgical outcomes ofab externotrabeculotomy and microhookab internotrabeculotomy using propensity score analysis

et al. 2020

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ObjectiveTo compare the 1-year outcomes of trabeculotomy ab externo (ab externo TLO) and trabeculotomy ab interno using a microhook (ab interno TLO) for glaucoma patients using propensity score analysis.Methods and analysisThe medical charts of 65 consecutive patients who underwent ab externo TLO and those of 69 patients who underwent ab interno TLO were reviewed. Logistic regression analysis was conducted to calculate the propensity score using 1:1 matched analysis, which indicates the likelihood of surgical success at 12 months. We set the outcome-related covariates as age, glaucoma type, mean deviation, preoperative intraocular pressure (IOP), the number of preoperative glaucoma eye drops and the presence or absence of combined cataract surgery. Fifty eyes per each surgery group were subsequently compared.ResultsThe mean preoperative IOP was 32.5±11.2 mm Hg in the ab externo TLO group and 28.4±7.8 mm Hg in the ab interno TLO group (p=0.08). The mean postoperative IOP at 12 months was 18.3±7.4 mm Hg in the former group and 17.8±6.3 mm Hg in the latter (p=0.91). When surgical success was defined as a postoperative IOP of between 5 and 21 mm Hg with a more than 20% IOP reduction from baseline and no additional glaucoma surgery, the rate at 12 months was 78% in the ab externo TLO group and 74% in the ab interno TLO group (p=1.00).ConclusionThe 1-year success rate was not significantly different between ab externo and ab interno TLO.

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Section: Introductionmentioning

confidence: 99%

“…Due to the short operation time and the minimal invasiveness, MIGS has become increasingly popular worldwide. However, there exist few reports that compare the effectiveness and safety of ab externo TLO and ab interno TLO 10…”

Section: Introductionmentioning

confidence: 99%

A comparison of the 1-year surgical outcomes ofab externotrabeculotomy and microhookab internotrabeculotomy using propensity score analysis

et al. 2020

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“…There were 29 prospective studies of the iStent (25 iStent, 3 iStent inject, 62-64 1 iStent +Supra), 65 with quality scores ranging from −1 to 5. There were 16 prospective studies of the Trabectome, [66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] but many described the outcomes of patients who had Trabectome using data from the Trabectome Database; thus, while the data were collected prospectively, the research questions were asked retrospectively, and many of these studies had lower quality scores based on lack of control group. There were 11 prospective studies of the Xen, [82][83][84][85][86][87][88][89][90][91][92] but none included a control group.…”

Section: Resultsmentioning

confidence: 99%

<p>Prospective Studies of Minimally Invasive Glaucoma Surgeries: Systematic Review and Quality Assessment</p>

Rosdahl¹,

Gupta²

2020

OPTH

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Glaucoma is a common blinding disease; while there is no cure, effective treatments include medications, laser, and incisional surgery. There is significant interest from patients and doctors to develop safer surgical options throughout the spectrum of disease, to minimize treatment burden in mild glaucoma patients and to minimize risk of complications in patients needing more aggressive treatment. Surgical procedures called Minimally or Micro-Invasive Glaucoma Surgery (MIGS) are growing in popularity. Eightyseven prospective studies on MIGS were identified and assessed for quality. Most (74%) did not have a control group. Twelve of the highest quality were reviewed. MIGS procedures appeared to have fewer complications, and lowered intraocular pressure, and reduced medication use. Studies were limited by small sample size, narrow spectrum of glaucomatous disease, and/or conflicts of interest. There is a need for high quality, independently funded and performed, comparative studies on the MIGS to help make treatment decisions.

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“…Anders als bei der Filtrationschirurgie umfasst die postoperative Behandlung nach kammerwinkelchirurgischen Eingriffen (Trabektom, Trabekulotomie, Kahook-Dual-Blade, Excimer-Laser-Trabekulotomie) auch die Gabe von Miotika über einen Zeitraum von 3-12 Wochen, am häufigsten über etwa 6 Wochen [31]. Hintergrund ist hierbei die Vermeidung von anterioren Synechien, die den Erfolg der Drucksenkung beeinflussen können.…”

Section: Therapie Nach Kammerwinkelchirurgieunclassified

“…Hintergrund ist hierbei die Vermeidung von anterioren Synechien, die den Erfolg der Drucksenkung beeinflussen können. Da diese Eingriffe häufig in Kombination mit der Kataraktchirurgie durchgeführt werden, ist ebenso wie bei der Phakotrabekulektomie die zusätzliche Gabe von nicht steroidalen Antiphlogistika über die topische Steroidgabe hinaus zu erwägen [31]. Etwas unterschiedlich ist das Vorgehen beim primären kongenitalen Glaukom, wo mitunter auch bei der (360°-)Trabekulotomie die standardmäßige postoperative Gabe von topischen Zykloplegika für mehrere Wochen empfohlen wird [32].…”

Section: Therapie Nach Kammerwinkelchirurgieunclassified

Perioperative antientzündliche Therapie im Rahmen der Glaukomchirurgie

Dietlein

Erb²

2019

Klin Monatsbl Augenheilkd

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ZusammenfassungViele klinische Studien belegen, dass der funktionelle Ausgang der Glaukomchirurgie, insbesondere der Filtrationschirurgie, durch eine topische antientzündliche Vor- und Nachbehandlung signifikant beeinflusst werden kann. Die topischen Steroide erweisen sich sowohl in der Vor- als auch in der Nachbehandlung nach Trabekulektomie als günstig, wobei die Dauer der postoperativen Behandlung vom individuellen Befund abhängig gemacht werden soll. Eine systemische Steroidtherapie oder Immunmodulation ist beim uveitischen Sekundärglaukom für den Erfolg der Glaukomchirurgie signifikant von Bedeutung, bei anderen Glaukomformen ist ein Nutzen der systemischen Therapie nicht belegt. Eine zusätzliche topische Therapie mit nicht steroidalen Antiphlogistika ist bei einer kombinierten Katarakt-Glaukom-Chirurgie zu erwägen. Eine topische antientzündliche Therapie nach selektiver Lasertrabekuloplastik ist nicht notwendig, bei Argonlasertrabekuloplastik und Zyklophotokoagulation wirkt diese sich schmerzlindernd aus. Die intravitreale Gabe von Steroiden im Rahmen der Glaukomchirurgie muss aufgrund der Induktion von Augendruckspitzen immer kritisch abgewogen werden.

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Comparative outcomes of trabeculotomy ab externo versus trabecular ablation ab interno for open angle glaucoma

Abstract: Surgical successes following TLO and TAT are not significantly different 3 years postoperatively after adjustment of potential prognostic factors.

Cited by 21 publications

References 22 publications

A comparison of the 1-year surgical outcomes ofab externotrabeculotomy and microhookab internotrabeculotomy using propensity score analysis

A comparison of the 1-year surgical outcomes ofab externotrabeculotomy and microhookab internotrabeculotomy using propensity score analysis

<p>Prospective Studies of Minimally Invasive Glaucoma Surgeries: Systematic Review and Quality Assessment</p>

Perioperative antientzündliche Therapie im Rahmen der Glaukomchirurgie

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