Comparing Surgical Outcomes in Neovascular Glaucoma between Tube and Trabeculectomy

Iwasaki, Kentaro; Kojima, Sachi; Wajima, Ryotaro; Okazaki, Tadashi; Yokoyama, Yû; Inoue, Toshihiro; Higashide, Tomomi; Miki, Atsuya; Nakazawa, Toru; Inatani, Masaru

doi:10.1016/j.ogla.2022.05.003

Cited by 8 publications

(12 citation statements)

References 30 publications

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“…The AVB Study did not stratify results to report success rates specifically for NVG eyes, but similar to prior studies, found that NVG was a significant risk factor for GDI failure (56.0% failure rate for NVG eyes vs. 40.0% for non-NVG eyes) 68 . A recent prospective randomized control trial of NVG eyes comparing Baerveldt glaucoma implants to trabeculectomy showed a higher probability of success for the tube shunt group for both IOP targets of <21 and <17 mm Hg and a lower rate of reoperation with additional glaucoma surgery in the Baerveldt group 77 …”

Section: Surgical Management Of Nvgsupporting

confidence: 69%

“…68 A recent prospective randomized control trial of NVG eyes comparing Baerveldt glaucoma implants to trabeculectomy showed a higher probability of success for the tube shunt group for both IOP targets of <21 and <17 mm Hg and a lower rate of reoperation with additional glaucoma surgery in the Baerveldt group. 77 The addition of anti-VEGF therapy to surgical management of NVG has been recently studied [78][79][80][81] A recent retrospective study compared GDI surgery including Ahmed valve, Baerveldt, and Keiki Mehta implants found that the addition of intravitreal bevacizumab injection at the time of surgery did not ultimately improve postoperative IOP, number of glaucoma medications, or the surgical success rate. 78 A retrospective study of NVG eyes assessing adjunctive preoperative intravitreal bevacizumab combined with Ahmed valve surgery not only showed higher complete success rates in the bevacizumab group (84.0% compared with 64.3% in the tube shunt-only group at 12 mo and 80.0% and 53.6%, respectively at 18 mo) but also demonstrated markedly lower rates of postoperative hyphema (4.0% in the intravitreal bevacizumab group vs. 28.6% in the tube-only group), suggesting a benefit to preoperative anti-VEGF therapy.…”

Section: Glaucoma Drainage Implants (Gdis)mentioning

confidence: 99%

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Management of Neovascular Glaucoma

Lidder,

Paranjpe,

Lauter

2023

International Ophthalmology Clinics

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Section: Surgical Management Of Nvgsupporting

confidence: 69%

Section: Glaucoma Drainage Implants (Gdis)mentioning

confidence: 99%

Management of Neovascular Glaucoma

Lidder,

Paranjpe,

Lauter

2023

International Ophthalmology Clinics

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“…Repeated intraocular surgeries have been associated with poor surgical prognosis. 12,[24][25][26]31,32 Non-functioning blebs express more extracellular matrix components and activated broblasts than functioning blebs after tube-shunt surgery. 33 Furthermore, broblast activation may occur in the subconjunctival tissue owing to the intraoperative conjunctival incisions made during phacoemulsi cation or vitrectomy.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10][11] Our previous study demonstrated the superiority of Baerveldt glaucoma implant (BGI) surgery over trabeculectomy in the management of IOP in eyes with NVG. 12 The use of BGI and the Ahmed glaucoma valve (AGV) in tubeshunt surgery has been approved in Japan, and BGI and AGV surgery have been performed at an almost equal frequency at the discretion of the surgeon. 3 However, few studies have compared the surgical outcomes of BGI surgery with those of AGV surgery for the treatment of NVG.…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of Baerveldt glaucoma implant versus Ahmed glaucoma valve in neovascular glaucoma: A multicenter study

Iwasaki,

Kojima,

Wajima

et al. 2024

Preprint

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This multicenter retrospective study compared the surgical outcomes of Baerveldt glaucoma implant (BGI) surgery with those of Ahmed glaucoma valve (AGV) surgery in patients with neovascular glaucoma (NVG). This study included patients with NVG aged ≥ 20 years who had undergone BGI (223 eyes) or AGV (146 eyes) surgery between April 1, 2012, and December 31, 2021, across 10 clinical centers in Japan. Surgical success or failure was the primary outcome measure of this study. We defined surgical failure as a reduction of < 20% in the pre-operative intraocular pressure (IOP) or criterion A (IOP > 21 mmHg), criterion B (IOP > 17 mmHg), or criterion C (IOP > 14 mmHg). In addition, we considered a requirement for reoperation, loss of light perception, and hypotony as surgical failure. The surgical success rate of the BGI surgery group was significantly higher than that of the AGV group for criteria A (P = 0.01) and B (P = 0.01). Multivariate analysis revealed that AGV surgery showed significant associations with surgical failure for criteria A (hazard ratio, 1.74), B (hazard ratio, 1.72), and C (hazard ratio, 1.33). The overall incidence of postoperative complications was comparable between the two groups. The requirement for reoperation in the AGV surgery group was significantly higher than that in the BGI surgery group (12.3% vs. 5.8%, P = 0.03). BGI surgery yielded a higher success rate than AGV surgery in patients with NVG for a target IOP of < 21 or < 17 mmHg. No significant differences were observed between the two procedures in terms of the incidence of postoperative complications. Additional glaucoma surgery was required more frequently following AGV surgery.

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“…Although trabeculectomy is considered to be the most common surgical option in patients with NVG due to its success rate, Kentaro Iwasaki el al. demonstrated that Baerveldt glaucoma implant surgery achieved a higher success rate than trabeculectomy when IOP was monitored between 21 and 17 mmHg [11,12].…”

Section: Introductionmentioning

confidence: 99%

A Review of Neovascular Glaucoma: Etiology, Pathogenesis, Diagnosis, and Treatment

2022

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Neovascular glaucoma (NVG) is a rare, aggressive, blinding secondary glaucoma, which is characterized by neovascularization of the anterior segment of the eye and leading to elevation of the intraocular pressure (IOP). The main etiological factor is retinal ischemia leading to an impaired homeostatic balance between the angiogenic and antiangiogenic factors. High concentrations of vasogenic substances such as vascular endothelial growth factor (VEGF) induce neovascularization of the iris (NVI) and neovascularization of the angle (NVA) that limits the outflow of aqueous humor from the anterior chamber and increases the IOP. NVG clinical, if untreated, progresses from secondary open-angle glaucoma to angle-closure glaucoma, leading to irreversible blindness. It is an urgent ophthalmic condition; early diagnosis and treatment are necessary to preserve vision and prevent eye loss. The management of NVG requires the cooperation of retinal and glaucoma specialists. The treatment of NVG includes both control of the underlying disease and management of IOP. The main goal is the prevention of angle-closure glaucoma by combining panretinal photocoagulation (PRP) and antiangiogenic therapy. The aim of this review is to summarize the current available knowledge about the etiology, pathogenesis, and symptoms of NVG and determine the most effective treatment methods.

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Comparing Surgical Outcomes in Neovascular Glaucoma between Tube and Trabeculectomy

Cited by 8 publications

References 30 publications

Management of Neovascular Glaucoma

Management of Neovascular Glaucoma

Surgical outcomes of Baerveldt glaucoma implant versus Ahmed glaucoma valve in neovascular glaucoma: A multicenter study

A Review of Neovascular Glaucoma: Etiology, Pathogenesis, Diagnosis, and Treatment

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