Efficacy and safety of ab interno trabeculectomy in juvenile open-angle glaucoma

Arora, Sourabh; Francis, Brian A.; Maeda, Mariko; Sit, Arthur J.; Mosaed, Sameh; Nazarali, Samir; Damji, Karim F.

doi:10.1016/j.jcjo.2017.12.013

Cited by 9 publications

(8 citation statements)

References 15 publications

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“…Also, since most children with glaucoma have normal life expectancies and may need several operations to control IOP, in contrast to ab externo trabeculotomy, the ab interno approach spares the conjunctiva and sclera for future surgery if needed. Other case reports of ab interno MIGS procedures include implantation of the gel stent implant in 4 children ranging in age from 4 months to 14 years for congenital glaucoma or steroid-induced ocular hypertension, 12,13 as well as several reports of excisional 14,15 and incisional 16 goniotomy in children.…”

Section: Discussionmentioning

confidence: 99%

Combined Viscodilation of Schlemm’s Canal and Collector Channels and 360° Ab-Interno Trabeculotomy for Congenital Glaucoma Associated with Sturge–Weber Syndrome

Porsia¹,

Nicoletti²

2020

IMCRJ

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This case report demonstrates the potential role of the OMNI surgical system in the surgical management of congenital glaucoma. Patients and Methods: The case was a 4-month-old full-term, otherwise healthy female infant with cutaneous hemangiomas of both upper lids, corneal edema in the right eye (RE) and IOP > 30 mmHg. Sturge-Weber syndrome (SWS) was diagnosed. The RE was surgically treated with ab-interno circumferential viscodilation and trabeculotomy. Results: Through 10 months of follow-up, intraocular pressure was adequately controlled without the need for adjunctive medical therapy. Conclusion: Given its advantages over other angle surgery techniques, this procedure's role in treating glaucomas of childhood warrants further evaluation.

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Section: Discussionmentioning

confidence: 99%

Combined Viscodilation of Schlemm’s Canal and Collector Channels and 360° Ab-Interno Trabeculotomy for Congenital Glaucoma Associated with Sturge–Weber Syndrome

Porsia¹,

Nicoletti²

2020

IMCRJ

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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%

Prospective Studies of Minimally Invasive Glaucoma Surgeries: Systematic Review and Quality Assessment

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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“…As mentioned previously, angle-based procedures such as goniotomy, ab interno trabeculectomy, or trabeculotomy are typically deployed as first-line treatment for JOAG. Specifically, Arora et al [7] observed mean reductions of 10 mm Hg in IOP and 0.7 medications 12 months after ab interno trabeculectomy with the trabectome (NeoMedix Corp., Tustin, CA). Moreover, Yeung and Walton [2] observed a comparative 12.7 mm Hg reduction in IOP after goniotomy.…”

Section: Discussionmentioning

confidence: 99%

“…However, ab externo trabeculectomy is not recommended as a first-line treatment for JOAG despite the potential for greater IOP reduction [2,7]. Rather, angle-based procedures are preferred as they spare the conjunctiva and avoid the potential of life-long bleb-related complications [2,7,8]. As bleb morphology is critical to ocular health, the potential for long-term bleb-related complications should be emphasized when discussing surgical options with these young patients.…”

Section: Discussionmentioning

confidence: 99%

“…The substantial reductions in IOP and glaucoma medications observed in the current case align more closely with those reported following ab externo trabeculectomy in JOAG patients, which range from 16–22 mm Hg and 2.3–2.8 medications [ 11 − 13 ]. However, ab externo trabeculectomy is not recommended as a first-line treatment for JOAG despite the potential for greater IOP reduction [ 2 , 7 ]. Rather, angle-based procedures are preferred as they spare the conjunctiva and avoid the potential of life-long bleb-related complications [ 2 , 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Bilateral XEN Gel Stent Implantation in Juvenile-Onset Open-Angle Glaucoma

Klug

Valle

2020

Case Rep Ophthalmol

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The purpose of the current case is to report the successful management of juvenile-onset open-angle glaucoma with bilateral XEN Gel Stent (Allegran Inc., Irvine, CA) implantation in a patient first diagnosed during pregnancy with co-existing dysautonomia. Treatment with the XEN Gel Stent provided dramatic reductions in intraocular pressure (IOP), and glaucoma medications sustained up to 23 months postoperatively. The success of this case may suggest that this minimally invasive procedure could be an effective treatment option for younger patients who require substantial reductions in IOP and glaucoma medication burden.

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Efficacy and safety of ab interno trabeculectomy in juvenile open-angle glaucoma

Cited by 9 publications

References 15 publications

<p>Combined Viscodilation of Schlemm’s Canal and Collector Channels and 360° Ab-Interno Trabeculotomy for Congenital Glaucoma Associated with Sturge–Weber Syndrome</p>

<p>Combined Viscodilation of Schlemm’s Canal and Collector Channels and 360° Ab-Interno Trabeculotomy for Congenital Glaucoma Associated with Sturge–Weber Syndrome</p>

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

Bilateral XEN Gel Stent Implantation in Juvenile-Onset Open-Angle Glaucoma

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