Glaucoma and cataract surgery

Shah, Manjool; Law, Geoffrey; Ahmed, Iqbal Ike K.

doi:10.1097/icu.0000000000000224

Cited by 20 publications

(11 citation statements)

References 28 publications

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“…The introduction of MIGS has altered the management of open-angle glaucoma, particularly those with mild-moderate stage of disease needing additional IOP reduction not achievable with conservative treatment options, but do not yet warrant the need for an aggressive filtering procedure and associated risks. 20 MIGS has been demonstrated to be of particular value for reducing medication use. Owing to the recognized side effects of topical medication use and the reduced adherence with >1 drop, reduction of the medication burden in any capacity has long-term benefits for patients.…”

Section: Discussionmentioning

confidence: 99%

<p>iStent Trabecular Microbypass Stent Implantation with Phacoemulsification in Patients with Open-Angle Glaucoma: 6-Year Outcomes</p>

Ferguson

Mechels

Dockter

et al. 2020

OPTH

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Purpose: To investigate the long-term safety and efficacy of an iStent trabecular microbypass stent in combination with cataract surgery in eyes with primary open-angle glaucoma (POAG). Setting: Private practice; Sioux Falls, South Dakota. Design: Retrospective, consecutive case series. Methods: This case series included eyes implanted with a single trabecular microbypass stent in combination with phacoemulsification in patients with mild to severe POAG. Data were collected preoperatively and at day 1, week 1, month 1, and up to 6 years postoperatively. Primary outcome measures included mean intraocular pressure (IOP) and number of glaucoma medications. Safety was noted by assessing the incidence of IOP spikes and need for additional surgery. Results: The study comprised 411 eyes. Mean IOP was reduced to 14.9±4.2 mmHg compared to 18.8±5.6 mmHg at baseline at 6 years postoperative. The mean number of medications was reduced to 1.2±1.0 from 1.4±1.1 at baseline. In eyes with severe stage of disease, there was a mean IOP reduction >6 mmHg at 6 years postoperative. Eyes with baseline IOP ≥18 mmHg achieved a more robust reduction in IOP. Fifteen eyes underwent a secondary glaucoma procedure. There were no intra-or postoperative complications. Conclusion: Trabecular microbypass stent implantation in combination with cataract surgery provides a sustained IOP reduction in eyes with mild-to-severe POAG. The degree of IOP reduction was more significant in eyes with higher baseline IOP and severe stage of disease.

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Section: Discussionmentioning

confidence: 99%

<p>iStent Trabecular Microbypass Stent Implantation with Phacoemulsification in Patients with Open-Angle Glaucoma: 6-Year Outcomes</p>

Ferguson

Mechels

Dockter

et al. 2020

OPTH

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“…Both glaucoma and cataract are intrinsically correlated with age. Recently there has been growing evidence to support the fact that cataract surgery can be a helpful tool in glaucoma treatment by lowering intraocular pressure which is the only treatable risk factor for glaucoma [22], so we used the prevalence of cataract as an indicator, and cataract surgery rate as a predictor. Axial lengths are also thought to influence the prevalence of glaucoma [23,24], as longer axial length is a risk factor of primary open angle glaucoma and short axial length is a risk factor of primary close angle glaucoma.…”

Section: Methodsmentioning

confidence: 99%

Time trends and heterogeneity in the disease burden of glaucoma, 1990-2017: a global analysis

Zhang

Jin

Fan

et al. 2019

Journal of Global Health

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BackgroundTo evaluate the disease burden of glaucoma in terms of disability-adjusted life years (DALY) and assess the contribution of risk factors to DALY due to glaucoma.MethodsGlobal, regional, and country DALY number, rate, and age-standardized rates of glaucoma were obtained from the Global Burden of Disease Study 2017 database. The Human Development Index (HDI), Inequality-Adjusted HDI, Socio-Demographic Index (SDI), and other country-level data were derived from international open databases. Regression analysis was used to assess the correlations between the age-standardized DALY rate and the variables.ResultsThe global DALY due to glaucoma increased by 81% from 1990 to 2017 and decreased by 10% over the last two decades after adjusting for age and population size. Males had higher age-standardized DALY rates (P < 0.001). The age-standardized DALY rate was higher in countries with lower income or lower SDI (P < 0.001). The country-level age-standardized DALY rates in 2017 were negatively associated with HDI, SDI, country-level age-standardized prevalence rates of cataracts, cataract surgery rates (CRS), physician rates, and Inequality-Adjusted HDI. Stepwise multiple regressions showed that HDI, CRS, and Inequality-Adjusted HDI were significantly negatively associated with the country-level age-standardized DALY rate in 2017 after adjusting for other confounding factors (P < 0.001).ConclusionsHigher education, higher CRS, and diminishing the inequality in resource distribution may help reduce the disease burden of glaucoma. These findings can provide information for policymakers and could serve as an impetus for efforts toward alleviating the disease burden of glaucoma.

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“…MIGS procedures primarily target four approaches to IOP reduction, including increased trabecular outflow, increased uveoscleral outflow, increased subconjunctival outflow, and decreased aqueous production. MIGS procedures carry a superior safety profile compared with traditional surgery but are less effective at lowering IOP and reducing medication burden [47][48][49]. In addition, while MIGS offer a safer alternative to surgery for patients with mild-to-moderate disease who are intolerant to pharmacotherapy, such procedures still have attendant risks of adverse events such as infection and hypotony, often necessitating additional device-related interventions or surgery [50,51].…”

Section: Treatment Optionsmentioning

confidence: 99%

Open-Angle Glaucoma: Burden of Illness, Current Therapies, and the Management of Nocturnal IOP Variation

et al. 2019

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Glaucoma is a chronic, debilitating disease and a leading cause of global blindness. Despite treatment efforts, 10% of patients demonstrate loss of vision. In the US, [ 80% of glaucoma cases are classified as open-angle glaucoma (OAG), with primary open-angle (POAG) being the most common. Although there has been tremendous innovation in the surgical treatment of glaucoma as of late, two clinical variants of OAG, normaltension glaucoma (NTG) and severe POAG, are especially challenging for providers because patients with access to care and excellent treatment options may progress despite achieving a ''target'' intraocular pressure value. Additionally, recent research has highlighted the importance of nocturnal IOP control in avoiding glaucomatous disease progression. There remains an unmet need for new treatment options that can effectively treat NTG and severe POAG patients, irrespective of baseline IOP, while overcoming adherence limitations of current pharmacotherapies, demonstrating a robust safety profile, and more effectively controlling nocturnal IOP.

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Glaucoma and cataract surgery

Cited by 20 publications

References 28 publications

<p>iStent Trabecular Microbypass Stent Implantation with Phacoemulsification in Patients with Open-Angle Glaucoma: 6-Year Outcomes</p>

<p>iStent Trabecular Microbypass Stent Implantation with Phacoemulsification in Patients with Open-Angle Glaucoma: 6-Year Outcomes</p>

Time trends and heterogeneity in the disease burden of glaucoma, 1990-2017: a global analysis

Open-Angle Glaucoma: Burden of Illness, Current Therapies, and the Management of Nocturnal IOP Variation

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