<p>Comparison of anterior chamber flare among different glaucoma surgeries</p>

Abstract

PurposeTo compare postsurgical anterior chamber flare (ACF) among conventional (trabeculectomy, LEC) and novel (EX-PRESS Shunt, EXP) filtration surgeries and microhook ab interno trabeculotomy (μLOT), a novel minimally invasive glaucoma surgery (MIGS).Subjects and methodsThis retrospective study included 125 primary open angle glaucoma eyes (89 consecutive subjects) treated with μLOT (n=38), LEC (n=12), or EXP (n=75). The intraocular pressure (IOP), numbers of antiglaucoma medication, and ACF at preoperatively and 2 weeks; 1, 3, and 6 months postoperatively were compared among the surgical groups using a mixed-effects regression model.ResultsThe postoperative IOP (p<0.0001) and medication use were significantly (p<0.0001) lower in the LEC and EXP groups than with μLOT for up to 6 months postoperatively. The ACF differed significantly (p=0.0004) among groups; the ACF was significantly higher (p=0.0097, post-hoc Student’s t-test) with μLOT (33.6±52.8 pc/msec) than the EXP (15.7±19.9 pc/msec) at 2 weeks and was significantly (p=0.0111, post-hoc t-test) lower with μLOT (7.9±2.0 pc/msec) than LEC (12.0±6.1 pc/msec) at 6 months.ConclusionConsidering our observation, although its clinical significance is unclear, not all MIGS are minimally invasive regarding early postsurgical inflammation.

Midterm Results of Microhook ab Interno Trabeculotomy in Initial 560 Eyes with Glaucoma

“…We observed increased AC flare after µLOT ( Table 7 ), which returned to the preoperative level by 6 months postoperatively. As reported previously, postoperative increases in AC flare after µLOT might last longer than filtration surgery, such as Ex-PRESS shunt [ 36 ]. The loss of CECD was reported to be 6.5% 1 year after cataract surgery alone in eyes with glaucoma [ 37 ], 6.3% 2 years after trabeculectomy monotherapy [ 38 ], and 2.4% 1 year after Trabectome (combined surgery, 47%) [ 39 ].…”

Characterization of Peripheral Anterior Synechiae Formation After Microhook Ab-interno Trabeculotomy Using a 360-Degree Gonio-Camera

“…However, in the latter condition, PAS may result from iris apposition on the TM, which includes trauma and increased IOP. 22 Therefore, the total PAS and PAS within the µLOT incision would develop gradually over time postoperatively because of the continuous increased outflow into Schlemm’s canal within the incision, which induces iris apposition on the TM. Inflammation associated with surgery might contribute to PAS formation; however, we did not detect this because aqueous flare, which is used to estimate postoperative inflammation, was not associated significantly with the PAS rate.…”

Effect of postoperative corticosteroids on surgical outcome and aqueous autotaxin following combined cataract and microhook ab interno trabeculotomy

“…In the same study, the postoperative AC flare was 6.3 pc/ms, which is within range of the baseline level. In another study, it was reported that the postoperative AC flare after μLOT returned to baseline at 1 month and was significantly lower compared with that associated with trabeculectomy at 6 months 38 . In the present study, we did not monitor the patients for AC cell or flare quantitatively, so additional study using lase flare-cell meter will be needed for quantitative analysis 39 ; however, there were no significant differences in postoperative inflammation graded by SUN working group criteria between the non-steroid and steroid groups, and none of the eyes in either group showed prolonged inflammation at 1 week requiring additional anti-inflammatory medications.…”