Outcomes of Fornix-based Versus Limbus-based Conjunctival Incisions for Glaucoma Drainage Device Implant

Suhr, Abraham W.; Lim, Michele C.; Brandt, James D.; Izquierdo, Juan Carlos; Willits, Neil H.

doi:10.1097/ijg.0b013e318227a565

Cited by 14 publications

(9 citation statements)

References 27 publications

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“…Moreover, there was a tendency for the increased occurrence of a shallow anterior chamber in the LBCF group (OR = 1.38, 95% CI: 0.97 to 1.98; P = 0.076). This may be due to the increased exposition of sclera and subconjunctival tissue with this technique: the initial outflow resistance in the subconjunctival space may be lower, as the initial hypotony was more pronounced when the subconjunctival tissue was opened over a larger area[37], [38]. However, no significant between-group differences in complications were found in the current meta-analysis.…”

Section: Discussionmentioning

confidence: 62%

Fornix-Based versus Limbus-Based Conjunctival Flap in Trabeculectomy: A Quantitative Evaluation of the Evidence

Wang

Zhou

et al. 2013

PLoS ONE

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ObjectiveTo evaluate the efficacy and tolerability of limbus-based (LBCF) compared with fornix-based conjunctival flaps (FBCF) for trabeculectomy in the treatment of patients with uncontrolled glaucoma.MethodsA comprehensive literature meta-analysis was performed according to the Cochrane Collaboration methodology to identify controlled clinical trials comparing LBCF with FBCF in trabeculectomy. The efficacy measures were the weighted mean differences (WMDs) for intraocular pressure reduction (IOPR), the reduction in glaucoma medications, and the relative risks (RRs) for success rates. Tolerability estimates were measured by RR for adverse events. The pooled effects were calculated using the random effects model.ResultsSixteen controlled clinical trials meeting the predefined criteria were included in the meta-analysis. A total of 1,825 eyes from 1,392 patients with medically uncontrolled glaucoma were included. The WMD of the IOPR from baseline was 1.12 (95% CI: −0.88 to 3.12) when comparing LBCF with FBCF. LBCF was associated with numerically greater but non-significant IOP lowering efficacy than FBCF (P = 0.270). LBCF was comparable with FBCF in the reduction of glaucoma medication, with a WMD of 0.15 (−0.05 to 0.36) at the follow-up endpoint (P = 0.141). The pooled RR comparing LBCF with FBCF were 1.08 (0.94, 1.23) for the complete success rate and 1.01 (0.92, 1.10) for the qualified success rate. Rates of adverse events did not differ significantly between LBCF and FBCF.ConclusionsThere is no significant difference in IOP lowering, number of glaucoma medications, or proportion of patients who reached the IOP target between LBCF and FBCF trabeculectomy. Both incision techniques may contribute equally to adverse events.

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Section: Discussionmentioning

confidence: 62%

Fornix-Based versus Limbus-Based Conjunctival Flap in Trabeculectomy: A Quantitative Evaluation of the Evidence

Wang

Zhou

et al. 2013

PLoS ONE

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“…The Argus II design incorporates transcleral cables, which may increase risk of infection 22 23. Image processing is as follows: data from the external camera are transferred to a processor and transmitter coil, then wirelessly to an electronics case.…”

Section: Resultsmentioning

confidence: 99%

“…Intraocular designs, which minimally disrupt barriers between patients’ internal body cavity and the outside environment, should reduce the risk of infection with chronic ocular implants 22 23. Alpha-IMS uses intraocular light-sensitive photodiodes for image acquisition, allowing microsaccades to help prevent image fading and better simulate natural vision.…”

Section: Discussionmentioning

confidence: 99%

Retinal implants: a systematic review: Table 1

2014

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Retinal implants present an innovative way of restoring sight in degenerative retinal diseases. Previous reviews of research progress were written by groups developing their own devices. This systematic review objectively compares selected models by examining publications describing five representative retinal prostheses: Argus II, Boston Retinal Implant Project, Epi-Ret 3, Intelligent Medical Implants (IMI) and Alpha-IMS (Retina Implant AG). Publications were analysed using three criteria for interim success: clinical availability, vision restoration potential and long-term biocompatibility. Clinical availability: Argus II is the only device with FDA approval. Argus II and Alpha-IMS have both received the European CE Marking. All others are in clinical trials, except the Boston Retinal Implant, which is in animal studies. Vision restoration: resolution theoretically correlates with electrode number. Among devices with external cameras, the Boston Retinal Implant leads with 100 electrodes, followed by Argus II with 60 electrodes and visual acuity of 20/1262. Instead of an external camera, Alpha-IMS uses a photodiode system dependent on natural eye movements and can deliver visual acuity up to 20/546. Long-term compatibility: IMI offers iterative learning; Epi-Ret 3 is a fully intraocular device; Alpha-IMS uses intraocular photosensitive elements. Merging the results of these three criteria, Alpha-IMS is the most likely to achieve long-term success decades later, beyond current clinical availability.

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“…37 Suhr ve ark. 38 160 gözde implantın yerleştirilmesi için açılan konjonktival insizyonun limbus (69 göz) veya forniks (91 göz) tabanlı olmasına göre iki gruba ayırarak yaptıkları çalışmada her iki gruba da aynı antibiyotik proflaksisi uygulanmasına rağmen, şant cerrahisinden sonraki bir yıl içerisinde limbus tabanlı konjonktival insizyonlarda hiç endoftalmi görülmezken, forniks tabanlı insizyonlarda üç gözde endoftalmi geliştiği bildirmişlerdir. Forniks tabanlı insizyonlarda, sklerostomi sahasından mikroorganizmaların glob içine erişiminin daha kolay olması nedeniyle endoftalmi oranının fazla olabileceğini öne sürmüşlerdir.…”

Section: öNlemeunclassified

“…Forniks tabanlı insizyonlarda, sklerostomi sahasından mikroorganizmaların glob içine erişiminin daha kolay olması nedeniyle endoftalmi oranının fazla olabileceğini öne sürmüşlerdir. 38 GDİ cerrahisi sonrası steril endoftalmi de bildirilmiştir ve bu durum enfeksiyonu taklit edebilir. 39 Steril endoftalmi, tek başına steroid tedavisine iyi yanıt verdiği için enfeksiyöz ve non-enfeksiyöz endoftalmi ayırımını yapmak çok önemlidir.…”

Section: öNlemeunclassified

Glokom Drenaj İmplantı Cerrahisi Sonrası Endoftalmi

Kocatürk¹,

Erkan²,

Çakmak³

2014

tjo

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Glokom cerrahisi, dirençli glokomlarda göz içi basıncını azaltmak için ülkemizde ve tüm dünyada yaygın olarak uygulanmaktadır. Glokom drenaj implantı cerrahisi glokom cerrahileri arasında özel ve önemli bir yere sahiptir. Glokom drenaj implantasyonundan sonra görülen çeşitli komplikasyonların arasında endoftalmi, nadir görülen fakat en yıkıcı komplikasyondur. Bu derlemede, glokom drenaj implant cerrahisi sonrası görülen endoftalminin, klinik özellikleri ve tedavi seçenekleri güncel literatüre göre tartışılmıştır. (Turk J Ophthalmol 2014; 44: 138-43) Anah tar Ke li me ler: Glokom, glokom drenaj implantı, endoftalmi Glaucoma surgery is performed widely in our country and all around the world to lower the intraocular pressure in refractory glaucoma. Glaucoma drainage implant surgery has a special and important place among glaucoma surgeries. Among various complications, endophthalmitis is a rare but the most devastating complication after glaucoma drainage implantation. In this review, the clinical characteristics and treatment options of endophthalmitis after glaucoma drainage implant surgery are discussed according to recent literature. (Turk J Ophthalmol 2014; 44: 138-43)

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Outcomes of Fornix-based Versus Limbus-based Conjunctival Incisions for Glaucoma Drainage Device Implant

Abstract: Both incision techniques were equally effective in controlling IOP. Each surgical approach has its advantages and this study suggests that either technique may be used safely and effectively.

Cited by 14 publications

References 27 publications

Fornix-Based versus Limbus-Based Conjunctival Flap in Trabeculectomy: A Quantitative Evaluation of the Evidence

Fornix-Based versus Limbus-Based Conjunctival Flap in Trabeculectomy: A Quantitative Evaluation of the Evidence

Retinal implants: a systematic review: Table 1

Glokom Drenaj İmplantı Cerrahisi Sonrası Endoftalmi

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