Primary Deep Sclerectomy in Open-Angle Glaucoma

Rabiolo, Alessandro; Leadbetter, Duncan; Alaghband, Pouya; Anand, Nitin

doi:10.1016/j.ogla.2020.08.013

Cited by 16 publications

(12 citation statements)

References 49 publications

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“…In addition to the two, one patient had endophthalmitis 10 years after DS but had been treated with intravitreal aflibercept 12 days prior to infection, likely the infection cause. This finding aligns with others' findings, because endophthalmitis after DS is remarkably rare, with, to our knowledge, no endophthalmitis rate being reported, apart from a few individual cases (Anand et al, 2011; Chiseliţă & Danielescu, 2010; Rabiolo et al, 2021a). We found three presumed blebitis cases, two after DS and one after converted trabeculectomy.…”

Section: Discussionsupporting

confidence: 92%

“…The combined incidence of blebitis and endophthalmitis has been between 0.46% and 2.2% (Kim et al, 2015; Wallin et al, 2014; Yamamoto et al, 2014). Reports on infections after deep sclerectomy (DS) are scarce, with few case reports found (Anand et al, 2011; Chiseliţă & Danielescu, 2010; Rabiolo et al, 2021a; Wallin & Montan, 2007). Of all endophthalmitis cases, from zero to 5% have been bleb‐related (Durand, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Endophthalmitis and blebitis following deep sclerectomy and trabeculectomy with routine use of mitomycin C

Kankainen

Harju

2022

Acta Ophthalmologica

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The purpose of the study was to investigate the incidence for endophthalmitis and blebitis after deep sclerectomy (DS) and trabeculectomy with routine use of Mitomycin C (MMC) 0.4 mg/ml. Methods: Electronic medical records of patients who underwent surgery 1/2008-4/2020 were reviewed. Cumulative incidence for bleb-associated infection (BAI), including both endophthalmitis and blebitis, was calculated with cumulative incidence function (CIF) and Kaplan-Meier analysis. Risk factors for BAI were evaluated with univariate competing risk regression analysis and Log-rank analysis.Competing event in CIF was death. Results:In this retrospective single-centre cohort study, a total of 2653 patients and 3411 eyes underwent surgery: 3478 glaucoma surgeries, 2419 DS and 1059 trabeculectomies. Two cases of endophthalmitis and three of isolated blebitis developed. Median follow-up from the most recent surgery on the eye until the end of the study was 5.5 years, and until last visit at the ophthalmology department was 1.9 years. For the whole follow-up period in CIF-analysis, cumulative incidence for BAI was 0.16% (95% CI 0.06-0.36) at five years. Incidence was higher with eyes not treated with an antifibrotic during surgery (sub-hazard ratio 11.66, 95% CI 1.94-70.21, p = 0.007). Cumulative incidence between surgery and last visit with Kaplan-Meier analysis was 0.21% (95% CI 0.08-0.52) at five years, similarly, not using an antifibrotic increased incidence (Log-rank p < 0.001). Conclusion:Cumulative incidence for BAI was low despite routine use of high-dose MMC.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Endophthalmitis and blebitis following deep sclerectomy and trabeculectomy with routine use of mitomycin C

Kankainen

Harju

2022

Acta Ophthalmologica

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“…Same-site TRAB shows lower success rates compared with primary NPDS 22 or TRAB, 23 especially for more stringent criteria. Same-site TRAB is performed in eyes with previous surgeries and a repeated intervention has shown lower success rates than those achieved when performed primarily.…”

Section: Discussionmentioning

confidence: 92%

Same-site trabeculectomy with mitomycin and Ologen™ following failed non-penetrating deep sclerectomy

Muñoz‐Negrete

Casanova

Huelin

et al. 2022

European Journal of Ophthalmology

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Purpose To assess the effectiveness and safety of same-site trabeculectomy (TRAB) with mitomycin C (MMC) and Ologen™ (Aeon Astron Europe BV. Leiden, The Netherlands) in patients with a failed non-penetrating deep sclerectomy (NPDS). Methods A retrospective study of 24 consecutive eyes (22 patients) undergoing reintervention by same-site TRAB with at least one-year follow-up after failed NPDS. Mean visual acuity (VA), intraocular pressure (IOP) and use of glaucoma medications were compared before and one year after surgery. Early and late postoperative complications were registered. Kaplan-Meier survival analysis was performed according to four levels of success criteria. Results Overall the mean IOP reduced significantly (24.9 ± 7.1 vs. 14.4 ± 4.5 mmHg; p < 0.001), and the number of glaucoma medications (2.80 ± 1.01 vs. 0.55 ± 0.94; p < 0.001) significantly decreased, one year after surgery. The mean VA remained stable one year after surgery ( p = 0.516). Hypotony, defined as IOP ≤ 5 mmHg, in the early postoperative period was observed in 62.5% of eyes, but only in 2 patients (8.33%) in the long term. The mean survival time ranged from 10 months (CI 95% 5–15) to 29 months (CI 95%: 26–32) according to the most stringent and lenient success criteria respectively. Conclusion Same-site TRAB augmented with MMC and Ologen™ may provide an effective, safe and lasting alternative following failed NPDS, especially when sparing of the conjunctiva is highly desirable. Postoperative hypotony is the most common postoperative complication.

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“…veröffentlichten im September 2020 eine retrospektive Kohortenstudie, in der sie die Langzeitergebnisse nach primärer tiefer Sklerektomie beim Offenwinkelglaukom untersuchten [25]. 513 Augen von 409 Patienten wurde über einen mittleren Zeitraum von etwa 7 Jahren beobachtet [25]. Erfolgsraten für eine Augeninnendrucksenkung auf 18 mmHg oder darunter und 20 % Reduktion waren 66,3 %, 57,9 % bzw.…”

Section: Nicht Penetrierende Glaukomchirurgieunclassified

“…54,0 % nach 3, 5 bzw. 7 Jahren [25]. In der Untersuchung der postoperativen Komplikationen zeigte sich, dass das Vorliegen eines PDG oder eines Pseudoexfoliationsglaukoms statistisch signifikant mit einem erhöhten Risiko schwerer postoperativer Komplikationen assoziiert ist [25].…”

Section: Nicht Penetrierende Glaukomchirurgieunclassified

Pigmentdispersionssyndrom

Nobl¹,

Mackert²

2021

Augenheilkunde up2date

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ZusammenfassungDas Pigmentdispersionssyndrom ist eine Erkrankung, die durch Abschilferung von Pigment aus dem Irispigmentepithel und dessen Ablagerung im vorderen Augenabschnitt charakterisiert ist. Typisch ist eine Trias aus Ablagerungen am Hornhautendothel, zirkulären Iristransilluminationen und einer Pigmentierung des Trabekelwerks. Das Spektrum reicht vom einfachen Pigmentdispersionssyndrom bis zum Pigmentdispersionsglaukom mit Optikusatrophie.

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Primary Deep Sclerectomy in Open-Angle Glaucoma

Cited by 16 publications

References 49 publications

Endophthalmitis and blebitis following deep sclerectomy and trabeculectomy with routine use of mitomycin C

Endophthalmitis and blebitis following deep sclerectomy and trabeculectomy with routine use of mitomycin C

Same-site trabeculectomy with mitomycin and Ologen™ following failed non-penetrating deep sclerectomy

Pigmentdispersionssyndrom

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