Risk assessment of sudden visual loss following non-penetrating deep sclerectomy in severe and end-stage glaucoma

Leleu, Igor; Penaud, Benjamin; Blumen-Ohana, E.; Rodallec, T.; Raphael, Anthony P.; Laplace, O.; Nordmann, Jean‐Philippe

doi:10.1038/s41433-019-0336-z

Cited by 12 publications

(6 citation statements)

References 40 publications

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“…reported that the VA of severe and end stage glaucoma patients was not improved when combined the glaucoma surgery of NPDS with phacoemulsification [23]. While in his later study, the VA was improved after the same surgeries [9]. Both of the studies were last for 6 months.…”

Section: Discussionmentioning

confidence: 96%

Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP:A Retrospective Study

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Chan

et al. 2020

Preprint

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Background: To investigate the long term surgical outcomes of cataract surgery in severe and end stage glaucoma patients with preoperative intraocular pressure less than 21mmHg, and to detect the associated factors.Methods: A retrospective study of primary angle closure glaucoma patients was conducted on who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications. Results: Sixteen patients (19 eyes) were included. The mean age was 64.89 ± 11.68 years and the mean followed up duration was 21.89 ± 7.85 months. The final visual acuity was significantly improved from 0.69 ± 0.55 to 0.46 ± 0.52 logMAR , within 12 (63.2%) eyes improved, 4 (21.1%) eyes kept unchanged, and 3 (15.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with better final visual acuity (r = -0.511, r = -0.493, r = 0.537 respectively). Moreover, the final number of medications were reduced from 1.26 ± 0.99 to 0.26 ± 0.56 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 14.48 ± 3.74 mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was decreased to 6 (31.6%) eyes compared to 10 (52.6%) eyes at baseline. Moreover, the number of eyes free of medications was increased from 4 (21.1%) preoperatively to 15 (78.9%) eyes postoperatively.Conclusions: Final visual acuity was significantly improved in the severe and end stage primary angle closure glaucoma patients and the number of eyes came off medications increased by 57.8% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the final visual acuity after cataract surgery.

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Section: Discussionmentioning

confidence: 96%

Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP:A Retrospective Study

Фу

Chan

et al. 2020

Preprint

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“…And in 2018, Igor et al reported that the VA of severe and end stage glaucoma patients was not improved when combined the glaucoma surgery of NPDS with phacoemulsification [23]. While in his later study, the VA was improved after the same surgeries [9]. Both of the studies were last for 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…Particularly, the understanding on the visual outcome of these patients after cataract surgery is lacking. The reported surgical outcomes of cataract surgery in severe and end stage glaucoma in literature were mainly come up from patients who were medically uncontrolled [9,21]. In glaucoma patients with controlled IOP, cataract surgery is seldomly performed since they are at high risk of "wipe out" [6,7].…”

Section: Discussionmentioning

confidence: 99%

“…Glaucomatous eyes, as reported, can still gain satisfactory visual outcomes after phacoemulsification [8]. Combined phacoemulsification and non-penetrating deep sclerectomy (NPDS) was ever performed in the severe and end stage glaucoma patients, no "wipe out" was observed and the mean VA was improved at month-6 postoperatively [9]. Another study demonstrated that 73% glaucoma patients with low vision had better vision or maintained at 5 years after cataract surgery [10].…”

Section: Introductionmentioning

confidence: 90%

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Long term outcomes of cataract surgery in severe and end stage primary angle closure glaucoma with controlled IOP: a retrospective study

Фу

Chan

et al. 2020

BMC Ophthalmol

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Background: To investigate the long term surgical outcomes of cataract surgery in severe and end stage glaucoma patients with preoperative intraocular pressure less than 21 mmHg, and to detect the associated factors. Methods: A retrospective study of primary angle closure glaucoma patients was conducted on who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications. Results: Sixteen patients (19 eyes) were included. The mean age was 64.89 ± 11.68 years and the mean followed up duration was 21.89 ± 7.85 months. The final visual acuity was significantly improved from 0.69 ± 0.55 to 0.46 ± 0.52 logMAR, within 12 (63.2%) eyes improved, 4 (21.1%) eyes kept unchanged, and 3 (15.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with better final visual acuity (r = − 0.511, r = − 0.493, r = 0.537 respectively). Moreover, the final number of medications were reduced from 1.26 ± 0.99 to 0.26 ± 0.56 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 14.48 ± 3.74 mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was decreased to 6 (31.6%) eyes compared to 10 (52.6%) eyes at baseline. Moreover, the number of eyes free of medications was increased from 4 (21.1%) preoperatively to 15 (78.9%) eyes postoperatively. Conclusions: Final visual acuity was significantly improved in the severe and end stage primary angle closure glaucoma patients and the number of eyes came off medications increased by 57.8% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the final visual acuity after cataract surgery.

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“…To demonstrate progression in advanced glaucoma, 10-2 VF test offers better results than 24-2 VF test in assessing rates of mean deviation (MD) changes (15). The previous studies investigated wipeout phenomenon after trabeculectomy and non-penetrating deep sclerectomy (NPDS) (9)(10)(11)(12)(13)16). To the best of our knowledge, this phenomenon has not been reported after Ahmed glaucoma valve (AGV) surgery in the literature yet.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Sudden Visual Loss and Central 10-Degree Visual Field Change Following Glaucoma Surgery in Severe and End-Stage Eyes

et al. 2022

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Objectives:The purpose of the study was to evaluate the sudden visual loss and central 10-degree visual field (VF) change following glaucoma surgery in eyes with severe and end-stage glaucoma. Methods: This was a single-center retrospective study. The charts of patients with severe and end-stage glaucoma who had undergone trabeculectomy and Ahmed glaucoma valve (AGV) implantation surgery were reviewed. Patients who had 10-2 Humphrey VF automated (HVFA) at follow-up were included and classified into two following groups: With split fixation on 10-2 HVFA before surgery split fixation group (SFG) and those without split fixation (WSFG). Results: The data of 37 patients in SFG and 28 patients in WSFG were reviewed. The mean follow-up duration was 2.06±0.24 years in SFG and 2±0.3 years in WSFG. 10-2 HVFA revealed that SFG had a mean MD -25.8±5.2 dB preoperatively and -25.2±1.1 dB (p=0.18) at last visit, WSFG had a mean MD −9.8±4.8 dB preoperatively and −10.8±1.5 dB at last visit (p=0.10). In SFG, the mean intraocular pressure (IOP) decreased from 30.1±9.5 mmHg to 12.3±0.62 mmHg (p<0.001), and in WSFG, the mean IOP decreased from 30±6.9 mmHg to 12.3±0.90 mmHg at last visit (p<0.001). There was no statistical difference for visual acuity of both the groups at the follow-up (p=0.30 and p=0.70). In SFG, one patient had wipe-out phenomenon who had undergone AGV surgery. Conclusion: Although wipe-out phenomenon was a rare complication, it can develop not only after trabeculectomy but also after AGV surgery, and patients with split fixation and severe and end-stage glaucoma were at risk for this phenomenon regardless of the type of surgery. Both trabeculectomy and AGV surgery appear to provide stability of the central 10° VF.

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Risk assessment of sudden visual loss following non-penetrating deep sclerectomy in severe and end-stage glaucoma

Cited by 12 publications

References 40 publications

Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP:A Retrospective Study

Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP:A Retrospective Study

Long term outcomes of cataract surgery in severe and end stage primary angle closure glaucoma with controlled IOP: a retrospective study

Evaluation of Sudden Visual Loss and Central 10-Degree Visual Field Change Following Glaucoma Surgery in Severe and End-Stage Eyes

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