XEN gel implant versus gonioscopy-assisted transluminal trabeculotomy for the treatment of open-angle glaucoma

Olgun, Ali; Aktaş, Zeynep; Üçgül, Ahmet Yücel

doi:10.1007/s10792-019-01271-w

Cited by 27 publications

(45 citation statements)

References 15 publications

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“…Studies of gonioscopy-assisted transluminal trabeculotomy (GATT)-which can be performed with either a suture or microcatheter-have reported IOP reductions on the order of 30-45% and medication reductions of approximately 30-70% as a standalone procedure; when performed in combination with phacoemulsification, IOP reductions of approximately 30-70% and medication reductions of approximately 45-90% have been reported through 6-24 months of follow-up. [18][19][20][21][22][23][24][25] Ab interno trabeculotomy using the TRAB360 device lowered IOP approximately 30% and medications approximately 35-80% in a retrospective study of patients with refractory glaucoma of various etiologies. 26 In the present study, the protocol specified that trabeculotomy would be limited to 180 degrees.…”

Section: Discussionmentioning

confidence: 99%

Canaloplasty and Trabeculotomy Combined with Phacoemulsification in Open-Angle Glaucoma: Interim Results from the GEMINI Study

Gallardo¹,

Sarkisian²,

Vold³

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Canaloplasty and Trabeculotomy Combined with Phacoemulsification in Open-Angle Glaucoma: Interim Results from the GEMINI Study

Gallardo¹,

Sarkisian²,

Vold³

et al. 2021

OPTH

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“…Standalone incisional goniotomy with the Trabectome has been reported to produce mean IOP reductions of 23-39% 26,27 and medication reductions of 7-43%. [27][28][29][30][31] Gonioscopy-assisted transluminal trabeculotomy can lower IOP 28-44% and medications 28-70%, [32][33][34][35][36][37] while ab interno trabeculotomy produces IOP reductions of 31-32% and medication reductions of 35-82%. 38,39 With so many novel glaucoma surgeries available, the significance of glaucoma severity on the choice of surgical procedures to perform is incompletely characterized.…”

Section: Discussionmentioning

confidence: 99%

<p>Twelve-Month Outcomes of Stand-Alone Excisional Goniotomy in Mild to Severe Glaucoma</p>

ElMallah¹,

Berdahl²,

Williamson³

et al. 2020

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Purpose To describe 12-month intraocular pressure (IOP) and medication use outcomes following excisional goniotomy (EG) as a stand-alone procedure in eyes with medically uncontrolled glaucoma. Methods This was a retrospective analysis of data from surgeons at 8 centers (6 US, 2 Mexico). Eyes with glaucoma undergoing standalone EG with a specialized instrument (Kahook Dual Blade, New World Medical, Rancho Cucamonga, CA) for IOP reduction and followed for 12 months postoperatively were included. Data were collected preoperatively, intraoperatively, and 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. The primary outcome was reduction from baseline in IOP, and key secondary outcomes included IOP-lowering medication reduction as well as adverse events. Results A total of 42 eyes were analyzed, of which 36 (85.7%) had mild to severe primary open-angle glaucoma (POAG). Mean (standard error) IOP at baseline was 21.6 (0.8) mmHg, and mean number of medications used at baseline was 2.6 (0.2). At 3, 6, and 12 months postoperatively, mean IOP reductions from baseline were 4.6 mmHg (22.3%), 5.6 mmHg (27.7%), and 3.9 mmHg (19.3%) (p≤0.001 at each time point). At the same time points, mean medications reductions of 0.7 (25.8%), 0.9 (32.6%), and 0.3 (12.5%) medications were seen (p<0.05 at months 3 and 6, not significant at month 12). Six eyes (14.3%) underwent additional glaucoma surgery during the 12-month follow-up period. Discussion Standalone EG with KDB can reduce IOP, and in many cases reduce medication use, through up to 12 months in eyes with mild to severe glaucoma. Statistically significant and clinically relevant reductions in IOP were seen at every time point. While the goal of surgery was not to reduce medication burden, mean medication use was significantly reduced at all but the last time point. In the majority of eyes, the need for a bleb-based glaucoma procedure was delayed or prevented for at least 12 months.

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“…Together this system features three mechanisms of action for IOP reduction: excision of the TM to overcome the known increased resistance to aqueous outflow through the TM in OAG, along with viscodilation of Schlemm's canal and the distal collector channels, which are secondary points of outflow resistance. [5][6][7][8] Each procedure alone has been shown to effectively and safely lower IOP in eyes with primary open-angle glaucoma (POAG), [9][10][11][12][13][14][15][16][17][18][19] and the combination of both procedures using the OMNI system was recently reported to lower IOP by an average of ~35% and medications by ~25-50% in retrospective studies. 9,20,21 In this paper, we describe the 12-month interim analysis of an ongoing prospective 24-month evaluation of combined viscodilation/trabeculotomy with or without phacoemulsification in eyes with mild to moderate OAG.…”

Section: Introductionmentioning

confidence: 99%

12-month interim results of a prospective study of patients with mild to moderate open-angle glaucoma undergoing combined viscodilation of Schlemm’s canal and collector channels and 360° trabeculotomy as a standalone procedure or combined with cataract surgery

Grabska‐Liberek

Duda

Rogowska

et al. 2021

European Journal of Ophthalmology

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Purpose: To characterize clinical outcomes of combined viscodilation of Schlemm’s canal and collector channels and 360° trabeculotomy as a standalone procedure or combined with cataract surgery in eyes with mild to moderate open-angle glaucoma (OAG). Methods: In this prospective case series, the OMNI glaucoma surgical platform (Sight Sciences, Menlo Park, CA) was utilized to perform the procedure either combined with phacoemulsification or as a standalone procedure. Changes from baseline in intraocular pressure (IOP) and IOP-lowering medications were evaluated through the first 12 months of a planned 24-month follow-up period. Results: Among 17 eyes of 15 subjects, mean IOP was reduced from 20.4 mmHg to 12.7–13.7 mmHg through 12 months of follow-up ( p < 0.001 at every time point) and mean medications reduced from 2.5 to 0.1–0.6 ( p < 0.001 at every time point). IOP reductions in eyes undergoing standalone surgery were approximately 2–4 mmHg greater at each time point compared to eyes undergoing surgery combined with phacoemulsification; this may be related to a higher baseline IOP in the former eyes (22.1 vs 18.5 mmHg). Six eyes developed hyphema, of which three required washout for elevated IOP on the first postoperative day; six additional eyes had IOP elevations that resolved with medical management. Conclusion: Viscodilation of Schlemm’s canal and collector channels paired with ab interno trabeculotomy performed with a single integrated instrument (OMNI), whether as standalone or combined with phacoemulsification, effectively lowers both IOP and the need for IOP-lowering medications through 12 months of follow-up.

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XEN gel implant versus gonioscopy-assisted transluminal trabeculotomy for the treatment of open-angle glaucoma

Cited by 27 publications

References 15 publications

Canaloplasty and Trabeculotomy Combined with Phacoemulsification in Open-Angle Glaucoma: Interim Results from the GEMINI Study

Canaloplasty and Trabeculotomy Combined with Phacoemulsification in Open-Angle Glaucoma: Interim Results from the GEMINI Study

<p>Twelve-Month Outcomes of Stand-Alone Excisional Goniotomy in Mild to Severe Glaucoma</p>

12-month interim results of a prospective study of patients with mild to moderate open-angle glaucoma undergoing combined viscodilation of Schlemm’s canal and collector channels and 360° trabeculotomy as a standalone procedure or combined with cataract surgery

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