One-year follow-up of the XEN® implant with mitomycin-C in pseudoexfoliative glaucoma patients

2018 ◽  
Vol 29 (3) ◽  
pp. 309-314 ◽  
Author(s):  
Ana Ibáñez-Muñoz ◽  
Víctor Santiago Soto-Biforcos ◽  
María Chacón-González ◽  
Oscar Rúa-Galisteo ◽  
Alexandra Arrieta-Los Santos ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Primary Outcome ◽  
Primary Outcome Measure ◽  
Pressure Reduction ◽  
Pseudoexfoliative Glaucoma ◽  
Intraocular Pressure Reduction ◽  
Pressure Lowering ◽  
One Year

Purpose: To evaluate the intraocular pressure–lowering effect, the safety profile, and the success rate of the XEN45 Gel Stent (Allergan, Dublin, Ireland) in patients with pseudoexfoliative glaucoma. Methods: Retrospective study conducted on patients with pseudoexfoliative glaucoma, with or without cataract, who underwent XEN45 implantation surgery with subconjunctival mitomycin-C and had a minimum postoperative follow-up period of 12 months. The primary outcome measure was intraocular pressure reduction at 1 year as compared to baseline. Complete success was defined as a postoperative intraocular pressure reduction of ⩾20% from preoperative baseline at 12 months without any glaucoma medications. Qualified success was defined as a postoperative intraocular pressure reduction of ⩾20% at 12 months with medications. Results: Of the 24 screened patients, 21 eyes of 20 patients met the inclusion/exclusion criteria and were included in the study. A total of 13 (62%) eyes underwent XEN alone surgery and 8 (38%) eyes had combined XEN + cataract surgery. Mean intraocular pressure was significantly reduced from 21.1 (3.8) mmHg at baseline to 15.2 (3.9) mmHg at 1 year, p < 0.001. Mean antiglaucoma medications dropped from 2.95 (0.97) preoperatively to 1.23 (1.22) at month 12 (p < 0.001). Of the 21 eyes included in the study, 18 (85.7%) were considered as success, 6 (28.6%) as complete success, and 12 (57.1%) as qualified success. Five eyes required needling revision. Complications included uveitis, choroidal detachment, hyphema, and cystoid macular edema in 2, 1, 1, and 1 eye, respectively. Conclusion: XEN45 Gel Stent implant significantly reduced the intraocular pressure and the number of antiglaucoma medications in patients with pseudoexfoliative glaucoma.

scholarly journals Intracameral Bevacizumab Versus Sub-Tenon’s Mitomycin C as Adjuncts to Trabeculectomy: 3-Year Results of a Prospective Randomized Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2054
Author(s):  
Gerasimos Kopsinis ◽  
Dimitrios Tsoukanas ◽  
Dimitra Kopsini ◽  
Theodoros Filippopoulos
Keyword(s):  
Mitomycin C ◽  
Primary Outcome ◽  
Randomized Study ◽  
Primary Outcome Measure ◽  
Complication Rates ◽  
Filtration Surgery ◽  
Significant Difference ◽  
Exfoliative Glaucoma

Conjunctival wound healing determines success after filtration surgery and the quest for better antifibrotic agents remains active. This study compares intracameral bevacizumab to sub-Tenon’s mitomycin C (MMC) in trabeculectomy. Primary open-angle or exfoliative glaucoma patients were randomized to either bevacizumab (n = 50 eyes) or MMC (n = 50 eyes). The primary outcome measure was complete success, defined as Intraocular Pressure (IOP) > 5 mmHg and ≤ 21 mmHg with a minimum 20% reduction from baseline without medications. Average IOP and glaucoma medications decreased significantly in both groups at all follow-up points compared to baseline (p < 0.001), without significant difference between groups at 3 years (IOP: bevacizumab group from 29 ± 9.4 to 15 ± 3.4 mmHg, MMC group from 28.3 ± 8.7 to 15.4 ± 3.8 mmHg, p = 0.60; Medications: bevacizumab group from 3.5 ± 0.9 to 0.5 ± 1, MMC group from 3.6 ± 0.7 to 0.6 ± 1.1, p = 0.70). Complete success, although similar between groups at 3 years (66% vs. 64%), was significantly higher for bevacizumab at months 6 and 12 (96% vs. 82%, p = 0.03; 88% vs. 72%, p = 0.04, respectively) with fewer patients requiring medications at months 6, 9 and 12 (4% vs. 18%, p = 0.03; 6% vs. 20%, p = 0.04; 8% vs. 24%, p = 0.03, respectively). Complication rates were similar between groups. In conclusion, intracameral bevacizumab appears to provide similar long-term efficacy and safety results as sub-Tenon’s MMC after trabeculectomy.

Intraocular pressure reduction with topical medications and progression of normal-tension glaucoma: a 12-year mean follow-up study

2013 ◽  
Vol 91 (4) ◽  
pp. e270-e275 ◽  
Author(s):  
Martha Kim ◽  
Dong Myung Kim ◽  
Ki Ho Park ◽  
Tae-Woo Kim ◽  
Jin Wook Jeoung ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Normal Tension Glaucoma ◽  
Pressure Reduction ◽  
Follow Up Study ◽  
Intraocular Pressure Reduction ◽  
Topical Medications

Comparison of performance between two microcatheter systems in ab externo canaloplasty: A retrospective comparison study

2019 ◽  
Vol 30 (3) ◽  
pp. 487-493
Author(s):  
Iraklis Vastardis ◽  
Kalliopi Kontopoulou ◽  
Sofia Fili ◽  
Zisis Gatzioufas ◽  
Markus Kohlhaas
Keyword(s):  
Intraocular Pressure ◽  
Drug Therapy ◽  
Group Formation ◽  
Pairwise Comparison ◽  
Pressure Reduction ◽  
Intraocular Pressure Reduction ◽  
Kaplan Meier ◽  
Phakic Eyes ◽  
Selection Of

Purpose: To compare the performance of two different microcatheter systems, iTrack™ 250A and Glaucolight, in ab externo canaloplasty in three major categories: intraocular pressure reduction, drug therapy reintroduction, and evaluation of viscodilation over distension of the inner wall of Schlemm’s canal. Methods: A total of 56 and 46 eyes from different glaucoma types underwent ab externo canaloplasty using two different microcatheter systems. Group formation was made according to microcatheter system used. Kaplan–Meier test was performed for drug therapy reintroduction in relation to the two microcatheters. Tests of between-subject effects in two-way analysis of variance evaluated the efficacy of the two microcatheters and their features in relation to intraocular pressure reduction. Results: Kaplan–Meier test was not statistically significant (p = 0.20) regardless of microcatheter system. Tests of between-subject effects in relation to intraocular pressure reduction was not statistically different between the two microcatheters (p = 0.26) or between microcatheter and follow-up (p = 0.90). Intraocular pressure reduction in different glaucoma type was statistically significant during the follow-up period and glaucoma types showed different results between them in relation to follow-up (p < 0.001 and p = 0.002, respectively), but the pairwise comparison was not statistically important (p = 0.42). Intraocular pressure reduction was better in pseudophakic eyes in comparison with phakic eyes (p = 0.03), but the selection of microcatheter seemed not to affect this result (p = 0.11 and p = 0.32, respectively). Conclusion: Both microcatheter systems performed equal in terms of intraocular pressure reduction. Drug therapy reintroduction was not affected by the selection of the two microcatheters. Different types of glaucoma responded different to canaloplasty. Pseudophakic eyes responded better to treatment than phakic eyes, but the microcatheter selection seemed not affect this result.

A standardized protocol of laser suture lysis in postoperative management in trabeculectomy with mitomycin C: One-year study

2020 ◽  
pp. 112067212090169
Author(s):  
Sofia Sousa Mano ◽  
Raquel Marques Esteves ◽  
Nuno Pinto Ferreira ◽  
Luís Abegão Pinto
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Open Angle Glaucoma ◽  
Postoperative Management ◽  
Mean Value ◽  
Early Postoperative Period ◽  
Tertiary Centre ◽  
Laser Suture Lysis ◽  
Pressure Lowering

Aim: To analyse the efficacy and safety of a standardized laser suture lysis protocol following trabeculectomy. Materials and methods: Prospective interventional study conducted at a tertiary centre, between June 2016 and July 2017. Consecutive patients undergoing primary trabeculectomy with mitomycin C (0.4 mg/mL) for open angle glaucoma were enrolled. According to study protocol, a first laser suture lysis was performed routinely when intraocular pressure was greater than 10 mmHg, starting at postoperative day 8, and a second laser suture lysis was done whenever the intraocular pressure was newly greater than 10 mmHg, with a minimum interval of 1 week after the first laser suture lysis. Primary outcome was intraocular pressure (mean value, and mean difference from baseline in percentage). Safety parameters were also analysed. Results: Thirty-three eyes of 28 patients (13 males) were enrolled with a mean age of 69.6 ± 15.1 years. Pre-operative intraocular pressure was 24.9 ± 8.6 mmHg. All eyes underwent a laser suture lysis before the 12th postoperative week, with a mean intraocular pressure–lowering efficacy of 42.4% (p < 0.01). A second laser suture lysis procedure, when performed (n = 14), had an additional intraocular pressure–lowering efficacy of 26.7% (p = 0.02). Mean intraocular pressure at 1-month follow-up was 12.9 ± 8.2 mmHg, and during this period, two cases of self-limited choroidal detachments were noticed. Ten patients needed additional bleb needling. Mean intraocular pressure at 1-year follow-up was 13.8 ± 8.0 mmHg under an average of 0.4 topical intraocular pressure–lowering drugs (p < 0.01). Conclusion: In our study, laser suture lysis was an effective tool to lower intraocular pressure during the early postoperative period, with an acceptable safety profile.

Trabeculectomy with OloGen versus Mitomycin C for the Treatment of Silicone Oil-Induced Glaucoma

2021 ◽  
Author(s):  
Hisham Samy Shalaby ◽  
Noureldin Hussein Hashem
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Silicone Oil ◽  
Success Rates ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Pressure Lowering ◽  
Group A ◽  
Group B

Abstract Aim To compare the intraocular pressure-lowering effect and success rate of trabeculectomy with OloGen to that of trabeculectomy with mitomycin C (MMC) in cases of silicone oil-induced glaucoma. Materials and Methods Forty eyes of forty patients with elevated intraocular pressure (IOP) after vitrectomy and silicone oil injection (followed by silicone oil removal) were assigned to two groups. Group A included 20 cases who underwent trabeculectomy with OloGen, while group B cases contained 20 cases undergoing trabeculectomy with MMC. The follow-up period was 24 months. Patients enrolled had IOP > 21 mmHg despite being on antiglaucoma medications. Results The mean postoperative IOP reduction was lower in group A than in group B at all follow-up visits, but this difference was not statistically significant (p > 0.05). Moreover, group A and B patients were found to be similar as regards the need for postoperative antiglaucoma medications on all follow-up visits. The Kaplan-Meier survival analysis curves for the two groups revealed slightly higher success rates in group B than in group A. However, these differences were not statistically significant for both qualified success (IOP ≤ 21 mmHg with or without antiglaucoma medications) and complete success (IOP ≤ 21 mmHg without antiglaucoma medications). There was no significant difference in the postoperative complication rate between the two groups. Conclusion OloGen implant lowers IOP to a similar extent as MMC when combined with trabeculectomy for the treatment of silicone oil-induced glaucoma, and with comparable success rates. The rate of postoperative complications is similar for OloGen implantation and MMC.

Outcome of trabeculectomy with Ologen versus Mitomycin C: A comparative prospective study in Bangladesh

2018 ◽  
Vol 29 (2) ◽  
pp. 183-188 ◽  
Author(s):  
Bipul Kumer De Sarker ◽  
Sadiq M Abdullahi ◽  
Zafrul Hassan ◽  
Jahangir Kabir ◽  
Sarat Badmus ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Prospective Study ◽  
Mitomycin C ◽  
Primary Outcome Measure ◽  
Glaucoma Medication ◽  
Significant Difference ◽  
Primary Glaucoma ◽  
A Prospective Study ◽  
Comparative Prospective Study

Aims: To compare the efficacy and safety of trabeculectomy with Ologen versus Mitomycin C in primary glaucoma Materials and methods: This is a prospective study of patients aged 18 years and above, diagnosed with primary glaucoma randomised to having trabeculectomy with Ologen or Mitomycin C. The primary outcome measure was success of trabeculectomy defined as intraocular pressure >5 mmHg but ≤21 mmHg. Complete success was defined as intraocular pressure achieved without anti-glaucoma medication and qualified success was defined as intraocular pressure achieved with additional anti-glaucoma medication. Results: At the end of 12 months follow-up, the postoperative mean intraocular pressure in the Ologen group was 12.8 ± 1.6 mmHg and 13.4 ± 2.2 mmHg in the Mitomycin C group. The Ologen group achieved complete success in 86.5% and qualified success in 13.5% of the patients, while the Mitomycin C group achieved complete and qualified success in 85.5% and 14.5%, respectively. There was no statistically significant difference in the success rate of both the groups ( p = 0.57). Furthermore, no significant intraocular pressure difference was noted between the two groups at the end of 12 months follow-up ( p = 0.14). Conclusion: Trabeculectomy augmented with Ologen appeared to be as successful and safe as trabeculectomy augmented with Mitomycin C, with no reported adverse reaction to Ologen.

scholarly journals Intraluminal stenting versus external ligation of Ahmed glaucoma valve in prevention of postoperative hypotony

2021 ◽  
Vol 14 (10) ◽  
pp. 1560-1564
Author(s):  
Dina Abd Elfattah ◽  
◽  
Tharwat Mokbel ◽  
Hisham Elsorogy ◽  
Abd-Elmonem A. Elhesy ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Primary Outcome ◽  
Ahmed Glaucoma Valve ◽  
Refractory Glaucoma ◽  
Group 2 ◽  
One Year ◽  
Prevention Methods ◽  
Age Range ◽  
Group 1

AIM: To compare intraluminal stenting and external ligation of Ahmed glaucoma valves (AGV) for refractory glaucoma management and postoperative hypotony prevention. METHODS: This randomized prospective blind study included 30 eyes of 25 patients (age range: 44-56y) with refractory glaucoma. This study was conducted from September 2018 to January 2020. The study included two groups, AGV with intraluminal stenting group (n=15 eyes) and AGV with external ligation group (n=15 eyes). Follow-up period was one year postoperatively. The primary outcome was intraocular pressure (IOP) and its association with the number of postoperative glaucoma medications. IOP?≤?21 mm Hg without medications indicated complete success while IOP?≤?21 mm Hg with medications indicated qualified success; and IOP<6 mm Hg was defined as hypotony. RESULTS: After a year of follow-up, IOP was significantly reduced in the intraluminal stenting group than in the external ligation group (11.67±0.89 vs 14.2±4.0 mm Hg, respectively, P=0.024). Postoperative hypotony was more common in the external ligation group (2 cases, 13.33%) than in the intraluminal stenting group (1 case, 6.67%). CONCLUSION: Application of intraluminal stenting or external ligation during AGV surgery usually prevents postoperative hypotony (transient and persistent) that occurs in conventional AGV surgery.

scholarly journals Intraocular Pressure Control after Trabeculectomy with Adjunctive Use of Mitomycin-C versus Bevacizumab: A Hospital Based Study

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
P S Mahar ◽  
Sobia Tabassum ◽  
Mujahid Inam ◽  
Muhammad Faaz Malik ◽  
Tauseef Mahmood
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Pressure Control ◽  
T Test ◽  
P Value ◽  
Open Angle ◽  
One Year

Purpose:  To compare the control of intra ocular pressure (IOP) after trabeculectomy with adjunctive use of Mitomycin–C (MMC) versus Bevacizumab. Study Design:  Quasi experimental study. Place and Duration of Study:  Al-Ibrahim Eye Hospital, Isra Postgraduate Institute of Ophthalmology, Karachi, from August 2017 to August 2019. Methods:  One hundred and six patients of either gender, fulfilling the inclusion criteria were planned for trabeculectomy with adjunctive use of Mitomycin-C (MMC) or Bevacizumab. Each group consisted of 53 patients (53 Eyes). The patients diagnosed with Primary Open Angle Glaucoma (POAG) with IOP ? 21 mm Hg and not controlled with topical anti-glaucoma medication were selected. Data were analyzed by using SPSS Version 22.0. Independent sample t test was used to check significance between two drugs. Paired sample t test was used to check significance of pre and post-operative IOP. Results:  Mean age of patients was 56.67±7.34 years. Mean preoperative IOP was 31.51 ± 9.66 mm Hg in MMC group and 29.21 ± 7.69 mm Hg in Bevacizumab group. At first postoperative day, mean IOP after use of MMC was 14.75 ± 9.46 mm Hg and for Bevacizumab was 15.07 ± 6.47 mm Hg (p-value 0.001). Similarly, at one year follow-up, mean IOP for MMC group was 11.26 ± 2.31 mm Hg and for Bevacizumab was 11.73 ± 2.12 mm Hg(p-value 0.001). Conclusion:  There was significant reduction in IOP in both MMC and Bevacizumab groups. However, the difference between the two groups was not statistically significant at mean follow-up of one year. Key Words:  Primary Open Angle Glaucoma, Mitomycin–C, Intraocular Pressure, Bevacizumab, Trabeculectomy.

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