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Kateki Vinod, Steven J Gedde
PURPOSE OF REVIEW: This article reviews recent studies evaluating the efficacy and complication profiles of novel glaucoma procedures promoting aqueous outflow. RECENT FINDINGS: Literature from the 2015 to 2016 review period includes abundant data regarding new and emerging glaucoma procedures. Notable findings from recent randomized clinical trials include titratability of intraocular pressure with multiple trabecular microbypass stents (iStent; Glaukos, Laguna Hills, California, USA) and greater reduction in intraocular pressure and medication usage following intracanalicular scaffolding (Hydrus Microstent; Ivantis Inc...
October 19, 2016: Current Opinion in Ophthalmology
Richard Lindstrom, Richard Lewis, Dana M Hornbeak, Lilit Voskanyan, Jane Ellen Giamporcaro, John Hovanesian, Steven Sarkisian
INTRODUCTION: The study objective was to evaluate the intraocular pressure (IOP) and medication-lowering effect of 2 second-generation trabecular micro-bypass stents in eyes with open-angle glaucoma (OAG) on one preoperative medication. METHODS: Fifty-seven qualified phakic eyes with OAG on 1 medication, preoperative medicated IOP of 18-30 mmHg, and preoperative unmedicated (post-washout) IOP of 22-38 mmHg underwent implantation of 2 second-generation trabecular micro-bypass stents in a standalone procedure...
October 13, 2016: Advances in Therapy
Leonard K Seibold, Kevin M Gamett, Jeffrey B Kennedy, Matthew J Mulvahill, Miranda E Kroehl, Jeffrey R SooHoo, Mina B Pantcheva, Malik Y Kahook
PURPOSE: To study the effect of combined phacoemulsification cataract surgery and iStent (trabecular microbypass stent) implantation on intraocular pressure (IOP) and medication use in open-angle glaucoma (OAG) patients with a low mean preoperative IOP. SETTING: University of Colorado Health Eye Center, Aurora, Colorado, USA. DESIGN: Retrospective case series. METHODS: Treatment outcomes analyzed included IOP, medication use, and corrected distance visual acuity (CDVA)...
September 2016: Journal of Cataract and Refractive Surgery
Steven D Vold, Lilit Voskanyan, Manfred Tetz, Gerd Auffarth, Imran Masood, Leon Au, Iqbal Ike K Ahmed, Hady Saheb
PURPOSE: To examine outcomes through 36 months in phakic eyes with newly diagnosed primary open-angle glaucoma (POAG) naïve to therapy randomized to treatment with two trabecular micro-bypass stents or topical prostaglandin. METHODS: Subjects with POAG naïve to therapy, with intraocular pressure (IOP) ≥21 and ≤40 mmHg, were randomized to implantation of two stents or travoprost. Additional medication was to be prescribed post-treatment for elevated IOP or glaucomatous optic nerve findings...
September 12, 2016: Ophthalmology and Therapy
Hidenoba Tanihara, Ikuko Abe
It is said that the description of an ocular disorder related to the color of the sea in the Hippocratic Corpus is the oldest medical reference to glaucoma. In the early Edo period in Japan, the Books of Secrets of the Majima school, describe a disorder called aosokohi. This nomenclature is believed to be based upon the Five Elements' Theory (Wu-Xing Thought)in ancient China, which assigned five colors for intraocular disorders ("naisho/sokohi" in Japanese), blue ("ao" in Japanese), red, yellow, white and black...
May 2016: Nippon Ganka Gakkai Zasshi
Tobias H Neuhann
PURPOSE: To evaluate long-term safety and efficacy of iStent trabecular micro-bypass stent implantation during cataract surgery in patients with primary open-angle, pseudo-exfoliation glaucoma, ocular hypertension, or secondary or post-traumatic glaucoma. SETTING: AaM Augenklinik am Marienplatz, Munich, Germany. DESIGN: Prospective, open-label, non-randomized study. METHODS: Preoperative and postoperative evaluations included intra-ocular pressure (IOP), topical ocular hypotensive medication use, cup/disc ratio, corrected-distance visual acuity (CDVA), complications, and adverse events...
December 2015: Journal of Cataract and Refractive Surgery
Madhvi Deol, Joshua R Ehrlich, Mitsugu Shimmyo, Nathan M Radcliffe
PURPOSE: To evaluate the relationship between baseline corneal hysteresis (CH) and the change in intraocular pressure (IOP) before and after cataract extraction in patients without glaucoma. SETTING: Private practice, New York City, New York, USA. DESIGN: Retrospective cohort study. METHODS: Charts of consecutive patients who had phacoemulsification cataract extraction with posterior chamber intraocular lens implantation were analyzed...
June 2015: Journal of Cataract and Refractive Surgery
Christopher T Leffler, Stephen G Schwartz, Tamer M Hadi, Ali Salman, Vivek Vasuki
To the ancient Greeks, glaukos occasionally described diseased eyes, but more typically described healthy irides, which were glaucous (light blue, gray, or green). During the Hippocratic period, a pathologic glaukos pupil indicated a media opacity that was not dark. Although not emphasized by present-day ophthalmologists, the pupil in acute angle closure may appear somewhat green, as the mid-dilated pupil exposes the cataractous lens. The ancient Greeks would probably have described a (normal) green iris or (diseased) green pupil as glaukos...
2015: Clinical Ophthalmology
Iqbal Ike K Ahmed, L Jay Katz, David F Chang, Eric D Donnenfeld, Kerry D Solomon, Lilit Voskanyan, Thomas W Samuelson
PURPOSE: To evaluate the intraocular pressure (IOP) lowering effect of 2 trabecular microbypass stents and postoperative travoprost in patients with open-angle glaucoma (OAG) not controlled on 2 medications preoperatively. SETTING: S.V. Malayan Ophthalmology Centre, Yerevan, Armenia. DESIGN: Prospective open-label nonrandomized study. METHODS: This prospective pilot study involved 39 qualified phakic patients with OAG, medicated IOP between 18 mm Hg and 30 mm Hg, and unmedicated baseline (after washout) IOP between 22 mm Hg and 38 mm Hg...
August 2014: Journal of Cataract and Refractive Surgery
Andrew K Bailey, Steven R Sarkisian, Steven D Vold
UNLABELLED: Although glaucoma filtration surgery options are generally effective means of surgically lowering intraocular pressure (IOP), complications have driven innovators to develop novel approaches to the lowering of IOP. Using the suprachoroidal space has been one novel way to avoid these complications. This article reviews how recent innovation has exploited this space to lower IOP. FINANCIAL DISCLOSURE: Dr. Sarkisian and Dr. Vold have received research support from Transcend Medical, Inc...
August 2014: Journal of Cataract and Refractive Surgery
Swarup S Swaminathan, Dong-Jin Oh, Min Hyung Kang, Douglas J Rhee
UNLABELLED: The elevated intraocular pressure (IOP) of primary open-angle glaucoma is caused by impaired outflow of aqueous humor through the trabecular meshwork. Within the juxtacanalicular region, alterations of both extracellular matrix homeostasis and the cellular tone of trabecular meshwork endothelial and the inner wall of Schlemm canal cells affect outflow. Newer pharmacologic agents that target trabecular meshwork and Schlemm canal cell cytoskeleton lower IOP. Aqueous drainage occurs nonhomogenously with greater flow going through certain portions of the TM and less going through other portions-a concept known as segmental flow, which is theoretically the result of outflow being dependent on the presence of discrete pores within Schlemm canal...
August 2014: Journal of Cataract and Refractive Surgery
Kendall S Hunter, Todd Fjield, Hal Heitzmann, Robin Shandas, Malik Y Kahook
Micro-invasive glaucoma surgery with the Glaukos iStent® or iStent inject® (Glaukos Corporation, Laguna Hills, CA, USA) is intended to create a bypass through the trabecular meshwork to Schlemm's canal to improve aqueous outflow through the natural physiologic pathway. While the iStent devices have been evaluated in ex vivo anterior segment models, they have not previously been evaluated in whole eye perfusion models nor characterized by computational fluid dynamics. Intraocular pressure (IOP) reduction with the iStent was evaluated in an ex vivo whole human eye perfusion model...
2014: Clinical Ophthalmology
Lilit Voskanyan, Julián García-Feijoó, Jose I Belda, Antonio Fea, Anselm Jünemann, Christophe Baudouin
INTRODUCTION: Micro-invasive glaucoma surgical implantation of trabecular micro-bypass stents, previously shown to be safe and effective for open-angle glaucoma (OAG) subjects during cataract surgery, was considered for evaluation as a sole procedure. The aim of this study was to evaluate the safety and intraocular pressure (IOP)-lowering efficacy after ab interno implantation of two Glaukos Trabecular Micro-Bypass iStent inject second generation devices in subjects with OAG. This study was performed at sites in France, Germany, Italy, Republic of Armenia, and Spain...
February 2014: Advances in Therapy
Pedro Arriola-Villalobos, José Maria Martínez-de-la-Casa, David Díaz-Valle, Sara E García-Vidal, Cristina Fernández-Pérez, Julián García-Sánchez, Julián García-Feijoó
AIMS: To evaluate the mid-term efficacy and safety of the GTS-400-iStent combined with phacoemulsification in patients with cataract and open-angle glaucoma (OAG) or ocular hypertension (OHT). METHODS: Prospective, non-comparative, uncontrolled, interventional case series study. Subjects underwent phacoemulsification and two GTS-400 implantation. Efficacy outcomes: intraocular pressure (IOP) and antiglaucoma medications. Safety outcomes: complications, best-corrected visual acuity and endothelial cell count (ECC)...
October 2013: British Journal of Ophthalmology
Graham W Belovay, Abdulla Naqi, Brian J Chan, Mahmoud Rateb, Iqbal Ike K Ahmed
PURPOSE: To evaluate the efficacy of multiple trabecular micro-bypass stents combined with cataract surgery in patients with open-angle glaucoma (OAG) and cataract. SETTING: Private practice, Mississauga, Ontario, Canada. DESIGN: Comparative case series. METHODS: Eyes with OAG had implantation of 2 or 3 micro-bypass stents with concurrent cataract surgery and follow-up through 1 year. Efficacy measures were intraocular pressure (IOP) and topical ocular hypotensive medication use...
November 2012: Journal of Cataract and Refractive Surgery
Laura Morales-Fernandez, Jose M Martinez-De-La-Casa, Julian Garcia-Feijoo, David Diaz Valle, Pedro Arriola-Villalobos, Julian Garcia-Sanchez
PURPOSE: This case report illustrates the efficacy of the Glaukos trabecular bypass (Glaukos i-stent, Glaukos Corporation, Laguna Hills, California, USA) used for intraocular pressure (IOP) control in a patient with glaucoma induced by the steroid treatment of post–laser-assisted in situ keratomileusis (LASIK) bilateral anterior uveitis. METHODS: A 35-year-old woman who had undergone LASIK 5 months previously presented with blurred vision in both eyes. Examination revealed bilateral anterior uveitis and diffuse lamellar keratitis (DLK) requiring steroid treatment...
July 2012: European Journal of Ophthalmology
E Randy Craven, L Jay Katz, Jeffrey M Wells, Jane Ellen Giamporcaro
PURPOSE: To assess the long-term safety and efficacy of a single trabecular micro-bypass stent with concomitant cataract surgery versus cataract surgery alone for mild to moderate open-angle glaucoma. SETTING: Twenty-nine investigational sites, United States. DESIGN: Prospective randomized controlled multicenter clinical trial. METHODS: Eyes with mild to moderate glaucoma with an unmedicated intraocular pressure (IOP) of 22 mm Hg or higher and 36 mm Hg or lower were randomly assigned to have cataract surgery with iStent trabecular micro-bypass stent implantation (stent group) or cataract surgery alone (control group)...
August 2012: Journal of Cataract and Refractive Surgery
Pedro Arriola-Villalobos, José Maria Martínez-de-la-Casa, David Díaz-Valle, Cristina Fernández-Pérez, Julián García-Sánchez, Julián García-Feijoó
AIMS: To evaluate the long-term efficacy and safety of combined cataract surgery and Glaukos iStent implantation for coexistent open-angle glaucoma and cataract. METHODS: Prospective, non-comparative, uncontrolled, non-randomised, interventional case series study. Subjects older than 18 years with coexistent uncontrolled mild or moderate open-angle glaucoma (including pseudoexfoliative and pigmentary) and cataract underwent phacoemulsification and intraocular lens implantation along with ab-interno gonioscopically guided implantation of one Glaukos iStent...
May 2012: British Journal of Ophthalmology
Hady Saheb, Iqbal Ike K Ahmed
PURPOSE OF REVIEW: There is an increasing interest and availability of micro-invasive glaucoma surgery (MIGS) procedures. It is important that this increase is supported by sound, peer-reviewed evidence. This article will define MIGS, review relevant publications in the period of annual review and discuss future directions. RECENT FINDINGS: The results of the pivotal trial comparing a trabecular micro-bypass stent (iStent, Glaukos Corporation, Laguna Hills, CA, USA) combined with phacoemulsification to phacoemulsification alone showed a significantly higher percentage of patients with unmedicated intraocular pressure (IOP) ≤ 21 mmHg, and a comparable safety profile...
March 2012: Current Opinion in Ophthalmology
Brian A Francis, Kuldev Singh, Shan C Lin, Elizabeth Hodapp, Henry D Jampel, John R Samples, Scott D Smith
OBJECTIVE: To review the published literature and summarize clinically relevant information about novel, or emerging, surgical techniques for the treatment of open-angle glaucoma and to describe the devices and procedures in proper context of the appropriate patient population, theoretic effects, advantages, and disadvantages. DESIGN: Devices and procedures that have US Food and Drug Administration clearance or are currently in phase III clinical trials in the United States are included: the Fugo blade (Medisurg Ltd...
July 2011: Ophthalmology
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