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Davinder S Grover, David G Godfrey, Oluwatosin Smith, Wei Shi, William J Feuer, Ronald L Fellman
PURPOSE: To report on outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with prior incisional glaucoma surgery. PATIENTS AND METHODS: A retrospective review was performed for all patients who underwent a GATT procedure with a history of prior incisional glaucoma surgery. RESULTS: Thirty-five eyes of 35 patients were treated. The mean age was 67.7 years. Nineteen eyes had a prior trabeculectomy, 13 eyes had a prior glaucoma drainage device, 4 eyes had a prior trabectome, and 5 eyes had prior endocyclophotocoagulation...
October 6, 2016: Journal of Glaucoma
R A Widder, T S Dietlein
BACKGROUND: Trabectome surgery is a new method to lower intraocular pressure through ablation of the trabecular meshwork. Technically, it is an ab interno trabeculotomy. The goal of this review is to investigate the options after failed trabectome surgery and evaluate the possibilities of trabectome surgery after failed previous glaucoma surgery. OBJECTIVES: A literature review was performed to answer the following questions: (1) Is trabectome surgery an option after failed glaucoma surgery? (2) Is trabeculectomy an option after failed trabectome surgery? (3) Which postoperative constellations require early revision surgery after trabectome surgery? RESULTS: Trabectome surgery is an option after failed trabeculectomy or failed tube surgery...
September 5, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Kuang Hu, Gus Gazzard, Catey Bunce, Richard Wormald
BACKGROUND: Glaucoma is the leading cause of irreversible blindness. Minimally invasive surgical techniques, such as ab interno trabecular bypass surgery, have been introduced to prevent glaucoma progressing. OBJECTIVES: The main objective was to assess the results at two years of ab interno trabecular bypass surgery with Trabectome for open angle glaucoma in comparison to conventional medical, laser, or surgical treatment in terms of efficacy and safety. A secondary objective was to examine the effects of Trabectome surgery in people who have concomitant phacoemulsification in comparison to those who do not have concomitant phacoemulsification...
2016: Cochrane Database of Systematic Reviews
Thomas Wecker, Matthias Neuburger, Laura Bryniok, Kathrin Bruder, Jan Luebke, Alexandra Anton, Jens F Jordan
PURPOSE: Uncontrolled intraocular pressure (IOP) after glaucoma filtration surgery is a challenging problem in the management of glaucoma patients. The Trabectome is a device for selective electroablation of the trabecular meshwork through a clear cornea incision without affecting the conjunctiva. Minimally invasive glaucoma surgery using the Trabectome is safe and effective as primary glaucoma surgery. Here we investigate the results of ab interno trabeculectomy with the Trabectome for IOP control in patients with a failed filtering bleb...
September 2016: Journal of Glaucoma
S Siebelmann, B Bachmann, A Lappas, T Dietlein, M Hermann, S Roters, C Cursiefen, P Steven
BACKGROUND: Optical coherence tomography (OCT) is the clinical gold standard for anterior and posterior segment imaging. Since OCT devices have been integrated into surgical microscopes, this technique is also available intraoperatively in anterior segment surgery. OCT is well established in imaging very thin or transparent structures as they appear in corneal or glaucoma surgery. Therefore, intraoperative OCT can deliver important information for the surgeon which is superior to the normal surgical microscope...
August 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Yalong Dang, Kevin Kaplowitz, Hardik A Parikh, Pritha Roy, Ralitsa T Loewen, Brian A Francis, Nils A Loewen
BACKGROUND: To evaluate the outcomes of trabectome-mediated ab interno trabeculectomy in steroid-induced glaucoma (SIG) patients. DESIGN: A retrospective, observational cohort study performed in the Department of Ophthalmology, University of Pittsburgh Medical Center. PARTICIPANTS: The data of 60 SIG patients and 484 primary open angle glaucoma (POAG) controls matched by age, gender, and glaucoma index was collected from the Trabectome Study Group database...
June 24, 2016: Clinical & Experimental Ophthalmology
Yalong Dang, Pritha Roy, Igor I Bussel, Ralitsa T Loewen, Hardik Parikh, Nils A Loewen
Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma...
2016: F1000Research
Julia Polat, Nils A Loewen
Ab interno trabeculectomy with the trabectome is a microincisional glaucoma surgery (MIGS) modality with an electrosurgical device to ablate the trabecular meshwork (TM) and inner wall of Schlemm's canal (SC) in order to restore conventional outflow along its physiological route, thereby decreasing intraocular pressure (IOP). The device was approved by the FDA in 2004 and has since gained widespread use. Trabectome can be performed on its own or combined with cataract surgery for the treatment of ocular hypertension or advanced glaucoma with similar IOP reduction...
May 6, 2016: Survey of Ophthalmology
Jacky W Y Lee, Doris W F Yick, Susanna Tsang, Can Y F Yuen, Jimmy S M Lai
To investigate the clinical outcome of the Trabectome in Chinese open-angle glaucoma (OAG). This prospective case series recruited pseudophakic glaucoma subjects with open-angle configuration. Trabeculectomy ab interno was performed using the Trabectome to 120° of the trabecular meshwork. Intraocular pressure (IOP) and medications were recorded preoperatively and every 3 months postoperatively. Visual acuity was measured preoperatively and at 1 and 6 months postoperatively. One-way ANOVA with Tukey Multiple Comparison Test were used to measure the pre and postoperative parameters...
April 2016: Medicine (Baltimore)
Ashley E Neiweem, Igor I Bussel, Joel S Schuman, Eric N Brown, Nils A Loewen
PURPOSE: To compare intraocular pressure (IOP) reduction and to develop a predictive surgery calculator based on the results between trabectome-mediated ab interno trabeculectomy in pseudophakic patients versus phacoemulsification combined with trabectome-mediated ab interno trabeculectomy in phakic patients. METHODS: This observational surgical cohort study analyzed pseudophakic patients who received trabectome-mediated ab interno trabeculectomy (AIT) or phacoemulsification combined with AIT (phaco-AIT)...
2016: PloS One
Ralitsa T Loewen, Pritha Roy, Hardik A Parikh, Yalong Dang, Joel S Schuman, Nils A Loewen
PURPOSE: To stratify outcomes of trabectome-mediated ab interno trabeculectomy (AIT) by glaucoma severity using a simple and clinically useful glaucoma index. Based on prior data of trabectome after failed trabeculectomy, we hypothesized that more severe glaucoma might have a relatively more reduced facility compared to mild glaucoma and respond with a larger IOP reduction to trabecular meshwork ablation. METHODS: Patients with primary open angle glaucoma who had undergone AIT without any other same session surgery and without any second eye surgery during the following 12 months were analyzed...
2016: PloS One
Handan Akil, Vikas Chopra, Alex Huang, Nils Loewen, Jonathan Noguchi, Brian A Francis
BACKGROUND: To evaluate outcomes of Trabectome on pigmentary glaucoma (PG) patients compared to matched controls with primary open angle glaucoma (POAG). DESIGN: Prospective comparison study PARTICIPANTS: A total of 101 POAG cases were matched with 101 pigmentary glaucoma cases. METHODS: Data of the patients diagnosed with PG or POAG was obtained from Trabectome Study Group Database. A one-to-one exact matching was performed between POAG and pigmentary cases based on type of surgery, baseline IOP and baseline number of glaucoma medications...
March 6, 2016: Clinical & Experimental Ophthalmology
Nobuyuki Shoji, Masayuki Kasahara, Ayaka Iijima, Masahide Takahashi, Sonoko Tatsui, Kazuhiro Matsumura, Tetsuya Morita, Kimiya Shimizu
PURPOSE: To evaluate the short-term results of Trabectome surgery performed on Japanese patients. METHODS: Retrospective observational study. Trabectome surgery was performed on 117 eyes from 101 patients at Kitasato University Hospital from December 2010 to June 2013, involving 48 eyes with primary open-angle glaucoma (POAG), 62 eyes with secondary open-angle glaucoma (SOAG), and 7 eyes with developmental glaucoma. Trabectome surgery alone was performed on 34 phakic eyes (the phakic group) and 35 pseudophakic eyes (the pseudophakic group), and Trabectome surgery combined with phacoemulsification (the combined surgery group) was performed on 48 eyes...
May 2016: Japanese Journal of Ophthalmology
Hardik A Parikh, Igor I Bussel, Joel S Schuman, Eric N Brown, Nils A Loewen
PURPOSE: To compare intraocular pressure (IOP) after trabectome-mediated ab interno trabeculectomy surgery in phakic patients (T) and trabectome with same session phacoemulsification (PT) using Coarsened Exact Matching. Although phacoemulsification is associated with IOP reduction when performed on its own, it is not known how much it contributes in PT. METHODS: Subjects were divided into phakic T and PT. Exclusion criteria were follow-up for <12 months and additional glaucoma surgery...
2016: PloS One
Grace M Richter, Anne L Coleman
Minimally invasive glaucoma surgery aims to provide a medication-sparing, conjunctival-sparing, ab interno approach to intraocular pressure reduction for patients with mild-to-moderate glaucoma that is safer than traditional incisional glaucoma surgery. The current approaches include: increasing trabecular outflow (Trabectome, iStent, Hydrus stent, gonioscopy-assisted transluminal trabeculotomy, excimer laser trabeculotomy); suprachoroidal shunts (Cypass micro-stent); reducing aqueous production (endocyclophotocoagulation); and subconjunctival filtration (XEN gel stent)...
2016: Clinical Ophthalmology
Yildiray Yildirim, Taner Kar, Eyup Duzgun, Sercan Koray Sagdic, Ali Ayata, Melih Hamdi Unal
The aim of this study was to investigate the safety and efficacy of ab interno trabeculectomy which is a minimally invasive glaucoma surgery, in the late period, performed via trabectome instrument. A total of 70 eyes followed up with a diagnosis of open-angle glaucoma (OAG) and undertaken trabectome surgery were included in the study. Preoperative and postoperative intraocular pressures (IOPs), number of the drugs used, and complications were retrospectively investigated and the data were evaluated. The criteria of success were accepted as an IOP value ≤21 mmHg or ≥30 % reduction in IOP and no need for a second operation...
October 2016: International Ophthalmology
Kevin Kaplowitz, Igor I Bussel, Robert Honkanen, Joel S Schuman, Nils A Loewen
We analysed all of the PubMed publications on ab-interno trabeculectomy (AIT) with the Trabectome (Neomedix, Irvine, California, USA) to determine the reduction in intraocular pressure (IOP) and medications following the procedure. For IOP outcomes, PubMed was searched for 'trabectome', 'ab interno trabeculotomy' and 'ab interno trabeculectomy' and all available papers retrieved. The meta-analysis used a random-effects model to achieve conservative estimates and assess statistical heterogeneity. To investigate complications, we included all abstracts from the American Glaucoma Society, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery and the Association for Research in Vision and Ophthalmology...
May 2016: British Journal of Ophthalmology
Yotam Weiner, Melissa L Severson, Asher Weiner
PURPOSE: To evaluate intraocular pressure (IOP) immediately after cataract surgery with or without ab interno trabeculectomy (Trabectome) and whether trabeculectomy-related hyphema increases the risk for IOP spikes. SETTINGS: Private glaucoma practice. DESIGN: Retrospective interventional nonrandomized comparative chart review. METHODS: Intraocular pressure was measured 3 to 4 hours and 20 hours postoperatively. RESULTS: The combined group comprised 73 eyes of 73 patients and the cataract-only group, 75 eyes of 75 patients...
October 2015: Journal of Cataract and Refractive Surgery
Brian Toussaint, Michael R Petersen, Robert A Sisk, Christopher D Riemann, Daniel M Miller, Robert E Foster, Adeel H Shaikh, Anup H Khatana, Jeff Zink, Linda J Greff
PURPOSE: To report outcomes of patients who have undergone combined Trabectome and pars plana vitrectomy. METHODS: Institutional Review Board-approved retrospective chart review of patients seen at the Cincinnati Eye Institute before January 2014 undergoing combined Trabectome and pars plana vitrectomy for uncontrolled glaucoma and visually significant retina pathology. Charts were reviewed to identify changes in intraocular pressure, visual acuity, and change in glaucoma medication requirement up to 1 year after surgery...
June 2016: Retina
Takanori Mizoguchi, Shiro Nishigaki, Tomoki Sato, Harumi Wakiyama, Nobuchika Ogino
BACKGROUND: The purpose of this study was to determine outcomes when using Trabectome surgery and to evaluate factors associated with its effects in primary open-angle glaucoma (POAG) and exfoliation glaucoma (EXG). METHODS: This was a prospective, non-randomized, observational, comparative cohort study in which Trabectome surgery was used alone in patients with POAG or EXG. Trabectome surgery was considered to have failed when at least one of the following three criteria was fulfilled: intraocular pressure (IOP) ≥21 mmHg and a <20% reduction below the baseline IOP on two consecutive follow-up visits 3 months or more after surgery; need for additional glaucoma surgery; and an increase in number of medications compared with baseline...
2015: Clinical Ophthalmology
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