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Seyed Javad Hashemian, Arezoo Miraftabi, Mohammad Ebrahim Jafari, Mohsen Rezaei Hemami
PURPOSE: To provide efficacy and safety of surgery with Trabectome combined with phacoemulsification in primary open-angle glaucoma. METHODS: In this interventional case series, 30 consecutive eyes that have had combined phacoemulsification with Trabectome were included. The main outcome measures were change in intraocular pressure (IOP), glaucoma medication use, and the rate of complications. RESULTS: Mean IOP was 18.25 ± 3.28 mmHg preoperatively which decreased to 13...
March 2017: Journal of Current Ophthalmology
Pritha Roy, Ralitsa T Loewen, Yalong Dang, Hardik A Parikh, Igor I Bussel, Nils A Loewen
BACKGROUND: To stratify the outcomes of phacoemulsification combined with trabectome surgery using a new glaucoma severity index. METHODS: This is a retrospective, observational cohort study that included open angle glaucoma patients with visually significant cataract that had phacoemulsification combined with trabectome surgery. Exclusion criteria were follow-up less than 12 months, any other surgeries or diagnosis of neovascular or active uveitic glaucoma. Patients were stratified into four groups according to the Glaucoma Index (GI) that incorporated preoperative intraocular pressure (IOP), number of medications and visual field status...
March 21, 2017: BMC Ophthalmology
Khaliq Kurji, Christopher J Rudnisky, Jaspreet S Rayat, Sourabh Arora, Simrenjeet Sandhu, Karim F Damji, Michael W Dorey
OBJECTIVE: To investigate efficacy and safety of phaco-trabectome (PT) versus phaco-iStent (Pi) for intraocular pressure (IOP) control in open-angle glaucoma (OAG). DESIGN: Retrospective comparative case series. PARTICIPANTS: A total of 70 eyes of 55 patients with OAG underwent either PT surgery by a single surgeon or Pi (insertion of 2 stents) by another surgeon in Canada between January 2010 and December 2012. METHODS: The medical records of consecutive adult patients who underwent either PT or Pi surgery were reviewed...
February 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Milena Pahlitzsch, Johannes Gonnermann, Anna-Karina B Maier, Eckart Bertelmann, Matthias K J Klamann, Carl Erb
OBJECTIVE: To assess the outcome of modified goniotomy and trabeculotomy ab interno (Trabectome) surgery in adult primary open-angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma. DESIGN: Retrospective cohort outcome study. PARTICIPANTS: Two hundred and thirty-six eyes of 236 patients. METHODS: This cohort outcome study included 68 POAG (mean age: 65.7 ± 16.0 years) and 22 PEX glaucoma patients (mean age: 78...
February 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Philip Ngai, Grace Kim, Garrick Chak, Ken Lin, Masahiro Maeda, Sameh Mosaed
To determine the efficacy and safety of Trabectome surgery on patients with steroid response, ranging from ocular hypertension refractory to maximal medical therapy to the development of steroid-induced glaucoma.A nonrandomized, nonblinded, retrospective study of 20 subjects with steroid response was conducted. All 20 eyes underwent Trabectome surgery alone. Nine subjects had steroid response with unremarkable visual field, 3 had mild steroid-induced glaucoma, and 8 had advanced steroid-induced glaucoma. Outcome measures included intraocular pressure (IOP), number of glaucoma medications, need for secondary glaucoma surgery, and steroid regimen...
December 2016: Medicine (Baltimore)
Nathan M Kerr, Jing Wang, Keith Barton
Recently, many new devices and procedures have been developed to lower intraocular pressure in a less invasive and purportedly safer manner than traditional glaucoma surgery. These new devices might encourage an earlier transition to surgery and reduce the long-term commitment to topical glaucoma medications with their associated compliance and intolerance issues. Although often seen as an adjunct to cataract surgery, a growing body of evidence suggests that primary minimally invasive glaucoma surgery may be a viable initial treatment option...
December 8, 2016: Clinical & Experimental Ophthalmology
Milena Pahlitzsch, Matthias K J Klamann, Marie-Luise Pahlitzsch, Johannes Gonnermann, Necip Torun, Eckart Bertelmann
PURPOSE: This study was conducted to assess the impact on the Quality of Life (QOL) of micro-invasive glaucoma surgery (MIGS: iStent, Trabectome) and a penetrating technique such as Trabeculectomy (TE). METHODS: This study evaluated 88 eyes of 88 open angle glaucoma patients undergoing glaucoma surgery: 43 (mean age 72.8 ± 8.8y, female 59.5 %, male 40.5 %) Trabectome (NeoMedix, Inc., Tustin, CA, USA), 20 (mean age 68.6 ± 16.4y, female 60 %, male 40 %) iStent (Glaucos Corporation, Laguna Hills, CA, USA), and 25 TE patients (mean age 74...
February 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
Johannes Gonnermann, Eckart Bertelmann, Milena Pahlitzsch, Anna-Karina B Maier-Wenzel, Necip Torun, Matthias K J Klamann
PURPOSE: To compare the safety and efficacy profile after combined micro-incision cataract surgery (MICS) and micro-invasive glaucoma surgery (MIGS) with the ab interno trabeculectomy (Trabectome®) in one eye versus two iStent® inject devices in the contralateral eye in patients with open-angle glaucoma (OAG) and cataract. METHODS: This retrospective, intraindividual eye comparison study included 27 patients (54 eyes) who were treated with combined MICS and ab interno trabeculectomy (group I, Trabectome®) in one eye and two iStent® inject devices (group II, GTS 400) in the fellow eye...
February 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
Handan Akil, Ping Huang, Vikas Chopra, Brian Francis
Purpose. To compare the changes of anterior segment parameters, assessed by swept source anterior segment optical coherence tomography (AS-OCT) after combined Trabectome-cataract surgery and Trabectome-only surgery in open angle glaucoma patients. Methods. Thirty-eight eyes of 24 patients with open angle glaucoma were scanned with swept source AS-OCT before and 4 weeks after combined Trabectome-cataract or Trabectome-only surgery. Intraocular pressure, number of medications, and AS-OCT parameters, such as angle opening distance at 500 and 750 μm from the scleral spur (AOD500 and AOD750), trabecular-iris space area at 500 and 750 mm(2) (TISA500, TISA750), angle recess area at 500 and 750 mm(2) (ARA500, ARA750), trabecular iris angle (TIA), anterior chamber depth (ACD), anterior chamber width (ACW), and anterior chamber volume (ACV), were obtained before the surgery...
2016: Journal of Ophthalmology
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...
January 2017: 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...
November 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...
August 15, 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 patients with steroid-induced glaucoma (SIG). DESIGN: A retrospective, observational cohort study performed in the Department of Ophthalmology, University of Pittsburgh Medical Center. PARTICIPANTS: The data of 60 patients with SIG and 484 controls with primary open-angle glaucoma (POAG) matched by age, gender and glaucoma index were collected from the Trabectome Study Group database...
December 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 K Polat, Nils A Loewen
Ab interno trabeculectomy with the trabectome is a microincisional glaucoma surgery modality with an electrosurgical device to ablate the trabecular meshwork and inner wall of Schlemm canal to restore conventional outflow along its physiological route, thereby decreasing intraocular pressure. 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 intraocular pressure reduction...
May 7, 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
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