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Iqbal Ike K Ahmed - One of the best experts on this subject based on the ideXlab platform.

  • a prospective randomized trial comparing hydrus and istent microinvasive Glaucoma Surgery implants for standalone treatment of open angle Glaucoma the compare study
    Ophthalmology, 2020
    Co-Authors: Iqbal Ike K Ahmed, Henry D Jampel, Antonio Maria Fea, Robert E Ang, Paul Harasymowycz, Thomas W Samuelson, David F Chang, Douglas J Rhee, Compare Investigators
    Abstract:

    Purpose To compare the efficacy of different microinvasive Glaucoma Surgery (MIGS) devices for reducing intraocular pressure (IOP) and medications in open-angle Glaucoma (OAG). Design Prospective, multicenter, randomized clinical trial. Participants One hundred fifty-two eyes from 152 patients aged 45 to 84 years with OAG, Shaffer angle grade III–IV, best-corrected visual acuity (BCVA) 20/30 or better, and IOP 23 to 39 mmHg after washout of all hypotensive medications. Eyes with secondary Glaucoma other than pseudoexfoliative or pigmentary Glaucoma, angle closure, previous incisional Glaucoma Surgery, or any significant ocular pathology other than Glaucoma were excluded. Intervention Study eyes were randomized 1:1 to standalone MIGS consisting of either 1 Hydrus Microstent (Ivantis, Inc, Irvine, CA) or 2 iStent Trabecular Micro Bypass devices (Glaukos Inc, San Clemente, CA). Follow-up was performed 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Main Outcome Measures Within-group and between-group differences in IOP and medications at 12 months and complete surgical success defined as freedom from repeat Glaucoma Surgery, IOP 18 mmHg or less, and no Glaucoma medications. Safety measures included the frequency of surgical complications, changes in visual acuity, slit-lamp findings, and adverse events. Results Study groups were well matched for baseline demographics, Glaucoma status, medication use, and baseline IOP. Twelve-month follow-up was completed in 148 of 152 randomized subjects (97.3%). At 12 months, the Hydrus had a greater rate of complete surgical success (P Conclusion Standalone MIGS in OAG with the Hydrus resulted in a higher surgical success rate and fewer medications compared with the 2-iStent procedure. The 2 MIGS devices have similar safety profiles.

  • micro invasive Glaucoma Surgery current perspectives and future directions
    Current Opinion in Ophthalmology, 2012
    Co-Authors: Hady Saheb, Iqbal Ike K Ahmed
    Abstract:

    Purpose of reviewThere 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 dis

Masaki Tanito - One of the best experts on this subject based on the ideXlab platform.

  • microhook ab interno trabeculotomy a novel minimally invasive Glaucoma Surgery
    Clinical Ophthalmology, 2017
    Co-Authors: Masaki Tanito
    Abstract:

    : Trabeculotomy (LOT) is performed to reduce the intraocular pressure in patients with Glaucoma, both in children and adults. It relieves the resistance to aqueous flow by cleaving the trabecular meshwork and the inner walls of Schlemm's canal. Microhook ab interno LOT (µLOT), a novel minimally invasive Glaucoma Surgery, incises trabecular meshwork using small hooks that are inserted through corneal side ports. An initial case series reported that both µLOT alone and combination of µLOT and cataract Surgery normalize the intraocular pressure during the early postoperative period in Japanese patients with Glaucoma. Microhook can incise the inner wall of Schlemm's canal without damaging its outer wall easier than the regular straight knife that is used during goniotomy. Advantages of µLOT include: a wider extent of LOT (two-thirds of the circumference), a simpler surgical technique, being less invasiveness to the ocular surface, a shorter surgical time than traditional ab externo LOT, and no requirement for expensive devices. In this paper, the surgical technique of µLOT and tips of the technique are introduced.

Nils A Loewen - One of the best experts on this subject based on the ideXlab platform.

  • Glaucoma Surgery calculator limited additive effect of phacoemulsification on intraocular pressure in ab interno trabeculectomy
    PLOS ONE, 2016
    Co-Authors: Ashley E Neiweem, Igor I Bussel, Joel S Schuman, Eric N Brown, Nils A Loewen
    Abstract:

    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). Follow up for less than 12 months or neovascular Glaucoma led to exclusion. Missing data was imputed by generating 5 similar but non-identical datasets. Groups were matched using Coarsened Exact Matching based on age, gender, type of Glaucoma, race, preoperative number of Glaucoma medications and baseline intraocular pressure (IOP). Linear regression was used to examine the outcome measures consisting of IOP and medications. RESULTS:Of 949 cases, 587 were included consisting of 235 AIT and 352 phaco-AIT. Baseline IOP between groups was statistically significant (p≤0.01) in linear regression models and was minimized after Coarsened Exact Matching. An increment of 1 mmHg in baseline IOP was associated with a 0.73±0.03 mmHg IOP reduction. Phaco-AIT had an IOP reduction that was only 0.73±0.32 mmHg greater than that of AIT. The resulting calculator to determine IOP reduction consisted of the formula -13.54+0.73 × (phacoemulsification yes:1, no:0) + 0.73 × (baseline IOP) + 0.59 × (secondary open angle Glaucoma yes:1, no:0) + 0.03 × (age) + 0.09 × (medications). CONCLUSIONS:This predictive calculator for minimally invasive Glaucoma Surgery can assist clinical decision making. Only a small additional IOP reduction was observed when phacoemulsification was added to AIT. Patients with a higher baseline IOP had a greater IOP reduction.

  • Glaucoma Surgery calculator limited additive effect of phacoemulsification on intraocular pressure in ab interno trabeculectomy
    PLOS ONE, 2016
    Co-Authors: Ashley E Neiweem, Igor I Bussel, Joel S Schuman, Eric N Brown, Nils A Loewen
    Abstract:

    Author(s): Neiweem, Ashley E; Bussel, Igor I; Schuman, Joel S; Brown, Eric N; Loewen, Nils A | Abstract: PurposeTo 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.MethodsThis observational surgical cohort study analyzed pseudophakic patients who received trabectome-mediated ab interno trabeculectomy (AIT) or phacoemulsification combined with AIT (phaco-AIT). Follow up for less than 12 months or neovascular Glaucoma led to exclusion. Missing data was imputed by generating 5 similar but non-identical datasets. Groups were matched using Coarsened Exact Matching based on age, gender, type of Glaucoma, race, preoperative number of Glaucoma medications and baseline intraocular pressure (IOP). Linear regression was used to examine the outcome measures consisting of IOP and medications.ResultsOf 949 cases, 587 were included consisting of 235 AIT and 352 phaco-AIT. Baseline IOP between groups was statistically significant (p≤0.01) in linear regression models and was minimized after Coarsened Exact Matching. An increment of 1 mmHg in baseline IOP was associated with a 0.73±0.03 mmHg IOP reduction. Phaco-AIT had an IOP reduction that was only 0.73±0.32 mmHg greater than that of AIT. The resulting calculator to determine IOP reduction consisted of the formula -13.54+0.73 × (phacoemulsification yes:1, no:0) + 0.73 × (baseline IOP) + 0.59 × (secondary open angle Glaucoma yes:1, no:0) + 0.03 × (age) + 0.09 × (medications).ConclusionsThis predictive calculator for minimally invasive Glaucoma Surgery can assist clinical decision making. Only a small additional IOP reduction was observed when phacoemulsification was added to AIT. Patients with a higher baseline IOP had a greater IOP reduction.

Hady Saheb - One of the best experts on this subject based on the ideXlab platform.

  • Outcomes of Glaucoma reoperations in the tube versus trabeculectomy (TVT) study
    American Journal of Ophthalmology, 2014
    Co-Authors: Hady Saheb, Steven J Gedde, Joyce C. Schiffman, William J. Feuer
    Abstract:

    Purpose To describe the incidence and outcomes of reoperations for Glaucoma in the Tube Versus Trabeculectomy (TVT) Study. Design Cohort study of patients in a multicenter randomized clinical trial. Methods The TVT Study enrolled 212 patients with medically uncontrolled Glaucoma who had previous cataract and/or Glaucoma Surgery. Randomization assigned 107 patients to Surgery with a tube shunt (350 mm 2 Baerveldt Glaucoma implant) and 105 patients to trabeculectomy with mitomycin C (0.4 mg/mL for 4 minutes). Data were analyzed from patients who failed their assigned treatment and had additional Glaucoma Surgery. Outcome measures included intraocular pressure (IOP), use of Glaucoma medications, visual acuity, surgical complications, and failure (IOP >21 mm Hg or not reduced by 20%, IOP ≤5 mm Hg, additional Glaucoma Surgery, or loss of light perception vision). Results Additional Glaucoma Surgery was performed in 8 patients in the tube group and 18 patients in the trabeculectomy group in the TVT Study, and the 5-year cumulative reoperation rate was 9% in the tube group and 29% in the trabeculectomy group ( P  = .025). Follow-up (mean ± SD) after additional Glaucoma Surgery was 28.0 ± 16.0 months in the tube group and 30.5 ± 20.4 months in the trabeculectomy group ( P  = .76). At 2 years after a Glaucoma reoperation, IOP (mean ± SD) was 15.0 ± 5.5 mm Hg in the tube group and 14.4 ± 6.6 mm Hg in the trabeculectomy group ( P  = .84). The number of Glaucoma medications (mean ± SD) after 2 years of follow-up was 1.1 ± 1.3 in the tube group and 1.4 ± 1.4 in the trabeculectomy group ( P  = .71). The cumulative probability of failure at 1, 2, 3, and 4 years after additional Glaucoma Surgery was 0%, 43%, 43%, and 43%, respectively, in the tube group, and 0%, 9%, 20%, and 47% in the trabeculectomy group ( P  = .28). Reoperations to manage complications were required in 1 patient in the tube group and 5 patients in the trabeculectomy group ( P  = .63). Conclusions The rate of reoperation for Glaucoma was higher following trabeculectomy with mitomycin C than tube shunt Surgery in the TVT Study. Similar surgical outcomes were observed after additional Glaucoma Surgery, irrespective of initial randomized treatment in the study.

  • micro invasive Glaucoma Surgery current perspectives and future directions
    Current Opinion in Ophthalmology, 2012
    Co-Authors: Hady Saheb, Iqbal Ike K Ahmed
    Abstract:

    Purpose of reviewThere 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 dis

Fritz H Hengerer - One of the best experts on this subject based on the ideXlab platform.

  • ab interno gel implant for the treatment of Glaucoma patients with or without prior Glaucoma Surgery 1 year results
    Journal of Glaucoma, 2017
    Co-Authors: Fritz H Hengerer, Thomas Kohnen, Michael Mueller, Ina Conradhengerer
    Abstract:

    PURPOSE The purpose of this study is to evaluate IOP lowering effects and complication management of an ab interno gel implant for the treatment of patients refractory to antiGlaucoma medication or Glaucoma Surgery. METHODS Retrospective analysis of the medical records of 242 consecutive eyes of 146 patients with uncontrolled intraocular pressure (IOP) despite maximum tolerated medical therapy or prior surgical intervention that underwent XEN45 implantation (as sole procedure or in combination with cataract Surgery) between March 2014 and June 2015. Data included IOP, number of Glaucoma medications, the need for additional Surgery, needling, and complications. RESULTS During the study period, mean IOP had decreased by 54.1% from 32.19 (±9.1) mm Hg to 14.24 (±4.0) mm Hg (P=0.00; Wilcoxon test). The number of antiGlaucoma medications had decreased from a mean of 3.13±1.0 to 0.3±0.7 (P=0.00; Wilcoxon test). Needling was required between week 1 and months 3 in 27.7% of all eyes to enhance the outflow. Hypotony (IOP<6 mm Hg) was observed in 9 eyes (4.0%) at 1 month but normalized in all eyes at 12 months postoperatively. Two eyes experienced hypotony requiring the refill of the anterior chamber. CONCLUSIONS Our data indicate that the XEN45 gel implant has a favorable safety profile and is an effective treatment option for controlling IOP in Glaucoma patients with unregulated IOP despite IOP lowering medical therapy or prior surgical intervention. It offers an effective approach, both as sole procedure and in combination with cataract Surgery.