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Effect of Preoperative Intraocular Pressure in Patients with and without Intolerance to Their IOP-Lowering Medication on the Outcome of Trabectome Surgery
- Source :
- Clinical Ophthalmology (Auckland, N.Z.), Wons, Juliana; Mihic, Nadine; Pfister, Isabel B.; Anastasi, Stefano; Garweg, Justus G.; Halberstadt, Markus (2021). Effect of Preoperative Intraocular Pressure in Patients with and without Intolerance to Their IOP-Lowering Medication on the Outcome of Trabectome Surgery. Clinical ophthalmology, 15, pp. 1851-1860. Dove Medical Press 10.2147/OPTH.S303603
- Publication Year :
- 2021
- Publisher :
- Informa UK Limited, 2021.
-
Abstract
- Juliana Wons,1,* Nadine Mihic,2,* Isabel B Pfister,1 Stefano Anastasi,1 Justus G Garweg,1,2 Markus Halberstadt3 1Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland; 2Department of Ophthalmology, University of Bern, Bern, Switzerland; 3Private Practice for Ophthalmology, Flums, Switzerland*These authors contributed equally to this workCorrespondence: Markus HalberstadtAugenärzte Flums, Marktstrasse 21, Flums, 8890, SwitzerlandEmail augenaerzte-flums@hin.chPurpose: This study aimed to compare the effect of trabectome surgery in patients with and without intolerance to their medication and with preoperatively sufficiently controlled, insufficiently controlled, and uncontrolled intraocular pressure (IOP) on the surgical outcome.Patients and Methods: A total of 155 eyes (133 patients) with different forms of open angle glaucoma with or without intolerance to their glaucoma medication undergoing trabectome surgery alone (AIT) or combined with phacoemulsification (phaco-AIT) were included in this retrospective monocentric study. Patients were corresponding to IOP ≤ 18 mmHg (controlled but glaucoma progression or intolerance, group 1), 19– 26 mmHg (insufficiently controlled, group 2), and ≥ 26 mmHg (not controlled, group 3), respectively. Pre- and postoperative IOP and the number of IOP-lowering medications were registered over 12 months. Surgical success was defined as a postoperative IOP of ≤ 18mmHg and/or reduction of the topical treatment demand after 1 year.Results: Of the 155 included eyes, 79 received AIT and 76 received phaco-AIT. Sixty-nine eyes had a preoperatively sufficiently controlled IOP, 63 had an insufficiently controlled IOP, and 23 had an uncontrolled IOP. In all groups, the IOP significantly dropped by 6 and 12 months after surgery (p < 0.001). Surgical success war similar in all groups [47.8% (group 1), 38.1 (group 2) and 34.8% (group 3); p= 0.47]. The effect of AIT on IOP and glaucoma medication independent of intolerance to the anti-glaucoma medication and type of surgery (AIT/phaco-AIT).Conclusion: Independently of the preoperative IOP, a satisfying surgical success was achieved using AIT. In instances that do not qualify for filtrating surgery, trabectome surgery alone or in combination with phacoemulsification thus represents a safe and effective minimally invasive glaucoma surgery technique regardless of an intolerance to the topical medication.Keywords: glaucoma, ab interno trabeculectomy, trabectome, minimally-invasive glaucoma surgery, minimally-invasive glaucoma surgery, MIGS
- Subjects :
- medicine.medical_specialty
Intraocular pressure
minimally-invasive glaucoma surgery
genetic structures
Minimally invasive glaucoma surgery
Open angle glaucoma
medicine.medical_treatment
Glaucoma
610 Medicine & health
03 medical and health sciences
0302 clinical medicine
medicine
Trabectome
Original Research
Glaucoma medication
business.industry
MIGS
Clinical Ophthalmology
trabectome
Phacoemulsification
medicine.disease
eye diseases
Surgery
Topical medication
Ophthalmology
glaucoma
030221 ophthalmology & optometry
sense organs
ab interno trabeculectomy
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 11775483
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- Clinical Ophthalmology
- Accession number :
- edsair.doi.dedup.....88d95c970709b16193b06ae19c097ec6