Suprachoroidal shunts

This article reviews recent studies evaluating the efficacy and safety of ab externo and ab interno suprachoroidal shunts designed to augment uveoscleral outflow in patients with open angle glaucoma. Recent findings The Gold Shunt and STARflo are placed into the suprachoroidal space via an ab externo approach, while the CyPass Micro-Stent and iStent Supra are inserted ab interno through a clear corneal incision. A small randomized clinical trial suggested similar efficacy among two different models of the Gold Shunt and the Ahmed glaucoma valve. The pivotal multicenter, randomized COMPASS trial showed that the CyPass Micro-Stent combined with cataract surgery is more effective than cataract surgery alone through 2 years. Study results suggest a favorable safety profile for each suprachoroidal device and intraocular pressure-lowering to the mid-to-high teens with an associated reduction in medication burden. Given the relative novelty of these procedures, it is currently unknown whether fibroblastic proliferation within the suprachoroidal space may limit their long-term success. Summary Renewed interest in the suprachoroidal space has led to the development of new biocompatible glaucoma implants. Ab interno devices are easily combined with cataract surgery and preserve conjunctiva for future incisional glaucoma surgery. Additional data regarding the long-term efficacy and late complications of suprachoroidal shunts are needed.
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

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To assess a new training model (Tackdriver) for new-generation microinvasive glaucoma surgeries (MIGS).
Source: Journal of Cataract and Refractive Surgery - Category: Opthalmology Authors: Tags: Article Source Type: research
Implantation of the iStent Trabecular Micro-Bypass in conjunction with cataract surgery is associated with reduced need for glaucoma eyedrops, according to a new study.Reuters Health Information
Source: Medscape General Surgery Headlines - Category: Surgery Tags: Ophthalmology News Source Type: news
Purpose: The main purpose of this study was to compare the safety and efficacy of XEN gel implant surgery in patients with pseudoexfoliative glaucoma (PEXG) and primary open-angle glaucoma (POAG). Setting: This was a prospective, interventional study in a tertiary glaucoma center. Methods: Fifty-seven eyes (43 patients) with POAG and 53 eyes (42 patients) with PEXG with uncontrolled intraocular pressure (IOP) despite medical treatment underwent combined XEN+cataract surgery or standalone XEN surgery. Mean IOP, mean number of medications at 1-year follow-up, needling rates, and incidence of adverse effects (AEs) wer...
Source: Journal of Glaucoma - Category: Opthalmology Tags: Original Studies Source Type: research
Conclusions: Needling revision following XEN gel stent implantation showed a good IOP-lowering effect without significant increase in number of antiglaucoma medications, decrease in visual acuity, nor any major complications. Further studies with long-term follow-up and a larger number of patients are needed to fully assess the safety and efficacy of this procedure.
Source: Journal of Glaucoma - Category: Opthalmology Tags: Original Studies Source Type: research
Purpose: To assess the safety and efficacy of CO2 laser-assisted sclerectomy surgery (CLASS) combined with phacoemulsification in patients with primary open-angle glaucoma (POAG) and visually significant cataracts. Materials and Methods: This was a prospective, uncontrolled, interventional case series. Seventeen patients (17 eyes) diagnosed with POAG and cataracts were enrolled starting from November 2015. All subjects underwent CLASS combined with phacoemulsification surgery by the same surgeon. After the surgery, all patients were followed for 12 months. The preoperative to postoperative changes in intraocular press...
Source: Journal of Glaucoma - Category: Opthalmology Tags: Original Studies Source Type: research
Purpose: The purpose of this study was to determine whether a second trabeculotomy (LOT) can reduce the intraocular pressure (IOP) in eyes with primary open-angle glaucoma (POAG) that had undergone an unsuccessful LOT as the initial surgery. Patients and Methods: LOT ab externo was performed as a second surgery on 37 eyes of 34 POAG patients who had undergone an unsuccessful LOT as the initial surgery. The main outcome measure was the postoperative IOPs, and surgical failures were defined as eyes with a post-LOT IOP>20 mm Hg. The eyes were divided into 3 groups; those that underwent LOT as both the in...
Source: Journal of Glaucoma - Category: Opthalmology Tags: Original Studies Source Type: research
We present a case of a patient who was blind in 1 eye from neovascular glaucoma after 2 treatments with cyclophotocoagulation and who then presented with neovascular glaucoma in his only seeing eye. Following failure of cyclophotocoagulation, a Xen implant was performed due to multiple medical comorbitidies, which meant that the patient was not suitable for conventional surgery. Twelve months, after the Xen implant, the patient underwent uncomplicated cataract extraction and lens implant followed by laser capsulotomy at 15 months after Xen implant. At final follow-up (24 months after the Xen implant), the intraocular press...
Source: Journal of Glaucoma - Category: Opthalmology Tags: Case Report/Small Case Series Source Type: research
Conclusions: We conclude that trypan blue can be used safely to confirm both aqueous outflow and the patency of Schlemm’s canal and aqueous veins during canalicular glaucoma surgery.
Source: Journal of Glaucoma - Category: Opthalmology Tags: Online Articles: Case Report/Small Case Series Source Type: research
We report the first case of post-PKP glaucoma managed with gonioscopy-assisted transluminal trabeculotomy (GATT). The patient was a 33-year-old man with a history of keratoconus who underwent PKP in his right eye. On presentation, his visual acuity was 20/60 and intraocular pressure was 48 mm Hg OD. He underwent GATT and cataract phacoemulsification. Following 22 months of follow-up, the patient’s visual acuity was 20/30 and intraocular pressure 13 mm Hg, off all glaucoma medications. This case demonstrates GATT may be a good surgical option for post-PKP glaucoma, given the ability to perf...
Source: Journal of Glaucoma - Category: Opthalmology Tags: Online Articles: Case Report/Small Case Series Source Type: research
Condition:   Glaucoma, Closed-Angle Intervention:   Procedure: Cataract surgery with endoscopic goniosynechialysis Sponsor:   Wenzhou Medical University Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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