360° ab-interno trabeculotomy in refractory primary open-angle glaucoma

360° ab-interno trabeculotomy in refractory primary open-angle glaucoma

Steven R Sarkisian,1 Basil Mathews,2 Kai Ding,2 Aashka Patel,2 Zachary Nicek2 1University of Oklahoma College of Medicine, Dean McGee Eye Institute, Oklahoma City, OK, USA; 2University of Oklahoma, Oklahoma City, OK, USA Purpose: The purpose of this study was to evaluate the safety and efficacy of...

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Autores principales: Sarkisian SR, Mathews B, Ding K, Patel A, Nicek Z
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2019
Materias:
Glaucoma
intraocular pressure
micro invasive glaucoma surgery
primary open-angle glaucoma
refractory
trabeculotomy
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/60bbce9a42d24c2ea0ebec3ffaaff0a4
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spelling oai:doaj.org-article:60bbce9a42d24c2ea0ebec3ffaaff0a42021-12-02T00:26:55Z360° ab-interno trabeculotomy in refractory primary open-angle glaucoma1177-5483https://doaj.org/article/60bbce9a42d24c2ea0ebec3ffaaff0a42019-01-01T00:00:00Zhttps://www.dovepress.com/360deg-ab-interno-trabeculotomy-in-refractory-primary-open-angle-glauc-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Steven R Sarkisian,1 Basil Mathews,2 Kai Ding,2 Aashka Patel,2 Zachary Nicek2 1University of Oklahoma College of Medicine, Dean McGee Eye Institute, Oklahoma City, OK, USA; 2University of Oklahoma, Oklahoma City, OK, USA Purpose: The purpose of this study was to evaluate the safety and efficacy of microinvasive glaucoma surgery (MIGS) with 360° ab-interno trabeculotomy using the TRAB360 device as a stand-alone procedure in patients with refractory primary open-angle glaucoma (POAG) and preoperative IOP ≥18 mmHg.Setting: This study evaluated patients treated in a tertiary-referral clinical practice setting.Design: This study is a retrospective analysis of 81 eyes.Methods: Patients with refractory open-angle glaucoma underwent stand-alone 360° ab-interno trabeculotomy using the TRAB360 device. Effectiveness was determined by reduction in medicated IOP and the use of medications from baseline. Safety was determined by the rate of adverse events and secondary surgical interventions. The time points assessed were baseline and postoperative day 1, week 1, and months 1, 3, 6, and 12. A subgroup analysis was performed on eyes with medicated preoperative IOP values of ≥25 mmHg.Results: The reductions in IOP from 1 day to 12 months postoperatively were statistically significant compared to baseline values. The mean reduction in IOP at 12 months was 7.3±6.7 mmHg from baseline. At 12 months, 59% eyes achieved ≥20% reduction in IOP and IOP <18 mmHg with the same or fewer numbers of IOP-lowering medications compared with those at baseline. The mean number of IOP-lowering medications was reduced from 1.7±1.3 at baseline to 1.1±1.0 at 12 months. At 12 months, 67% of eyes with preoperative IOP values of ≥25 mmHg achieved ≥20% reduction in IOP and IOP <18 mmHg with the same or fewer numbers of IOP-lowering medications compared with those at baseline. The most common adverse event for all eyes was mild, transient hyphema (57 eyes). During the first year after the procedure, 20 (25%) eyes were considered failures since they required reinterventions.Conclusion: Trabeculotomy using the TRAB360 device resulted in significant IOP reductions up to 1 year with a favorable safety profile. The device is an effective stand-alone MIGS procedure for patients with refractory POAG. Keywords: 360 degree trabeculotomy, glaucoma, Schlemm’s canal, blebless MIGS, TRAB360 Sarkisian SRMathews BDing KPatel ANicek ZDove Medical PressarticleGlaucomaintraocular pressuremicro invasive glaucoma surgeryprimary open-angle glaucomarefractorytrabeculotomyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 161-168 (2019)
institution DOAJ
collection DOAJ
language EN
topic Glaucoma
intraocular pressure
micro invasive glaucoma surgery
primary open-angle glaucoma
refractory
trabeculotomy
Ophthalmology
RE1-994
spellingShingle Glaucoma
intraocular pressure
micro invasive glaucoma surgery
primary open-angle glaucoma
refractory
trabeculotomy
Ophthalmology
RE1-994
Sarkisian SR
Mathews B
Ding K
Patel A
Nicek Z
360° ab-interno trabeculotomy in refractory primary open-angle glaucoma
description Steven R Sarkisian,1 Basil Mathews,2 Kai Ding,2 Aashka Patel,2 Zachary Nicek2 1University of Oklahoma College of Medicine, Dean McGee Eye Institute, Oklahoma City, OK, USA; 2University of Oklahoma, Oklahoma City, OK, USA Purpose: The purpose of this study was to evaluate the safety and efficacy of microinvasive glaucoma surgery (MIGS) with 360° ab-interno trabeculotomy using the TRAB360 device as a stand-alone procedure in patients with refractory primary open-angle glaucoma (POAG) and preoperative IOP ≥18 mmHg.Setting: This study evaluated patients treated in a tertiary-referral clinical practice setting.Design: This study is a retrospective analysis of 81 eyes.Methods: Patients with refractory open-angle glaucoma underwent stand-alone 360° ab-interno trabeculotomy using the TRAB360 device. Effectiveness was determined by reduction in medicated IOP and the use of medications from baseline. Safety was determined by the rate of adverse events and secondary surgical interventions. The time points assessed were baseline and postoperative day 1, week 1, and months 1, 3, 6, and 12. A subgroup analysis was performed on eyes with medicated preoperative IOP values of ≥25 mmHg.Results: The reductions in IOP from 1 day to 12 months postoperatively were statistically significant compared to baseline values. The mean reduction in IOP at 12 months was 7.3±6.7 mmHg from baseline. At 12 months, 59% eyes achieved ≥20% reduction in IOP and IOP <18 mmHg with the same or fewer numbers of IOP-lowering medications compared with those at baseline. The mean number of IOP-lowering medications was reduced from 1.7±1.3 at baseline to 1.1±1.0 at 12 months. At 12 months, 67% of eyes with preoperative IOP values of ≥25 mmHg achieved ≥20% reduction in IOP and IOP <18 mmHg with the same or fewer numbers of IOP-lowering medications compared with those at baseline. The most common adverse event for all eyes was mild, transient hyphema (57 eyes). During the first year after the procedure, 20 (25%) eyes were considered failures since they required reinterventions.Conclusion: Trabeculotomy using the TRAB360 device resulted in significant IOP reductions up to 1 year with a favorable safety profile. The device is an effective stand-alone MIGS procedure for patients with refractory POAG. Keywords: 360 degree trabeculotomy, glaucoma, Schlemm’s canal, blebless MIGS, TRAB360 
format article
author Sarkisian SR
Mathews B
Ding K
Patel A
Nicek Z
author_facet Sarkisian SR
Mathews B
Ding K
Patel A
Nicek Z
author_sort Sarkisian SR
title 360° ab-interno trabeculotomy in refractory primary open-angle glaucoma
title_short 360° ab-interno trabeculotomy in refractory primary open-angle glaucoma
title_full 360° ab-interno trabeculotomy in refractory primary open-angle glaucoma
title_fullStr 360° ab-interno trabeculotomy in refractory primary open-angle glaucoma
title_full_unstemmed 360° ab-interno trabeculotomy in refractory primary open-angle glaucoma
title_sort 360° ab-interno trabeculotomy in refractory primary open-angle glaucoma
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/60bbce9a42d24c2ea0ebec3ffaaff0a4
work_keys_str_mv AT sarkisiansr 360degabinternotrabeculotomyinrefractoryprimaryopenangleglaucoma
AT mathewsb 360degabinternotrabeculotomyinrefractoryprimaryopenangleglaucoma
AT dingk 360degabinternotrabeculotomyinrefractoryprimaryopenangleglaucoma
AT patela 360degabinternotrabeculotomyinrefractoryprimaryopenangleglaucoma
AT nicekz 360degabinternotrabeculotomyinrefractoryprimaryopenangleglaucoma
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