Cargando…

Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma

BACKGROUND: Glaucoma is the leading cause of irreversible blindness. Normal tension glaucoma (NTG) is a subset of open-angle glaucoma, demonstrating glaucomatous optic nerve damage in the absence of raised intraocular pressure (IOP). NTG is more prevalent in Asian populations. While generally slow-p...

Descripción completa

Detalles Bibliográficos
Autores principales: Ang, Bryan Chin Hou, Chiew, Wenqi, Yip, Vivien Cherng Hui, Chua, Chun Hau, Han, Wei Shan, Tecson, Ivan O’Neill C., Ogle, Jeanne Joyce, Lim, Boon Ang, Hee, Owen Kim, Tay, Elton Lik Yong, Yong, Vernon Khet Yau, Wong, Hon Tym, Yip, Leonard Wei Leon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258099/
https://www.ncbi.nlm.nih.gov/pubmed/35794666
http://dx.doi.org/10.1186/s40662-022-00294-2
_version_ 1784741466863566848
author Ang, Bryan Chin Hou
Chiew, Wenqi
Yip, Vivien Cherng Hui
Chua, Chun Hau
Han, Wei Shan
Tecson, Ivan O’Neill C.
Ogle, Jeanne Joyce
Lim, Boon Ang
Hee, Owen Kim
Tay, Elton Lik Yong
Yong, Vernon Khet Yau
Wong, Hon Tym
Yip, Leonard Wei Leon
author_facet Ang, Bryan Chin Hou
Chiew, Wenqi
Yip, Vivien Cherng Hui
Chua, Chun Hau
Han, Wei Shan
Tecson, Ivan O’Neill C.
Ogle, Jeanne Joyce
Lim, Boon Ang
Hee, Owen Kim
Tay, Elton Lik Yong
Yong, Vernon Khet Yau
Wong, Hon Tym
Yip, Leonard Wei Leon
author_sort Ang, Bryan Chin Hou
collection PubMed
description BACKGROUND: Glaucoma is the leading cause of irreversible blindness. Normal tension glaucoma (NTG) is a subset of open-angle glaucoma, demonstrating glaucomatous optic nerve damage in the absence of raised intraocular pressure (IOP). NTG is more prevalent in Asian populations. While generally slow-progressing, NTG may be associated with significant central visual field loss. In recent years, minimally invasive glaucoma surgery has been added to the armamentarium of glaucoma surgery. This prospective study aims to evaluate 12-month surgical outcomes of combined iStent inject (Glaukos Corporation, Laguna Hills, CA) implantation and phacoemulsification in Asian eyes with NTG. METHODS: This is a prospective, single-centre case series of 30 eyes followed up until 12 months after surgery. Outcome measures included IOP, number of glaucoma medications, best-corrected visual acuity (BCVA) and intra and postoperative complications. RESULTS: Mean age of subjects was 73.1 ± 6.3 years. Majority were ethnic Chinese (n = 27, 90%). Baseline medicated mean IOP was 13.8 ± 2.4 mmHg and mean number of glaucoma medications was 1.3 ± 0.7. Mean Humphrey visual field mean deviation was − 13.7 ± 7.6. The mean IOP reduction at all timepoints from postoperative month (POM) 3 onwards was statistically significant (all P < 0.05), with mean reduction of 1.2 mmHg (95% CI: 0.1–2.2, P = 0.037) by POM12. There was statistically significant reduction in mean number of medications from postoperative day (POD) 1 onwards (all P < 0.05), with mean decrease of 1.0 medication (95% CI: 0.9–1.1, P < 0.001) by POM12. By POM12, 25 (83.3%) eyes were medication-free. Three (10%) eyes had stent occlusion by iris requiring laser iridoplasty. One eye had gross hyphema which resolved on conservative management before POM1. Mean BCVA improved from the baseline 0.3 ± 0.3 logMAR to 0.1 ± 0.1 logMAR postoperatively (P < 0.001). There were no major adverse or sight-threatening events. No eyes required further glaucoma surgery during the 12-month follow-up period. CONCLUSION: Asian eyes with NTG which underwent combined iStent inject implantation and phacoemulsification demonstrated a significant and sustained reduction in IOP and glaucoma medications, up to 12 months postoperatively.
format Online
Article
Text
id pubmed-9258099
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-92580992022-07-07 Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma Ang, Bryan Chin Hou Chiew, Wenqi Yip, Vivien Cherng Hui Chua, Chun Hau Han, Wei Shan Tecson, Ivan O’Neill C. Ogle, Jeanne Joyce Lim, Boon Ang Hee, Owen Kim Tay, Elton Lik Yong Yong, Vernon Khet Yau Wong, Hon Tym Yip, Leonard Wei Leon Eye Vis (Lond) Research BACKGROUND: Glaucoma is the leading cause of irreversible blindness. Normal tension glaucoma (NTG) is a subset of open-angle glaucoma, demonstrating glaucomatous optic nerve damage in the absence of raised intraocular pressure (IOP). NTG is more prevalent in Asian populations. While generally slow-progressing, NTG may be associated with significant central visual field loss. In recent years, minimally invasive glaucoma surgery has been added to the armamentarium of glaucoma surgery. This prospective study aims to evaluate 12-month surgical outcomes of combined iStent inject (Glaukos Corporation, Laguna Hills, CA) implantation and phacoemulsification in Asian eyes with NTG. METHODS: This is a prospective, single-centre case series of 30 eyes followed up until 12 months after surgery. Outcome measures included IOP, number of glaucoma medications, best-corrected visual acuity (BCVA) and intra and postoperative complications. RESULTS: Mean age of subjects was 73.1 ± 6.3 years. Majority were ethnic Chinese (n = 27, 90%). Baseline medicated mean IOP was 13.8 ± 2.4 mmHg and mean number of glaucoma medications was 1.3 ± 0.7. Mean Humphrey visual field mean deviation was − 13.7 ± 7.6. The mean IOP reduction at all timepoints from postoperative month (POM) 3 onwards was statistically significant (all P < 0.05), with mean reduction of 1.2 mmHg (95% CI: 0.1–2.2, P = 0.037) by POM12. There was statistically significant reduction in mean number of medications from postoperative day (POD) 1 onwards (all P < 0.05), with mean decrease of 1.0 medication (95% CI: 0.9–1.1, P < 0.001) by POM12. By POM12, 25 (83.3%) eyes were medication-free. Three (10%) eyes had stent occlusion by iris requiring laser iridoplasty. One eye had gross hyphema which resolved on conservative management before POM1. Mean BCVA improved from the baseline 0.3 ± 0.3 logMAR to 0.1 ± 0.1 logMAR postoperatively (P < 0.001). There were no major adverse or sight-threatening events. No eyes required further glaucoma surgery during the 12-month follow-up period. CONCLUSION: Asian eyes with NTG which underwent combined iStent inject implantation and phacoemulsification demonstrated a significant and sustained reduction in IOP and glaucoma medications, up to 12 months postoperatively. BioMed Central 2022-07-05 /pmc/articles/PMC9258099/ /pubmed/35794666 http://dx.doi.org/10.1186/s40662-022-00294-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Ang, Bryan Chin Hou
Chiew, Wenqi
Yip, Vivien Cherng Hui
Chua, Chun Hau
Han, Wei Shan
Tecson, Ivan O’Neill C.
Ogle, Jeanne Joyce
Lim, Boon Ang
Hee, Owen Kim
Tay, Elton Lik Yong
Yong, Vernon Khet Yau
Wong, Hon Tym
Yip, Leonard Wei Leon
Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma
title Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma
title_full Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma
title_fullStr Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma
title_full_unstemmed Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma
title_short Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma
title_sort prospective 12-month outcomes of combined istent inject implantation and phacoemulsification in asian eyes with normal tension glaucoma
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258099/
https://www.ncbi.nlm.nih.gov/pubmed/35794666
http://dx.doi.org/10.1186/s40662-022-00294-2
work_keys_str_mv AT angbryanchinhou prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT chiewwenqi prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT yipvivienchernghui prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT chuachunhau prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT hanweishan prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT tecsonivanoneillc prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT oglejeannejoyce prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT limboonang prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT heeowenkim prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT tayeltonlikyong prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT yongvernonkhetyau prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT wonghontym prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma
AT yipleonardweileon prospective12monthoutcomesofcombinedistentinjectimplantationandphacoemulsificationinasianeyeswithnormaltensionglaucoma