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MicroShunt versus Trabeculectomy for Surgical Management of Glaucoma: A Retrospective Analysis

This case-control study aims to compare the efficacy, safety, and postoperative burden of MicroShunt versus trabeculectomy. The first consecutive cohort of MicroShunt procedures (n = 101) was matched to recent historical trabeculectomy procedures (n = 101) at two London hospital trusts. Primary endp...

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Autores principales: Fu, Michael X., Normando, Eduardo M., Luk, Sheila M. H., Deshmukh, Mira, Ahmed, Faisal, Crawley, Laura, Ameen, Sally, Vig, Niten, Cordeiro, Maria Francesca, Bloom, Philip A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505905/
https://www.ncbi.nlm.nih.gov/pubmed/36143128
http://dx.doi.org/10.3390/jcm11185481
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author Fu, Michael X.
Normando, Eduardo M.
Luk, Sheila M. H.
Deshmukh, Mira
Ahmed, Faisal
Crawley, Laura
Ameen, Sally
Vig, Niten
Cordeiro, Maria Francesca
Bloom, Philip A.
author_facet Fu, Michael X.
Normando, Eduardo M.
Luk, Sheila M. H.
Deshmukh, Mira
Ahmed, Faisal
Crawley, Laura
Ameen, Sally
Vig, Niten
Cordeiro, Maria Francesca
Bloom, Philip A.
author_sort Fu, Michael X.
collection PubMed
description This case-control study aims to compare the efficacy, safety, and postoperative burden of MicroShunt versus trabeculectomy. The first consecutive cohort of MicroShunt procedures (n = 101) was matched to recent historical trabeculectomy procedures (n = 101) at two London hospital trusts. Primary endpoints included changes in intraocular pressure (IOP) and glaucoma medications. Secondary outcome measures included changes in retinal nerve fibre layer (RNFL) thickness, rates of complications, further theatre interventions, and the number of postoperative visits. From the baseline to Month-18, the median [interquartile range] IOP decreased from 22 [17–29] mmHg (on 4 [3–4] medications) to 15 [10–17] mmHg (on 0 [0–2] medications) and from 20 [16–28] mmHg (on 4 [3–4] medications) to 11 [10–13] mmHg (on 0 [0–0] medications) in the MicroShunt and trabeculectomy groups, respectively. IOP from Month-3 was significantly higher in the MicroShunt group (p = 0.006), with an increased number of medications from Month-12 (p = 0.024). There were greater RNFL thicknesses from Month-6 in the MicroShunt group (p = 0.005). The rates of complications were similar (p = 0.060) but with fewer interventions (p = 0.031) and postoperative visits (p = 0.001) in the MicroShunt group. Therefore, MicroShunt has inferior efficacy to trabeculectomy in lowering IOP and medications but provides a better safety profile and postoperative burden and may delay RNFL loss.
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spelling pubmed-95059052022-09-24 MicroShunt versus Trabeculectomy for Surgical Management of Glaucoma: A Retrospective Analysis Fu, Michael X. Normando, Eduardo M. Luk, Sheila M. H. Deshmukh, Mira Ahmed, Faisal Crawley, Laura Ameen, Sally Vig, Niten Cordeiro, Maria Francesca Bloom, Philip A. J Clin Med Article This case-control study aims to compare the efficacy, safety, and postoperative burden of MicroShunt versus trabeculectomy. The first consecutive cohort of MicroShunt procedures (n = 101) was matched to recent historical trabeculectomy procedures (n = 101) at two London hospital trusts. Primary endpoints included changes in intraocular pressure (IOP) and glaucoma medications. Secondary outcome measures included changes in retinal nerve fibre layer (RNFL) thickness, rates of complications, further theatre interventions, and the number of postoperative visits. From the baseline to Month-18, the median [interquartile range] IOP decreased from 22 [17–29] mmHg (on 4 [3–4] medications) to 15 [10–17] mmHg (on 0 [0–2] medications) and from 20 [16–28] mmHg (on 4 [3–4] medications) to 11 [10–13] mmHg (on 0 [0–0] medications) in the MicroShunt and trabeculectomy groups, respectively. IOP from Month-3 was significantly higher in the MicroShunt group (p = 0.006), with an increased number of medications from Month-12 (p = 0.024). There were greater RNFL thicknesses from Month-6 in the MicroShunt group (p = 0.005). The rates of complications were similar (p = 0.060) but with fewer interventions (p = 0.031) and postoperative visits (p = 0.001) in the MicroShunt group. Therefore, MicroShunt has inferior efficacy to trabeculectomy in lowering IOP and medications but provides a better safety profile and postoperative burden and may delay RNFL loss. MDPI 2022-09-18 /pmc/articles/PMC9505905/ /pubmed/36143128 http://dx.doi.org/10.3390/jcm11185481 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fu, Michael X.
Normando, Eduardo M.
Luk, Sheila M. H.
Deshmukh, Mira
Ahmed, Faisal
Crawley, Laura
Ameen, Sally
Vig, Niten
Cordeiro, Maria Francesca
Bloom, Philip A.
MicroShunt versus Trabeculectomy for Surgical Management of Glaucoma: A Retrospective Analysis
title MicroShunt versus Trabeculectomy for Surgical Management of Glaucoma: A Retrospective Analysis
title_full MicroShunt versus Trabeculectomy for Surgical Management of Glaucoma: A Retrospective Analysis
title_fullStr MicroShunt versus Trabeculectomy for Surgical Management of Glaucoma: A Retrospective Analysis
title_full_unstemmed MicroShunt versus Trabeculectomy for Surgical Management of Glaucoma: A Retrospective Analysis
title_short MicroShunt versus Trabeculectomy for Surgical Management of Glaucoma: A Retrospective Analysis
title_sort microshunt versus trabeculectomy for surgical management of glaucoma: a retrospective analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505905/
https://www.ncbi.nlm.nih.gov/pubmed/36143128
http://dx.doi.org/10.3390/jcm11185481
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