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Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation

Best-corrected visual acuity often decreases temporarily or permanently after trabeculectomy (TE). The purpose of this study was to compare visual acuity and refractive changes after TE or XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEX) cas...

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Autores principales: Bormann, Caroline, Busch, Catharina, Rehak, Matus, Schmidt, Manuela, Scharenberg, Christian, Ziemssen, Focke, Unterlauft, Jan Darius
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692314/
https://www.ncbi.nlm.nih.gov/pubmed/36431024
http://dx.doi.org/10.3390/life12111889
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author Bormann, Caroline
Busch, Catharina
Rehak, Matus
Schmidt, Manuela
Scharenberg, Christian
Ziemssen, Focke
Unterlauft, Jan Darius
author_facet Bormann, Caroline
Busch, Catharina
Rehak, Matus
Schmidt, Manuela
Scharenberg, Christian
Ziemssen, Focke
Unterlauft, Jan Darius
author_sort Bormann, Caroline
collection PubMed
description Best-corrected visual acuity often decreases temporarily or permanently after trabeculectomy (TE). The purpose of this study was to compare visual acuity and refractive changes after TE or XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEX) cases naïve to prior glaucoma surgery over a 24-month follow-up period. We analyzed 149 consecutive glaucoma patients who received either TE or XEN because of medically uncontrollable POAG or PEX. Intraocular pressure (IOP), IOP-lowering medication use, subjective and objective refraction and best-corrected visual acuity were evaluated. In addition, surgically induced astigmatism (SIA) was calculated and compared using the vector analysis method described by Jaffe and Clayman. A total of 93 eyes (85 POAG; 8 PEX) were treated with TE and 56 eyes (50 POAG; 6 PEX) with XEN. After 24 months, the mean IOP and number of IOP-lowering medications used decreased significantly after TE (p < 0.01) and XEN (p < 0.01). In the TE group, mean best-corrected visual acuity (BCVA) changed from 0.16 ± 0.26 to 0.23 ± 0.28 logMAR (p < 0.01) after 24 months, while mean BCVA did not change significantly in the XEN group (preoperative: 0.40 ± 0.50 logMAR, postoperative: 0.36 ± 0.49 logMAR; p = 0.28). SIA was almost the same in both groups at the end of the 24-month follow-up period (0.75 ± 0.60 diopters after TE and 0.81 ± 0.56 diopters after XEN; p = 0.57). In addition, there was no significant correlation between SIA and the observed BCVA changes or SIA and IOP reduction 12 or 24 months after TE or XEN. Our results demonstrate that TE and XEN are effective methods for reducing IOP and IOP-lowering medication use. The SIA was nearly similar in both groups. The SIA does not seem responsible for the decreased visual acuity after TE.
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spelling pubmed-96923142022-11-26 Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation Bormann, Caroline Busch, Catharina Rehak, Matus Schmidt, Manuela Scharenberg, Christian Ziemssen, Focke Unterlauft, Jan Darius Life (Basel) Article Best-corrected visual acuity often decreases temporarily or permanently after trabeculectomy (TE). The purpose of this study was to compare visual acuity and refractive changes after TE or XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEX) cases naïve to prior glaucoma surgery over a 24-month follow-up period. We analyzed 149 consecutive glaucoma patients who received either TE or XEN because of medically uncontrollable POAG or PEX. Intraocular pressure (IOP), IOP-lowering medication use, subjective and objective refraction and best-corrected visual acuity were evaluated. In addition, surgically induced astigmatism (SIA) was calculated and compared using the vector analysis method described by Jaffe and Clayman. A total of 93 eyes (85 POAG; 8 PEX) were treated with TE and 56 eyes (50 POAG; 6 PEX) with XEN. After 24 months, the mean IOP and number of IOP-lowering medications used decreased significantly after TE (p < 0.01) and XEN (p < 0.01). In the TE group, mean best-corrected visual acuity (BCVA) changed from 0.16 ± 0.26 to 0.23 ± 0.28 logMAR (p < 0.01) after 24 months, while mean BCVA did not change significantly in the XEN group (preoperative: 0.40 ± 0.50 logMAR, postoperative: 0.36 ± 0.49 logMAR; p = 0.28). SIA was almost the same in both groups at the end of the 24-month follow-up period (0.75 ± 0.60 diopters after TE and 0.81 ± 0.56 diopters after XEN; p = 0.57). In addition, there was no significant correlation between SIA and the observed BCVA changes or SIA and IOP reduction 12 or 24 months after TE or XEN. Our results demonstrate that TE and XEN are effective methods for reducing IOP and IOP-lowering medication use. The SIA was nearly similar in both groups. The SIA does not seem responsible for the decreased visual acuity after TE. MDPI 2022-11-15 /pmc/articles/PMC9692314/ /pubmed/36431024 http://dx.doi.org/10.3390/life12111889 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
Bormann, Caroline
Busch, Catharina
Rehak, Matus
Schmidt, Manuela
Scharenberg, Christian
Ziemssen, Focke
Unterlauft, Jan Darius
Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation
title Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation
title_full Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation
title_fullStr Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation
title_full_unstemmed Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation
title_short Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation
title_sort refractive changes after glaucoma surgery—a comparison between trabeculectomy and xen microstent implantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692314/
https://www.ncbi.nlm.nih.gov/pubmed/36431024
http://dx.doi.org/10.3390/life12111889
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