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Gunay M, Kurt IM, Turk A, Erdol H, Akyol N, Imamoglu HI, Uzlu D. Comparison of clinical outcomes between gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in advanced-stage pseudoexfoliation glaucoma. Graefes Arch Clin Exp Ophthalmol 2024; 262:567-574. [PMID: 37804451 DOI: 10.1007/s00417-023-06246-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 10/09/2023] Open
Abstract
PURPOSE To compare clinical outcomes between gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) in patients with advanced-stage pseudoexfoliation glaucoma (PEXG). METHODS This comparative study comprised 62 patients who underwent GATT (N = 31) or TRAB (N = 31) for advanced-stage PEXG. Primary outcome was cumulative probability of surgical success at the end of 12-month follow-up. Success was determined as intraocular pressure (IOP) reduction ≥ 30% from baseline, IOP between 6 and 18 mmHg and IOP upper limits for IOP < 15 mmHg and < 12 mmHg, separately. Secondary outcomes were IOP reduction, antiglaucoma medication (AGM) use, and complications in the study. RESULTS Age, sex, cup/disc ratio, mean deviation, pattern standard deviation, and retinal nerve fiber layer thickness did not significantly differ between the groups (p > 0.05 for all). The probability of cumulative surgical success at the end of 12 months was similar between the two groups for IOP < 15 mmHg and < 18 mmHg but significantly higher after TRAB (92.0%) than GATT (82.5%) for IOP < 12 mmHg (log-rank test p = 0.035). Percentage of IOP reduction from baseline was similar between the groups (53.1 ± 18.6% in GATT group and 53.0 ± 16.6% in TRAB group, p = 0.98) at the end of 12 months. No significant difference in the mean number of AGM was present at the 12-month visit (1.3 ± 1.4 in GATT and 1.1 ± 1.4 in TRAB, p = 0.65). CONCLUSION At the end of 12 months, IOP reduction rate was similar between GATT and TRAB. Cumulative surgical success was higher after TRAB than GATT for IOP < 12 mmHg.
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Affiliation(s)
- Murat Gunay
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey.
| | - Ibrahim Mert Kurt
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey
| | - Adem Turk
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey
| | - Hidayet Erdol
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey
| | - Nurettin Akyol
- Department of Ophthalmology, Kuzey Eye Hospital, Trabzon, Turkey
| | | | - Dilek Uzlu
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Farabi Cad, No:10, Trabzon, Turkey
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Wei H, Wang J, Wang R, Wang Y, Wang X, Feng Z. Effects of atorvastatin on the function of Tenon's capsule fibroblasts in human eyes. Int Ophthalmol 2023; 43:3707-3715. [PMID: 37422546 DOI: 10.1007/s10792-023-02780-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 06/22/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE This study aimed to explore the role of atorvastatin (ATO) in the prevention and treatment of the scarring of filtration channels after glaucoma surgery. METHODS Human Tenon's capsule fibroblasts (HTFs) were co-cultured with various concentrations of ATO. First, Cell Counting Kit-8 assay was performed to evaluate the effects of various concentrations of ATO on the viability of HTFs. Then, after the ATO stimulated the HTFs for 24 h, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was performed to evaluate the apoptosis of HTFs. Transwell assay was also performed to evaluate the migration of HTFs. Moreover, enzyme-linked immunosorbent assay (ELISA) was performed to detect the protein expression levels of transforming growth factor-β1 (TGF-β1) and TGF-β2 in the cell culture supernatant of HTFs. Western blot was carried out to detect the protein expression levels of smooth muscle actin (SMA), p38, Smad3, fibronectin, collagen I and collagen III in different groups. RESULTS The results revealed that ATO could inhibit the proliferation and migration of HTFs. Based on the TUNEL assay, 100 μM and 150 μM ATO could induce cell apoptosis. The ELISA results indicated that ATO could down-regulate the expression level of TGF-β2, and western blot analysis revealed that the protein expression levels of SMA, p38, Smad3, fibronectin, collagen I and collagen III in the TGF-β2 group were all up-regulated compared with the control group, whereas the addition of ATO could reverse this up-regulation. CONCLUSIONS ATO could inhibit the proliferation and migration of HTFs and induce their apoptosis. It was preliminary proven that ATO could inhibit the signaling pathway induced by TGF-β. It is suggested that ATO could be a basis for the treatment of the scarring of filtration channels after glaucoma surgery.
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Affiliation(s)
- Haiying Wei
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Jian Wang
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Ruiqi Wang
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Yeqing Wang
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Xiaodan Wang
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Zhuolei Feng
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China.
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Storp JJ, Vietmeier FE, Merté RL, Koch R, Zimmermann JA, Eter N, Brücher VC. Long-Term Outcomes of the PRESERFLO MicroShunt Implant in a Heterogeneous Glaucoma Cohort. J Clin Med 2023; 12:4474. [PMID: 37445509 DOI: 10.3390/jcm12134474] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/14/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
The Preserflo MicroShunt represents a novel glaucoma treatment device, necessitating long-term follow-up data to accurately assess its efficacy. The aim of this study is to report real-world data of a heterogenous glaucoma cohort who received Preserflo implantation at a specialized glaucoma clinic. A total of 160 eyes of 160 patients who underwent Preserflo MicroShunt implantation were retrospectively enrolled in this study. Patient characteristics, as well as success and failure rates, were assessed. The numbers of adverse events and revision procedures were recorded, along with any reduction in supplementary medication. The progression of intraocular pressure (IOP) was assessed over the course of 12 months, and fluctuations were analyzed. The overall success rate was 61.9% (complete success: 51.3%, qualified success: 10.6%). Revision surgery was performed in 25% of cases. Excessive hypotony occurred postoperatively in 54.4% of patients and regressed after 7 days in 88.8% of all cases. Median IOP decreased from 22 (interquartile range (IQR): 17-27) mmHg preoperatively to 14 (IQR 12-16) mmHg at 12 months postoperatively (p < 0.01). The median number of antiglaucomatous agents decreased from three to zero at latest follow-up. The Preserflo MicroShunt achieved a noticeable reduction in IOP over the course of 12 months in glaucoma patients, irrespective of disease severity or disease subtype. The frequency of postoperative adverse events and number for revision surgeries over the course of the follow-up period were low.
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Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | | | - Ralph-Laurent Merté
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Muenster, Germany
| | | | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
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Canaloplasty in Pseudoexfoliation Glaucoma. Can It Still Be Considered a Good Choice? J Clin Med 2022; 11:jcm11092532. [PMID: 35566656 PMCID: PMC9105440 DOI: 10.3390/jcm11092532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 02/05/2023] Open
Abstract
Purpose: The aim of this study was to assess the long-term outcomes of canaloplasty surgery in pseudoexfoliation glaucoma (PEXG) patients. Material and Methods: A total of 116 PEXG patients with an intraocular pressure (IOP) > 21 mm/Hg and maximum tolerated local medical therapy who underwent canaloplasty from February 2008 to January 2022 were considered. Every six months, all subjects underwent a complete ophthalmic examination. The period of follow-up ranged from 2 to 167 months. Inclusion criteria included only patients for whom the entire procedure could be completed with a follow-up of at least 2 years. Results: Amongst the 116 PEXG patients, the entire procedure could not be performed in 10 eyes (8.6%), and thus they were not considered in the analysis. Twenty-three patients did not reach the two-year follow-up and another 16 patients during this time period were lost. A total of 67 patients with a mean follow-up of 49 ± 32.3 months were considered in the analysis. The pre-operative mean IOP was 31.2 ± 8.7 mm/Hg (range 20−60). The mean IOP at the two-year follow-up was 17.2 ± 6.7 mmHg, with a mean reduction from baseline of 44.9%. After two years, the qualified success rates according to three different criteria (IOP ≤ 21, ≤18 and ≤16 mmHg) were 80.6%, 73.1% and 61.0%, respectively. The total number of medications used pre- and at the follow-up at 2 years was 3.5 ± 0.8 and 1.2 ± 1.4, respectively. Early complications included: hyphema, in about 30% of cases; Descemet membrane detachment (4.9%); and IOP spikes > 10 mmHg (9.7%). A late failure with an acute IOP rise of up to 50 mmHg was observed in 41 cases (61.2%) after 3 to 72 months. Conclusions: Long-term post-operative outcomes of canaloplasty in PEXG patients appear to be quite good on average; however, an acute rise in IOP can be observed in more than 60% of the cases after a long period of satisfactory IOP control. For this reason, canaloplasty may not be suitable in eyes with PEXG, especially in patients with severe functional damage.
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Vidal-Villegas B, Burgos-Blasco B, Santiago Alvarez JL, Espino-Paisán L, Fernández-Vigo J, Andrés-Guerrero V, García-Feijoo J, Martínez-de-la-Casa JM. Proinflammatory Cytokine Profile Differences between Primary Open-Angle and Pseudoexfoliative Glaucoma. Ophthalmic Res 2021; 65:111-120. [PMID: 34662885 DOI: 10.1159/000519816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/13/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Few studies have investigated glaucoma biomarkers in aqueous humor and tear and have found elevations of proinflammatory cytokines in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PXG). In this study, we investigate differences in inflammatory cytokines between POAG and PXG patients to find specific disease biomarkers. METHODS For this purpose, tear and aqueous humor samples of 14 eyes with POAG and 15 eyes with PXG undergoing cataract surgery were immunoassayed for 27 proinflammatory cytokines. The concentrations of cytokines in tear and aqueous humor and their association with clinical variables were analyzed, correlated, and compared between the groups. RESULTS We found that the levels of three cytokines differed significantly in the aqueous humor of POAG and PXG patients: IL-12 and IL-13 were higher in the POAG group, while monocyte chemoattractant protein-1 (monocyte chemotactic and activating factor) was higher in the PXG group. The number of topical hypotensive medications was correlated with diminished levels of two cytokines (IL-7 and basic fibroblast growth factor) in aqueous humor in the POAG group and with diminished levels of IL-12 in tear in the PXG group. CONCLUSION We conclude that both POAG and PXG show elevated concentrations of proinflammatory cytokines in tear and aqueous humor that could be used as biomarkers for these types of glaucoma and that the concentrations in aqueous humor of three cytokines, IL-12, IL-13, and monocyte chemoattractant protein-1 (monocyte chemotactic and activating factor), could be used to differentiate POAG and PXG.
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Affiliation(s)
- Beatriz Vidal-Villegas
- Servicio de Oftalmología, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Bárbara Burgos-Blasco
- Servicio de Oftalmología, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | - Laura Espino-Paisán
- Laboratorio de Investigación en Genética de Enfermedades Complejas, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Jose Fernández-Vigo
- Servicio de Oftalmología, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Vanessa Andrés-Guerrero
- Servicio de Oftalmología, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Julián García-Feijoo
- Servicio de Oftalmología, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Jose María Martínez-de-la-Casa
- Servicio de Oftalmología, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Gillmann K, Mermoud A. Response to Letter to the Editor: Surgical Management of Pseudoexfoliative Glaucoma: A Review of Current Clinical Considerations and Surgical Outcomes. J Glaucoma 2021; 30:e378. [PMID: 34008533 DOI: 10.1097/ijg.0000000000001874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Kevin Gillmann
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland
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Fontana L, De Maria M. Letter to the Editor: Surgical Management of Pseudoexfoliative Glaucoma: A Review of Current Clinical Considerations and Surgical Outcomes. J Glaucoma 2021; 30:e378. [PMID: 34008529 DOI: 10.1097/ijg.0000000000001873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Luigi Fontana
- Ophthalmology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia
| | - Michele De Maria
- Ophthalmology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
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Nobl M, Freissinger S, Kassumeh S, Priglinger S, Mackert MJ. One-year outcomes of microshunt implantation in pseudoexfoliation glaucoma. PLoS One 2021; 16:e0256670. [PMID: 34449795 PMCID: PMC8396760 DOI: 10.1371/journal.pone.0256670] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/11/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To compare the safety and efficacy of microshunt implantation augmented with Mitomycin C in patients with pseudoexfoliation glaucoma (PEXG) and primary open-angle glaucoma (POAG). METHODS In this retrospective, single centre, interventional study, 46 eyes of 41 patients with PEXG (20 eyes) and POAG (26 eyes) underwent microshunt implantation. Definition of failure was an intraocular pressure (IOP) lower than 5 or higher than 17mmHg on two consecutive visits, an IOP reduction lower than 20% on two consecutive visits, the need of surgical revisions or reoperations or loss of light perception. Outcome was rated as complete success if achieved without medication, otherwise as qualified success. Furthermore, postoperative complications and interventions were compared between the two groups. RESULTS Patient demographics were similar, except for older age in the PEXG group (70.9±8.6 versus 77.6±8; p = 0.02). Mean IOP dropped from 21.5±5.8mmHg (PEXG) and 18.2±4.5mmHg (POAG) at baseline to 12.8±3.0mmHg (p<0.0001) and 12.9±4.2mmHg (p<0.0001), respectively, at one year. Mean number of medications were reduced from 2.8±1.3 to 0.3±0.8 for PEXG patients (p<0.0001) and from 2.7±1.3 to 0.3±0.8 for POAG patients (p<0.0001). At one year of follow-up 75.0% of PEXG patients achieved complete success and 80.0% qualified success. In the POAG group rates were 73.1% and 76.9%, respectively. Postoperative complications were comparable between both groups, except for higher rates of hypotony (p = 0.04) and choroidal detachment (p = 0.03) in the PEXG group. CONCLUSION Microshunt implantation demonstrated similar efficacy results in PEXG and POAG eyes at a follow-up of 12 months. Higher rates of transient hypotony and choroidal detachment were observed in PEXG eyes.
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Affiliation(s)
- Matthias Nobl
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany
- * E-mail:
| | - Sigrid Freissinger
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Stefan Kassumeh
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Siegfried Priglinger
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Marc J. Mackert
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany
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