Comparison of subconjunctival microinvasive glaucoma surgery and trabeculectomy
Purpose To assess surgical success and the post‐operative development of intraocular pressure between XEN45® gelstent, Preserflo® MicroShunt and trabeculectomy with mitomycin C. Methods Data from 105 eyes from 105 patients of matched cases with refractory open‐angle glaucoma, who underwent surgery b...
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| Veröffentlicht in: | Acta ophthalmologica (Oxford, England) England), 2022-08, Vol.100 (5), p.e1120-e1126 |
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| creator | Wagner, Felix M. Schuster, Alexander K. Munder, Annika Muehl, Marius Chronopoulos, Panagiotis Pfeiffer, Norbert Hoffmann, Esther M. |
| description | Purpose
To assess surgical success and the post‐operative development of intraocular pressure between XEN45® gelstent, Preserflo® MicroShunt and trabeculectomy with mitomycin C.
Methods
Data from 105 eyes from 105 patients of matched cases with refractory open‐angle glaucoma, who underwent surgery between January 2019, and August 2020, were evaluated. Patients underwent either stand‐alone XEN gelstent insertion with Mitomycin C, stand‐alone Preserflo with Mitomycin C or trabeculectomy with Mitomycin C. The primary outcome was the proportion of complete surgical success at 6 months post‐operatively (i.e. intraocular pressure between 5mmHg and 18mmHg, no revision surgery, no loss of light perception and no post‐operative pharmaceutical antiglaucomatous treatment). The reduction of intraocular pressure after 6 months, the classes of antiglaucomatous medication used post‐operatively, best‐corrected visual acuity, spherical refractive errors and astigmatism were assessed as secondary outcomes.
Results
We included 35 eyes in each group. After 6‐month follow‐up, complete success was 73.5% [95%‐CI: 57.9%–89.2%] in the trabeculectomy group, 51.4% [95%‐CI: 34.0%–68.8%] in the XEN group and 74.2% [95%‐CI: 57.9%–90.5%] in the Preserflo group (p = 0.08). Regarding secondary outcomes, the reduction of intraocular pressure was 12.1 ± 7.9 mmHg in the trabeculectomy group and was thereby 5.8 [95%‐CI: 2.2–9.6] mmHg greater compared with the XEN group (p |
| doi_str_mv | 10.1111/aos.15042 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2580693592</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2685322370</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4542-868f1bea9861d27a48d908cab6a75c76fee903f6444c8d8bb1468be90dd9c7683</originalsourceid><addsrcrecordid>eNp10E1PwyAcBnBiNG5OD34B08SLHroBBUqPy-JbYrKDmngjQOnC0pYJ60y_vWjnDiZygcAvT_48AFwiOEVxzaQLU0QhwUdgjHJK0yxn_Phwpu8jcBbCGkKGGCOnYJQRhhkssjFYLlyzkd4G1yauSkKntGvXXau3difrpLHaO9vuZLA7k6xq2WnXyMj8yvg-kW2ZbL1URne10VvX9OfgpJJ1MBf7fQLe7u9eF4_p8_LhaTF_TjWhBKec8QopIwvOUIlzSXhZQK6lYjKnOmeVMQXMKkYI0bzkSiHCuIp3ZVnEZ55NwM2Qu_HuozNhKxobtKlr2RrXBYEph6zIaIEjvf5D167zbZxOYMZphnGWw6huBxU_HII3ldh420jfCwTFd8sitix-Wo72ap_YqcaUB_lbawSzAXza2vT_J4n58mWI_AKRRYc0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2685322370</pqid></control><display><type>article</type><title>Comparison of subconjunctival microinvasive glaucoma surgery and trabeculectomy</title><source>Wiley Free Content</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Wagner, Felix M. ; Schuster, Alexander K. ; Munder, Annika ; Muehl, Marius ; Chronopoulos, Panagiotis ; Pfeiffer, Norbert ; Hoffmann, Esther M.</creator><creatorcontrib>Wagner, Felix M. ; Schuster, Alexander K. ; Munder, Annika ; Muehl, Marius ; Chronopoulos, Panagiotis ; Pfeiffer, Norbert ; Hoffmann, Esther M.</creatorcontrib><description>Purpose
To assess surgical success and the post‐operative development of intraocular pressure between XEN45® gelstent, Preserflo® MicroShunt and trabeculectomy with mitomycin C.
Methods
Data from 105 eyes from 105 patients of matched cases with refractory open‐angle glaucoma, who underwent surgery between January 2019, and August 2020, were evaluated. Patients underwent either stand‐alone XEN gelstent insertion with Mitomycin C, stand‐alone Preserflo with Mitomycin C or trabeculectomy with Mitomycin C. The primary outcome was the proportion of complete surgical success at 6 months post‐operatively (i.e. intraocular pressure between 5mmHg and 18mmHg, no revision surgery, no loss of light perception and no post‐operative pharmaceutical antiglaucomatous treatment). The reduction of intraocular pressure after 6 months, the classes of antiglaucomatous medication used post‐operatively, best‐corrected visual acuity, spherical refractive errors and astigmatism were assessed as secondary outcomes.
Results
We included 35 eyes in each group. After 6‐month follow‐up, complete success was 73.5% [95%‐CI: 57.9%–89.2%] in the trabeculectomy group, 51.4% [95%‐CI: 34.0%–68.8%] in the XEN group and 74.2% [95%‐CI: 57.9%–90.5%] in the Preserflo group (p = 0.08). Regarding secondary outcomes, the reduction of intraocular pressure was 12.1 ± 7.9 mmHg in the trabeculectomy group and was thereby 5.8 [95%‐CI: 2.2–9.6] mmHg greater compared with the XEN group (p < 0.001) and 4.8 [95%‐CI: 0.9–8.7] mmHg higher than the Preserflo group (p = 0.01).
Conclusions
No statistically significant differences were found between trabeculectomy, XEN45® gelstent implantation and Preserflo® MicroShunt implantation regarding surgical success after 6 months. Yet reduction in intraocular pressure was significantly higher in the trabeculectomy group. However, all three interventions resulted in sufficiently low post‐operative intraocular pressure and may therefore be considered individually for glaucoma treatment.</description><identifier>ISSN: 1755-375X</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/aos.15042</identifier><identifier>PMID: 34626093</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Acuity ; filtration surgery ; Glaucoma ; MIGS ; Mitomycin C ; Patients ; Pressure ; Statistical analysis ; Surgery ; surgical glaucoma treatment ; Surgical outcomes ; trabeculectomy</subject><ispartof>Acta ophthalmologica (Oxford, England), 2022-08, Vol.100 (5), p.e1120-e1126</ispartof><rights>2021 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Foundation</rights><rights>2021 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4542-868f1bea9861d27a48d908cab6a75c76fee903f6444c8d8bb1468be90dd9c7683</citedby><cites>FETCH-LOGICAL-c4542-868f1bea9861d27a48d908cab6a75c76fee903f6444c8d8bb1468be90dd9c7683</cites><orcidid>0000-0002-0949-4268 ; 0000-0001-9560-0524</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Faos.15042$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faos.15042$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34626093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wagner, Felix M.</creatorcontrib><creatorcontrib>Schuster, Alexander K.</creatorcontrib><creatorcontrib>Munder, Annika</creatorcontrib><creatorcontrib>Muehl, Marius</creatorcontrib><creatorcontrib>Chronopoulos, Panagiotis</creatorcontrib><creatorcontrib>Pfeiffer, Norbert</creatorcontrib><creatorcontrib>Hoffmann, Esther M.</creatorcontrib><title>Comparison of subconjunctival microinvasive glaucoma surgery and trabeculectomy</title><title>Acta ophthalmologica (Oxford, England)</title><addtitle>Acta Ophthalmol</addtitle><description>Purpose
To assess surgical success and the post‐operative development of intraocular pressure between XEN45® gelstent, Preserflo® MicroShunt and trabeculectomy with mitomycin C.
Methods
Data from 105 eyes from 105 patients of matched cases with refractory open‐angle glaucoma, who underwent surgery between January 2019, and August 2020, were evaluated. Patients underwent either stand‐alone XEN gelstent insertion with Mitomycin C, stand‐alone Preserflo with Mitomycin C or trabeculectomy with Mitomycin C. The primary outcome was the proportion of complete surgical success at 6 months post‐operatively (i.e. intraocular pressure between 5mmHg and 18mmHg, no revision surgery, no loss of light perception and no post‐operative pharmaceutical antiglaucomatous treatment). The reduction of intraocular pressure after 6 months, the classes of antiglaucomatous medication used post‐operatively, best‐corrected visual acuity, spherical refractive errors and astigmatism were assessed as secondary outcomes.
Results
We included 35 eyes in each group. After 6‐month follow‐up, complete success was 73.5% [95%‐CI: 57.9%–89.2%] in the trabeculectomy group, 51.4% [95%‐CI: 34.0%–68.8%] in the XEN group and 74.2% [95%‐CI: 57.9%–90.5%] in the Preserflo group (p = 0.08). Regarding secondary outcomes, the reduction of intraocular pressure was 12.1 ± 7.9 mmHg in the trabeculectomy group and was thereby 5.8 [95%‐CI: 2.2–9.6] mmHg greater compared with the XEN group (p < 0.001) and 4.8 [95%‐CI: 0.9–8.7] mmHg higher than the Preserflo group (p = 0.01).
Conclusions
No statistically significant differences were found between trabeculectomy, XEN45® gelstent implantation and Preserflo® MicroShunt implantation regarding surgical success after 6 months. Yet reduction in intraocular pressure was significantly higher in the trabeculectomy group. However, all three interventions resulted in sufficiently low post‐operative intraocular pressure and may therefore be considered individually for glaucoma treatment.</description><subject>Acuity</subject><subject>filtration surgery</subject><subject>Glaucoma</subject><subject>MIGS</subject><subject>Mitomycin C</subject><subject>Patients</subject><subject>Pressure</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>surgical glaucoma treatment</subject><subject>Surgical outcomes</subject><subject>trabeculectomy</subject><issn>1755-375X</issn><issn>1755-3768</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp10E1PwyAcBnBiNG5OD34B08SLHroBBUqPy-JbYrKDmngjQOnC0pYJ60y_vWjnDiZygcAvT_48AFwiOEVxzaQLU0QhwUdgjHJK0yxn_Phwpu8jcBbCGkKGGCOnYJQRhhkssjFYLlyzkd4G1yauSkKntGvXXau3difrpLHaO9vuZLA7k6xq2WnXyMj8yvg-kW2ZbL1URne10VvX9OfgpJJ1MBf7fQLe7u9eF4_p8_LhaTF_TjWhBKec8QopIwvOUIlzSXhZQK6lYjKnOmeVMQXMKkYI0bzkSiHCuIp3ZVnEZ55NwM2Qu_HuozNhKxobtKlr2RrXBYEph6zIaIEjvf5D167zbZxOYMZphnGWw6huBxU_HII3ldh420jfCwTFd8sitix-Wo72ap_YqcaUB_lbawSzAXza2vT_J4n58mWI_AKRRYc0</recordid><startdate>202208</startdate><enddate>202208</enddate><creator>Wagner, Felix M.</creator><creator>Schuster, Alexander K.</creator><creator>Munder, Annika</creator><creator>Muehl, Marius</creator><creator>Chronopoulos, Panagiotis</creator><creator>Pfeiffer, Norbert</creator><creator>Hoffmann, Esther M.</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0949-4268</orcidid><orcidid>https://orcid.org/0000-0001-9560-0524</orcidid></search><sort><creationdate>202208</creationdate><title>Comparison of subconjunctival microinvasive glaucoma surgery and trabeculectomy</title><author>Wagner, Felix M. ; Schuster, Alexander K. ; Munder, Annika ; Muehl, Marius ; Chronopoulos, Panagiotis ; Pfeiffer, Norbert ; Hoffmann, Esther M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4542-868f1bea9861d27a48d908cab6a75c76fee903f6444c8d8bb1468be90dd9c7683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acuity</topic><topic>filtration surgery</topic><topic>Glaucoma</topic><topic>MIGS</topic><topic>Mitomycin C</topic><topic>Patients</topic><topic>Pressure</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>surgical glaucoma treatment</topic><topic>Surgical outcomes</topic><topic>trabeculectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wagner, Felix M.</creatorcontrib><creatorcontrib>Schuster, Alexander K.</creatorcontrib><creatorcontrib>Munder, Annika</creatorcontrib><creatorcontrib>Muehl, Marius</creatorcontrib><creatorcontrib>Chronopoulos, Panagiotis</creatorcontrib><creatorcontrib>Pfeiffer, Norbert</creatorcontrib><creatorcontrib>Hoffmann, Esther M.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Acta ophthalmologica (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wagner, Felix M.</au><au>Schuster, Alexander K.</au><au>Munder, Annika</au><au>Muehl, Marius</au><au>Chronopoulos, Panagiotis</au><au>Pfeiffer, Norbert</au><au>Hoffmann, Esther M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of subconjunctival microinvasive glaucoma surgery and trabeculectomy</atitle><jtitle>Acta ophthalmologica (Oxford, England)</jtitle><addtitle>Acta Ophthalmol</addtitle><date>2022-08</date><risdate>2022</risdate><volume>100</volume><issue>5</issue><spage>e1120</spage><epage>e1126</epage><pages>e1120-e1126</pages><issn>1755-375X</issn><eissn>1755-3768</eissn><abstract>Purpose
To assess surgical success and the post‐operative development of intraocular pressure between XEN45® gelstent, Preserflo® MicroShunt and trabeculectomy with mitomycin C.
Methods
Data from 105 eyes from 105 patients of matched cases with refractory open‐angle glaucoma, who underwent surgery between January 2019, and August 2020, were evaluated. Patients underwent either stand‐alone XEN gelstent insertion with Mitomycin C, stand‐alone Preserflo with Mitomycin C or trabeculectomy with Mitomycin C. The primary outcome was the proportion of complete surgical success at 6 months post‐operatively (i.e. intraocular pressure between 5mmHg and 18mmHg, no revision surgery, no loss of light perception and no post‐operative pharmaceutical antiglaucomatous treatment). The reduction of intraocular pressure after 6 months, the classes of antiglaucomatous medication used post‐operatively, best‐corrected visual acuity, spherical refractive errors and astigmatism were assessed as secondary outcomes.
Results
We included 35 eyes in each group. After 6‐month follow‐up, complete success was 73.5% [95%‐CI: 57.9%–89.2%] in the trabeculectomy group, 51.4% [95%‐CI: 34.0%–68.8%] in the XEN group and 74.2% [95%‐CI: 57.9%–90.5%] in the Preserflo group (p = 0.08). Regarding secondary outcomes, the reduction of intraocular pressure was 12.1 ± 7.9 mmHg in the trabeculectomy group and was thereby 5.8 [95%‐CI: 2.2–9.6] mmHg greater compared with the XEN group (p < 0.001) and 4.8 [95%‐CI: 0.9–8.7] mmHg higher than the Preserflo group (p = 0.01).
Conclusions
No statistically significant differences were found between trabeculectomy, XEN45® gelstent implantation and Preserflo® MicroShunt implantation regarding surgical success after 6 months. Yet reduction in intraocular pressure was significantly higher in the trabeculectomy group. However, all three interventions resulted in sufficiently low post‐operative intraocular pressure and may therefore be considered individually for glaucoma treatment.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34626093</pmid><doi>10.1111/aos.15042</doi><tpages>1126</tpages><orcidid>https://orcid.org/0000-0002-0949-4268</orcidid><orcidid>https://orcid.org/0000-0001-9560-0524</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Free Content; Wiley Online Library Journals Frontfile Complete |
| subjects | Acuity filtration surgery Glaucoma MIGS Mitomycin C Patients Pressure Statistical analysis Surgery surgical glaucoma treatment Surgical outcomes trabeculectomy |
| title | Comparison of subconjunctival microinvasive glaucoma surgery and trabeculectomy |
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