EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/387844
EW GLAUCOMA 90 October 2014 beautifully highlighted in this year's Binkhorst Lecture by Ike Ahmed, MD, and was the subject of numerous paper and poster presentations. This study by Dr. Khan and colleagues stood out as one of the few that compared two currently available MIGS procedures— iStent and Trabectome—to each other. This retrospective study included 12 months of follow-up. Both iStent and Trabectome reduced IOP and the need for glaucoma medications, with iStent doing slightly better in this study. Dr. Khan's study underscores the promise of MIGS, and it will be interesting to see more comparative studies as more MIGS procedures become available. Comparison of argon-laser peripheral iridoplasty and medical therapy in immediate treatment of acute primary angle closure Chelvin Sng, MBBChir, FRCSEd, and colleagues Purpose: Evaluate and compare incision enlargement as well as in- gress of trypan blue from the ocular surface into the anterior chamber following implantation of a foldable hydrophobic acrylic intraocular lens (IOL) through a 2.2 mm clear corne- al incision (CCI) using 1 automated and 2 manual injector systems. Methods: Randomized clinical trial in 120 eyes (120 patients) undergo- ing microcoaxial phacoemulsific - tion through a 2.2 mm CCI random- ized to 3 groups depending on IOL injector used: Group I (n=40), where an automated motorized injector (Autosert) was used; Group II (n=40), where a plunger type injector (Royale) was used; and Group III (n=40), where a screw type injector (Monarch III) was used. Incision widths were measured before and after implantation of a foldable, single-piece aspheric hydrophobic acrylic IOL using D cartridge. Following IOL implantation and (iStents, Glaukos, Laguna Hills, Calif.) (Group i) and 52 patients with combined phaco and ab-in- terno micro-cautery trabeculotomy (Trabectome, NeoMedix, Tustin, Calif.) (Group t) with 12-month follow-up were included. Efficacy measures were intraocular pressure (IOP), topical ocular hypotensive medication use, and frequency of postoperative complications. Results: A significant decrease in both IOP and medication use oc- curred in both groups. Postoperative IOP (p=0.008) and medication use (p<0.01) were significantly lower in Group i vs. Group t. 39% of patients in Group i and 14% in Group t had an IOP<18 on no medications at 12 months (p=0.03). There were no differences between the groups for preoperative IOP (p=0.39) and medication use (p=0.82). In terms of postoperative complications, the occurrence of hyphema was signifi- cantly less in Group i (p=0.008). Conclusion: Both groups showed a significant reduction of IOP and medication use over a 12-month period. Combined phaco and micro-stents showed lower IOP, less medication use, and reduced frequency of hyphema forma- tion postoperatively compared to combined phaco and micro-cautery trabeculotomy. Dr. Ansari: The advent of microinvasive glaucoma surgery (MIGS) has sparked a revolution in the management of glaucoma. MIGS gives us the potential to treat glaucoma as a surgical disease much earlier in its course and reduce the burden of long-term use of topical medications. Furthermore, these benefits are realized in the setting of very little added risk when the MIGS procedure is combined with cataract surgery. At this year's ASCRS meeting, MIGS was the hot topic. It was Comparison of combined cataract surgery with trabecular micro-bypass stent versus ab-interno micro-cautery trabeculotomy Michelle Khan, BSc(Hons) Purpose: To evaluate and compare the intraocular pressure, medication reduction, and postoperative com- plications of trabecular micro-bypass stent versus ab-interno micro-cau- tery trabeculotomy when combined with cataract surgery in patients with open angle glaucoma. Methods: 49 patients who under- went combined phaco and 2 trabecular micro-bypass stents Husam Ansari, MD, PhD, highlighted the best glaucoma papers at the "Hot Off the Press" session at the 2014 ASCRS•ASOA Symposium & Congress. The papers were chosen from the Best Paper of Session winners. Here are the abstracts from the studies, with Dr. Ansari's comments regarding selection. Hot off the press: Fifth in a series of 5 presentations Dr. Ansari highlights the best glaucoma papers at the "Hot Off the Press" session. Source: EyeWorld