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Advances in Glaucoma Surgery: 2nd Edition
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Advances in Glaucoma Surgery: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 25 December 2024 | Viewed by 3878

Special Issue Editors

Prof. Dr. Michele Figus

E-Mail Website
Guest Editor
Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
Interests: glaucoma; cataract; ocular surface; uveitis
Special Issues, Collections and Topics in MDPI journals
Dr. Karl Mercieca

E-Mail Website
Guest Editor
Glaucoma Unit, University Hospital Eye Clinic, Bonn, Germany
Interests: glaucoma; cataract; uveitis; surgical innovation; medical education
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Glaucoma surgery still represents a real challenge both in terms of ensuring safety and efficacy, and particularly the balance between the two. Significant technological advances have led to innovative surgeries,which have in turn been rapidly introduced into clinical practice. New devices to lower intraocular pressure show promising results, but it is still unclear whether they can replace the current ‘standard’ surgeries, such as trabeculectomy or glaucoma drainage devices. Moreover, even these standard procedures are being continuously modified in various ways in the search for better safety and efficacy outcomes. At the same time, more and more attention is being paid to the ocular surface. It is well known that glaucoma-therapy-related ocular surface disease can worsen patients’ quality of life and affect the outcome of glaucoma filtration surgery. This is the reason for this Special Issue, for which we welcome manuscripts on the following topics:

  • Minimally invasive glaucoma surgery;
  • Minimally invasive bleb surgery;
  • Non-plate, bleb-forming glaucoma devices;
  • Trabeculectomy;
  • Glaucoma-therapy-related ocular surface disease;
  • Glaucoma drainage devices;
  • Non-penetrating glaucoma surgery;
  • Ciliary body function modulation;
  • Selective laser trabeculoplasty.

It is our pleasure to invite you to contribute to the Special Issue entitled "Advances in Glaucoma Surgery: 2nd Edition". This is one new edition, and we published 23 papers in the first edition. For more details, please visit: https://www.mdpi.com/journal/jcm/special_issues/glaucoma_surgery_clinical.

Prof. Dr. Michele Figus
Dr. Karl Mercieca
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • glaucoma surgery
  • minimally invasive glaucoma surgery
  • intraocular pressure
  • ocular surface
  • glaucoma

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Related Special Issue

Published Papers (4 papers)

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Research

9 pages, 670 KiB  
Article
Flow-Adjusted Trabeculectomy
by Assaf Kratz, Ivan Goldberg, Tal Koren, Aviel Hadad, Boris Knyazer and Ridia Lim
J. Clin. Med. 2024, 13(21), 6609; https://doi.org/10.3390/jcm13216609 - 4 Nov 2024
Viewed by 473
Abstract
Background/Objectives: As one of the most efficacious glaucoma surgical techniques, trabeculectomy is considered by many surgeons to be the “gold standard” intra-ocular pressure (IOP)-reducing intervention. The purpose of this study is to present our intra-operative flow-adjusted surgical method, which aims to provide safety [...] Read more.
Background/Objectives: As one of the most efficacious glaucoma surgical techniques, trabeculectomy is considered by many surgeons to be the “gold standard” intra-ocular pressure (IOP)-reducing intervention. The purpose of this study is to present our intra-operative flow-adjusted surgical method, which aims to provide safety and efficacy more simply than previous methods. Methods: Retrospectively, we evaluated outcomes for trabeculectomy or phacotrabeculectomy in surgery-naïve eyes over three years for patients with glaucoma not associated with other ocular co-morbidities. We defined complete success as an IOP between 5 and 18 mmHg plus at least a 20% reduction from baseline, without concomitant medications. Relative success was the same result, with glaucoma medication(s). Failure was regarded as an IOP less than 5 or higher than 18 mmHg, or by the need for a subsequent glaucoma operation. Results: We assessed the results from 186 eyes of 186 patients. After exclusion, a group of 45 trabeculectomies and 35 phacotrabeculectomies were analyzed. In eyes undergoing a trabeculectomy, over a mean follow-up of 16.0 months, IOP fell from 28.1 ± 8.0 mmHg with 3.6 ± 1.1 medications to 9.7 ± 3.6 mmHg (66% reduction) with 0.4 ± 1.0 medications (each p < 0.00001). The success rate was 88.9% (75.6% complete success). In eyes undergoing a phacotrabeculectomy, over a mean of 19.1 months, IOP fell from 26.1 ± 10.2 mmHg with 3.5 ± 1.3 medications to 10.0 ± 3.6 mmHg (62% reduction) on 0.9 ± 1.4 medications (each p < 0.00001). The success rate was 91.4% (57.1% complete success). Complication rates were low, with no major complications in either group. Conclusion: To lower IOP, our intra-operative flow-adjusted trabeculectomy and phacotrabeculectomy techniques appear to be safe and effective. Full article
(This article belongs to the Special Issue Advances in Glaucoma Surgery: 2nd Edition)
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11 pages, 930 KiB  
Article
Is the Advent of New Surgical Procedures Changing the Baseline Features of Patients Undergoing First-Time Glaucoma Surgery?
by Alessandro Palma, Giuseppe Covello, Chiara Posarelli, Maria Novella Maglionico, Luca Agnifili and Michele Figus
J. Clin. Med. 2024, 13(11), 3342; https://doi.org/10.3390/jcm13113342 - 6 Jun 2024
Viewed by 753
Abstract
Background: The aim of this study was to determine if the rise in new surgical procedures for glaucoma is changing the baseline features of patients. Methods: In this retrospective study, we reviewed the baseline features of patients undergoing their first glaucoma [...] Read more.
Background: The aim of this study was to determine if the rise in new surgical procedures for glaucoma is changing the baseline features of patients. Methods: In this retrospective study, we reviewed the baseline features of patients undergoing their first glaucoma surgery in 2011 and 2021, collecting data regarding intraocular pressure (IOP), visual field (VF) parameters, stage of disease, and the type of surgery. Results: In the study, 455 patients were included in the analysis. From these, 230 eyes had glaucoma surgery performed in 2011 (Group A) and 225 eyes in 2021 (Group B). When considering the baseline features, Group A was older than Group B (72.7 ± 10.7 and 70 ± 12.4 years; p = 0.02, respectively), and showed a significantly more advanced VF mean defect (−16.4 ± 8.8 and −13.8 ± 8.7 dB; p < 0.01, respectively) and a higher IOP (25.9 ± 6.6 and 24.9 ± 7.8 mmHg; p = 0.02, respectively). Overall, severe VF damage at the time of surgery was more frequent in Group A (74.3%) than in Group B (60.8%) (p < 0.01). The overall number of traditional glaucoma surgeries was 211 in 2011, reducing to 94 ten years later, with similar severe pre-operative VF defects. In 2021, minimally invasive bleb surgery (MIBS) represented 58% of all surgeries. Conclusions: In the last ten years, patients receiving glaucoma surgery for the first time were younger, had less severe disease, and a more contained IOP. The baseline feature modifications were probably related to the diffusion of new procedures, especially MIBS, which allowed for treating patients at an earlier stage, reserving traditional procedures for advanced cases. Full article
(This article belongs to the Special Issue Advances in Glaucoma Surgery: 2nd Edition)
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8 pages, 832 KiB  
Article
Clinical Results of the MINIject Implant for Suprachoroidal Drainage
by Timothy Gläser, Daniel Böhringer, Charlotte Evers, Philip Keye, Thomas Reinhard and Jan Lübke
J. Clin. Med. 2024, 13(10), 2831; https://doi.org/10.3390/jcm13102831 - 11 May 2024
Viewed by 1012
Abstract
Objective: This retrospective study evaluated the safety and efficacy of the new minimally invasive MINIject implant placed in the suprachoroidal space. The aim was to assess its impact on intraocular pressure (IOP) reduction and complication rate. Methods: 18 eyes from 18 patients with [...] Read more.
Objective: This retrospective study evaluated the safety and efficacy of the new minimally invasive MINIject implant placed in the suprachoroidal space. The aim was to assess its impact on intraocular pressure (IOP) reduction and complication rate. Methods: 18 eyes from 18 patients with insufficiently controlled glaucoma received the implant using topical medications. Outcomes were changes in IOP, change in IOP medication, need for other glaucoma surgery, and rate of adverse events. Results: IOP reduced by 15% (p < 0.05) following MINIject implantation. IOP medication decreased from 3 to 1 agent (p < 0.05). Four patients (22%) required other glaucoma surgery while we did not observe any clinically relevant adverse event. Conclusions: This retrospective study indicates that MINIject implants may be a safe and effective means of reducing IOP together with a reduction in IOP medications in most patients. Larger prospective studies with longer follow-ups are necessary to confirm our results, though. Full article
(This article belongs to the Special Issue Advances in Glaucoma Surgery: 2nd Edition)
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13 pages, 1363 KiB  
Article
Steroids and/or Non-Steroidal Anti-Inflammatory Drugs as Postoperative Treatment after Trabeculectomy—12-Month Results of a Randomized Controlled Trial
by Afrouz Ahmadzadeh, Line Kessel, Bo Simmendefeldt Schmidt, Miriam Kolko and Daniella Bach-Holm
J. Clin. Med. 2024, 13(3), 887; https://doi.org/10.3390/jcm13030887 - 2 Feb 2024
Viewed by 1208
Abstract
This prospective randomized controlled trial aimed to compare the efficacy and safety of topical preservative-free diclofenac (DICLO) to dexamethasone (DEX) eyedrops, and their combination (DEX+DICLO) after trabeculectomy. Sixty-nine patients with medically uncontrolled glaucoma were randomized to receive topical postoperative treatment with DICLO ( [...] Read more.
This prospective randomized controlled trial aimed to compare the efficacy and safety of topical preservative-free diclofenac (DICLO) to dexamethasone (DEX) eyedrops, and their combination (DEX+DICLO) after trabeculectomy. Sixty-nine patients with medically uncontrolled glaucoma were randomized to receive topical postoperative treatment with DICLO (n = 23), DEX (n = 23), or a combination of DEX and DICLO (n = 23). The primary outcome was the intraocular pressure (IOP) 12 months postoperatively. Secondary outcomes included surgical success, failure, visual field, and visual acuity from baseline to 12 months postoperatively. IOP reached the lowest point one day after trabeculectomy. At 12 months, IOP was 10.0 mmHg (95% CI, 8.4–11.6 mmHg) for DICLO, 10.9 mmHg (95% CI, 9.4–12.3 mmHg) for DEX, and 11.2 mmHg (95% CI, 9.1–13.3 mmHg) for DEX+DICLO. There were no significant differences in IOP, surgical success, failure, visual field, or visual acuity between the DICLO, DEX, or DEX+DICLO groups. We found that topical diclofenac was not statistically different from topical dexamethasone in controlling IOP 12 months after trabeculectomy. Combining diclofenac and dexamethasone offered no added IOP control compared to dexamethasone alone. Full article
(This article belongs to the Special Issue Advances in Glaucoma Surgery: 2nd Edition)
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