Ahmed Iqbal Ike K

Efficacy, Safety, and Risk Factors for Failure of Standalone Ab Interno Gelatin Microstent Implantation versus Standalone Trabeculectomy.

There was no detectable difference in risk of failure and safety profiles between standalone ab interno microstent with MMC and trabeculectomy with MMC.

A Schlemm Canal Microstent for Intraocular Pressure Reduction in Primary Open-Angle Glaucoma and Cataract: The HORIZON Study.

This 24-month multicenter randomized controlled trial demonstrated superior reduction in MDIOP and medication use among subjects with mild-to-moderate POAG who received a Schlemm canal microstent combined with phacoemulsification compared with phacoemulsification alone.

A Prospective Randomized Trial Comparing Hydrus and iStent Microinvasive Glaucoma Surgery Implants for Standalone Treatment of Open-Angle Glaucoma: The COMPARE Study.

Standalone MIGS in OAG with the Hydrus resulted in a higher surgical success rate and fewer medications compared with the 2-iStent procedure. The 2 MIGS devices have similar safety profiles.

Hydrus microstent compared to selective laser trabeculoplasty in primary open angle glaucoma: one year results.

Both SLT and Hydrus implantation reduced IOP without serious adverse events. Hydrus implantation led to a significant and further reduction in medication dependence at 12 months.

Long-term Outcomes from the HORIZON Randomized Trial for a Schlemm's Canal Microstent in Combination Cataract and Glaucoma Surgery.

The addition of a Schlemm's canal microstent in conjunction with CS was safe, resulted in lowered IOP and medication use, and reduced the need for postoperative incisional glaucoma filtration surgery compared with CS after 5 years.

Intermediate Outcomes of a Novel Standalone Ab Externo SIBS Microshunt With Mitomycin C.

One-year results of the ab externo SIBS microshunt demonstrated promising rates of qualified and complete success, decreased drop use, few complications, and infrequent postoperative interventions.

Three-Year Findings of the HORIZON Trial: A Schlemm Canal Microstent for Pressure Reduction in Primary Open-Angle Glaucoma and Cataract.

Combined CS and microstent placement for mild to moderate POAG is safe, more effective in lowering IOP with fewer medications, and less likely to result in further incisional glaucoma filtration surgery than CS alone at…

Once-Daily Netarsudil/Latanoprost Fixed-Dose Combination for Elevated Intraocular Pressure in the Randomized Phase 3 MERCURY-2 Study.

Once-daily netarsudil/latanoprost FDC demonstrated IOP reductions that were statistically and clinically superior to its individual components at all 9 time points over 3 months, with tolerable ocular safety.

Five-Year, Prospective, Randomized, Multi-Surgeon Trial of Two Trabecular Bypass Stents versus Prostaglandin for Newly Diagnosed Open-Angle Glaucoma.

This prospective randomized trial demonstrates 5-year effectiveness and safety of 2 trabecular bypass stents in patients with newly diagnosed, treatment-naive POAG, with comparably favorable outcomes as topical prostaglandin.

Five-Year Visual Field Outcomes of the HORIZON Trial.

CS-HMS has a significant effect on VF preservation in glaucoma patients compared with CS alone, reducing the proportion of fast progressors.

A First-in-Human Study of the Efficacy and Safety of MINIject in Patients with Medically Uncontrolled Open-Angle Glaucoma (STAR-I).

The MINIject glaucoma drainage system significantly lowered IOP and eliminated the need for medication in most patients 6 months after surgery when implanted in a standalone procedure. There were no serious ocular adverse events.

Intraocular Lens Complications: Decentration, Uveitis-Glaucoma-Hyphema Syndrome, Opacification, and Refractive Surprises.

Intraocular lens complications are uncommon with modern cataract surgery. A number of these complications require proper identification and care to optimize patient outcomes.

A Canadian Cost-Utility Analysis of 2 Trabecular Microbypass Stents at Time of Cataract Surgery in Patients with Mild to Moderate Open-Angle Glaucoma.

iStent Inject TBS implantation during cataract surgery seems to be cost effective for reducing IOP in patients with mild to moderate OAG versus cataract surgery alone.

Ab Externo SIBS Microshunt with Mitomycin C for Open-Angle Glaucoma: Three-Year Results as a Primary Surgical Intervention.

Three-year follow-up data from this large cohort continues to support promising rates of qualified and complete success, with decreased medication burden postoperatively and few postoperative complications and interventions.

Inadvertent Cyclodialysis Cleft and Hypotony Following Ab-Interno Trabeculotomy Using the Trabectome Device Requiring Surgical Repair.

Inadvertent cyclodialysis cleft from a malpositioned AIT and resultant hypotony is rare and in this case was successfully treated by direct suture cyclopexy.

Comparative Effects of Glucagon-like Peptide 1 Receptor Agonists and Metformin on Glaucoma Risk in Patients with Type 2 Diabetes.

Glucagon-like peptide 1 receptor agonists are associated with a significantly lower incidence of POAG, ocular hypertension, and the need for first-line glaucoma treatments compared with metformin in patients with T2DM.

All Consecutive Ab Externo SIBS Microshunt Implantations With Mitomycin C: One-Year Outcomes and Risk Factors for Failure.

The 1-year follow-up data from this large and diverse cohort support promising rates of qualified and complete surgical success with decreased medication burden and few postoperative complications and interventions.

Multicenter Comparison of the Toronto Portable Perimeter with the Humphrey Field Analyzer: A Pilot Study.

Mean deviation, PSD, and VFI outcomes measured by the TPP were statistically similar to corresponding parameters obtained with the HFA.

Evaluation of the IOP-Lowering Effect of a Multi-Pressure Dial at Different Negative Pressure Settings.

Negative pressure application to the periocular space with a multi-pressure dial can produce titratable IOP reduction while the device is worn with active negative pressure.

Standalone Ab Interno Gelatin Stent versus Trabeculectomy: Postoperative Interventions, Visual Outcomes, and Visits.

Microstent eyes had more TCNRs (though fewer in-clinic interventions), fewer postoperative visits, and less vision loss, and experienced less surgically induced astigmatism, than trabeculectomy eyes.

Corneal endothelial safety profile in minimally invasive glaucoma surgery.

Through 5 years postoperative, there were no differences in proportion of eyes with significant ECL or mean ECD between the iStent inject and control groups.

Midterm failure of combined phacoemulsification with trabecular microbypass stenting: Clinicopathological analysis.

Although MIGS techniques prioritize safety, an understanding of the potential mechanisms of failure is paramount.

Two-Year Performance and Safety Results of the MINIject Supraciliary Implant in Patients With Primary Open-Angle Glaucoma: Meta-Analysis of the STAR-I, II, III Trials.

This meta-analysis demonstrates the favorable safety and efficacy profile of a supraciliary device implanted in a stand-alone, ab-interno procedure in patients with mild-to-moderate POAG.

Intermediate Outcomes of the Novel 63-μm Gelatin Microstent versus the Conventional 45-μm Gelatin Microstent.

63-μm gelatin microstent resulted in higher surgical success rates and fewer medications compared with 45-μm gelatin microstent.

Segmental Suture Gonioscopy-Assisted Transluminal Trabeculotomy: Comparison of Superior Versus Inferior Hemisphere Outcomes.

This retrospective study showed no difference in inferior versus superior 180 degrees of hemi-GATT/phacoemulsification cataract surgeries through the majority of analyses.

Long-Term Endothelial Safety Profile With iStent Inject in Patients With Open-Angle Glaucoma.

Implantation of iStent inject during phacoemulsification in patients with mild-to-moderate POAG did not produce any device-related complications or ECD safety concerns compared to phacoemulsification alone through 60 months.

Validation of a Wearable Virtual Reality Perimeter for Glaucoma Staging, The NOVA Trial: Novel Virtual Reality Field Assessment.

Estimated sensitivities of RATA-Standard are comparable to SITA-Standard between 23 to 40 dB with high concordance in glaucoma staging.

Mitomycin C 0.2 mg/ml versus Mitomycin C 0.4 mg/ml during the Implantation of an Ab Externo Polystyrene-isobutylene-styrene Microshunt: A Mega-analysis.

Polystyrene-isobutylene-styrene microshunt implantation with MMC 0.4 mg/ml resulted in a higher success rate with greater IOP reduction compared with MMC 0.2 mg/ml.

Neodymium Laser Treatment of IOP Rise Following Ex-Press Glaucoma Device Implantation: A Retrospective Review From 4 Institutions.

Our retrospective case series suggests that neodymium laser is a potential consideration in eyes with sustained IOP rise after Ex-Press device implantation.

Surgeon Experience as a Risk Factor for Short-Term Failure for Ab Interno Gelatin Microstent: A Canadian Multicenter Propensity-Matched Study.

There is some evidence for improved success in the later cases group.

Goniosynechialysis … to Release or Not to Release? That Is Not the Question.

Association Between Sociodemographic Factors and Self-reported Glaucoma in the National Health Interview Survey: A Population-Based Analysis.

Non-Hispanic Black race and poor health status were associated with self-reported glaucoma diagnosis. Physicians and policymakers may consider SDH when assessing clinical risk and designing public health interventions.

Consultation Section: Glaucoma. July consultation #2.

Bleb Morphology After Needling With Viscoelastic of an Ab Interno Microstent Assessed by Optical Coherence Tomography.

Glaucoma Surgery Comparison: SIBS Microshunt Versus Gelatin 45 µm Microstent Versus Trabeculectomy as Primary Surgical Interventions.

Overall, patients with the SIBS microshunt achieved higher success rates compared to both trabeculectomy and the gelatin 45 μm microstent group, with fewer postoperative complications, interventions, and reoperations for glaucoma.

Development and validation of the Iris Glare, Appearance, and Photophobia questionnaire for patients with iris defects.

Iris GAP can reliably evaluate symptomatology and patient-reported appearance in patients with iris defects.

Outcomes of the 63-μm Gelatin Microstent Versus 45-μm Gelatin Microstent: An International Multicenter Study.

Xen63 demonstrated superior IOP-lowering effectiveness compared with its 45-μm variant in patients requiring more robust IOP targets.

A Prospective, Real-World, Multicenter Study to Support the Role of Ab-Interno Canaloplasty in Glaucoma Management.

In real-world clinical practice, iTrack canaloplasty significantly reduced IOP and medication burden with a favorable safety profile when performed alone or with phacoemulsification and in diverse glaucoma populations.

A Large-Scale Cohort Analysis of Topical Prostaglandin Analog Use and Pseudophakic Cystoid Macular Edema Following Cataract Surgery.

Perioperative PGA use before or after cataract surgery was not associated with an increased risk of PCME.

Cost-Effectiveness Analysis of Hydrus Microstent for Patients with Mild to Moderate Primary Open-Angle Glaucoma in Canada.

Hydrus Microstent combined with CS is a cost-effective long-term treatment for patients with POAG. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Difficult decisions, filtration surgery, and the heartbreak of the numerator.

An extensive discussion ensued about the best course of action for the right eye.

Deadbolt cataract due to misplanted minishunt.

How would you manage the misplanted minishunt? What surgical approaches or specific techniques would you consider for cataract removal and visual rehabilitation?

Re: Kaba et al.: The effectiveness and safety of micropulse cyclophotocoagulation in the treatment of ocular hypertension and glaucoma (Ophthalmology Glaucoma. 2020;3:181-189).

Two-Year COMPASS Trial Results: Supraciliary Microstenting with Phacoemulsification in Patients with Open-Angle Glaucoma and Cataracts.

This RCT demonstrated safe and sustained 2-year reduction in IOP and glaucoma medication use after microinterventional surgical treatment for mild-to-moderate POAG.

Iritis, glaucoma and corneal decompensation associated with BrightOcular cosmetic iris implant.

Cosmetic iris implants carry the risk of ocular damage when implanted in the anterior chamber of normal phakic eyes.

Biocompatibility of a Novel Microfistula Implant in Nonprimate Mammals for the Surgical Treatment of Glaucoma.

In nonprimate mammals, the material composing the microfistula implant and the implant itself do not induce significant inflammation or tissue reaction.

Advancing the Economic Assessment of Microinvasive Glaucoma Surgery.

Effect of endocyclophotocoagulation on refractive outcomes in angle-closure eyes after phacoemulsification and posterior chamber intraocular lens implantation.

In this study, patients with PACS, PAC, or PACG having phacoemulsification and IOL implantation with ECP had decreased predictability of the postoperative refraction and a small myopic shift compared with those without ECP.

Refractive outcomes in nanophthalmic eyes after phacoemulsification and implantation of a high-refractive-power foldable intraocular lens.

Implanting foldable high-power IOLs in a series of nanophthalmic eyes yielded significant improvement in UDVA and SE. Cataract surgery in these eyes carries increased risk.

Laser iridotomy to treat uveitis-glaucoma-hyphema syndrome secondary to reverse pupillary block in sulcus-placed intraocular lenses: Case series.

The UGH syndrome due to reverse pupillary block occurred after sulcus-placed PC IOLs in susceptible patients, those with axial myopia, and post-vitrectomized eyes. The cases were managed with LPIs.

Phacoemulsification combined with a new ab interno gel stent to treat open-angle glaucoma: Pilot study.

Cataract surgery combined with implantation of the gelatin stent resulted in a significant reduction in IOP in eyes with OAG.

MIGS and the FDA: What's in a Name?

Efficacy and safety of combined cataract surgery with 2 trabecular microbypass stents versus ab interno trabeculotomy.

Both types of surgery achieved a significant reduction in IOP and medication use at 12 months, with the stent group achieving higher success and a reduced incidence of postoperative hyphema.

Fluid Dynamics of a Novel Micro-Fistula Implant for the Surgical Treatment of Glaucoma.

Under flow testing, the XEN micro-fistula implant was able to maintain backpressure above numerical hypotony levels without the use of complex valve systems.

Electron microscopic evaluation of a gold glaucoma micro shunt after explantation.

Ahmed is a consultant to and has received research grants from Solx, Inc. No other author has a financial or proprietary interest in any material or method mentioned.

Inter-eye differences in patients with pseudoexfoliation syndrome presenting with intraocular lens dislocation.

In patients with PXF, the eye presenting with IOL dislocation was more likely than its fellow eye to have a diagnosis of glaucoma and to have glaucoma of greater severity.

December consultation #2.

Surgical technique for explantation of cosmetic anterior chamber iris implants.

This suggests that as long as these implants are present, ocular structures are at risk. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.