Glokomda Yeni Cerrahi Yaklaşımlar: Mikroinvaziv (Minimal İnvaziv) Glokom Cerrahisi

Yıllardan beri trabekülektomi oftalmologlarca en sık uygulanan glokom cerrahisi yöntemidir. Ancak etkin göz içi basıncı (GİB) kontrolü yanında komplikasyonlarının ağırlığı araştırıcıları yeni cerrahi alanlara yöneltmiştir. Son yıllarda nonpenetran cerrahilerin gelişimiyle birlikte Schlemm kanalı (SK) odaklı cerrahi ve implantlar üzerindeki araştırmalar da yoğunlaşmıştır. Uygulama sonuçları yeni yeni tartışılmaya başlayan minimal invaziv ya da mikroinvaziv glokom cerrahisi (MİGC) olarak nitelendirilen cerrahilere ilgi giderek artmaktadır. Bu cerrahilerin glokom ve GİB kontrolü, maliyetleri ve hekim tarafından kabulü konusundaki yansımalar gelecek için yol gösterici olacaktır. Bu makalede MİGC yöntemleri olan kanaloplasti ve kanal expander, Gold mikroşant (Solx), Trabektom (NeoMedix), Ecximer lazer trabekülotomi, iStent (Glaucos), Hydrus (İvantis), Cypass (Transcend), Xen (Aquesys) implantları güncel bilgiler ışığında etraflıca incelenecektir.

New Surgical Approaches in Glaucoma: Micro-invasive (Minimally invasive) Glaucoma Surgery

Trabeculectomy has been the most common glaucoma surgery method among ophthalmologists for many years. However, in addition to its’ effective control of intraocular pressure (IOP), serious complications lead researchers to perform new surgical tecniques. In recent years, together with the development of non-penetrating surgery, researches are focused on Schlemm’s canal (SC) based surgeries and implants. There is an increasing interest for minimal invasive surgery or microinvasive glaucoma surgery (MIGS), results of whom have recently started to be discussed. Control of glaucoma and IOP, costs, and the adaptation of surgeons to these new techniques will be a guide for future of these surgeries. In the current study; MIGS methods; including Canaloplasty and canal expander, Gold micro shunt (Solx), Trabectome (NeoMedix), Excimer laser trabeculotomy, iStent (Glaucos), Hydrus (İvantis), Cypass (Transcend), and Xen (Aquesys ) implants will be discussed in detail in the light of current knowledge.

Kaynakça

1. Grant WM. Experimental aqueous perfusion in enucleated human eyes. Arch Ophthalmol. 1963;69:783-801.

2. Johnson MC, Kamm RD. The role of Schlemm’s canal in aqueous outflow from the human eye. Invest Ophthalmol Vis Sci. 1983;24:320-5.

3. Krasnov MM. Externalization of Schlemm’s canal (sinusotomy) in glaucoma. Br J Ophthalmol. 1968;52:157-61.

4. Mansouri K, Ravinet E. Effect of different application depths of mitomycin-C in deep sclerectomy with collagen implant: a randomized controlled trial. Clin Experiment Ophthalmol. 2009;37:286-92.

5. Russo V, Scott IU, Stella A, et al. Nonpenetrating deep sclerectomy with reticulated hyaluronic acid implant versus punch trabeculectomy: a prospective clinical trial. Eur J Ophthalmol. 2008;18:751-7.

6. Sarıcaoğlu MS, Aktaş Z, Karakurt A ve ark. Trabekülektomi ve nonpenetran derin sklerektomide ultrason biyomikroskopik değerlendirme. Glo-Kat 2007;2:99-102.

7. Ateş H, Uretmen O, Andaç K, Azarsiz SS. Deep sclerectomy with a nonabsorbable implant (T-Flux): preliminary results. Can J Ophthalmol. 2003;38:482-8.

8. Loscos-Arenas J, Parera-Arranz A, Romera-Romera P, et al. Deep Sclerectomy with a new nonabsorbable uveoscleral implant (Esnoper-Clip): 1-year outcomes. J Glaucoma. 2015;24.

9. Saheb H, Ahmed II. Micro-invasive glaucoma surgery: current perspectives and future directions. Curr Opin Ophthalmol. 2012;23:96-104.

10. Mansouri K, Shaarawy T. Update on Schlemm’s canal based procedures. Middle East Afr J Ophthalmol. 2015;22:38-44.

11. Johnson DH, Matsumoto Y. Schlemm’s canal becomes smaller after successful filtration surgery. Arch Ophthalmol. 2000;118:1251-6.

12. Brandão LM, Grieshaber MC. Update on minimally invasive glaucoma surgery (MIGS) and new implants. J Ophthalmol. 2013;2013:705915.

13. Klink T, Sauer J, Körber NJ, et al. Quality of life following glaucoma surgery: canaloplasty versus trabeculectomy. Clin Ophthalmol. 2014 18;9:7-16.

14. Lewis RA, von Wolff K, Tetz M, et al. Canaloplasty: circumferential viscodilation and tensioning of Schlemm canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults: two-year interim clinical study results. J Cataract Refract Surg. 2009;35:814-24.

15. Lewis RA, von Wolff K, Tetz M, et al. Canaloplasty: Three-year results of circumferential viscodilation and tensioning of Schlemm canal using a microcatheter to treat open-angle glaucoma. J Cataract Refract Surg. 2011;37:682-90.

16. Grieshaber MC, Pienaar A, Olivier J, Stegmann R. Canaloplasty for primary open-angle glaucoma: long-term outcome. Br J Ophthalmol. 2010;94:1478-82.

17. Grieshaber MC, Fraenkl S, Schoetzau A, et al. Circumferential viscocanalostomy and suture canal distension (canaloplasty) for whites with open-angle glaucoma. J Glaucoma. 2011;20:298-302.

18. Grieshaber MC, Pienaar A, Olivier J, et al. Comparing two tensioning suture sizes for 360 degrees viscocanalostomy (canaloplasty): a randomised controlled trial. Eye (Lond). 2010;24:1220-6.

19. Arthur SN, Cantor LB, WuDunn D, et al. Efficacy, safety, and survival rates of IOP-lowering effect of phacoemulsification alone or combined with canaloplasty in glaucoma patients. J Glaucoma. 2014;23:316-20.

20. Bull H, von Wolff K, Körber N, et al. Three-year canaloplasty outcomes for the treatment of open-angle glaucoma: European study results. Graefes Arch Clin Exp Ophthalmol. 2011;249:1537-45.

21. Tetz M, Koerber N, Shingleton BJ,et al. Phacoemulsification and intraocular lens implantation before, during, or after canaloplasty in eyes with open-angle glaucoma: 3-year results. J Glaucoma. 2015;24:187-94.

22. Koerber NJ. Canaloplasty in one eye compared with viscocanalostomy in the contralateral eye in patients with bilateral open-angle glaucoma. J Glaucoma. 2012;21:129-34.

23. Brüggemann A, Despouy JT, Wegent A, et al.. Intraindividual comparison of Canaloplasty versus trabeculectomy with mitomycin C in a single-surgeon series. J Glaucoma. 2013;22:577-83.

24. Ayyala RS, Chaudhry AL, Okogbaa CB, et al. Comparison of surgical outcomes between canaloplasty and trabeculectomy at 12 months’ follow-up. Ophthalmology. 2011;118:2427-33.

25. Matlach J, Freiberg FJ, Leippi S, Grehn F, Klink T. Comparison of phacotrabeculectomy versus phacocanaloplasty in the treatment of patients with concomitant cataract and glaucoma. BMC Ophthalmol. 2013;29;13:1.

26. Rękas M, Byszewska A, Petz K, et al. Canaloplasty versus nonpenetrating deep sclerectomy - a prospective, randomised study of the safety and efficacy of combined cataract and glaucoma surgery; 12-month follow-up. Graefes Arch Clin Exp Ophthalmol. 2015;253:591-9.

27. Voykov B, Szurman P, Dimopoulos S, et al. Micro-invasive suture trabeculotomy after canaloplasty: preliminary results. Clin Experiment Ophthalmol. 2014;15.

28. Grieshaber MC, Pienaar A, Olivier J, et al. Clinical evaluation of the aqueous outflow system in primary open-angle glaucoma for canaloplasty. Invest Ophthalmol Vis Sci. 2010;51:1498-504.

29. Klink T, Panidou E, Kanzow-Terai B, et al. Are there filtering blebs after canaloplasty? J Glaucoma. 2012;21:89-94.

30. Melamed S, Ben Simon GJ, Goldenfeld M, et al. Efficacy and safety of gold micro shunt implantation to the supraciliary space in patients with glaucoma: a pilot study. Arch Ophthalmol. 2009;127:264-9.

31. Agnifili L, Costagliola C, Figus M,et al. Histological findings of failed gold micro shunts in primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol. 2012;250:143-9.

32. Rękas M, Pawlik B, Grala B, et al. Clinical and morphological evaluation of gold micro shunt after unsuccessful surgical treatment of patients with primary open-angle glaucoma. Eye (Lond). 2013;27:1214-7.

33. Spiegel D, Kobuch K. Trabecular meshwork bypass tube shunt: initial case series. Br J Ophthalmol. 2002;86:1228-31.

34. Spiegel D, Wetzel W, Haffner DS, et al. Initial clinical experience with the trabecular micro-bypass stent in patients with glaucoma. Adv Ther. 2007;24:161-70.

35. Kaplowitz K, Schuman JS, Loewen NA. Techniques and outcomes of minimally invasive trabecular ablation and bypass surgery. Br J Ophthalmol. 2014;98:579-85.

36. Belovay GW, Naqi A, Chan BJ, et al. Using multiple trabecular microbypass stents in cataract patients to treat open-angle glaucoma. J Cataract Refract Surg. 2012;38:1911-7.

37. Buchacra O, Duch S, Milla E, et al. One-year analysis of the iStent trabecular microbypass in secondary glaucoma. Clin Ophthalmol. 2011;5:321-6.

38. Samuelson TW, Katz LJ, Wells JM, et al; US iStent Study Group. Randomized evaluation of the trabecular micro-bypass stent with phacoemulsification in patients with glaucoma and cataract. Ophthalmology. 2011;118:459-67.

39. Craven ER, Katz LJ, Wells JM, et al; iStent Study Group. Cataract surgery with trabecular micro-bypass stent implantation in patients with mild-to-moderate open-angle glaucoma and cataract: two-year follow-up. J Cataract Refract Surg. 2012;38:1339-45.

40. Fea AM. Phacoemulsification versus phacoemulsification with microbypass stent implantation in primary open-angle glaucoma: randomized double-masked clinical trial. J Cataract Refract Surg. 2010;36:407-12.

41. Spiegel D, Wetzel W, Neuhann T, et al. Coexistent primary open-angle glaucoma and cataract: interim analysis of a trabecular micro-bypass stent and concurrent cataract surgery. Eur J Ophthalmol. 2009;19:393-9.

42. Arriola-Villalobos P, Martínez-de-la-Casa JM, Díaz-Valle D, et al. Combined iStent trabecular micro-bypass stent implantation and phacoemulsification for coexistent open-angle glaucoma and cataract: a long-term study. Br J Ophthalmol. 2012;96:645-9.

43. Bayraktar Ş, Yılamz ÖF, Mert S, ve ark. Açık açılı glokomda trabekü- ler bypass (Glaucos İstent uygulaması. Glo-Kat 2008;3:69-75.

44. Fernández-Barrientos Y, García-Feijoó J, Martínez-de-la-Casa JM, et al. Fluorophotometric study of the effect of the glaukos trabecular microbypass stent on aqueous humor dynamics. Invest Ophthalmol Vis Sci. 2010;51:3327-32.

45. Bahler CK, Hann CR, Fjield T, et al. Second-generation trabecular meshwork bypass stent (iStent inject) increases outflow facility in cu

46. Voskanyan L, García-Feijoó J, Belda JI, et al; Synergy Study Group. Prospective, unmasked evaluation of the iStent® inject system for open-angle glaucoma: synergy trial. Adv Ther. 2014;31(2):189-201.

47. Fea AM, Belda JI, Rękas M, et al. Prospective unmasked randomized evaluation of the iStent inject (®) versus two ocular hypotensive agents in patients with primary open-angle glaucoma. Clin Ophthalmol. 2014;8:875-82.

48. Minckler DS, Baerveldt G, Alfaro MR, et al. Clinical results with the Trabectome for treatment of open-angle glaucoma. Ophthalmology. 2005;112:962-7

49. Minckler D, Mosaed S, Dustin L, et al. Trabectome Study Group. Trabectome (trabeculectomy‑internal approach): Additional experience and extended follow‑up. Trans Am Ophthalmol Soc 2008;106:149-59.

50. Maeda M, Watanabe M, Ichikawa K. Evaluation of trabectome in openangle glaucoma, J Glaucoma 2013;22:205-8.

51. Francis BA, Minckler, Dustin L, et al. Combined cataract extraction and trabeculotomy by the internal approach for coexisting cataract and open-angle glaucoma: initial results. J Cataract Refract Surg. 2008; 34:1096-103.

52. Ahuja Y, Ma Khin Pyi S, Malihi M, et al. Clinical results of Ab Interno trabeculotomy using the trabectome for open -angle glaucoma: The Mayo Clinic Series in Rochester, Minnesota, Am J Ophthalmol. 2013;156:927-35.

53. Jea SY, Francis BA, Vakili G, et al. Ab Interno trabeculectomy versus trabeculectomy for open-angle glaucoma, Ophthalmology. 2012;119:36-42.

54. Jea SY, Mosaed S, Vold SD, et al. Effect of a failed trabectome on subsequent trabeculectomy. J Glaucoma. 2012;21:71-5.

55. Wang Q, Harasymowycz P. Goniopuncture in the treatment of shortterm post-Trabectome intraocular pressure elevation: a retrospective case series study. J Glaucoma. 2013;22:17-20.

56. Vold SD, Dustin L; Trabectome Study Group. Impact of laser trabeculoplasty on Trabectome® outcomes. Ophthalmic Surg Lasers Imaging. 2010;41:443-51.

57. Ahuja Y, Malihi M, Sit AJ. Delayed-onset symptomatic hyphema after ab interno trabeculotomy surgery. Am J Ophthalmol. 2012;154:476-480.

58. Ting JL, Damji KF, Stiles MC; Trabectome Study Group. Ab interno trabeculectomy: outcomes in exfoliation versus primary open-angle glaucoma J Cataract Refract Surg. 2012;38:315-23.

59. Babighian S, Rapizzi E, Galan A. Efficacy and safety of ab interno excimer laser trabeculotomy in primary open-angle glaucoma: two years of follow-up. Ophthalmologica. 2006;220:285-90.

60. Babighian S, Caretti L, Tavolato M, et al. Excimer laser trabeculotomy vs 180 degrees selective laser trabeculoplasty in primary openangle glaucoma. A 2-year randomized, controlled trial. Eye (Lond). 2010;24:632-8.

61. Töteberg-Harms M, Ciechanowski PP, et al. One-year results after combined cataract surgery and excimer laser trabeculotomy for elevated intraocular pressure. Ophthalmologe. 2011;108:733-8.

62. Töteberg-Harms M, Hanson JV, Funk J. Cataract surgery combined with excimer laser trabeculotomy to lower intraocular pressure: effectiveness dependent on preoperative IOP. BMC Ophthalmol. 2013 24;13:24.

63. Camras LJ, Yuan F, Fan S, Samuelson TW, Ahmed IK, Schieber AT, Toris CB. A novel Schlemm’s Canal scaffold increases outflow facility in a human anterior segment perfusion model. Invest Ophthalmol Vis Sci. 2012;53:6115-21.

64. Gulati V, Fan S, Hays CL, et al. A novel 8-mm Schlemm’s canal scaffold reduces outflow resistance in a human anterior segment perfusion model. Invest Ophthalmol Vis Sci. 2013;54:1698-704.

65. Hays CL, Gulati V, Fan S, et al. Improvement in outflow facility by two novel microinvasive glaucoma surgery implants. Invest Ophthalmol Vis Sci. 2014;55:1893-900.

66. Johnstone MA, Saheb H, Ahmed II, et al. Effects of a Schlemm canal scaffold on collector channel ostia in human anterior segments. Exp Eye Res. 2014;119:70-6.

67. Hoeh H, Ahmed II, Grisanti S, et al. Early postoperative safety and surgical outcomes after implantation of a suprachoroidal micro-stent for the treatment of open-angle glaucoma concomitant with cataract surgery. J Cataract Refract Surg. 2013;39:431-7.

68. Hoeh H, Vold SD, Ahmed IK, et al. Initial Clinical Experience With the CyPass Micro-Stent: Safety and Surgical Outcomes of a Novel Supraciliary Microstent. J Glaucoma. 2014; 9.

69. Lewis RA. Ab interno approach to the subconjunctival space using a collagen glaucoma stent. J Cataract Refract Surg. 2014;40:1301-6.

70. Hong J, Xu J, Wei A, et al. Spectral-domain optical coherence tomographic assessment of Schlemm’s canal in Chinese subjects with primary open-angle glaucoma. Ophthalmology. 2013;120:709-15.

Kaynak Göster

839 380

Arşiv
Sayıdaki Diğer Makaleler

Kollajen Çapraz Bağlamanın Göz İçi Basıncı ve Merkezi Kornea Kalınlığı Üzerine Etkisi

Mehmet Özgür ZENGİN, Esat ÇINAR, Aslı ÇELİK, Cem KÜÇÜKERDÖNMEZ

Study of Final Visual Outcome in Penetrating Sub Group of Open Globe Injuries Following Surgical Treatment of Traumatic Cataract According to Birmingham Eye Trauma Terminology System

Mehul SHAH, Shreya SHAH, Parth KALYANI, Ruchir MEHTA, Prerna SHAH

Persistan Epitel Defekti Varlığında Kontrolsüz Topikal Streroid Kullanımı Sonrası Gelişen Korneal Perforasyon ve Göz İçi Lens Prolapsusu

Musa ÇAPKIN, ALİ ŞİMŞEK, BURAK BİLGİN, Ali Hakim REYHAN

Glokom Cerrahisinde Minimal İnvaziv Bir Prosedür: Trabektom

Yıldıray YILDIRIM, Eyüp DÜZGÜN, Taner KAR

Normal Basınçlı Glokom Hastalarında Klinik Özellikler ve Kardiovasküler Bulguların Glokomun Progresyonu Üzerine Olan Etkisi

Fatma EROĞLU ÇORAK, SİREL GÜR GÜNGÖR, Yusuf GÜNEŞ, Ahmet AKMAN

Korneal Astigmatizması ve Kataraktı Olan Hastalarda Torik Göz İçi Lensi İmplantasyonu Sonuçları

Sabite Emine GÖKÇE, Orhan AYAR, MEHMET CÜNEYT ÖZMEN, SERPİL YAZGAN, MEHMET ORÇUN AKDEMİR, MUSTAFA KOÇ

Göz İçi Mercek Gücü Hesaplamasında Özelleştirilmiş A Sabiti Kullanımı

Emine Deniz EĞRİLMEZ, Emrah MAT, Arda KARAGÖZ, İlkay MERMUT ÇAKIR, Şeyda UĞURLU

Kataraktı ve Beraberinde Kornea Opasitesi Olan Gözlerde Fakoemülsifikasyon

ERKAN ÇELİK, Emine DOĞAN, Sibel ALİŞAN, BURÇİN ÇAKIR, Elif Betül TÜRKOĞLU, MUSTAFA GÜRKAN ERDOĞAN, GÜRSOY ALAGÖZ

Vitreusa Spontan Lens Dislokasyonu Görülen Bir Ektopia Lentis ET Pupilla Olgusu

MEHMET ALİ ŞEKEROĞLU, Mustafa Alpaslan ANAYOL, Bayram GÜLPAMUK, Başak CERAN BOSTANCI, Pelin YILMAZBAŞ

Glokomda Yeni Cerrahi Yaklaşımlar: Mikroinvaziv (Minimal İnvaziv) Glokom Cerrahisi

M. Sinan SARICAOĞLU