Effektivität und Sicherheit der Trabekulotomie ab interno mit dem Ivanov-Spatel in Kombination mit der Kataraktoperation - Ergebnisse nach 6 und 12 Monaten
Loading...
Files
Date
Authors
Publisher
Philipps-Universität Marburg
Supervisors
Abstract
In the work presented here, the ab interno trabeculotomy with the Ivanov® spatula in combination with cataract surgery was evaluated at 6 and 12 months postoperatively. Different glaucoma subtypes could be treated successfully, significantly and cost-effectively. For the first time and independently, the data from the University Eye Clinic in Marburg verify and prove the previous results of Ivanov et al.
With the presented procedure of trabeculotomy ab interno with the Ivanov® spatula in combination with cataract surgery, an effective reduction in intraocular pressure from 19.92 ± 7.67 mm Hg to 12.17 ± 2.67 (-7, 75 ± 7.71 mm Hg or -38.91%, p<0.001) was achieved after 6 months. In addition, the number of topical glaucoma medications decreased from 2.38 ± 1.23 to 1.31 ± 1.18 active substances (-1.07 ± 1.48 or -46.93%; p < 0.001) during this period. After 12 months, an effective reduction in intraocular pressure from 19.52 ± 7.96 mm Hg to 12.53 ± 3.09 mm Hg (-6.99 ± 8.15 mm Hg or -35.81%) was statistically significant in 113 eyes (p<0.001). In addition, a significant reduction in the number of topical glaucoma medications from 2.37 ± 1.32 to 1.63 ± 1.22 (-0.73 ± 1.56 or -30.80%; p<0.001) was achieved during the study period. The qualified success, defined as intraocular pressure below 21 mm Hg, intraocular pressure reduction by ≥ 20% of the baseline pressure with and without medication was 71.96% (154 of 214 eyes) after 6 months and 63.72% (72 of 113 eyes) after 12 month. Complete success (same criteria, without medication) was 23.83% 6 months postoperatively and 18.58% 12 months postoperatively (21 of 113 eyes).
The intraocular pressure lowering effect was independent of the glaucoma subtype.
In all statistical analyses, the preoperative intraocular pressure value was found to be the strongest predictive factor for the absolute reduction in intraocular pressure or pressure difference (p<0.001). All other factors like cup-to disc-ratio, number of topical glaucoma medications and anterior chamber depth were either not significant at all or reached a lower level of significance. Relevant complications occurred in 12.33% of the 219 eyes evaluated. 6 out of 574 eyes suffered a loss of vision of more than 2 lines (1.05%). 49 of 574 eyes required further glaucoma surgery (8.54%).
Cataract surgery combined with ab interno trabeculotomy using the Ivanov® spatula is safe and effective for lowering intraocular pressure in eyes with glaucoma. As a combined procedure, comparing to competing products, such as transtrabecular stents, the Kohook Dual Blade®, the Trabectome® oder the iTrack®-catheter, the Ivanov® spatula offers somewhat equivalent safety and efficiency with superior cost-effectiveness.
Review
Metadata
Contributors
Supervisor:
Dates
Created: 2024Issued: 2025-01-08Updated: 2025-01-08
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
MIGS GlaucomaGlaucomaCataractMIGS Glaukom
DDC-Numbers
610
show more
Schiller, Sarah Isabelle: Effektivität und Sicherheit der Trabekulotomie ab interno mit dem Ivanov-Spatel in Kombination mit der Kataraktoperation - Ergebnisse nach 6 und 12 Monaten. : Philipps-Universität Marburg 2025-01-08. DOI: https://doi.org/10.17192/z2024.0390.
License
This item has been published with the following license: In Copyright