Most Read Articles
Dr. Joseph Delano Fule Robles, 4 days ago

A recent study conducted by The University of Hong Kong (HKU) revealed that long-term use of proton pump inhibitors (PPIs) is associated with a significantly increased risk of gastric cancer even in patients who have had Helicobacter pylori eradicated. 

11 Nov 2017
Sensitivity to blue-enriched light is influenced by sex differences, such that males display a stronger response even to very low light levels, a recent study suggests. Moreover, sex differences also affect the acute benefits of bedtime blue light exposure such as sustained attention.
5 days ago
High levels of marijuana exposure appear to not be longitudinally associated with prevalent albuminuria and substantial changes in estimated glomerular filtration rate by cystatin C (eGFRcys), a recent US epidemiological study has shown.
3 days ago
Men with breast cancer have tumours that are typically of the human epidermal growth factor receptor 2-negative Luminal B subtype and positive for oestrogen receptor, progesterone receptor and androgen receptor, according to the results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program study.

Microstent on par with trabeculectomy for uncontrolled glaucoma

30 Oct 2017

The risk of failure and safety profiles are comparable between standalone ab interno microstent with mitomycin C (MMC) and trabeculectomy with MMC, a recent study has found.

Researchers conducted a multicentre, retrospective interventional cohort study including 354 eyes of 293 patients with no prior incisional surgery. Consecutive eyes with uncontrolled glaucoma underwent microstent (n=185) or trabeculectomy (n=169) surgery from 1 January 2011 through 31 July 2015 at four academic ophthalmology centres in Canada, Germany, Austria and Belgium.

Hazard ratio (HR) of failure was the primary outcome measure. Failure was defined as two consecutive intraocular pressure (IOP) readings <6 mm Hg with vision loss >17 mm Hg without glaucoma medications (complete success) at least 1 month after surgery despite in-clinic interventions. Secondary outcome measures were IOP thresholds of 6 to 14 mm Hg and 6 to 21 mm Hg, and same thresholds allowing for medications (qualified success), interventions, complications and reoperations.

Baseline characteristics were similar, except that the microstent group had more men (56 vs 43 percent), younger patients (average, by 3 years), better preoperative visual acuity (22. Vs 32 percent with 0.4 logarithm of the minimum angle of resolution vision or worse) and more trabeculoplasty (52 vs 30 percent).

The adjusted HR of failure of the microstent vs trabeculectomy was 1.2 (95 percent CI, 0.7 to 2.0) for complete success and 1.3 (0.6 to 2.8) for qualified success, and similar for other outcomes. For complete success, time to 25-percent failure was 11.2 (6.9 to 16.1 months) and 10.6 months (6.8 to 16.2 months), and 30.3 (19.0 to ∞ months) and 33.3 months (25.7 to 46.2 months) for qualified success.

In general, an association existed between white ethnicity and decreased risk of failure (adjusted HR, 0.49; 0.25 to 0.96), and between diabetes and increased risk of failure (adjusted HR, 4.21; 2.10 to 8.45).

There were 117 and 165 interventions: 43 and 31 percent underwent needling, respectively, and 50 percent of trabeculectomy eyes underwent laser suture lysis. A total of 22 and 30 distinct complications were reported, but most were transient. Finally, 10 and 5 percent underwent reoperation (p=0.11).

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Dr. Joseph Delano Fule Robles, 4 days ago

A recent study conducted by The University of Hong Kong (HKU) revealed that long-term use of proton pump inhibitors (PPIs) is associated with a significantly increased risk of gastric cancer even in patients who have had Helicobacter pylori eradicated. 

11 Nov 2017
Sensitivity to blue-enriched light is influenced by sex differences, such that males display a stronger response even to very low light levels, a recent study suggests. Moreover, sex differences also affect the acute benefits of bedtime blue light exposure such as sustained attention.
5 days ago
High levels of marijuana exposure appear to not be longitudinally associated with prevalent albuminuria and substantial changes in estimated glomerular filtration rate by cystatin C (eGFRcys), a recent US epidemiological study has shown.
3 days ago
Men with breast cancer have tumours that are typically of the human epidermal growth factor receptor 2-negative Luminal B subtype and positive for oestrogen receptor, progesterone receptor and androgen receptor, according to the results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program study.