Tulsi Changulani 1,*, Jenny Bo 2, Mei-Ling Cheng 1, Andrew Tatham 1

Slides:

Advertisements

Similar presentations

ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute.

Advertisements

Anterior Chamber Depth, Iridocorneal Angle Width, and Intraocular Pressure Changes After Phacoemulsification: Narrow vs Open Iridocorneal Angles Huang.

Phacoemulsification with Goniosynechialysis in the Management of Refractory Acute Angle-closure Glaucoma Ghasem Fakhraie*, MD, Mahmoud Jabbarvand, MD,

The Diabetic Retinopathy Clinical Research Network Repeated Intravitreous Ranibizumab Injections for DME and Risk of Sustained IOP Elevation or Need for.

Will my Glaucoma patient lose vision ?

Copyright restrictions may apply JAMA Ophthalmology Journal Club Slides: Trabeculectomy for Open-Angle Glaucoma Takihara Y, Inatani M, Ogata-Iwao M, et.

TARIQ ALASBALI WHICH PATIENTS ARE AT RISK FOR THE PROGRESSION?

Corneal graft survival and intraocular pressure control after Descemet stripping automated endothelial keratoplasty in eyes with pre-existing glaucoma.

Cataract Surgery After Trabeculectomy: The Effect on Trabeculectomy Function Husain R, Liang S, Foster PJ. Cataract surgery after trabeculectomy: the effect.

Published in Circulation 2003 Rory Hachamovitch, MD, MSc; Sean W. Hayes, MD; John D. Friedman, MD; Ishac Cohen PhD; Daniel S. Berman, MD Comparison of.

Effect of Corneal Thickness on Selective Laser Trabeculoplasty to Decrease Intraocular Pressure as Primary or Secondary Treatment of Glaucoma ASCRS 2010.

Young Joo Shin, 1 Sang Mok Lee, 2 Jin Choi, 3 Eun Ryung Han, 4 Dong Hae Kim 4 1 H ally m University Gangnam Sacred Heart Hospital 2 3The Armed Forces Medical.

1 Clinical Outcomes of DSEK Surgery Combined With Other Intraocular Procedures Neil Mahesh Vyas, MD Fei Yu, PhD Anthony J. Aldave, MD Sophie Deng, MD,

Effect of Race on Selective Laser Trabeculoplasty  1st author has no financial interest in the subject matter of this poster.  2nd and 3rd co-authors.

Introduction  Selective Laser Trabeculoplasty (SLT) uses a Q-Switched frequency- doubled (532 nm), low energy Nd:YAG laser, which targets melanocytes.

Canadian Ophthalmological Society Evidence-based Clinical Practice Guidelines for the Management of Glaucoma in the Adult Eye.

Zonular Weakness in Patients with Primary Angle-Closure Glaucoma Yong Yeon Kim 1, Keny Kirti 2, Bokun Rho 1 Department of Ophthalmology, Korea University.

Effect of East Asian Race on Selective Laser Trabeculoplasty ASCRS 2011 Minerva Kim Johns Hopkins University Lawrence F. Jindra, MD Columbia University.

Six-Year Longevity of Selective Laser Trabeculoplasty as Primary Therapy in Patients with Glaucoma ASCRS 2009 Lawrence F. Jindra, MD Columbia University.

Effect of Previous Argon Laser Trabeculoplasty on Selective Laser Trabeculoplasty ASCRS 2011 Lawrence F. Jindra, MD Columbia University Winthrop University.

SUBACUTE ANGLE CLOSURE MISDIAGNOSED AS MIGRAINE / CHRONIC HEADACHE IN MIDDLE AGED SOUTH INDIAN POPULATION Poornima Kandasamy1, Ajita Sasidharan1 1Glaucoma,

ALBUMIN IS AN EFFECT MODIFIER IN THE RELATIONSHIP BETWEEN ERYTHROPOIETIN STIMULATING AGENT AND MORTALITY IN HEMODIALYSIS PATIENTS. Satoshi Mikami1, Takayuki.

iStent with phacoemulsification, n=50

Mamounas EP et al. Proc SABCS 2012;Abstract S1-10.

Primary angle-closure glaucoma

COMBINED PHACOEMULSIFICATION AND TRANS-SCLERAL CYCLOPHOTOCOAGULATION

CRF variations ( initial CRF – final CRF )

IOP control and corneal endothelial cell density changes

Selective laser trabeculoplasty in Korean eyes with medically uncontrolled pseudoexfoliation glaucoma Su Chan Lee1, Jung Hyun Lee1,

Characteristics of Primary Angle-Closure Glaucoma Patients with Normal Intraocular Pressure at the First Visit Won Hyuk Oh1, Bum Gi Kim1, Joo Hwa Lee2.

Safety of medication reduction for Primary Angle Closure (PAC) –

Anastasiia Raievska (Veramed)

Trauma z Surgical treatment of extremely complicated forms of glaucoma

B. Kozomara, E. Potkonjak, R. Lazic, N. Gabric

Lasers in Glaucoma: Meta analysis

New concepts of Angle Closure Glaucoma

A presentation to: Meeting name Date

1: Houston Methodist Neurological Institute, Houston, TX

Treatment With Continuous, Hyperfractionated, Accelerated Radiotherapy (CHART) For Non-Small Cell Lung Cancer (NSCLC): The Weston Park Hospital Experience.

EVIDENCE LEVEL III CONFIRMATORY

Effect of Selective Laser Trabeculoplasty on

A presentation to: Meeting name Date

Clinical outcome after SVR: Veterans Affairs

Frolov Mikhail, Dushina Galina

Kyoto Prefectural University of Medicine

Early Experience with Descemet’s Stripping Automated Endothelial Keratoplasty Combined with Phacoemulsification: Clinical and Refractive Outcome University.

Winthrop University Hospital

Baseline and Serial Brain Natriuretic Peptide Level Predicts 5-Year Overall Survival in Patients With Pulmonary Arterial Hypertension: Data From the REVEAL.

Comparison of Post-operative Pachymetry After Penetrating Keratoplasty Using Prednisolone Acetate 1% Versus Loteprednol Etabonate 0.5% E. Lillian Cheng,

Clinical study of open angle glaucoma surgery treatment trough deep slerectomy with T-Flux NV implant: three years follow-up Dr. Marco Rossi Dr Michele.

Volume 388, Issue 10052, Pages (October 2016)

A presentation to: Meeting name Date

Volume 385, Issue 9975, Pages (April 2015)

A presentation to: Meeting name Date

Significance of Periprocedural Myocardial Infarctions in Percutaneous Coronary Interventions A New Look at an Old Topic Abhiram Prasad, MD, FRCP, FESC,

Published online September 20, 2017 by JAMA Surgery

Kaplan-Meier curves comparing: (A) overall survival for patients treated on trial compared to those outside of a trial; (B) progression-free survival for.

Cheil Eye Hospital , Daegu, Korea

A presentation to: Meeting name Date

DRCR Retina Network Treatment for Center-Involved DME in Eyes with Good Visual Acuity (Protocol V)

Simvastatin in Patients With Prior Cerebrovascular Disease: HPS

Baseline Clinical Characteristics of All Patients and Patients Grouped by Statin Therapy - Part I H. Fukuta et al. Circulation 2005;112:

Winthrop University Hospital

The Effect of Corneal Thickness on Ocular Drug Penetration

EFFECT OF CORNEAL THICKNESS ON SELECTIVE LASER TRABECULOPLASTY

Kristina E. Fittipaldi, BA

Diabetic Retinopathy Clinical Research Network

ASCRS 2010 Joseph A. Donnelly Albert Einstein College of Medicine

Floral Park Ophthalmology Winthrop University Hospital

Avasare et al. Am J Nephrol 2017;45:99-106 (DOI: / )

Presentation transcript:

Tulsi Changulani 1,*, Jenny Bo 2, Mei-Ling Cheng 1, Andrew Tatham 1 WGCSUB-1151 A Study Of Factors Predicting Future Lens Extraction Following Laser Peripheral Iridotomy Tulsi Changulani 1,*, Jenny Bo 2, Mei-Ling Cheng 1, Andrew Tatham 1 1Ophthalmology, 2Princess Alexandra Eye Pavillion, Edinburgh, United Kingdom Primary angle closure glaucoma (PACG) is a common cause of blindness (1). The current first line treatment is laser peripheral iridotomy (LPI), however a significant proportion of eyes need further treatment, especially lens extraction. A recent randomised control study has shown primary lens extraction to be effective and cost effective for eyes with PACG and primary angle closure (PAC) with raised intraocular pressure (IOP) (2). AIM - To evaluate the outcome of LPI for the initial management of angle closure and determine predictors of future lens extraction. INTRODUCTION RESULTS (cont.) Overall, at one year following LPI there was a 20% chance of having had lens extraction, increasing to a 50% chance at 4 years (Figure 1). Each year of increasing age was associated with a 1.06-fold increase in chance of needing lens extraction (95% CI 1.04 to 1.08, P<0.001). Univariate Cox proportional hazard regression analyses showed older age, higher IOP prior to laser, PACG diagnosis, shorter axial length, and worse SAP MD at baseline were significantly associated with lens extraction (P <0.05). A retrospective chart review including 218 consecutive eyes of 118 subjects treated with LPI between 23rd November 2010 and 23rd May 2012 at Princess Alexandra Eye Pavilion. Baseline information collected included age at LPI, gender, diagnosis (primary angle closure suspect (PACS), PAC or PACG), gonioscopy, central corneal thickness, peak IOP prior to LPI, visual field mean deviation (MD), axial length, number of anti-glaucoma medications prior to LPI and number at most recent follow up. The study endpoint was defined as date of lens extraction or date of most recent follow up. Survival analysis was performed using Kaplan-Meier curves. Univariate and multivariate analysis were performed to determine factors associated with increased likelihood of lens extraction. METHODS Table 1. Additional treatment following LPI for control of IOP. Figure 1. Kaplan-Meier survival probability for phacoemulsification 54.1% of all eyes required additional surgical treatment following LPI, the most common of which was lens extraction. The multivariate model was used to predict survival probabilities (Figure 2) for lens extraction based on age and peak IOP before laser. Patients who were older, had higher peak IOP prior to laser, PACG diagnosis, shorter axial length, and worse SAP MD at baseline were significantly more likely to need lens extraction during follow up. Patients at high risk of needing lens extraction following LPI may be better having lens extraction as the primary procedure. DISCUSSION HR 95% CI P-value Age (per year older) 1.03 1.00 to 1.05 0.027 Peak IOP before laser (per 1 mmHg higher) 1.01 to 1.05 0.004 Axial length (per mm longer) 0.68 0.52 to 0.90 0.007 Average age at time of LPI was 68 ± 11 years and patients were followed for an average of 3.7 ± 1.6 years after LPI. 111 of 218 eyes (50.9%) had PACS, 42 (19.3%) PAC and 65 (29.8%) PACG. 91 of 218 eyes (41.7%) underwent lens extraction following LPI, including 31.5% of eyes with PACS, 35.7% with PAC, and 63.1% with PACG (Table 1). RESULTS Table 2. Multivariate Cox proportional hazard regression analysis. Predicted survival probabilities for phacoemulsification Additional Treatment PACS (n=111) PAC (n=42) PACG (n=65) No. Percentage Phacoemulsification 35 31.5% 15 35.7% 41 63.1% Repeat/enlargement of PI 18 16.2% 6 14.3% 24 36.9% Cyclodiode Laser 1 0.9% 2 4.8% - Trabeculectomy 1.5% Selective Laser Trabeculoplasty 2.4% Figure 2. Multivariate predicted survival probabilities for phacoemulsification. Increased age, peak IOP prior to laser, severity of glaucomatous changes and shorter axial length at baseline predicted earlier intervention with lens extraction. CONCLUSION Table 1. Additional treatment following LPI for control of IOP. European Glaucoma Society. Terminology and Guidelines for Glaucoma. 4th ed. Savona, Italy: PubliComm; 2014. Azuara-Blanco A, Burr J, Ramsay C, Cooper D, Foster PJ, Friedman DS, et al. Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. Lancet. 2016;388(10052):1389-97.