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1. Subconjunctival draining minimally-invasive glaucoma devices for medically uncontrolled glaucoma. (PubMed)

Subconjunctival draining minimally-invasive glaucoma devices for medically uncontrolled glaucoma. Glaucoma is a leading cause of irreversible blindness. Subconjunctival draining minimally-invasive glaucoma devices such as the Xen gelatin implant and InnFocus stent have been introduced as a treatment to prevent glaucoma progressing.These implants provide a channel to allow aqueous humour from the anterior chamber of the eye to drain into the subconjunctival space on the surface of the eye thus (...) reducing intraocular pressure (IOP) and mimicking the mechanism of the most commonly undertaken glaucoma surgery, trabeculectomy.To evaluate the efficacy and safety of subconjunctival draining minimally-invasive glaucoma devices in treating people with open angle glaucoma and ocular hypertension whose condition is inadequately controlled with drops.We searched the Cochrane Central Register of Controlled Trials (CENTRAL; which contains the Cochrane Eyes and Vision Trials Register; 2018, Issue 6); Ovid

2018 Cochrane

2. Micro-bypass glaucoma surgery (MBGS) device implantation as a standalone procedure in patients with open-angle glaucoma

Micro-bypass glaucoma surgery (MBGS) device implantation as a standalone procedure in patients with open-angle glaucoma 1 Public Summary Document Application No. 1541 – Micro-bypass glaucoma surgery device implantation as a standalone procedure in patients with open angle glaucoma Applicant: Australian and New Zealand Glaucoma Society and the Royal Australian & New Zealand College of Ophthalmologists Date of MSAC consideration: MSAC 74th Meeting, 22-23 November 2018 Context for decision: MSAC (...) makes its advice in accordance with its Terms of Reference, visit the MSAC website 1. Purpose of application An application requesting Medicare Benefit Schedule (MBS) listing for trabecular micro- bypass glaucoma surgery and suprachoroidal micro-invasive glaucoma surgery using stent implantation in the standalone population (i.e. not in conjunction with cataract surgery) was received from the Australian and New Zealand Glaucoma Society (ANZGS) and the Royal Australian and New Zealand College

2018 Medical Services Advisory Committee

3. EX-PRESS Glaucoma Filtration Device (Alcon Inc.) for treatment of open-angle glaucoma

EX-PRESS Glaucoma Filtration Device (Alcon Inc.) for treatment of open-angle glaucoma EX-PRESS Glaucoma Filtration Device (Alcon Inc.) for treatment of open-angle glaucoma EX-PRESS Glaucoma Filtration Device (Alcon Inc.) for treatment of open-angle glaucoma HAYES, Inc. Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. EX-PRESS Glaucoma Filtration (...) Device (Alcon Inc.) for treatment of open-angle glaucoma. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication / G. 2016 Authors' conclusions Description of Technology: The EX-PRESS Glaucoma Filtration Device (EGFD) is a miniature, stainless steel aqueous shunt that is implanted using a modified surgical trabeculectomy. Once inserted, the filtration device immediately begins to shunt aqueous humor from the anterior chamber to the subconjunctival space forming a conjunctival filtering bleb

2016 Health Technology Assessment (HTA) Database.

4. Endoscopic cyclophotocoagulation (ECP) for open angle glaucoma and primary angle closure. (PubMed)

Endoscopic cyclophotocoagulation (ECP) for open angle glaucoma and primary angle closure. Glaucoma is a leading cause of irreversible blindness. A number of minimally invasive surgical techniques have been introduced as a treatment to prevent glaucoma progressing. Among them, endoscopic cyclophotocoagulation (ECP) is a cyclodestructive procedure developed by Martin Uram in 1992.To evaluate the efficacy and safety of ECP in people with open angle glaucoma (OAG) and primary angle closure whose (...) condition is inadequately controlled with drops.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2018, Issue 6); Ovid MEDLINE; Ovid Embase; the ISRCTN registry; ClinicalTrials.gov and the WHO ICTRP. The date of the search was 12 July 2018.We searched for randomised controlled trials (RCTs) of ECP compared to other surgical treatments (other minimally invasive glaucoma device techniques, trabeculectomy), laser

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2019 Cochrane

5. Cyclodestructive procedures for refractory glaucoma. (PubMed)

Cyclodestructive procedures for refractory glaucoma. Cyclodestructive procedures are often used in patients with refractory glaucoma who have failed to achieve lower intraocular pressure (IOP) from filtration procedures and maximal medical therapy. Destruction of the ciliary body helps to lower IOP by reducing aqueous humor formation. Of the many types of cyclodestructive procedures, laser cyclophotocoagulation (CPC) has become the most common surgical method for reducing aqueous inflow (...) . Options for CPC are wide-ranging: they can be performed using a neodymium:yttrium-aluminum-garnet (Nd:YAG) or diode laser and laser energy can be delivered by either the contact or non-contact method. Another cyclodestructive procedure is endoscopic cyclophotocoagulation (ECP), which the ophthalmologist can use selectively to target the ciliary epithelium and ablate ciliary body tissue. There is debate regarding which cyclodestructive method is best and how they compare to other glaucoma surgeries.To

2019 Cochrane

6. Ab interno trabecular bypass surgery with iStent for open-angle glaucoma. (PubMed)

Ab interno trabecular bypass surgery with iStent for open-angle glaucoma. Glaucoma is a leading cause of irreversible blindness worldwide. In early stages, glaucoma results in progressive loss of peripheral (side) vision; in later stages, it results in loss of central vision leading to blindness. Elevated intraocular pressure (IOP) is the only known modifiable risk factor for glaucoma. Minimally invasive glaucoma surgical (MIGS) techniques, such as ab interno trabecular bypass surgery (...) with iStent (Glaukos Corporation, Laguna Hills, CA, USA), have been introduced as a new treatment modality for glaucoma. However, the effectiveness of MIGS on keeping people 'drop-free' (i.e. not having to use eye drops to control IOP) and other outcomes is uncertain.To assess the effectiveness and safety of ab interno trabecular bypass surgery with iStent (or iStent inject) for open-angle glaucoma in comparison to conventional medical, laser, or surgical treatment.Cochrane Eyes and Vision's Information

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2019 Cochrane

7. Aqueous shunts with mitomycin C versus aqueous shunts alone for glaucoma. (PubMed)

Aqueous shunts with mitomycin C versus aqueous shunts alone for glaucoma. Glaucoma affects more than 70 million people worldwide, with about 10% being bilaterally blind, making it the leading cause of irreversible blindness globally. In patients with advanced glaucoma or those who have failed medical treatment without achieving adequate intraocular pressure (IOP) control, trabeculectomy (glaucoma filtration surgery where an ostium is created into the anterior chamber from underneath a partial (...) reviewed titles and abstracts from the literature searches. We obtained full-text reports of potentially relevant studies and assessed them for inclusion. Two review authors independently extracted data related to study characteristics, risk of bias, and outcomes. We used standard methodological procedures expected by Cochrane.We included five RCTs, with a total of 333 eyes with glaucoma randomized, and identified two ongoing trials. All included trials examined the effect of MMC versus no MMC when

2019 Cochrane

8. Comparison of Visual Field Progression Rates Among the High Tension Glaucoma, Primary Angle Closure Glaucoma, and Normal Tension Glaucoma. (PubMed)

Comparison of Visual Field Progression Rates Among the High Tension Glaucoma, Primary Angle Closure Glaucoma, and Normal Tension Glaucoma. To compare the visual field (VF) progression among high tension glaucoma (HTG), primary angle closure glaucoma (PACG), and normal tension glaucoma (NTG) subjects in routine clinical care.All patients had ≥5 VF tests using HFA, 24-2, SITA-standard strategy. We compared the progression between glaucoma subtypes after matching the VFs for baseline severity (...) and SD compared to other zones (P < 0.05).In our cohort of treated primary glaucoma with matched baseline severity, a greater proportion of HTG eyes progressed faster compared to PACG. SA zone in HTG and NTG and IA zone in PACG showed greater VF progression.

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2019 Investigative Ophthalmology & Visual Science

9. A prospective randomized trial comparing Hydrus and iStent micro-invasive glaucoma glaucoma surgery implants for standalone treatment of open-angle glaucoma: The COMPARE Study. (PubMed)

A prospective randomized trial comparing Hydrus and iStent micro-invasive glaucoma glaucoma surgery implants for standalone treatment of open-angle glaucoma: The COMPARE Study. To compare the efficacy of different MIGS devices for reducing intraocular pressure (IOP) and medications in open-angle glaucoma (OAG).Prospective, multicenter, randomized clinical trial.152 eyes from 152 patients aged 45-84 years with OAG, Shaffer angle grade III-IV, BCVA 20/30 or better, and IOP 23-39 mmHg after wash (...) out of all hypotensive medications. Eyes with secondary glaucoma other than pseudoexfoliative or pigmentary glaucoma, angle closure, previous incisional glaucoma surgery, or any significant ocular pathology other than glaucoma were excluded.Study eyes were randomized 1:1 to standalone microinvasive glaucoma surgery (MIGS) consisting of either one Hydrus® Microstent (Ivantis, Inc., Irvine, CA) or two iStent® Trabecular Micro Bypass devices (Glaukos Inc., San Clemente CA). Follow-up was performed 1

2019 Ophthalmology

10. Glaucoma: diagnosis and management

Glaucoma: diagnosis and management Glaucoma: diagnosis and management Glaucoma: diagnosis and management NICE guideline Published: 1 November 2017 nice.org.uk/guidance/ng81 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising (...) . Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Glaucoma: diagnosis and management (NG81) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 41Contents Contents Overview 4 Who is it for? 4 Recommendations 5 1.1 Case-finding 5 1.2 Diagnosis 6 1.3

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

11. Latanoprostene bunod (Vyzulta) - for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension

Latanoprostene bunod (Vyzulta) - for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization of a product

2019 Health Canada - Drug and Health Product Register

12. Comparison of glaucoma patients referred by glaucoma screening versus referral from primary eye clinic. (PubMed)

Comparison of glaucoma patients referred by glaucoma screening versus referral from primary eye clinic. To investigate whether mass glaucoma screening relative to opportunistic case finding at a primary eye clinic is helpful for early detection of glaucoma.Subjects referred by glaucoma screening (by non-contact tonometry and non-mydriatic fundus photography; group A, n = 220) and from a primary eye clinic (group B, n = 327) were retrospectively recruited. The positive predictive value (PPV (...) ) for glaucoma and the rate of glaucoma awareness were compared. Also, for the newly diagnosed glaucoma ('definite glaucoma') patients, the demographics and structural and functional severities of glaucoma were compared.The PPV for definite glaucoma was 25.5% for group A and 52.4% for group B. The rate of false-positive for 'glaucoma referral to tertiary hospital' was significantly higher for group A than for group B (38.6 vs. 18.3%, P < 0.001). Among the definite-glaucoma patients (group A: n = 56; group B

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2019 PLoS ONE

13. Color visual acuity in preperimetric glaucoma and open-angle glaucoma. (PubMed)

Color visual acuity in preperimetric glaucoma and open-angle glaucoma. To investigate the clinical significance of color visual acuity (CVA) in preperimetric glaucoma (PPG) and open-angle glaucoma (OAG).A total of 123 eyes of 73 subjects (22 normal eyes, 14 PPG eyes, and 87 OAG eyes; mean age: 44.9 ± 10.1 years, age range: 21-64 years) were enrolled. CVA was tested for red, green-yellow, blue-green and blue-purple with a newly developed test.There was no statistical difference in clinical (...) -yellow VA and blue-purple VA were not.Red VA and blue-green VA were detectably worse in eyes with OAG, in close association with the degree of functional loss. This suggests that measuring CVA with the new color test described here may be a promising supplement to existing methods of detecting glaucoma and evaluating its severity.

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2019 PLoS ONE

14. Iridotomy to slow progression of visual field loss in angle-closure glaucoma. (PubMed)

Iridotomy to slow progression of visual field loss in angle-closure glaucoma. Primary angle-closure glaucoma is a type of glaucoma associated with a physically obstructed anterior chamber angle. Obstruction of the anterior chamber angle blocks drainage of fluids (aqueous humor) within the eye and may raise intraocular pressure (IOP). Elevated IOP is associated with glaucomatous optic nerve damage and visual field loss. Laser peripheral iridotomy (often just called 'iridotomy') is a procedure (...) to eliminate pupillary block by allowing aqueous humor to pass directly from the posterior to anterior chamber through use of a laser to create a hole in the iris. It is commonly used to treat patients with primary angle-closure glaucoma, patients with primary angle closure (narrow angles and no signs of glaucomatous optic neuropathy), and patients who are primary angle-closure suspects (patients with reversible obstruction). The effectiveness of iridotomy on slowing progression of visual field loss

2018 Cochrane

17. Open-angle glaucoma

Open-angle glaucoma Open-angle glaucoma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Open-angle glaucoma Last reviewed: February 2019 Last updated: October 2018 Summary Glaucoma is the second leading cause of blindness in the world, with open-angle glaucoma being the most common type. Frequently presents asymptomatically and may be identified on routine ophthalmic examination. Intra-ocular pressure is most often (...) elevated, but may be normal in some cases. Optic disc cupping is diagnostic. May lead to irreversible loss of peripheral vision and, later, of central vision if untreated. Definition Glaucoma is a neurodegenerative condition primarily due to dysfunction in outflow of the nutrient-rich fluid, aqueous humour that constantly flows through the eye. Aqueous humour, created in the ciliary body, passes through the pupil into the small area between the iris and the cornea, called the anterior chamber

2018 BMJ Best Practice

18. Angle-closure glaucoma

Angle-closure glaucoma Angle-closure glaucoma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Angle-closure glaucoma Last reviewed: February 2019 Last updated: March 2018 Summary Acute angle-closure glaucoma is an urgent but uncommon, dramatic symptomatic event with blurring of vision, painful red eye, headache, nausea, and vomiting. Diagnosis is made by noting high intra-ocular pressure, corneal oedema, shallow (...) anterior chamber, and a closed angle on gonioscopy. Medical or surgical therapy is directed at widening the angle and preventing further angle closure. If glaucoma has developed it is treated with therapies to lower intra-ocular pressure. Chronic angle-closure glaucoma is diagnosed by noting peripheral anterior synechiae on gonioscopy, as well as progressive damage to the optic nerve and characteristic visual field loss. It is treated with therapies to lower intra-ocular pressure. Definition Angle

2018 BMJ Best Practice

19. Cyclodestructive procedures for non-refractory glaucoma. (PubMed)

Cyclodestructive procedures for non-refractory glaucoma. Glaucoma is a leading cause of blindness worldwide. It results in a progressive loss of peripheral vision and, in late stages, loss of central vision leading to blindness. Early treatment of glaucoma aims to prevent or delay vision loss. Elevated intraocular pressure (IOP) is the main causal modifiable risk factor for glaucoma. Aqueous outflow obstruction is the main cause of IOP elevation, which can be mitigated either by increasing (...) outflow or reducing aqueous humor production. Cyclodestructive procedures use various methods to target and destroy the ciliary body epithelium, the site of aqueous humor production, thereby lowering IOP. The most common approach is laser cyclophotocoagulation.To assess the effectiveness and safety of cyclodestructive procedures for the management of non-refractory glaucoma (i.e. glaucoma in an eye that has not undergone incisional glaucoma surgery). We also aimed to compare the effect of different

2018 Cochrane

20. Latanoprost + timolol (Fixapost) Reduction of intraocular pressure (IOP) in patients with open angle glaucoma and ocular hypertension who are insufficiently responsive to topical beta-blockers or prostaglandin analogues.

Latanoprost + timolol (Fixapost) Reduction of intraocular pressure (IOP) in patients with open angle glaucoma and ocular hypertension who are insufficiently responsive to topical beta-blockers or prostaglandin analogues. Published 13 May 2019 Product update SMC2159 latanoprost 50 micrograms/mL plus timolol 5mg/mL preservative free eye drops (Fixapost®) Thea Pharmaceuticals Limited 5 April 2019 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises (...) NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following an abbreviated submission latanoprost plus timolol (Fixapost®) is accepted for restricted use within NHSScotland. Indication under review: reduction of intraocular pressure (IOP) in patients with open angle glaucoma and ocular hypertension who are insufficiently responsive to topical beta-blockers or prostaglandin analogues. SMC restriction: to use

2019 Scottish Medicines Consortium

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