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Article: Surgical Outcomes of Ab Interno Trabeculotomy Without Phacoemulsification.

Mochizuki, Tsukasa / Hirooka, Kazuyuki / Okada, Naoki / Onoe, Hiromitsu / Tokumo, Kana / Okumichi, Hideaki / Kiuchi, Yoshiaki

Clinical ophthalmology (Auckland, N.Z.)

2024 Volume 18, Page(s) 9–16

Abstract: Purpose: The aim of this study was to evaluate ab interno trabeculotomy outcomes without phacoemulsification.: Methods: This retrospective study evaluated 118 eyes of patients aged 18 and above who underwent ab interno trabeculotomy between December ... ...

Abstract	Purpose: The aim of this study was to evaluate ab interno trabeculotomy outcomes without phacoemulsification. Methods: This retrospective study evaluated 118 eyes of patients aged 18 and above who underwent ab interno trabeculotomy between December 2017 and August 2022. When surgeries were performed in both eyes, only the eye undergoing the initial surgery was evaluated. Prior to and after surgery, the intraocular pressure (IOP) and mean number of IOP-lowering medications were compared. An IOP of ≤21 mmHg (A) and ≤18 mmHg (B) along with a ≥20% reduction in the preoperative IOP was defined as survival. Cases that required reoperation for glaucoma were defined as surgical failure. The Kaplan-Meier method was used to evaluate the survival rates. A Cox proportional hazards model was used to analyze the preoperative factors that influenced survival rates. Results: At 36 months postoperatively, the 13.4 ± 2.8 mmHg average IOP was significantly decreased from the preoperative 23.5 ± 9.8 mmHg value ( Conclusion: Utilization of ab interno trabeculotomy effectively lowered the IOP and reduced the number of IOP-lowering medications. Patients with higher preoperative IOP exhibited better postoperative outcomes.
Language	English
Publishing date	2024-01-03
Publishing country	New Zealand
Document type	Journal Article
ISSN	1177-5467
ISSN	1177-5467
DOI	10.2147/OPTH.S446168
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Article: Comparison of Mid-Term Outcomes between Microhook ab Interno Trabeculotomy and Goniotomy with the Kahook Dual Blade.

Okada, Naoki / Hirooka, Kazuyuki / Onoe, Hiromitsu / Okumichi, Hideaki / Kiuchi, Yoshiaki

Journal of clinical medicine

2023 Volume 12, Issue 2

Abstract: This study retrospectively examined the mid-term surgical outcomes between microhook ab interno trabeculotomy (μLOT) and goniotomy when one was using the Kahook Dual Blade (KDB) in combination with phacoemulsification in primary open-angle glaucoma and ... ...

Abstract	This study retrospectively examined the mid-term surgical outcomes between microhook ab interno trabeculotomy (μLOT) and goniotomy when one was using the Kahook Dual Blade (KDB) in combination with phacoemulsification in primary open-angle glaucoma and exfoliation glaucoma patients. Between December 2016 and December 2020, the current study examined 47 μLOT and 52 KDB eyes that underwent surgery. When there was a < 20% reduction in the preoperative intraocular pressure (IOP) or when the IOP was > 18 mmHg (criterion A), the IOP was > 14 mmHg (criterion B) at two consecutive follow-up visits, or when there was a requirement for reoperation, these were all considered to indicate that the surgery failed. A genetic algorithm that used the preoperative IOP was used to determine the score matching. After score matching, a total of 27 eyes were evaluated. In the μLOT and KDB groups, the mean postoperative follow-up periods were 31.2 ± 13.3 and 37.2 ± 16.3 months, respectively. The results for both of the groups show there were significant postoperative reductions in the IOP (p < 0.05) and medication scores (p < 0.05) at 6, 12, 24 and 36 months. At 12, 24, and 36 months, the probabilities of success in the μLOT and KDB groups for criterion A were 70.4% and 48.2%, 61.9% and 48.2%, and 55.0% and 48.2% (p = 0.32; log-rank test), respectively. For criterion B, the results for the two groups were 55.6% and 33.3%, 44.4% and 33.3%, and 44.4% and 33.3% (p = 0.15; log-rank test), respectively. Similar postoperative complications were found between the groups. Comparable mid-term surgical outcomes were found for the uses of μLOT and KDB.
Language	English
Publishing date	2023-01-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12020558
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Article ; Online: Blood flow in the optic nerve head in patients with primary aldosteronism.

Hirooka, Kazuyuki / Oki, Kenji / Ogawa-Ochiai, Keiko / Nakaniida, Yuta / Onoe, Hiromitsu / Kiuchi, Yoshiaki

PloS one

2023 Volume 18, Issue 4, Page(s) e0285039

Abstract: Purpose: Optic nerve head (ONH) blood flow decrease without changes in intraocular pressure in a possible rat model of retinal ganglion cell loss by systemic administration of aldosterone. To compare the blood flow in the ONH, using laser speckle ... ...

Abstract	Purpose: Optic nerve head (ONH) blood flow decrease without changes in intraocular pressure in a possible rat model of retinal ganglion cell loss by systemic administration of aldosterone. To compare the blood flow in the ONH, using laser speckle flowgraphy (LSFG), in healthy eyes and in eyes with primary aldosteronism (PA). Methods: The ONH tissue area mean blur rate (MT) was evaluated in this single center, retrospective, cross-sectional study using LSFG. In order to compare the MT between PA patients and normal subjects, mixed-effects models were used, with adjustments made for the mean arterial pressure, disc area, and β-peripapillary atrophy (β-PPA) area. Mixed-effects models were also used to analyze the risk factors affecting the MT. Results: This study evaluated a total of 29 eyes of 17 PA patients and 61 eyes of 61 normal subjects. There was a significantly lower MT in PA patients (10.8 ± 0.4) as compared to the normal subjects (12.3 ± 0.3) (P = 0.004). The MT was significantly lower in PA patients (10.8 ± 0.6) even after adjusting for the potential confounding factors when compared to normal subjects (12.3 ± 0.3) (P = 0.046). Multivariate mixed-effects model analysis demonstrated that the MT was significantly associated with the PA and β-PPA. Conclusions: There was a significantly lower ONH blood flow in PA patients as compared to normal subjects.
MeSH term(s)	Rats ; Animals ; Optic Disk/blood supply ; Retrospective Studies ; Cross-Sectional Studies ; Regional Blood Flow/physiology ; Intraocular Pressure ; Hyperaldosteronism ; Laser-Doppler Flowmetry ; Blood Flow Velocity/physiology
Language	English
Publishing date	2023-04-26
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0285039
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Article ; Online: Posterior sclerectomy for persistent serous retinal detachment with secondary glaucoma in Sturge-Weber syndrome: A case report.

Nurtania, Ariyanie / Kiuchi, Yoshiaki / Muhlisah, Aisyah / Hirooka, Kazuyuki / Okada, Naoki / Onoe, Hiromitsu / Tokumo, Kana

Medicine

2023 Volume 102, Issue 26, Page(s) e34144

Abstract: Introduction: A serous retinal detachment is one of the most likely ocular manifestation of Sturge-Weber syndrome (SWS). This finding can frequently occur as a complication after filtering surgery to maintain the intraocular pressure (IOP). Proper ... ...

Abstract	Introduction: A serous retinal detachment is one of the most likely ocular manifestation of Sturge-Weber syndrome (SWS). This finding can frequently occur as a complication after filtering surgery to maintain the intraocular pressure (IOP). Proper treatment has been approached with choroidal hemangioma as an organ target. To the best of our knowledge, various treatments for SRD are associated with diffuse choroidal hemangioma has been approached. However, a second retinal detachment following radiation therapy has worsened the situation. Here, we report an unexpected serous retina and choroidal detachment after non penetrating trabeculectomy. Although radiation therapy has been proposed for previous detachment to the ipsilateral eye in this case, repetition radiation therapy was not suggested concerning the health and quality of life especially in for young subjects. However, the kissing choroidal detachment in this case necessitated immediate intervention. Thus, posterior sclerectomy was performed for the recurrent retinal detachment. We believe that an intervention for a SWS case related complication will remain a significant and important to share as a public health contribution. Case presentation: A 20 year-old male confirmed with SWS with no known family history was diagnosed with SWS. He was gain from another hospital for glaucoma therapy. On the left brain MRI showed severe hemiatrophy in the frontal and parietal lobes and leptomeningeal angioma. Although his right (RE) eye had 3 gonio surgeries, 2 Baerveldt tube shunts and Micropulse trans-scleral cyclophotocoagulation, his IOP remained uncontrollable when he was 20 years old. RE IOP was in controlled after non-penetrating filtering surgery hence, his RE developed a recurrent serous retinal detachment. A posterior sclerectomy was performed in 1 quadrant of the globe to drain subretinal fluid. Conclusion: Sclerectomies to the inferotemporal quadrant of the globe for serous retinal detachment associated with SWS are considered efficient for optimal drain subretinal fluid, resulting in complete regression of detachment.
MeSH term(s)	Male ; Humans ; Young Adult ; Adult ; Retinal Detachment/etiology ; Retinal Detachment/surgery ; Quality of Life ; Sturge-Weber Syndrome/complications ; Sturge-Weber Syndrome/surgery ; Glaucoma/etiology ; Glaucoma/surgery ; Intraocular Pressure ; Choroid Neoplasms
Language	English
Publishing date	2023-06-30
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000034144
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Article: Vision-Related Quality of Life following Combined Cataract and Minimally Invasive Glaucoma Surgery or Cataract Surgery Alone in Glaucoma Patients.

Yuasa, Yuki / Hirooka, Kazuyuki / Okada, Naoki / Onoe, Hiromitsu / Murakami, Yumiko / Okumichi, Hideaki / Kiuchi, Yoshiaki

Journal of clinical medicine

2023 Volume 12, Issue 9

Abstract: This study examined glaucoma patients after undergoing combined cataract and minimally invasive glaucoma surgery (MIGS), microhook ab interno trabeculotomy and goniotomy with the Kahook Dual Blade (KDB), or cataract surgery alone, and it then evaluates ... ...

Abstract	This study examined glaucoma patients after undergoing combined cataract and minimally invasive glaucoma surgery (MIGS), microhook ab interno trabeculotomy and goniotomy with the Kahook Dual Blade (KDB), or cataract surgery alone, and it then evaluates their vision-related quality of life (VR-QOL) following the procedure. A total of 75 eyes of 75 consecutive glaucoma patients in this prospective cohort study underwent phacoemulsification (Phaco) or phaco and MIGS (Phaco-TLO) between October 2019 and March 2022. In all cases, the National Eye Institute Visual Function Questionnaire (VFQ-25) was used to evaluate the 20 eyes in the Phaco group and the 55 eyes in the Phaco-TLO group before and at 2 months after surgery. There was a significant increase in the visual acuity (logMAR) at 2 months post-operatively (Phaco group; 0.34 ± 0.10 to -0.07 ± 0.1,
Language	English
Publishing date	2023-05-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12093279
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Article: A Retrospective Study of Risk Factors Affecting Long-Term Outcomes Following Ab Interno Trabeculotomy and Goniotomy Concomitant with Phacoemulsification.

Okada, Naoki / Hirooka, Kazuyuki / Onoe, Hiromitsu / Tokumo, Kana / Okumichi, Hideaki / Kiuchi, Yoshiaki

Clinical ophthalmology (Auckland, N.Z.)

2023 Volume 17, Page(s) 3563–3568

Abstract: Purpose: To examine the potential risk factors affecting the long-term outcomes following a combination of phacoemulsification with ab interno trabeculotomy with the microhook (μLOT-Phaco) and goniotomy with the Kahook Dual Blade (KDB-Phaco).: Methods! ...

Abstract	Purpose: To examine the potential risk factors affecting the long-term outcomes following a combination of phacoemulsification with ab interno trabeculotomy with the microhook (μLOT-Phaco) and goniotomy with the Kahook Dual Blade (KDB-Phaco). Methods: For 12 months, we retrospectively examined a total of 100 eyes of 100 patients with primary open-angle glaucoma (POAG) and exfoliation glaucoma (EG) who had previously undergone surgery between December 2016 and December 2020. Patients with a preoperative intraocular pressure (IOP) ˂12 mmHg were excluded. Probability of success was calculated using the Kaplan-Meier method, with surgical failure defined as an IOP >18 mmHg, <20% IOP reduction or additional glaucoma surgery. The Cox proportional hazards model was used to examine the potential risk factors for failure, which included age, gender, type of glaucoma, surgical techniques, preoperative IOP, number and type of preoperative IOP-lowering medications, preoperative visual field mean deviation (MD) value, and axial length. Results: For the 51 males and 49 females, mean preoperative age was 74.4 ± 9.0 years, with μLOT-Phaco performed in 44 and KDB-Phaco in 56 subjects. The type of glaucoma was POAG in 68 and EG in 32 eyes. Preoperative IOP was 20.5 ± 6.7 mmHg, while postoperative IOPs were 14.4 ± 4.2 mmHg, 13.7 ± 2.8 mmHg, and 14.6 ± 3.9 mmHg, respectively ( Conclusion: Long-term follow-ups showed IOP decreased in μLOT-Phaco and KDB-Phaco patients. Results suggest that patients with higher preoperative IOP may have better postoperative outcomes.
Language	English
Publishing date	2023-11-22
Publishing country	New Zealand
Document type	Journal Article
ISSN	1177-5467
ISSN	1177-5467
DOI	10.2147/OPTH.S436594
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Article: Comparison of Corvis ST Parameters between Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma.

Nakaniida, Yuta / Tokumo, Kana / Onoe, Hiromitsu / Okada, Naoki / Nakakura, Shunsuke / Asaoka, Ryo / Kiuchi, Yoshiaki

Journal of clinical medicine

2023 Volume 12, Issue 15

Abstract: Background: We compared corneal visualization Scheimpflug technology (CST) parameters between eyes with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG).: Methods: A retrospective analysis was performed on data from 89 ... ...

Abstract	Background: We compared corneal visualization Scheimpflug technology (CST) parameters between eyes with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Methods: A retrospective analysis was performed on data from 89 eyes with POAG and 83 eyes with PACG that had CST examinations. CST parameters were compared between eyes with POAG and those with PACG using a linear mixed model (LMM). Results: No differences were observed in age, central corneal thickness, intraocular pressure, or use of antiglaucoma eye drops between the two groups. Patients with PACG had a significantly shorter axial length (AL), a higher proportion of females, CST parameters, longer applanation 2 (A2) time, deeper A2 deformation amplitude, shorter peak distance, longer whole eye movement, and longer whole eye movement time than patients with POAG. The highest concavity (HC) length and PD showed a significant positive correlation with AL. However, A1 length, A1 deformation amplitude, A2 time, A2 velocity, A2 length, A2 deformation amplitude, HC time, whole eye movement, and whole eye movement time were negatively correlated with AL. Conclusions: The biomechanical properties of the cornea differed between POAG and PACG. In some parts, AL differences between the POAG and PACG groups might contribute to the variation in CST parameters.
Language	English
Publishing date	2023-08-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12155108
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Article ; Online: The gonio scratch study: methodology of a multicenter clinical trial establishing a new minimally invasive glaucoma surgery.

Tokumo, Kana / Okada, Naoki / Mochizuki, Tsukasa / Onoe, Hiromitsu / Komatsu, Kaori / Okumichi, Hideaki / Hirooka, Kazuyuki / Mochizuki, Hideki / Yokoyama, Mitsunobu / Kiuchi, Yoshiaki

Nagoya journal of medical science

2024 Volume 86, Issue 1, Page(s) 36–42

Abstract: There are numerous surgical procedures for glaucoma. Minimally invasive glaucoma surgery is becoming popular; however, the disadvantage is the high incidence of anterior chamber hemorrhage. Heavy bleeding can also lead to increased intraocular pressure ( ... ...

Abstract	There are numerous surgical procedures for glaucoma. Minimally invasive glaucoma surgery is becoming popular; however, the disadvantage is the high incidence of anterior chamber hemorrhage. Heavy bleeding can also lead to increased intraocular pressure (IOP) postoperatively. Gonio scratch is a surgical procedure that improves aqueous humor outflow by rubbing off deposits on the trabecular meshwork with a Diamond Dusted Sweeper. As the conjunctiva and trabecular meshwork are not incised, no postoperative bleeding is expected, and the IOP spike will be minimal. We designed this study to determine the efficacy and safety of gonio scratch. This is an on-going multicenter, prospective, clinical trial. Patients who are scheduled for glaucoma surgery with or without cataract surgery are being enrolled. A total of 80 eyes will be recruited in the Hiroshima University Hospital, Miyoshi Eye Clinic, Yokoyama Retina Clinic, and Kusatsu Eye Clinic. All patients will undergo gonio scratch. When combined with cataract surgery, gonio scratch is performed after the intraocular lens is inserted. The primary study endpoint is the change in IOP from baseline to 1 year after surgery. The secondary endpoints are complications, number of glaucoma medications, surgical time, and changes in visual acuity and the visual field. This study protocol was approved by the institutional review board of Hiroshima University. The trial results will be shared with the scientific community at international conferences and by publication in a peer-reviewed journal. Trial registration number is jRCTs062200003.
MeSH term(s)	Humans ; Trabeculectomy/methods ; Prospective Studies ; Intraocular Pressure ; Glaucoma/surgery ; Glaucoma/complications ; Cataract/complications ; Treatment Outcome
Language	English
Publishing date	2024-03-04
Publishing country	Japan
Document type	Multicenter Study ; Journal Article
ZDB-ID	193148-9
ISSN	2186-3326 ; 0027-7622
ISSN (online)	2186-3326
ISSN	0027-7622
DOI	10.18999/nagjms.86.1.36
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Article: Corneal Higher-Order Aberrations after Microhook ab Interno Trabeculotomy and Goniotomy with the Kahook Dual Blade: Preliminary Early 3-Month Results.

Onoe, Hiromitsu / Hirooka, Kazuyuki / Okumichi, Hideaki / Murakami, Yumiko / Kiuchi, Yoshiaki

Journal of clinical medicine

2021 Volume 10, Issue 18

Abstract: We examined postoperative corneal higher-order aberrations (HOAs) present after combined phacoemulsification with either microhook ab interno trabeculotomy (μLOT-Phaco) or goniotomy, using the Kahook Dual Blade (KDB-Phaco). Retrospective study: A total ... ...

Abstract	We examined postoperative corneal higher-order aberrations (HOAs) present after combined phacoemulsification with either microhook ab interno trabeculotomy (μLOT-Phaco) or goniotomy, using the Kahook Dual Blade (KDB-Phaco). Retrospective study: A total of 45 eyes underwent μLOT-Phaco and KDB-Phaco (LOT-Phaco) procedures, with 21 eyes that underwent cataract surgery alone used as controls. Visual acuity and corneal HOAs, coma-like aberrations, and spherical-like aberrations were analyzed before and at 1, 2, and 3 months after the surgeries. Risk factors that could potentially influence HOAs were evaluated. No significant postoperative changes were noted for corneal HOAs, coma-like aberrations, and spherical-like aberrations after cataract surgery alone. The mean corneal HOAs, coma-like aberrations, and spherical-like aberrations were 0.222 ± 0.115 μm, 0.203 ± 0.113 μm, and 0.084 ± 0.043 μm at baseline and 0.326 ± 0.195 μm (
Language	English
Publishing date	2021-09-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10184115
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Article: A Case of Intraocular Proliferative Changes Caused by a Glaucoma Tube Device.

Miyako, Fumiya / Kiuchi, Yoshiaki / Onoe, Hiromitsu / Okada, Naoki / Okumichi, Hideaki / Hirooka, Kazuyuki

Cureus

2022 Volume 14, Issue 6, Page(s) e26445

Abstract: In recent years, glaucoma tube surgery has been recommended for refractory cases that have failed to respond to angle surgery. In this study, we described the case of the fibrous proliferative membrane caused in the anterior chamber after Ahmed glaucoma ... ...

Abstract	In recent years, glaucoma tube surgery has been recommended for refractory cases that have failed to respond to angle surgery. In this study, we described the case of the fibrous proliferative membrane caused in the anterior chamber after Ahmed glaucoma valve implantation in a pediatric glaucoma patient. He was born full term, weighing 3228 g. Corneal opacity in both eyes was seen at birth and he was referred to the Department of Ophthalmology, Hiroshima University Hospital on the 13th day of his life. At the initial examination, the intraocular pressure was 37mmHg right 25mmHg left. Corneal diameter expansion and diffuse corneal opacity were seen in both eyes. Nine days after the initial examination, trabeculotomy was performed in both eyes but they were ineffective, and Ahmed glaucoma tubes were inserted in both eyes two months later. Four months later the intraocular pressure remained 30mmHg range in both eyes and micropulse cyclophotocoagulation was performed. One year after the Ahmed glaucoma valve implantation, the tube of right eye was exposed, and we planned to perform a repair procedure. At this time, ultrasound biomicroscopy (UBM) showed proliferative tissue around both tubes. They were removed next month. Although silicone is a highly biocompatible material, it can cause foreign body reactions such as encapsulation around the silicone plate and proliferative membranes around silicone oil. We speculated that a similar reaction occurred to the silicone tube in this case. We reported a case of fibrous proliferative membrane in the anterior chamber. This might be caused by the silicon tube of the Ahmed glaucoma valve.
Language	English
Publishing date	2022-06-30
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.26445
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