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Subconjunctival draining minimally-invasive glaucoma devices for medically uncontrolled glaucoma
Anthony J King1, Anupa Shah, Eleni Nikita
1Ophthalmology, Nottingham University Hospital, Derby Road, Nottingham, UK, NG7 2UH.
The Cochrane Database of Systematic Reviews
|December 17, 2018
Summary
No completed studies evaluated subconjunctival draining glaucoma devices for open-angle glaucoma. More high-quality randomized controlled trials are needed to determine the efficacy and safety of these minimally invasive glaucoma surgeries.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Glaucoma Management
Background:
- Glaucoma is a leading cause of irreversible blindness.
- Subconjunctival draining minimally-invasive glaucoma devices (MIGS) like Xen and InnFocus offer a new treatment approach.
- These devices reduce intraocular pressure (IOP) by creating a channel for aqueous humor drainage, mimicking trabeculectomy.
Purpose of the Study:
- To evaluate the efficacy and safety of subconjunctival draining MIGS.
- To assess their use in open-angle glaucoma and ocular hypertension inadequately controlled by medication.
Main Methods:
- Searched multiple databases (CENTRAL, MEDLINE, Embase, etc.) up to July 2018.
- Included randomized controlled trials (RCTs) comparing Xen or InnFocus to other treatments (surgery, laser, medical).
- Planned data extraction and analysis focusing on IOP reduction and complication rates.
Main Results:
- No completed RCTs met the inclusion criteria.
- One ongoing study (NCT01881425) compares InnFocus MicroShunt to trabeculectomy in primary open-angle glaucoma.
- This ongoing study has enrolled 889 participants and is expected to complete in November 2019.
Conclusions:
- Currently, there is a lack of high-quality evidence on subconjunctival draining MIGS for medically uncontrolled open-angle glaucoma.
- Further well-designed RCTs are essential to establish the medium- and long-term efficacy and safety of these devices.
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