Comparison of Postoperative Hyphemas between Microhook Ab Interno Trabeculotomy and iStent Using a New Hyphema Scoring System
We have been using our in-house scoring system of hyphemas, i.e., Shimane University RLC postoperative hyphema scoring system (SU-RLC), which we designed to classify postoperative hyphema. SU-RLC classifies the severities of hyphemas based on three factors, i.e., red blood cells (RBCs) (R) 0–3, laye...
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MDPI AG
2021-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/23/5541 |
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| author | Akiko Ishida Sho Ichioka Yuji Takayanagi Aika Tsutsui Kaoru Manabe Masaki Tanito |
| author_facet | Akiko Ishida Sho Ichioka Yuji Takayanagi Aika Tsutsui Kaoru Manabe Masaki Tanito |
| author_sort | Akiko Ishida |
| collection | DOAJ |
| description | We have been using our in-house scoring system of hyphemas, i.e., Shimane University RLC postoperative hyphema scoring system (SU-RLC), which we designed to classify postoperative hyphema. SU-RLC classifies the severities of hyphemas based on three factors, i.e., red blood cells (RBCs) (R) 0–3, layer formation (L) 0–3, and clot (C) 0–1, by slit-lamp observation. To test the clinical usefulness of the SU-RLC for quantifying the postoperative hyphema severity, the SU-RLC scores were compared between eyes that underwent different minimally invasive glaucoma surgery (MIGS) procedures, i.e., Tanito microhook ab interno trabeculotomy and cataract extraction (TMH-CE) (<i>n</i> = 64 eyes of 64 subjects; mean age ± standard deviation, 72.4 ± 8.1 years) and iStent-CE (<i>n</i> = 21 eyes of 21 subjects; 76.1 ± 10.6 years). Compared to the iStent-CE, higher hyphema scores with the TMH-CE were found for the R scores on postoperative days 1, 2, and 3; for the L score on postoperative day 1; and for the C score on postoperative day 2. The sums of the R, L, and C scores (RLC) on postoperative day 1 were 3.2 ± 1.1 with the TMH-CE and 1.1 ± 1.3 with the iStent-CE; the scores reached almost 0 by 2 weeks in both groups. Significant differences in the RLC scores between the surgical groups were found on postoperative days 1, 2, and 3. Multivariate analyses showed that the TMH-CE rather than iStent-CE was associated with higher R, C, and RLC scores; anticoagulant/antiplatelet use was associated with higher R score; and myopia was associated with a higher C score. In the TMH-CE group, myopia was associated with a higher C score. In the iStent-CE group, anticoagulant/antiplatelet use was associated with higher R and RLC scores; and higher postoperative 1-day intraocular pressure was associated with a higher C score. The SU-RLC successfully detected the difference in hyphema severity between different MIGS procedures; thus, we concluded that our classification system may be feasible to evaluate hyphemas after glaucoma surgery. |
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| publishDate | 2021-11-01 |
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| spelling | doaj.art-cdc97834c0cc4e8db61b75cda47c66c12023-11-23T02:35:37ZengMDPI AGJournal of Clinical Medicine2077-03832021-11-011023554110.3390/jcm10235541Comparison of Postoperative Hyphemas between Microhook Ab Interno Trabeculotomy and iStent Using a New Hyphema Scoring SystemAkiko Ishida0Sho Ichioka1Yuji Takayanagi2Aika Tsutsui3Kaoru Manabe4Masaki Tanito5Department of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, JapanDepartment of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, JapanDepartment of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, JapanDepartment of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, JapanDepartment of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, JapanDepartment of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, JapanWe have been using our in-house scoring system of hyphemas, i.e., Shimane University RLC postoperative hyphema scoring system (SU-RLC), which we designed to classify postoperative hyphema. SU-RLC classifies the severities of hyphemas based on three factors, i.e., red blood cells (RBCs) (R) 0–3, layer formation (L) 0–3, and clot (C) 0–1, by slit-lamp observation. To test the clinical usefulness of the SU-RLC for quantifying the postoperative hyphema severity, the SU-RLC scores were compared between eyes that underwent different minimally invasive glaucoma surgery (MIGS) procedures, i.e., Tanito microhook ab interno trabeculotomy and cataract extraction (TMH-CE) (<i>n</i> = 64 eyes of 64 subjects; mean age ± standard deviation, 72.4 ± 8.1 years) and iStent-CE (<i>n</i> = 21 eyes of 21 subjects; 76.1 ± 10.6 years). Compared to the iStent-CE, higher hyphema scores with the TMH-CE were found for the R scores on postoperative days 1, 2, and 3; for the L score on postoperative day 1; and for the C score on postoperative day 2. The sums of the R, L, and C scores (RLC) on postoperative day 1 were 3.2 ± 1.1 with the TMH-CE and 1.1 ± 1.3 with the iStent-CE; the scores reached almost 0 by 2 weeks in both groups. Significant differences in the RLC scores between the surgical groups were found on postoperative days 1, 2, and 3. Multivariate analyses showed that the TMH-CE rather than iStent-CE was associated with higher R, C, and RLC scores; anticoagulant/antiplatelet use was associated with higher R score; and myopia was associated with a higher C score. In the TMH-CE group, myopia was associated with a higher C score. In the iStent-CE group, anticoagulant/antiplatelet use was associated with higher R and RLC scores; and higher postoperative 1-day intraocular pressure was associated with a higher C score. The SU-RLC successfully detected the difference in hyphema severity between different MIGS procedures; thus, we concluded that our classification system may be feasible to evaluate hyphemas after glaucoma surgery.https://www.mdpi.com/2077-0383/10/23/5541minimally invasive glaucoma surgery (MIGS)Tanito microhook (TMH)iStent trabecular micro-bypass systemsurgical efficacysurgical complicationhyphema |
| spellingShingle | Akiko Ishida Sho Ichioka Yuji Takayanagi Aika Tsutsui Kaoru Manabe Masaki Tanito Comparison of Postoperative Hyphemas between Microhook Ab Interno Trabeculotomy and iStent Using a New Hyphema Scoring System Journal of Clinical Medicine minimally invasive glaucoma surgery (MIGS) Tanito microhook (TMH) iStent trabecular micro-bypass system surgical efficacy surgical complication hyphema |
| title | Comparison of Postoperative Hyphemas between Microhook Ab Interno Trabeculotomy and iStent Using a New Hyphema Scoring System |
| title_full | Comparison of Postoperative Hyphemas between Microhook Ab Interno Trabeculotomy and iStent Using a New Hyphema Scoring System |
| title_fullStr | Comparison of Postoperative Hyphemas between Microhook Ab Interno Trabeculotomy and iStent Using a New Hyphema Scoring System |
| title_full_unstemmed | Comparison of Postoperative Hyphemas between Microhook Ab Interno Trabeculotomy and iStent Using a New Hyphema Scoring System |
| title_short | Comparison of Postoperative Hyphemas between Microhook Ab Interno Trabeculotomy and iStent Using a New Hyphema Scoring System |
| title_sort | comparison of postoperative hyphemas between microhook ab interno trabeculotomy and istent using a new hyphema scoring system |
| topic | minimally invasive glaucoma surgery (MIGS) Tanito microhook (TMH) iStent trabecular micro-bypass system surgical efficacy surgical complication hyphema |
| url | https://www.mdpi.com/2077-0383/10/23/5541 |
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