A comparison of the 1-year surgical outcomes ofab externotrabeculotomy and microhookab internotrabeculotomy using propensity score analysis

Abstract

ObjectiveTo compare the 1-year outcomes of trabeculotomy ab externo (ab externo TLO) and trabeculotomy ab interno using a microhook (ab interno TLO) for glaucoma patients using propensity score analysis.Methods and analysisThe medical charts of 65 consecutive patients who underwent ab externo TLO and those of 69 patients who underwent ab interno TLO were reviewed. Logistic regression analysis was conducted to calculate the propensity score using 1:1 matched analysis, which indicates the likelihood of surgical success at 12 months. We set the outcome-related covariates as age, glaucoma type, mean deviation, preoperative intraocular pressure (IOP), the number of preoperative glaucoma eye drops and the presence or absence of combined cataract surgery. Fifty eyes per each surgery group were subsequently compared.ResultsThe mean preoperative IOP was 32.5±11.2 mm Hg in the ab externo TLO group and 28.4±7.8 mm Hg in the ab interno TLO group (p=0.08). The mean postoperative IOP at 12 months was 18.3±7.4 mm Hg in the former group and 17.8±6.3 mm Hg in the latter (p=0.91). When surgical success was defined as a postoperative IOP of between 5 and 21 mm Hg with a more than 20% IOP reduction from baseline and no additional glaucoma surgery, the rate at 12 months was 78% in the ab externo TLO group and 74% in the ab interno TLO group (p=1.00).ConclusionThe 1-year success rate was not significantly different between ab externo and ab interno TLO.

Comparison of effectiveness and complications in trabeculotomy with phacoemulsification between ab externo and ab interno using a spatula-shaped microhook

“…investigated the IOP-lowering effect of trabeculotomy using Tanito microhook in 50 eyes of various types of glaucoma patients for 1 year postoperatively. They showed that IOP and Med changed from 28.4 to 17.8 mmHg and from 4.9 to 3.1, respectively 18 . In our study, IOP significantly decreased from 16.5 to 12.2 mmHg (37.0% reduction), and Med decreased from 2.6 to 0.7 (56.7% reduction).…”

“…showed that IOP and Med changed from 32.5 to 18.3 mmHg and 4.3 to 1.7 in 50 glaucoma patients in 1 year after trabeculotomy combined with deep sclerectomy. Cataract surgery was done in 46% of patients in this group 18 . In our study, IOP significantly decreased from 19.7 to 14.5 mmHg (39.3% reduction) and Med changed from 3.1 to 1.1 (52.1% reduction) at 6 months.…”

“…Thus, in the future, both procedures should be use depending on the condition of the eye. There has been only one study on the direct comparison of clinical results of ab interno and ab externo trabeculotomy 18 . Mori et al .…”

Comparison of Surgical Outcomes Between Ab Interno Suture Trabeculotomy and Ab Externo Metal Trabeculotomy in Adult Patients with Glaucoma

“…Mori et al reported that the success rates of AbE-TLO combined with deep sclerectomy and AbI-TLO using a microhook were not significantly different at the 12-month follow-up. 18 In their study, the definition of surgical success was a postoperative IOP ≤21 mmHg and ≥20% reduction in IOP. They reported that the IOP reduction rate for AbI-TLO using a microhook (28.4 ± 7.8 mmHg, 4.9 ± 1.1) and AbE-TLO with deep sclerectomy (preoperative IOP 32.5 ± 11.2 mmHg, preoperative glaucoma drug score 4.3 ±1.4) was 34.4% and 40.5% at 12 months after surgery, respectively.…”

“…The glaucoma drug scores were as follows: (1) the use of glaucoma eye drops contributed one point, while (2) a fixed combination and the use of an oral carbonic anhydrase inhibitor contributed two points. 18 …”