Outcomes of Microhook ab Interno Trabeculotomy in Consecutive 36 Eyes with Uveitic Glaucoma

Abstract

Microhook trabeculotomy (μLOT), recently developed by Tanito belongs to minimally invasive glaucoma surgery and contributes to intraocular pressure (IOP) control in eyes with glaucoma resistant to medical therapy. In this study, we aimed to investigate the effectiveness and safety of μLOT for uveitic glaucoma. The medical records of consecutive 36 eyes from 30 patients who underwent μLOT and were followed up over post-operative 1 year were reviewed. The surgical success (IOP = 5–20 mmHg and ΔIOP ≥ 20% with additional anti-glaucoma drugs) was achieved in 67% of eyes at post-operative 12 months. The median IOP significantly decreased from 30.5 mmHg pre-operatively to 15 mmHg at 12 months post-operatively (p = 0.001), and the median glaucoma drug score changed from 5 pre-operatively to 2.5 at 12 months post-operatively (p = 0.301). Intraocular inflammation scores at post-operative 6 weeks did not show a significant worsening as compared to pre-operatively, and 8 (22%) eyes exhibited exacerbation of inflammation during the 12-month follow-up period. Post-operative complications were confirmed in 58% of eyes, but most of them were mild and transient or successfully managed. With its favorable benefit–risk profile, μLOT would be an option worth considering as the first glaucoma surgery for uveitic glaucoma.

Update on Diagnosis and Treatment of Uveitic Glaucoma

“…No sight-threatening complications occurred during surgery or follow-up [ 83 ]. Sotani et al performed microhook trabeculotomy with a straight Tanito microhook (M-2215 s, Inami & Co., Ltd., Tokyo, Japan) in 36 eyes of 30 patients and reported that after 1 year, surgical success was achieved in 67% of eyes [ 84 ]. Other MIGS used are the i-stent and Hydrous, which might have a role as primary or secondary conjunctival sparing procedures in UG [ 85 ].…”