Twelve-month surgical outcome and prognostic factors of stand-alone ab interno trabeculotomy in Japanese patients with open-angle glaucoma

Abstract

The purpose of the study was to evaluate the 12-month surgical outcome and prognostic factors of stand-alone ab interno trabeculotomy. The changes in the intraocular pressure (IOP) and medication score and the success rate of the surgery were analyzed. Thirty-four eyes of 29 patients with primary open-angle glaucoma (POAG; n = 16) or pseudoexfoliation glaucoma (PEG; n = 18) with a 12-month follow-up period were included in the study. The decreases in IOP and medication score from the baseline to the all-time-point were statistically significant (P < 0.001). The surgical success rates were 97.1%, 76.5%, and 44.0% at 3 months (90 days), 6 months (180 days), and 12 months (365 days), respectively. A mixed effect Cox model revealed that the type of glaucoma (POAG) was significantly associated with surgical failure (P = 0.044). Furthermore, the surgical success rate was significantly higher in eyes with PEG than it was in those with POAG (P = 0.019). Stand-alone ab interno trabeculotomy significantly lowered both the IOP and the medication score in patients with glaucoma, although almost one quarter of the cases needed additional glaucoma surgeries. The surgical success rate was significantly higher in eyes with PEG than it was in those with POAG.

Long-Term Outcomes of a Kahook Dual Blade Procedure Combined with Phacoemulsification in Japanese Patients with Open-Angle Glaucoma

“…P -values < 0.05 were considered statistically significant. If the difference in surgical success rate between the POAG and ExG group was ≥35% [ 24 ] with a two-sided significance level of 0.05 and a power of 0.8. The estimated sample size of at least 36 eyes in each group was considered as essential to detect a significant difference between the two groups.…”

“…One report suggests that conventional trabeculotomy is more effective in eyes with exfoliation glaucoma (ExG) than in those with primary open-angle glaucoma (POAG) [ 1 ]. Another study suggests that a stand-alone KDB procedure is more effective for eyes with ExG than for those with POAG [ 24 ]. A third report suggests that a KDB procedure achieves greater IOP reduction in eyes with ExG than in eyes with POAG, irrespective of whether it is combined with cataract surgery [ 25 ].…”

The effects of antithrombotic therapy in ab interno trabeculotomy with a spatula-shaped microhook

“…Trabeculotomy aims to cleave the trabecular meshwork (TM) and the inner wall of the Schlemm's canal (SC), which is the main site of resistance for aqueous outflow [1][2][3][4][5][6][7]. Conventional trabeculotomy is achieved via the ab externo approach through a conjunctival incision, which takes a relatively long operation time and induces conjunctival scarring, which may affect future filtration surgery.…”

“…Thus, devices or implants for MIGS are minimally invasive and require high biocompatibility. Their safety and the fast recovery of patients in terms of visual acuity (VA) and quality of life (QOL) have been fully evaluated in outflow channel surgeries [1][2][3][7][8][9][10][11][12][13][14][15][16][17].…”

Three-dimensional heads-up surgery in ab-interno trabeculotomy: Image processing-assisted trabeculotomy

“…IOP reduction is considered the only reliable, evidence-based treatment for glaucoma and has been reported to suppress the onset and progression of glaucoma, regardless of its type or stage [2][3][4][5][6][7][8][9]. IOP-reducing treatment modalities for glaucoma include administration of eye drops or oral medications; laser therapy, such as SLT and CPC; and surgery, including trabeculectomy, trabeculotomy, or tube shunt implantation.…”