Micropulse transscleral cyclophotocoagulation: clinical outcomes of treatment of early stages open-angle glaucoma

2021 ◽  
pp. 36-41
Author(s):  
Y.V. Milasheuski ◽  
◽  
T.A. Imshanetskaya ◽  
Keyword(s):  
Visual Acuity ◽  
Open Angle Glaucoma ◽  
Laser Exposure ◽  
Open Angle ◽  
Pseudoexfoliative Glaucoma ◽  
Early Stages ◽  
Corrected Visual Acuity ◽  
Transscleral Cyclophotocoagulation ◽  
Best Corrected Visual Acuity ◽  
Observation Period

Purpose. To evaluate treatment efficiency of open-angle glaucoma with micropulse transscleral cyclophotocoagulation, to determine the optimal total energy of laser exposure and to assess the stability of the glaucoma process after treatment. Material and methods. A prospective study was carried out. It included 34 (21 patients) with primary open-angle and pseudoexfoliative glaucoma of stages 1-3, which undergone micropulse transscleral cyclophotocoagulation. The patients were divided into subgroups 1 and 2, depending on the total amount of laser energy (100 J and 150 J, respectively). At different periods of observation, the intraocular pressure, best corrected visual acuity, visual fields, cup-to-disc ratio and the number of antiglaucoma drugs were determined. Results. In the general group, all operated patients achieved a decrease in IOP to a tolerant level, from a median value of 27 [25; 28] in the preoperative period, up to 17.5 [15; 20] at the end of the observation period. The number of used drugs decreased statistically significantly, from 3.0 [3.0; 3.0] to 2.0 [1.0; 2.0]. There was a statistically significant increase in the mean deviation of the retinal photosensitivity, from –4.85 [–8.25; –2.17] to –4.36 [–7.06; –2.37] after 18 months. Indicators of best corrected visual acuity and CDR remained stable throughout the observation period. In subgroup 2 (150J), a statistically more significant decrease in IOP level (p=0.033) and the number of used drugs (p=0.001) was achieved compared with subgroup 1 (100J). Conclusion. Micropulse transscleral cyclophotocoagulation is an effective and safe method of treating open-angle glaucoma in patients with early stages of the disease and high values of best corrected visual acuity. Using a total amount of energy in 150J contributes to a more pronounced decrease in IOP and a decrease in the number of applied drugs than an energy in 100J. Key words: open-angle glaucoma, pseudoexfoliative glaucoma, micropulse cyclophotocoagulation.

scholarly journals Primary Outcomes of combined cataract extraction technique with ab-interno trabeculectomy  Dual-Blade and Endoscopic cyclophotocoagulation in patients with primary open angle glaucoma

2019 ◽  
Author(s):  
Juan Carlos Izquierdo ◽  
Josefina Mejias ◽  
Laura Cañola ◽  
Natalia Agudelo ◽  
Barbara Rubio
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Cataract Extraction ◽  
Open Angle ◽  
Corrected Visual Acuity ◽  
Ab Interno Trabeculectomy ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

Abstract Purpose:  To provide an update of primary outcomes of combined phacoemulsification technique with ab-interno trabeculectomy  Dual Blade and Endoscopic cyclophotocoagulation (ECP) in patients with primary open angle glaucoma. Methods: Retrospective case series comprised 27 consecutive eyes, with open-angle glaucoma (POAG) and cataract with combined phacoemulsification, ab-interno trabeculectomy-Kahook Dual Blade and Endocyclophotocoagulation at Instituto de ojos Oftalmosalud, Lima, Perú, between April 2017 and May 2017. Inclusion criteria were Glaucoma patients with POAG from mild to severe, according to Glaucoma Grading Scale (HODAPP), cataract condition, treatment with two or more glaucoma medications and visual field defects continued worsen. Intraocular pressure (IOP), Best corrected visual acuity (BCVA) logMAR, and number of glaucoma medications were recorded before, and 1 day, 1 week, and 1, 3, 6 and 9 months after surgery. Defining succes as IOP <14 mmHg with or without medications. Results:  A total of 27 cases of glaucoma eyes were included. The mean IOP was 17.0±3.7 mmHg preoperatively, 11.6±1.9mmHg at 6 months, and 11.4±1.8 mmHg at 9 months(P<0.001). There was a corresponding drop in glaucoma medications from 1.9±1.41 at mean to 0.56±1.05 at 9 months (P<0.001). Preoperative best corrected visual acuity (BCVA) showed and improvement preoperative value from 0.4± 0.4 LogMAR (p= 0.001) to 0.2 ± 0.4 logMAR at 9 months. The main complication was blood reflux intraoperatively(66.7%), resolved within a few days. The mean IOP was reduce 32.9% from baseline and the qualifed succes was 92.6% at 9 months. Conclusions:  Cataract extraction with phacoemulsification combined with ab-interno trabeculectomy Dual Blade and endoscopic Cyclophotocoagulation effectively lowered IOP and dependence on glaucoma medications.

scholarly journals Primary Outcomes of Combined Cataract Extraction Technique with Ab-interno Trabeculectomy  and Endoscopic Cyclophotocoagulation  in Patients with Primary Open Angle Glaucoma

2020 ◽  
Author(s):  
Juan Carlos Izquierdo ◽  
Josefina Mejias ◽  
Laura Cañola ◽  
Natalia Agudelo ◽  
Barbara Rubio
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Surgical Success ◽  
Corrected Visual Acuity ◽  
Ab Interno Trabeculectomy ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

Abstract Background: To determine the outcome of using combined phacoemulsification technique, ab-interno trabeculectomy dual blade and endoscopic cyclophotocoagulation (ECP) surgeries in patients with primary open angle glaucoma. Methods: A retrospective case series was performed on 27 consecutive eyes with both primary open-angle glaucoma (POAG) and cataract; each eye was treated with combined phacoemulsification, ab-interno trabeculectomy-Kahook Dual Blade and Endocyclophotocoagulation at Instituto de ojos Oftalmosalud, Lima, Peru, between April 2017 and May 2017. Inclusion criteria: 1) Patients with uncontrolled mild to advanced POAG (according to Glaucoma Grading Scale HODAPP) 2) cataract condition 3) treatment with two or more glaucoma medications due to rapid progression in the visual fields (at least two in a short period of time). Intraocular pressure (IOP), best corrected visual acuity (BCVA) logMAR and number of glaucoma medications were recorded prior to the study, at day 1, week 1, and 1,3,6 and 9 months after surgery. Primary outcome measure was surgical success defined in terms of IOP <14 mmHg either with no medications (complete success) or with medications (qualified success). Results: A total of 27 eyes from 27 patients were included. The mean basal IOP was 17.0±3.7 mmHg and postoperatively was 11.6±1.9 mmHg and 11.4±1.8 mmHg (P<0.001) at 6 and 9 months respectively. Glaucoma medications decreased from 1.9±1.4 to 0.56±1.05 at 9 month follow-ups (P<0.001). Preoperative best corrected visual acuity (BCVA) showed and improvement from 0.4± 0.4 LogMAR (p<0.001) to 0.2 ± 0.4 logMAR at 9 months. The main complication was blood reflux intra-operatively (66.7%), which resolved without re-operation. The mean IOP was reduced by 32.9% from baseline and the surgical success was 92,6%, (complete success 70,3% and qualified success 29,6%) at 9 months. Conclusions: In patients with POAG, combined treatment with phacoemulsification, ab-interno trabeculectomy and endoscopic cyclophotocoagulation effectively reduced IOP and glaucoma medication dependence.

Outcomes of phacoemulsification combined with two iStent inject trabecular microbypass stents with or without endocyclophotocoagulation

2020 ◽  
Vol 104 (10) ◽  
pp. 1378-1383 ◽  
Author(s):  
Anca Delia Pantalon ◽  
Andre Diogo De Oliveira Barata ◽  
Minas Georgopoulos ◽  
Gokulan Ratnarajan
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Cataract Extraction ◽  
Mean Deviation ◽  
Open Angle ◽  
Glaucoma Medication ◽  
Corrected Visual Acuity ◽  
Secondary Outcomes ◽  
Best Corrected Visual Acuity

AimComparing outcomes after combined phacoemulsification, two iStents insertion and endocyclophotocoagulation (ECP) versus phacoemulsification-iStents alone.MethodsThis is a longitudinal retrospective 12 months study in eyes with ocular hypertension or early-to-moderate open angle glaucoma. Level of disease, intraocular pressure (IOP) and tolerance of glaucoma medication were considered before planning surgery. Best-corrected visual acuity (BCVA-logMAR), IOP (mm Hg), number of medications were assessed at baseline, week 1, week 5, month 3, 6, 12 postop. Main outcome: percentage (%) in IOP reduction at 12 months vs medicated baseline. Secondary outcomes: absolute values of IOP/medication reduction, BCVA and postop complications.ResultsThe ICE2 (two iStents-cataract extraction-ECP) group included 63 eyes and Phaco-iStent group included 46 eyes. Baseline IOP was higher in the ICE2 than phaco-iStent group (19.97±4.31 mm Hg vs 17.63±3.86 mm Hg, p=0.004) and mean deviation was lower (−7.20±2.58 dB vs −4.94±4.51 dB, p=0.037). Number of medications were comparable at baseline: 2.22±1.06 (ICE2) vs 2.07±1.02 (phaco-iStent), p=0.442. At month 12 postop, IOP in the ICE2 group decreased 35% from baseline vs 21% in the phaco-iStent group (p=0.03); absolute IOP reduction was significantly lower than baseline in each group (p<0.001), yet final IOP was lower in the ICE2 group than phaco-iStent group (13.05±2.18 mm Hg vs 14.09±1.86 mm Hg, p=0.01). Similar results were found for glaucoma medication (1.24±1.05 in ICE2 group vs 1.39±1.03 in phaco-iStent group, p=0.01). Final BCVA was 0.11±0.18 (phaco-iStent group) vs 0.08±0.08 (ICE2 group), p=0.309. Safety outcomes were comparable between groups.ConclusionICE2 procedure offers better results in IOP/medication reduction at 12 months than phacoemulsification-iStents alone.

scholarly journals Primary Outcomes of Combined Cataract Extraction Technique with Ab-interno Trabeculectomy  and Endoscopic Cyclophotocoagulation  in Patients with Primary Open Angle Glaucoma

2020 ◽  
Author(s):  
Juan Carlos Izquierdo ◽  
Josefina Mejias ◽  
Laura Cañola ◽  
Natalia Agudelo ◽  
Barbara Rubio
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Surgical Success ◽  
Corrected Visual Acuity ◽  
Ab Interno Trabeculectomy ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

Abstract Background: To determine the outcome of using combined phacoemulsification technique, ab-interno trabeculectomy dual blade and endoscopic cyclophotocoagulation (ECP) surgeries in patients with primary open angle glaucoma. Methods:  A retrospective case series was performed on 27 consecutive eyes with both primary open-angle glaucoma (POAG) and cataract; each eye was treated with combined phacoemulsification, ab-interno trabeculectomy-Kahook Dual Blade and Endocyclophotocoagulation at Instituto de ojos Oftalmosalud, Lima, Peru, between April 2017 and May 2017. Inclusion criteria: 1) Patients with uncontrolled mild to advanced POAG (according to Glaucoma Grading Scale HODAPP) 2) cataract condition 3) treatment with two or more glaucoma medications due to rapid progression in the visual fields (at least two in a short period of time). Intraocular pressure (IOP), best corrected visual acuity (BCVA) logMAR and number of glaucoma medications were recorded prior to the study, at day 1, week 1, and 1,3,6 and 9 months after surgery. Primary outcome measure was surgical success defined in terms of IOP <14 mmHg either with no medications (complete success) or with medications (qualified success). Results: A total of 27 eyes from 27 patients were included. The mean basal IOP was 17.0±3.7 mmHg and postoperatively was 11.6±1.9 mmHg and 11.4±1.8 mmHg (P<0.001) at 6 and 9 months respectively. Glaucoma medications decreased from 1.9±1.4 to 0.56±1.05 at 9 month follow-ups (P<0.001). Preoperative best corrected visual acuity (BCVA) showed and improvement from 0.4± 0.4 LogMAR to 0.2 ± 0.4 logMAR at 9 months. The main complication was blood reflux intra-operatively (66.7%), which resolved without re-operation. The mean IOP was reduced by 32.9% from baseline and the surgical success was 92,6%, (complete success 70,3% and qualified success 29,6%) at 9 months.Conclusions: In patients with POAG, combined treatment with phacoemulsification, ab-interno trabeculectomy and endoscopic cyclophotocoagulation effectively reduced IOP and glaucoma medication dependence.

scholarly journals Outcomes of Trabeculectomy at a Newly Established Glaucoma Clinic in Khyber Pakhtunkhwa

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Ali Hassan Nasir ◽  
Mashal Bano ◽  
Yousaf Jamal Mahsood
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Chart Review ◽  
Open Angle Glaucoma ◽  
Retrospective Chart Review ◽  
Open Angle ◽  
Khyber Pakhtunkhwa ◽  
Corrected Visual Acuity ◽  
Significant Change ◽  
Best Corrected Visual Acuity

Purpose:  To determine the outcomes of trabeculectomy in patients with open angle glaucoma at a newly established glaucoma clinic in a tertiary care hospital of Khyber Pakhtunkhwa. Study Design:  Retrospective chart review. Place and Duration of Study:  Glaucoma Clinic, Hayatabad Medical Complex, Peshawar from May 2018 to December 2019. Methods:  A retrospective chart review of patients of 18 years age or above and who underwent trabeculectomy for open angle glaucoma, with at least one follow-up visit were included. Data was collected for age, gender, type of glaucoma, preoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of pre-operative/post-operative topical anti-glaucoma medications, indication for trabeculectomy, preoperative comorbidities and postoperative complications. Data were analyzed using SPSS version 23. The student’s paired t-test was used for comparative analysis of the same group. A p-value of < 0.05 was considered significant. Results:  A total of 20 eyes of 20 patients were included in this study, 13 (65%) patients were males, and the mean age was 54.60 ± 18.22 years. There was a statistically significant change in mean IOP postoperatively (35.60 ± 13.28 versus 11.2 ± 6.1, P < 0.001) and number of antiglaucoma medication (2.95 ± 1.19 versus 0.4 ± 0.99, P < 0.001). While there was no significant change in best-corrected visual acuity (1.35 ± 0.88 versus 1.06 ± 0.72, p = 0.36). Conclusion:  Trabeculectomy performed at the newly established glaucoma clinic showed a significant reduction in Intraocular pressure without compromising the visual acuity of the study participants. Key Words:  Trabeculectomy; Open Angle Glaucoma; Intraocular pressure.

scholarly journals Primary Outcomes of Combined Cataract Extraction Technique with Ab-interno Trabeculectomy  and Endoscopic Cyclophotocoagulation  in Patients with Primary Open Angle Glaucoma

2020 ◽  
Author(s):  
Juan Carlos Izquierdo ◽  
Josefina Mejias ◽  
Laura Cañola ◽  
Natalia Agudelo ◽  
Barbara Rubio
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Surgical Success ◽  
Corrected Visual Acuity ◽  
Ab Interno Trabeculectomy ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Ab Interno

Abstract Background: Glaucoma surgery have been developed to lower intraocular pressure in a less invasive manner than traditional glaucoma surgery. The purpose of this article is to determine the outcome of using combined phacoemulsification technique, ab-interno trabeculectomy dual blade and endoscopic cyclophotocoagulation (ECP) surgeries in patients with primary open angle glaucoma. Methods: A retrospective case series was performed on 27 consecutive eyes with both primary open-angle glaucoma (POAG) and cataract; each eye was treated with combined phacoemulsification, ab-interno trabeculectomy-Kahook Dual Blade and Endocyclophotocoagulation at Instituto de ojos Oftalmosalud, Lima, Peru, between April 2017 and May 2017. Inclusion criteria: 1) Patients with uncontrolled mild to advanced POAG (according to Glaucoma Grading Scale HODAPP) 2) cataract condition 3) treatment with two or more glaucoma medications due to rapid progression in the visual fields (at least two in a short period of time). Intraocular pressure (IOP), best corrected visual acuity (BCVA) logMAR and number of glaucoma medications were recorded prior to the study, at day 1, week 1, and 1,3,6 and 9 months after surgery. Primary outcome measure was surgical success defined in terms of IOP <14 mmHg either with no medications (complete success) or with medications (qualified success). Results: A total of 27 eyes from 27 patients were included. The mean basal IOP was 17.0±3.7 mmHg and postoperatively was 11.6±1.9 mmHg and 11.4±1.8 mmHg (P<0.001) at 6 and 9 months respectively. Glaucoma medications decreased from 1.9±1.4 to 0.56±1.05 at 9 month follow-ups (P<0.001). Preoperative best corrected visual acuity (BCVA) showed and improvement from 0.4± 0.4 LogMAR to 0.2 ± 0.4 logMAR at 9 months. The main complication was blood reflux intra-operatively (66.7%), which resolved without re-operation. The mean IOP was reduced by 32.9% from baseline and the surgical success was 92,6%, (complete success 70,3% and qualified success 29,6%) at 9 months.Conclusions: In patients with POAG, combined treatment with phacoemulsification, ab-interno trabeculectomy and endoscopic cyclophotocoagulation effectively reduced IOP and glaucoma medication dependence.

scholarly journals Ab interno trabeculotomy combined with cataract extraction in eyes with primary open-angle glaucoma

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095744
Author(s):  
Yuan-Zhi Chen ◽  
Ai-Ping Song ◽  
Wen-Yan Jin ◽  
Xiao Yang ◽  
Guang-Fu Dang
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Cataract Extraction ◽  
Open Angle ◽  
Efficacy And Safety ◽  
Corrected Visual Acuity ◽  
Postoperative Time ◽  
Best Corrected Visual Acuity ◽  
Ab Interno ◽  
Time Point

Objective To investigate the efficacy and safety of ab interno trabeculotomy using the VISCO360® Viscosurgical System (Sight Sciences, Inc., Menlo Park, CA, USA) combined with cataract extraction in the treatment of primary open-angle glaucoma (POAG). Methods Patients with POAG who underwent ab interno trabeculotomy combined with cataract extraction were retrospectively analyzed. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), the number of antiglaucomatous medications, and complications were recorded preoperatively and 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years postoperatively. Results Thirty-four patients (40 eyes) with POAG were included in this study, including 20 men (22 eyes) and 14 women (18 eyes). Compared with the preoperative IOP, the postoperative IOP was significantly lower at each time point. The greatest reduction in IOP was 60.7% at 1 month after surgery. The BCVA was also significantly improved at each postoperative time point. The number of antiglaucomatous medications used by the patients was significantly lower postoperatively than preoperatively. Conclusion Ab interno trabeculotomy combined with cataract extraction is effective and safe for treatment of POAG.

Combined phacoemulsification and iStent inject implantation in Asian eyes

2021 ◽  
pp. 112067212110006
Author(s):  
Jeremy Hu YW ◽  
Bryan Ang CH ◽  
Ivan O’Neill C. Tecson ◽  
John Kan Tsia-Chuen ◽  
Leonard Yip WL
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Single Institution ◽  
Istent Inject ◽  
Corrected Visual Acuity ◽  
Good Safety Profile ◽  
Sustained Reduction ◽  
Malignant Glaucoma

Purpose: To evaluate the safety and efficacy of the iStent inject device combined with phacoemulsification in Asian eyes with primary open angle glaucoma. Methods: A retrospective study of combined phacoemulsification and iStent inject surgeries performed in a single institution from July 2017 to August 2019 on patients with co-existing cataracts and primary open angle glaucoma (POAG). Outcome measures included best-corrected visual acuity, intraocular pressure (IOP), number of glaucoma eyedrop medications, and surgical complications. Results: A total of 95 eyes were included. Majority of subjects were male (59, 62.1%) and Chinese (83, 87.4%). Mean age was 74.7 ± 8.7 years. Pre-operatively, mean IOP was 16.2 ± 4.3 mmHg and number of medications was 1.9 ± 0.9. Significant post-operative reduction in mean IOP was observed at all timepoints – post-operative month (POM)1: 3.0 ± 5.6 mmHg reduction ( n = 95, p < 0.05); POM3: 1.6 ± 3.8 mmHg ( n = 66, p < 0.05); POM6: 1.8 ± 4.7 mmHg ( n = 55, p < 0.05); POM12: 1.3 ± 4.2 mmHg ( n = 48) ( p < 0.05). The number of glaucoma medications was also reduced from a mean of 1.9 ± 0.8 to 0.6 ± 1.0 at POM12 ( p < 0.05). Intraoperatively, one case of malignant glaucoma occurred. Post operatively, implant obstruction by iris was observed in two eyes post-operatively requiring iridoplasty. One case of cystoid macular edema and one case of drop in visual acuity due to glaucoma progression was/were also observed. Conclusion: Asian eyes undergoing combined phacoemulsification and iStent inject surgery demonstrate a significant and sustained reduction in both IOP and number of glaucoma medications. Overall, there is a good safety profile for iStent inject.

scholarly journals Two Cases of Corneal Neovascularization Treatment Using High-frequency Radio Wave Electrosurgery

2021 ◽  
Vol 62 (8) ◽  
pp. 1129-1134
Author(s):  
Young Joo Choi ◽  
Gyu Le Han ◽  
Tae Young Chung ◽  
Dong Hui Lim
Keyword(s):  
Visual Acuity ◽  
Radio Wave ◽  
High Frequency ◽  
Laser Photocoagulation ◽  
Corneal Opacity ◽  
Corneal Neovascularization ◽  
Eye Pain ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity ◽  
Observation Period

Purpose: To report two cases of treatment using high-frequency radio wave electrosurgery for corneal neovascularization that recurred after medication and laser photocoagulation attempts.Case summary: (Case 1) A 53-year-old man visited our hospital complaining of corneal opacity. The best-corrected visual acuity in the left eye was 0.6. Lipid keratopathy indicated new inferior vessels. There was no significant change in corneal opacity after medication and laser photocoagulation; however, the recurrence of feeder vessels was observed. Therefore, electrocautery was performed via high-frequency radio wave electrosurgery. Visual acuity, measured 1 month later, improved to 0.9. Over the subsequent 4-year observation period, new vessels did not recur and the corneal opacity decreased gradually. (Case 2) A 23-year-old woman visited complaining of left eye pain. She had undergone laser photocoagulation three times for corneal new vessels. Visual acuity in her left eye was 0.4. Recurrence of new vessels at the upper cornea was observed, and electrocautery was performed. After 2 months, corneal opacity decreased without revascularization, and visual acuity improved to 0.5.Conclusions: In patients with corneal neovascularization, electrocautery using high-frequency radio wave electrosurgery is simple and effective and can reduce corneal opacity and improve vision without complications.

scholarly journals Comparison Efficiency of Combined Trabeculectomy with MMC and Gonioscopy-Assisted Transluminal Trabeculotomy

2021 ◽  
Author(s):  
Ali Olgun ◽  
Hacı Ugur Celik ◽  
Fatih Yenihayat ◽  
Ercument Bozkurt ◽  
İbrahim Sahbaz
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Randomized Study ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Success Rates ◽  
Combined Procedure ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose: To compare the efficacy of gonioscopy-assisted transluminal trabeculotomy combined with cataract surgery (PGATT) and trabeculectomy combined with cataract surgery (PTRAB) in open-angle glaucoma patients.Methods: A multicentered, retrospective, non-randomized study included 67 PGATT patients and 70 PTRAB patients. We compared preoperative intraocular pressure (IOP), best-corrected visual acuity (BCVA) compared with early and final IOP, medication numbers, and BCVA levels. Success was determined as IOP reduction >20% from baseline, IOP between 5-21 mmHg, preoperative IOP of higher than 21 mmHg with medication and postoperative IOP of less than 21 mmHg without medication for surgeries performed for intolerance to medication, postoperative IOP <21 mmHg as well as <18 mmHg separately without medications, and no need for further glaucoma surgery. Results: Preoperative IOP values were 28.61 ± 6.02 mmHg in PTRAB group and 23.99±8.00 mmHg in PGATT group (P<0.0001). Early postoperative IOP values were found lower in PTRAB group as 12.19 ± 3.41 mmHg and as 15.69 ± 4.67 mmHg in PGATT group (P<0.0001). Last follow-up IOP reading were lower in PGATT group (P=0.009). IOP difference values were found higher both in early and last postoperative periods in PTRAB group (respectively, P<0.0001, P=0.018). Success rates were found higher in both at lower than 21 and 18 mmHg levels in PGATT group (respectively, P=0.014, P=0.010).Conclusion: We found the PGATT combined procedure to be a well-tolerated, effective procedure that can lower IOP both early and late in the postoperative period with different rates of IOP success compared with the combined PTRAB procedure.

Sign in / Sign up

Export Citation Format

Share Document