One-year outcomes of microhook trabeculotomy versus suture trabeculotomy ab interno

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 260; no. 1; pp. 215 - 224
• Main Authors: Yokoyama, Hiroshi, Takata, Masashi, Gomi, Fumi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-01-2022; Springer Nature B.V
• Subjects: Eye; Follow-Up Studies; Glaucoma; Humans; Intraocular Pressure; Medicine; Medicine & Public Health; Ophthalmology; Retrospective Studies; Success; Survival; Survival analysis; Sutures; Trabeculectomy; Treatment Outcome; Microhook trabeculotomy; Trabeculotomy ab interno; Goniotomy; Gonioscopy-assisted suture trabeculotomy; MIGS
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-021-05333-7

Purpose
To compare clinical success rates and reductions in intraocular pressure (IOP) and IOP-lowering medication use following suture trabeculotomy ab interno (S group) or microhook trabeculotomy (μ group).
Methods
This retrospective review collected data from S (
n
 = 104, 122 eyes) and μ (
n
 = 42, 47 eyes) groups who underwent treatment between June 1, 2016, and October 31, 2019, and had 12-month follow-up data including IOP, glaucoma medications, complications, and additional IOP-lowering procedures. The Kaplan–Meier survival analysis was used to evaluate treatment success rates defined as normal IOP (> 5 to ≤ 18 mm Hg), ≥ 20% reduction of IOP from baseline at two consecutive visits, and no further glaucoma surgery.
Results
Schlemm’s canal opening was longer in the S group than in the μ group (
P
 < 0.0001). The Kaplan–Meier survival analysis of all eyes showed cumulative clinical success rates in S and µ groups were 71.1% and 61.7% (
P
 = 0.230). The Kaplan–Meier survival analysis of eyes with preoperative IOP ≥ 21 mmHg showed cumulative clinical success rates in S and μ groups were 80.4% and 60.0% (
P
 = 0.0192). There were no significant differences in postoperative IOP at 1, 3, and 6 months (S group, 14.9 ± 5.6, 14.6 ± 4.5, 14.6 ± 3.9 mmHg; μ group, 15.8 ± 5.9, 15.2 ± 4.4, 14.7 ± 3.7 mmHg;
P
 = 0.364, 0.443, 0.823), but postoperative IOP was significantly lower in the S group at 12 months (S group, 14.1 ± 3.1 mmHg; μ group, 15.6 ± 4.1 mmHg;
P
 = 0.0361). There were no significant differences in postoperative numbers of glaucoma medications at 1, 3, 6, and 12 months (S group, 1.8 ± 1.6, 1.8 ± 1.5, 2.0 ± 1.6, 1.8 ± 1.5; μ group, 2.0 ± 1.6, 2.0 ± 1.6, 2.1 ± 1.6, 2.2 ± 1.7;
P
 = 0.699, 0.420, 0.737, 0.198).
Conclusion
S and µ group eyes achieved IOP reduction, but μ group eyes had lower clinical success rates among patients with high preoperative IOP at 12 months.