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Short-term results of microhook ab interno trabeculotomy, a novel minimally invasive glaucoma surgery in Japanese eyes: initial case series

2016; Wiley; Volume: 95; Issue: 5 Linguagem: Inglês

10.1111/aos.13288

1755-3768

Masaki Tanito, Ichiya Sano, Yoshifumi Ikeda, Etsuko Fujihara,

Proteoglycans and glycosaminoglycans research

Abstract Purpose To report the first early postoperative results and safety profile after microhook ab interno trabeculotomy ( μ LOT ). Methods This initial retrospective observational case series included 24 consecutive glaucomatous eyes of 17 Japanese patients (7 men, 10 women; mean age ± standard deviation, 66.7 ± 17.9 years) who underwent μ LOT . The trabeculotomy extent, surgical time, perioperative complications, interventions for complications and additional glaucoma surgeries during the follow‐up for more than 3 months were collected by reviewing the medical and surgical records. The intraocular pressure ( IOP ), numbers of antiglaucoma medications, logarithm of the minimum angle of resolution visual acuity ( VA ), anterior chamber ( AC ) flare and corneal endothelial cell density ( CECD ) were compared preoperatively and postoperatively. Results The trabecular meshwork was incised for a mean of 3.6 ± 0.5 clock hours temporally, 3.7 ± 0.5 clock hours nasally and total 7.3 ± 0.6 clock hours during the 6.2 ± 1.6‐min surgery. The mean preoperative IOP of 25.9 ± 14.3 mmHg and number of antiglaucoma medication of 3.3 ± 1.0 decreased significantly (p = 0.0002 and p = 0.005, respectively) to 14.7 ± 3.6 mmHg and 2.8 ± 0.8 at the final visit at 188.6 ± 68.8 days postoperatively. Compared with preoperatively, the final VA , AC flare and CECD did not change significantly. Hyphema with niveau formation (nine eyes, 38%) and washout of hyphema (two eyes, 8%) were the most common postoperative complication and intervention, respectively. At the final visit, 19 eyes (79%) achieved successful IOP control of 18 mmHg or less and a 15% reduction or greater. Conclusion Microhook trabeculotomy normalizes the IOP during the early postoperative period in patients with glaucoma.