In NTG, long-term significant IOP reduction can be achieved with deep sclerectomy with a low incidence of sight-threatening complications.

Précis: The preoperative factors associated with a decreased survival rate of ab interno trabeculotomy (AbIT) perfomed using a Trabectome in open-angle glaucoma were selective laser trabeculoplasty (SLT) performed previously and axial length (AL) over 23.82 mm. Purpose: The purpose of this study was to find preoperative factors that predict outcomes of AbIT by a Trabectome. Materials and Methods: This retrospective single-center cohort study involved consecutive patients with primary open-angle glaucoma and exfoliation glaucoma treated at Helsinki University Hospital with AbIT with preoperative intraocular pressure (IOP) ≥18 mm Hg and follow-up of at least 1 year. Success was defined as lowering of their IOP by at least 20% from baseline or reduction in glaucoma medications without any rise in IOP above baseline, and no subsequent glaucoma surgery. Results: Of the total 72 eyes of 67 patients, 51 eyes had exfoliation glaucoma and 21 had primary open-angle glaucoma. Mean preoperative IOP was 25.2±5.3 mm Hg, with a mean of 3.2±1.2 glaucoma medications. In the multivariable model, a history of preoperative SLT and higher preoperative AL had hazard ratios of 2.99 [95% confidence interval (CI): 1.26-7.10] and 1.53 (95% CI: 1.12-2.09) with statistical significance (P=0.013 and 0.007). The statistically significant cutoff point was 23.82 mm in AL in relation to the success rate, with success times taken into account (P<0.001). AL over 23.82 mm had hazard ratio of 5.75 (95% CI: 2.57-12.87, P<0.001). Conclusion: Previous SLT and AL over 23.82 mm reduce survival after AbIT.

Précis: Retrospective analysis of 38 suprachoroidal glaucoma stent implantations showed sudden intraocular pressure (IOP) elevations to >30 mm Hg in 37% of eyes, 39% needing additional glaucoma surgery, and a success rate at 12 months of 24%. Purpose: To study the efficacy and safety of suprachoroidal stent in everyday clinical practice at a tertiary glaucoma center. Materials and Methods: This retrospective single-center consecutive case series involved patients treated at Helsinki University Hospital with the CyPass Micro-Stent. Preoperative IOP was ≥18 mm Hg. Success was IOP between 6 and 18 mm Hg and lowering of IOP at least 20% from baseline without an increase in glaucoma medications over baseline or use of oral acetazolamide, and no subsequent glaucoma surgery. Results: Of the total 38 eyes of 33 patients, 17 had primary open-angle glaucoma, 16 had exfoliative glaucoma, 2 each had uveitic glaucoma or steroid-induced glaucoma, and 1 had pigmentary glaucoma. Median preoperative IOP was 25.8 [interquartile range (IQR), 9.7] mm Hg with a median of 3 (IQR, 2) glaucoma medications. Kaplan-Meier estimate of median survival time was 79 days (95% confidence interval, 37-121 d). Success rate at 12-month follow-up was 24%. Sudden IOP elevation to over 30 mm Hg occurred in 14 eyes (37%). Highest IOP was 68 mm Hg. IOP peaks occurred between 1 week and 8 months after the surgery. In total, 43% of those with IOP elevation to >30 mm Hg had no symptoms. After the CyPass implantation, 15 eyes (39%) needed additional glaucoma surgery within a median of 167 (IQR, 109) days. Conclusions: Suprachoroidal stenting in a heterogenous clinical population resulted in a high incidence of sudden IOP peaks with a low success rate.