Modified 360-degree suture trabeculotomy combined with phacoemulsification and intraocular lens implantation for glaucoma and coexisting cataract

Shinmei, Yasuhiro; Kijima, Riki; Nitta, Tsuyoshi; Ishijima, Kan; Ohguchi, Takeshi; Chin, Shinki; Ishida, Susumu

doi:10.1016/j.jcrs.2016.08.016

Cited by 12 publications

(22 citation statements)

References 12 publications

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“…Previous reports demonstrated that many confounding factors affect the surgical outcomes of TLO. Surgery involving elderly patients3 18 and concomitant cataract surgery7 8 10 19 generally had better outcomes. Meanwhile, some reported that exfoliation glaucoma patients showed better outcomes compared with POAG patients,3 while others found the opposite outcome 20.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the 1-year surgical outcomes ofab externotrabeculotomy and microhookab internotrabeculotomy using propensity score analysis

et al. 2020

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ObjectiveTo compare the 1-year outcomes of trabeculotomy ab externo (ab externo TLO) and trabeculotomy ab interno using a microhook (ab interno TLO) for glaucoma patients using propensity score analysis.Methods and analysisThe medical charts of 65 consecutive patients who underwent ab externo TLO and those of 69 patients who underwent ab interno TLO were reviewed. Logistic regression analysis was conducted to calculate the propensity score using 1:1 matched analysis, which indicates the likelihood of surgical success at 12 months. We set the outcome-related covariates as age, glaucoma type, mean deviation, preoperative intraocular pressure (IOP), the number of preoperative glaucoma eye drops and the presence or absence of combined cataract surgery. Fifty eyes per each surgery group were subsequently compared.ResultsThe mean preoperative IOP was 32.5±11.2 mm Hg in the ab externo TLO group and 28.4±7.8 mm Hg in the ab interno TLO group (p=0.08). The mean postoperative IOP at 12 months was 18.3±7.4 mm Hg in the former group and 17.8±6.3 mm Hg in the latter (p=0.91). When surgical success was defined as a postoperative IOP of between 5 and 21 mm Hg with a more than 20% IOP reduction from baseline and no additional glaucoma surgery, the rate at 12 months was 78% in the ab externo TLO group and 74% in the ab interno TLO group (p=1.00).ConclusionThe 1-year success rate was not significantly different between ab externo and ab interno TLO.

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Section: Discussionmentioning

confidence: 99%

A comparison of the 1-year surgical outcomes ofab externotrabeculotomy and microhookab internotrabeculotomy using propensity score analysis

et al. 2020

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“…Grover (“ab interno”) and Shinmei (“ab externo”) did not detect any significant difference in the IOP decrease between the trabeculotomy and combined surgery groups in their studies. [17] Chiara et al noted that combined “ab externo” trabeculotomy and cataract surgery provided a further decrease of 1–2 mmHg in IOP compared to trabeculotomy alone. [8] Tanito et al in their study evaluating patients who underwent combined surgery determined the rates of cases with an IOP under 21 mmHg, 17 mmHg, and 15 mmHg at the end of one year post-surgery to be 95.8%, 58.7%, and 30%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Hyphaema and transient IOP spikes are the most common complications that develop after trabeculotomy. [17] Hyphaema emerges when Schlemm's canal is filled with blood due to reflux from episcleral veins after the circumferential rupture of the trabecular meshwork. [10] Transient IOP spikes are related to prolonged hyphaema and can be eliminated by washing out the anterior chamber.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes of combined gonioscopy-assisted transluminal trabeculotomy and cataract surgery

Baykara

Poroy

Erseven

2019

Indian J Ophthalmol

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Purpose: To evaluate the success, safety, and complication rates of gonioscopy-assisted transluminal trabeculotomy (GATT) combined with cataract surgery. Methods: A retrospective study was conducted for 32 patients who underwent GATT combined with phacoemulsification and intraocular lens implantation. Patients with primary open-angle glaucoma were enrolled. The primary outcome measures were visual acuity, intraocular pressure (IOP), the number of antiglaucoma medications used, and complications. Results: The average preoperative visual acuity of the patients was logMAR 1.57 ± 1.2, and the average postoperative visual acuity was logMAR 0.39 ± 0.38. A significant increase in visual acuity was observed post-surgery ( P < 0.05). The average preoperative IOP was 34.2 ± 10.6 mmHg. In the 3 rd postoperative month, the average IOP was 10.5 ± 2.2 mmHg, and in the 6 th postoperative month, the average IOP was 11.2 ± 2.4 mmHg. In all postoperative follow-ups, IOP was significantly lower than that during the preoperative period ( P < 0.05). A decrease of 2.7 ± 0.6 on average was detected in the number of glaucoma medications used in the postoperative period compared to the preoperative period, and the average decrease in the number of active ingredients post-surgery was 3.5 ± 0.8. The most frequent complication was hyphaema (31.2%). In only one patient (3.1%), the surgery was considered to have failed due to the development of deep hypotony. Conclusion: Performing GATT in the same session as cataract surgery does not reduce the efficacy of GATT, yet this procedure reduces the incidence of the most frequent complication of GATT, i.e. hyphaema. Therefore, in convenient cases, combined surgery can safely be performed.

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“… 12 Two years following surgery, IOP was ~13 mmHg in eyes with OAG. 13 Additionally, Grover et al 14 found that gonioscopy-assisted transluminal trabeculotomy, which includes creating a 360-degree trabeculotomy with a thermally blunted suture or microcatheter, reduced IOP to 12.4–16.2 mmHg 1 year after surgery and ~16 mmHg 2 years after surgery. 15 This was even true in patients who had undergone prior incisional glaucoma surgery.…”

Section: Discussionmentioning

confidence: 99%

360-degree suture trabeculotomy ab interno to treat open-angle glaucoma: 2-year outcomes

Sato

Kawaji

Hirata

et al. 2018

OPTH

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PurposeThe purpose of this study was to evaluate the efficacy of 360-degree suture trabeculotomy (360S-LOT) ab interno for treating open-angle glaucoma (OAG). Risk factors of surgical failure were examined.Patients and methods360S-LOT ab interno alone was performed for patients with uncontrolled OAG, and combined 360S-LOT ab interno/phacoemulsification was performed for patients with controlled OAG with a visually significant cataract between March 2014 and September 2015 at a single center. The patients were prospectively followed for 2 years. The main outcome measures included 2-year intraocular pressure (IOP), number of anti-glaucoma medications used, postoperative complications, and predictive factors of surgical failure. Kaplan–Meier analysis was performed, with surgical success (with or without medication use) defined as postoperative IOP ≤15 mmHg and IOP reduction ≥20% (criterion A) or IOP ≤12 mmHg and IOP reduction ≥30% (criterion B). Predictive factors were evaluated using Cox proportional hazard ratios.ResultsA total of 64 eyes of 64 patients were included, and 50 (78%) eyes of 64 eyes underwent a phacoemulsification combination procedure. Surgery significantly reduced IOP from 18.4 ± 2.9 mmHg before surgery to 13.4 ± 3.0 mmHg after surgery (P < 0.001). Patients used an average of 1.8 ± 1.5 medications before surgery and 1.3 ± 1.5 medications after surgery (P = 0.101). No serious postoperative complications were observed. The probability of surgical success was 49.2% and 16.0% using criteria A and B, respectively. No risk factors of surgical failure were identified.ConclusionThe 360S-LOT ab interno procedure is a favorable option for treating eyes with mild or moderate OAG.

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Modified 360-degree suture trabeculotomy combined with phacoemulsification and intraocular lens implantation for glaucoma and coexisting cataract

Cited by 12 publications

References 12 publications

A comparison of the 1-year surgical outcomes ofab externotrabeculotomy and microhookab internotrabeculotomy using propensity score analysis

A comparison of the 1-year surgical outcomes ofab externotrabeculotomy and microhookab internotrabeculotomy using propensity score analysis

Surgical outcomes of combined gonioscopy-assisted transluminal trabeculotomy and cataract surgery

360-degree suture trabeculotomy ab interno to treat open-angle glaucoma: 2-year outcomes

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