AIM: To investigate the one-year outcomes and factors that influence the results of microhook ab interno trabeculotomy(μLOT). METHODS: The medical records of consecutive patients with open angle glaucoma who underwe...AIM: To investigate the one-year outcomes and factors that influence the results of microhook ab interno trabeculotomy(μLOT). METHODS: The medical records of consecutive patients with open angle glaucoma who underwent μLOT(including combination of μLOT and cataract surgery) between Februar y 2018 and July 2019 were retrospectively reviewed. Surgical success was defined as the following: an intraocular pressure(IOP)≤21 mm Hg or IOP≤preoperative IOP with a reduced number of glaucoma eye drops, without additional glaucoma surgery, and assessed using KaplanMeier survival analysis. A multivariate Cox proportionalhazards regression model was used to investigate the factors associated with surgical failure.RESULTS: The 59 eyes of 59 patients comprising 28 eyes with primary open angle glaucoma(POAG) and 31 with secondary open angle glaucoma(SOAG) were included. The mean IOP and number of glaucoma eye drops significantly decreased from 25.3±7.2 mm Hg and 3.9±1.1, preoperatively to 16.1±4.4 mm Hg(P<0.01) and 2.1±1.8(P<0.01),respectively, 12 mo postoperatively, with a cumulative success rate of 63.1%. The one-year success rate was significantly higher in POAG eyes than in SOAG eyes(80.0% vs 48.0%;P=0.011, log-rank test). Multivariate analyses revealed SOAG [P=0.017, adjusted hazard ratio(a HR): 3.468, 95%CI: 1.246-9.654] and the postoperative IOP spike(IOP>25 mm Hg within 2 wk post-surgery;P<0.001, a HR: 5.382, 95%CI:2.113-13.707) as independent factors associated with surgical failure.CONCLUSION: The μLOT is a good treatment option for POAG eyes. However, the postoperative course should be carefully followed in cases with postoperative IOP spike.展开更多
An 87-year-old woman with primary open-angle glaucoma presented to our hospital. Although the combined cataract and minimally invasive glaucoma surgeries (MIGS) were an appropriate surgical option, the presence of ban...An 87-year-old woman with primary open-angle glaucoma presented to our hospital. Although the combined cataract and minimally invasive glaucoma surgeries (MIGS) were an appropriate surgical option, the presence of band keratopathy made it difficult to perform ab interno glaucoma surgery in her right eye (OD);therefore, the corneal opacity was removed using ethylenediaminetetraacetic acid (EDTA) chelation procedure. One month after chelation, microhook ab interno trabeculotomy and cataract surgery were performed successfully. Clear intraoperative visualization of the angle structures is critical for the success of these MIGS procedures. In glaucomatous eyes that require MIGS, EDTA chelation is a good neoadjuvant therapy for coexisting band keratopathy.展开更多
文摘AIM: To investigate the one-year outcomes and factors that influence the results of microhook ab interno trabeculotomy(μLOT). METHODS: The medical records of consecutive patients with open angle glaucoma who underwent μLOT(including combination of μLOT and cataract surgery) between Februar y 2018 and July 2019 were retrospectively reviewed. Surgical success was defined as the following: an intraocular pressure(IOP)≤21 mm Hg or IOP≤preoperative IOP with a reduced number of glaucoma eye drops, without additional glaucoma surgery, and assessed using KaplanMeier survival analysis. A multivariate Cox proportionalhazards regression model was used to investigate the factors associated with surgical failure.RESULTS: The 59 eyes of 59 patients comprising 28 eyes with primary open angle glaucoma(POAG) and 31 with secondary open angle glaucoma(SOAG) were included. The mean IOP and number of glaucoma eye drops significantly decreased from 25.3±7.2 mm Hg and 3.9±1.1, preoperatively to 16.1±4.4 mm Hg(P<0.01) and 2.1±1.8(P<0.01),respectively, 12 mo postoperatively, with a cumulative success rate of 63.1%. The one-year success rate was significantly higher in POAG eyes than in SOAG eyes(80.0% vs 48.0%;P=0.011, log-rank test). Multivariate analyses revealed SOAG [P=0.017, adjusted hazard ratio(a HR): 3.468, 95%CI: 1.246-9.654] and the postoperative IOP spike(IOP>25 mm Hg within 2 wk post-surgery;P<0.001, a HR: 5.382, 95%CI:2.113-13.707) as independent factors associated with surgical failure.CONCLUSION: The μLOT is a good treatment option for POAG eyes. However, the postoperative course should be carefully followed in cases with postoperative IOP spike.
文摘An 87-year-old woman with primary open-angle glaucoma presented to our hospital. Although the combined cataract and minimally invasive glaucoma surgeries (MIGS) were an appropriate surgical option, the presence of band keratopathy made it difficult to perform ab interno glaucoma surgery in her right eye (OD);therefore, the corneal opacity was removed using ethylenediaminetetraacetic acid (EDTA) chelation procedure. One month after chelation, microhook ab interno trabeculotomy and cataract surgery were performed successfully. Clear intraoperative visualization of the angle structures is critical for the success of these MIGS procedures. In glaucomatous eyes that require MIGS, EDTA chelation is a good neoadjuvant therapy for coexisting band keratopathy.
