Clin Ophthalmol. 2016 May 23;10:929-34. doi: 10.2147/OPTH.S102414. eCollection 2016.

Comparison of ab externo trabeculotomy in primary open-angle glaucoma and uveitic glaucoma: long-term outcomes.

Clinical ophthalmology (Auckland, N.Z.)

Antony William, Martin S Spitzer, Deshka Doycheva, Spyridon Dimopoulos, Martin Alexander Leitritz, Bogomil Voykov

PMID: 27284237 PMCID: PMC4883803 DOI: 10.2147/OPTH.S102414

Abstract

BACKGROUND: The aim of this study was to compare the long-term outcomes of ab externo trabeculotomy in primary open-angle glaucoma (POAG) and uveitic glaucoma (UG).

DESIGN: This was a retrospective single-center case series study.

PARTICIPANTS: Twenty eyes of 17 patients with POAG and 22 eyes of 18 patients with UG were included in this study.

PATIENTS AND METHODS: The medical records of all consecutive patients with POAG and UG who underwent ab externo trabeculotomy since 2004 were reviewed.

MAIN OUTCOME MEASURE: The main outcome measure was change in median intraocular pressure (IOP). Success was defined as IOP ≤21 mmHg (success 1) and IOP ≤21 mmHg and at least 25% reduction from baseline (success 2).

RESULTS: In the POAG group, the median IOP decreased significantly from 22 mmHg (95% CI 21-25 mmHg; n=20) at baseline to 14 mmHg (95% CI 12-16; n=13) after 4 years, P<0.001. In the UG group, the median IOP decreased significantly from 27 mmHg (95% CI 24.5-30.5 mmHg; n=22) at baseline to 12 mmHg (95% CI 9-15 mmHg; n=15) after 4 years, P<0.001. Seven eyes in the UG group failed within the first year after surgery compared to none in the POAG group. Of these, four eyes had Fuchs' uveitis syndrome and two had granulomatous uveitis. No sight-threatening complications occurred in both POAG and UG groups.

CONCLUSION: Ab externo trabeculotomy effectively reduced IOP in both UG and POAG groups. However, the success rates in the UG group were significantly lower due to the high failure rate in patients with Fuchs' uveitis syndrome and granulomatous uveitis. The procedure demonstrated a high safety profile in both UG and POAG patients.

Keywords: ab externo trabeculotomy; primary open-angle glaucoma; uveitic glaucoma

References

1. Surv Ophthalmol. 1997 Mar-Apr;41(5):361-94 - PubMed
2. Prog Retin Eye Res. 2005 Sep;24(5):612-37 - PubMed
3. Invest Ophthalmol Vis Sci. 2002 Sep;43(9):2950-5 - PubMed
4. Curr Opin Ophthalmol. 2004 Apr;15(2):136-40 - PubMed
5. Arch Ophthalmol. 1974 Aug;92(2):134-8 - PubMed
6. Can J Ophthalmol. 2008 Aug;43(4):462-7 - PubMed
7. Am J Ophthalmol. 2002 Jul;134(1):17-26 - PubMed
8. Am J Ophthalmol. 2011 Jun;151(6):1047-1056.e1 - PubMed
9. J Glaucoma. 2014 Feb;23(2):88-94 - PubMed
10. Arch Ophthalmol. 1993 Dec;111(12):1653-61 - PubMed
11. Ophthalmologe. 2010 May;107(5):427-34 - PubMed
12. Graefes Arch Clin Exp Ophthalmol. 2016 Feb;254(2):355-60 - PubMed
13. Curr Opin Ophthalmol. 2005 Dec;16(6):356-63 - PubMed
14. Ophthalmology. 2015 Dec;122(12):2385-91.e1 - PubMed
15. Acta Ophthalmol. 2013 Mar;91(2):151-6 - PubMed
16. Am J Ophthalmol. 1977 Feb;83(2):174-9 - PubMed
17. Can J Ophthalmol. 2007 Feb;42(1):89-94 - PubMed
18. Exp Eye Res. 2009 Apr;88(4):648-55 - PubMed
19. J Glaucoma. 2015 Apr-May;24(4):316-22 - PubMed
20. Eye (Lond). 2009 Jul;23(7):1509-17 - PubMed
21. Prog Retin Eye Res. 1999 Jan;18(1):91-119 - PubMed
22. J Glaucoma. 2014 Aug;23(6):347-50 - PubMed

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