[External trabecular excision--alternative to filtering glaucoma operation in patients with open angle glaucoma]

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Techniques

Background:

• Glaucoma filtering surgery complications like hypotonia, athalamia, and choroidal detachment pose significant challenges.
• Cystic non-filtering blebs, resulting from postinflammatory reactions, can impede the success of traditional glaucoma surgeries.
• Existing methods such as trabeculectomy and goniotrepanation have known complication profiles.

Purpose of the Study:

• To compare the efficacy and complication rates of a novel surgical technique, external trabecular excision (ETE).
• To evaluate ETE against established glaucoma filtering surgeries like trabeculectomy and goniotrepanation.
• To assess the outcomes of ETE in patients with open-angle glaucoma.

Main Methods:

• External trabecular excision (ETE) was performed on 25 eyes of 24 patients with open-angle glaucoma.
• Mean preoperative intraocular pressure was 28.12 mm Hg.
• Retrospective comparison of preoperative visual acuity and intraocular pressure with postoperative values at day 1, month 1, and month 3.

Main Results:

• Postoperative intraocular pressure ranged from 0-16 mm Hg on day 1, 10-30 mm Hg at 1 month, and 9-26 mm Hg at 3 months.
• 45% of eyes required antiglaucomatous drugs at 1 month and 42% at 3 months.
• Complications included 6 choroidal detachments, 2 flat anterior chambers, and 3 eyes required repeat goniotrepanation.

Conclusions:

• Complications associated with ETE were similar to those of traditional filtering surgery but were reversible.
• ETE resulted in a less pronounced initial drop in intraocular pressure compared to goniotrepanation or trabeculectomy.
• A prospective long-term study is necessary to fully ascertain the success and complication profile of ETE.