Goniotomy for Steroid-Induced Glaucoma: Clinical and Tonographic Evidence to Support Therapeutic Goniotomy

To report the surgical results of goniotomy for corticosteroid-induced glaucoma and to provide evidence to support its use as initial surgical therapy.

The medical records of 5 patients with a history of goniosurgery for steroid-induced glaucoma were reviewed. Preoperative and postoperative clinical findings were reviewed, including the topical use of steroids, tonometric and gonioscopic findings, goniosurgery, and postoperative results. In addition, tonography was performed on one patient to document the improved facility of outflow following successful goniosurgery.

Surgical success was achieved in all patients, with intraocular pressures less than 18 mm Hg without the use of medication for an average follow-up period of 11.5 years (range: 9 months to 30 years). A normal postoperative facility of outflow (C = 0.30 mm3/min/mm Hg) was determined in one patient. No complications of surgery were experienced.

Goniotomy is an effective procedure for persistent steroid-induced glaucoma, and should be considered for initial surgical treatment.