[Trabeculectomy Ab Interno in Primary Open Angle Glaucoma and Exfoliative Glaucoma]

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Management

Context:

• Open-angle glaucoma, including primary (POAG) and secondary forms like exfoliative glaucoma (PEX), presents a significant challenge in managing intraocular pressure (IOP).
• Trabeculectomy is a surgical procedure aimed at reducing IOP, but its efficacy in routine clinical practice for diverse open-angle glaucoma subtypes requires ongoing assessment.
• Evaluating the combination of trabeculectomy with intraocular lens (IOL) implantation offers insights into enhanced surgical outcomes for specific glaucoma patient groups.

Purpose:

• To assess the clinical outcomes of routine trabeculectomy surgery in patients diagnosed with primary open-angle glaucoma (POAG) and secondary open-angle glaucoma (exfoliative glaucoma).
• To evaluate the reduction in intraocular pressure (IOP) and the change in the number of antiglaucoma medications required post-trabeculectomy.
• To compare the efficacy of trabeculectomy alone versus trabeculectomy combined with IOL implantation in managing POAG and PEX glaucoma.

Summary:

• A study analyzed 296 eyes with open-angle glaucoma (POAG and PEX) undergoing trabeculectomy between 2012 and 2014.
• Results at one-year follow-up demonstrated a significant reduction in IOP across all four study cohorts (trabeculectomy alone or with IOL for POAG and PEX).
• While IOP decreased significantly in all groups, POAG patients receiving trabeculectomy with IOL showed a statistically significant greater IOP reduction compared to trabeculectomy alone.

Impact:

• Trabeculectomy surgery proves to be a reliable and effective surgical intervention for managing mild to moderate open-angle glaucoma with uncontrolled IOP.
• The procedure leads to a significant and sustained reduction in intraocular pressure one year after surgery, contributing to better glaucoma control.
• Findings support the routine use of trabeculectomy as a valuable tool in ophthalmological practice for improving patient outcomes in open-angle glaucoma management.