Modified 360-degree Suture Trabeculotomy for Pseudoexfoliation Glaucoma: 12-Month Results

We aimed to evaluate the 12-month results of a modified 360-degree suture trabeculotomy (ST) technique in patients with pseudoexfoliation glaucoma (XFG).

The modified 360-degree ST was performed on 20 eyes of 20 consecutive patients with XFG resistant to maximal topical treatment. In 8 patients, ST was combined with phacoemulsification. The main outcome measures were the surgical success rate, the mean postoperative intraocular pressure (IOP), the number of antiglaucoma medications, and the operative complications.

The baseline IOP (26.55 ± 8.91) and medications (3.15 ± 0.81) decreased significantly to 10.90 ± 2.73 mm Hg and 0.30 ± 0.80, respectively, at 12 months postoperatively (P<0.001). The magnitude of IOP reduction was 58.9%. Complete and qualified success rates were 68.4% and 94.7%, respectively. The entire circumference of Schlemm's canal was opened successfully in all cases. Hyphema, perforation of the trabeculodesmetic window, posterior synechia, peripheral anterior synechia, and a transient elevation of the IOP were noted. The results are comparable to our 6-month results and other previously published results for circumferential trabeculotomy.

The modified 360-degree ST provides a feasible choice in patients with XFG with a reasonable rate of complications. The 12-month success rates are promising. It can also be combined effectively with the current cataract surgery.