Stab Incision Glaucoma Surgery: A Modified Guarded Filtration Procedure for Primary Open Angle Glaucoma

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Research

Background:

• Primary open angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Effective intraocular pressure (IOP) management is crucial for preventing glaucomatous visual field defects.
• Current surgical options for POAG aim to reduce IOP and preserve vision.

Purpose of the Study:

• To present a modified guarded filtration surgery technique, termed stab incision glaucoma surgery (SIGS).
• To evaluate the efficacy and safety of SIGS in patients with primary open angle glaucoma.
• To assess the impact of SIGS on intraocular pressure control and medication requirements.

Main Methods:

• A prospective, interventional case series was conducted on patients diagnosed with POAG.
• The SIGS procedure involved creating a conjunctival entry and superficial corneoscleral tunnel, followed by internal ostium creation using a Descemet's punch.
• Postoperative IOP and medication usage were monitored over a mean follow-up period of 14.18 months.

Main Results:

• Mean preoperative IOP of 27.41 mmHg was significantly reduced to a mean postoperative IOP of 16.47 mmHg (p < 0.000).
• A mean IOP reduction of 38.81% was observed.
• At final follow-up, 64.7% of patients achieved IOP <18 mmHg without medication, and 82.35% achieved IOP <18 mmHg with ≤2 medications.

Conclusions:

• The modified SIGS technique provides satisfactory IOP control in patients with POAG during interim follow-up.
• SIGS appears to be a safe and effective surgical option for managing primary open angle glaucoma.
• The procedure resulted in a significant reduction in IOP and medication dependency.