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Trabeculotomy opening size and IOP reduction after Trabectome® surgery.

Thomas Wecker1, Alexandra Anton1, Matthias Neuburger2

  • 1Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Graefe'S Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie
|May 22, 2017
PubMed
Summary

Trabectome surgery for glaucoma did not show a correlation between trabeculotomy opening size and intraocular pressure (IOP) reduction. Deeper anterior chamber depth may promote larger openings, but did not significantly impact IOP outcomes.

Keywords:
AngleGlaucomaIntraocular pressureMinimally invasive glaucoma surgery (MIGS)Treatment surgery

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Anatomic Factors in Ocular Surgery

Background:

  • Trabeculotomy with the Trabectome® is a surgical option for lowering intraocular pressure (IOP).
  • Some patients experience insufficient IOP reduction despite a visible opening of Schlemm's canal after trabeculotomy.
  • The relationship between surgical parameters and IOP reduction requires further investigation.

Purpose of the Study:

  • To investigate the correlation between trabeculotomy opening size and IOP reduction after Trabectome surgery.
  • To assess the influence of anterior chamber depth (ACD) and other parameters on IOP reduction.
  • To explore factors affecting the success of trabeculotomy in glaucoma management.

Main Methods:

  • Retrospective observational case series of 93 eyes undergoing Trabectome surgery.
  • Anterior segment swept source OCT used to measure trabeculotomy opening size and ACD.
  • IOP measured pre-operatively and at follow-up; analyzed using multiple linear regression.

Main Results:

  • Trabeculotomy opening size did not correlate with IOP reduction (p > 0.05).
  • Anterior chamber depth (ACD) showed a trend towards better IOP reduction with deeper AC, but was not statistically significant (p > 0.05).
  • Eyes with larger trabeculotomy openings had significantly deeper ACDs (p = 0.031).

Conclusions:

  • Trabeculotomy opening size is not a predictor of IOP reduction in Trabectome surgery.
  • The intrascleral aqueous outflow pathway's role in glaucomatous IOP elevation remains poorly understood.
  • Deeper anterior chamber depth may be associated with larger trabeculotomy openings, but its direct impact on IOP reduction needs further study.