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Updated: Dec 10, 2025
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Comparison of trabectome and microhook surgical outcomes
Naoki Tojo1, Mitsuya Otsuka1, Atsushi Hayashi2
1Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Background:
Several methods can be applied for a trabeculotomy, including the uses of thread, a blade, cauterization, and a hook. We compared the outcomes of trabectome surgery and microhook surgery.
Methods:
We analyzed the cases of 133 eyes that underwent trabectome (72 eyes) or microhook (61 eyes) surgery and were followed for > 1 year. We defined failure as a < 20% reduction in the postoperative intraocular pressure (IOP) value or requiring additional glaucoma surgery. We used three surgical success definitions: ≤ 21, ≤ 18, and ≤ 15 mmHg IOP reduction. A Kaplan-Meier survival analysis was performed for the surgical outcomes. We compared the trabectome and microhook groups' postoperative IOP values, number of glaucoma medications, and postoperative complications.
Results:
At 1 year postsurgery, the trabectome surgeries decreased the IOP significantly from 24.6 ± 7.3 to 13.3 ± 3.7 mmHg, and the microhook surgeries significantly decreased the IOP from 24.1 ± 9.2 to 12.5 ± 3.9 mmHg. The two groups' 1-year postoperative IOP values were not significantly different (p = 0.310). The surgical outcomes of the trabectome surgeries were significantly better than those of the microhook surgeries (≤ 21 mmHg: p = 0.0049, ≤ 18 mmHg: p = 0.0029, and ≤ 15 mmHg: p = 0.0393). There were three patients with ciliary detachment in the microhook surgery group.
Conclusions:
Trabectome surgery provided significantly better surgical outcomes than microhook surgery. The risk of postoperative ciliary detachment should be considered in microhook surgery cases.
