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Related Concept Videos

Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

708
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
708

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One-year outcomes and predictable factors for microhook ab interno trabeculotomy.

Daiki Sakai1,2,3, Masashi Fujihara1,2,3, Satoshi Yokota1,2

  • 1Department of Ophthalmology, Kobe City Eye Hospital, Kobe 650-0047, Japan.

International Journal of Ophthalmology
|April 22, 2022
PubMed
Summary

Microhook ab interno trabeculotomy (µLOT) effectively lowers intraocular pressure (IOP) in open-angle glaucoma patients. Careful monitoring is crucial for those experiencing postoperative IOP spikes, especially in secondary open-angle glaucoma.

Keywords:
ab internomicrohook ab interno trabeculotomyminimally invasive glaucoma surgerysurvival analysistrabeculotomy

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Minimally Invasive Glaucoma Surgery (MIGS)

Background:

  • Open-angle glaucoma (OAG) is a leading cause of irreversible blindness.
  • Current treatments aim to lower intraocular pressure (IOP) to prevent optic nerve damage.
  • Microhook ab interno trabeculotomy (µLOT) is a MIGS procedure for IOP reduction.

Purpose of the Study:

  • To evaluate the one-year outcomes of µLOT in OAG patients.
  • To identify factors influencing the success and failure of µLOT surgery.

Main Methods:

  • Retrospective review of 59 OAG patients undergoing µLOT (alone or combined with cataract surgery).
  • Surgical success defined by IOP ≤21 mmHg or pre-op IOP with reduced medications, without further surgery.
  • Kaplan-Meier analysis and multivariate Cox regression used to assess outcomes and failure factors.

Main Results:

  • Mean IOP decreased from 25.3±7.2 to 16.1±4.4 mmHg at 12 months (P<0.01).
  • Cumulative success rate was 63.1% at one year.
  • Higher success in primary open-angle glaucoma (POAG) (80.0%) vs. secondary OAG (SOAG) (48.0%).
  • SOAG (aHR: 3.468) and postoperative IOP spike (aHR: 5.382) were independent predictors of surgical failure.

Conclusions:

  • µLOT is a viable treatment option for POAG.
  • Postoperative IOP spikes require careful management and monitoring.
  • µLOT shows promising results but patient selection and monitoring are key.