'Intraoperative predictors for clinical outcomes after microinvasive glaucoma surgery".

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Outcomes

Background:

• Glaucoma management requires effective surgical interventions to control intraocular pressure (IOP).
• Gonioscopy-assisted transluminal trabeculotomy (GATT) and microincisional trabeculectomy (MIT) are surgical options for glaucoma.
• Identifying intraoperative predictors can optimize surgical outcomes and patient management.

Purpose of the Study:

• To evaluate the clinical applicability of intraoperative predictors for surgical outcomes after GATT and MIT.
• To determine if intraoperative findings predict the need for medications post-surgery.

Main Methods:

• A consecutive series of patients with uncontrolled glaucoma undergoing GATT or MIT were included.
• Intracameral injection of Trypan blue and observation of blanching were analyzed.
• Objective quantification of blanching and staining extent was performed using sector and protractor overlays.
• Multivariate regression identified predictors for surgical success and medication need.

Main Results:

• 167 eyes underwent GATT (49) or MIT (118), with 81 having concurrent cataract surgery.
• All eyes showed a reduction in medication use.
• Blanching was observed in 154 eyes (mean 2±1.8 quadrants).
• Trypan blue staining was assessed in 99 eyes, with patterns including venular, diffuse haze, or reticular.
• Neither blanching nor staining quadrants predicted surgical success.
• Blanching and blue staining in <2 quadrants significantly predicted the need for medications post-surgery.

Conclusions:

• Blanching and Trypan blue staining in >2 quadrants after GATT or MIT may serve as surrogate predictors for the need for medications.
• Further studies are required to identify reliable predictors for overall surgical success following GATT or MIT.