One-Year Outcomes of Gonio Scratch as a Minimally Invasive Glaucoma Surgery With Cataract Removal

This study evaluated the 1-year efficacy and safety of a novel minimally invasive glaucoma surgery, gonio scratch, in reducing intraocular pressure of eyes with open angle glaucoma and cataracts.

To evaluate the 1-year efficacy and safety of phacoemulsification cataract extraction combined with gonio scratch (GS-Phaco), a novel minimally invasive glaucoma surgery, in patients with open angle glaucoma and cataracts.

This prospective multicenter clinical trial was conducted at Hiroshima University, Yokoyama Retina Clinic, Kusatsu Eye Clinic, and Miyoshi Eye Clinic in Japan. The primary outcome measure was the rate of intraocular pressure (IOP) control. Failure was defined as an IOP of >18 mm Hg or >14 mm Hg, a <20% reduction from baseline IOP on 2 consecutive follow-up visits after 3 months, the need for additional glaucoma surgery, or loss of light perception. Kaplan-Meier analysis was used to assess surgical success rates.

Forty-seven eyes of 47 patients who underwent GS-Phaco surgery were included in the analysis. None of the patients had undergone prior ocular surgery. The median baseline IOP was 17 mm Hg. At 12 months postoperatively, there was a significant reduction in IOP to a median of 12 mm Hg ( P <0.01). The number of glaucoma medications also decreased significantly, from a median of 2 to 1 ( P <0.01). The surgical success rate at 12 months was 80.9%. The only complication observed was transient elevation of IOP in 2 (4.3%) eyes. No patients developed anterior chamber hemorrhage or hyphema with niveau formation.

GS-Phaco achieved sustained IOP reduction and a decrease in medication use at 12 months postoperatively in patients with open angle glaucoma and cataracts.