Trabecular meshwork peeling technique of ab interno trabeculectomy - A retrospective review

To assess 1-year outcomes of the trabecular meshwork peeling technique of ab interno trabeculectomy in patients with glaucoma.

This retrospective study reviewed medical records of 117 eyes from 117 glaucoma patients who underwent trabecular peeling (TRAP) surgery alone or combined with cataract surgery (TRAP-CS) at a single eye center. All procedures were performed by a single surgeon between June 1, 2016 and December 31, 2019. The surgery involved ab interno removal of 120 to 360 degrees of the trabecular meshwork using microforceps. The primary postoperative outcomes evaluated included changes in intraocular pressure (IOP), use of anti-glaucoma medications (AGMs), complications, and surgical success over a 1-year follow-up period.

The mean IOP reduced from a preoperative value of 21.58 ± 7.20 mm Hg to 14.5 ± 3.8, 14.9 ± 3.4, 15.0 ± 3.6, and 14.6 ± 3.4 mmHg at 1 month, 3 months, 6 months, and 1 year after surgery, respectively (P < 0.001). The use of AGM significantly reduced from 2.47 ± 1.01 before surgery to 0.50 ± 0.9 at 1 year after surgery (P < 0.001). The percentage reduction in IOP and AGM at 1 year postoperatively was 31.3% and 80.0%, respectively. The absolute and qualified success rates at 12 months after surgery were 56.0% and 75%, respectively (point success at 12 months: 68.5% absolute and 89.2% qualified). Two cases required resurgery. No significant complications were noted.

This study shows that the TRAP technique of ab interno trabeculectomy is a safe and effective approach to reducing IOP in patients with glaucoma.