Long-term results of trabeculotomy ab externo

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Interventions

Background:

• Primary open-angle glaucoma (POAG) management requires effective long-term intraocular pressure (IOP) control.
• Trabeculotomy is an established procedure for certain types of glaucoma, but its long-term efficacy in POAG is less defined.

Purpose of the Study:

• To evaluate the long-term effects of trabeculotomy on intraocular pressure (IOP) control in patients with primary open-angle glaucoma (POAG).
• To assess the safety and complication profile of trabeculotomy in POAG management.

Main Methods:

• Retrospective review of patient records.
• Analysis of IOP control over 4 years post-trabeculotomy.
• Assessment of medication requirements and surgical outcomes.

Main Results:

• 13.2% of eyes achieved IOP below 15 mm Hg without medication; an additional 15.1% achieved it with topical medication.
• 43.4% required topical medication for IOP between 16-20 mm Hg; 28.3% needed oral medication or further surgery.
• A postoperative IOP below 20 mm Hg correlated with a 71.2% survival probability.
• Trabeculotomy was not associated with severe complications like flat anterior chamber.

Conclusions:

• Trabeculotomy demonstrates a favorable safety profile for POAG, with limited severe complications.
• While ideal IOP control (below 15 mm Hg) was not consistently achieved, trabeculotomy shows potential as a first-line treatment for specific POAG cases.
• Consideration for POAG in young patients with early optic nerve or visual field damage, and cases with iris-lens diaphragm displacement.