[Trabeculotomy (ab externo) as primary intervention for open-angle glaucoma : 5-year results].

Autor: Bornhauser M; Augenärzte am Stachus, Sonnenstraße 1, 80331, München, Deutschland. mbornhauser@gmail.com., Neuhann L; MVZ Prof. Neuhann, Helene-Weber-Alle 19, 80637, München, Deutschland., Neuhann T; MVZ Prof. Neuhann, Helene-Weber-Alle 19, 80637, München, Deutschland., Maier M; Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
Jazyk: němčina
Zdroj: Die Ophthalmologie [Ophthalmologie] 2024 Jan; Vol. 121 (1), pp. 43-52. Date of Electronic Publication: 2023 Nov 15.
DOI: 10.1007/s00347-023-01954-x
Abstrakt: Background: The published results of trabeculotomy ab externo (TOT), as an outflow channel surgery in adults with open-angle glaucoma, are underrepresented in comparison with other pressure-lowering glaucoma procedures.
Objective: To determine the long-term pressure lowering effect and complications of TOT as a stand-alone procedure or in combination with phacoemulsification with intraocular lens implantation (PIT) as a primary pressure-lowering procedure in adult patients with forms of chronic open-angle glaucoma.
Method: This was a retrospective analysis of 121 eyes of 106 patients wherby 90 eyes underwent TOT and 31 eyes underwent PIT. The follow-up period was 5 years. Follow-up was performed in the same center under standardized conditions. Preoperative as well as postoperative best-corrected distance visual acuity, intraocular pressure, pressure-lowering medication, and complications were recorded. For success criterion 1, the intraocular pressure was not allowed to exceed 17 mm Hg at any control. For success criterion 2, the intraocular pressure was allowed to be above 17 mm Hg at 1 control throughout the follow-up period.
Results: Preoperative intraocular pressure in the TOT group was 25.92 mm Hg (SD 6.58) and 26.32 mm Hg (SD 6.06) in the PIT group. The annual cumulative success rates with pressure-lowering medications for success criterion 1 were 92.8%, 82.5%, 70.5%, 52.7% and 26.1%. For success criterion 2 these were 97.9%; 94.9%, 93.2%, 91.3%, and 89%. We found no relevant difference in pressure reduction between TOT and PIT. Without pressure-lowering medications, success rates were significantly lower for both success criteria. No serious complications occurred. The most common postoperative complication was spontaneously resorbable hyphema.
Conclusion: Performing TOT or PIT as a primary glaucoma procedure for chronic open-angle glaucoma in adults is reasonable, has a significant pressure-lowering effect and very low complication rate.
(© 2023. The Author(s).)
Databáze: MEDLINE
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