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Modified trabeculotomy an option for primary, secondary open-angle glaucoma
Patients who underwent a modified 360° suture trabeculotomy demonstrated a lower mean postop IOP and needed fewer antiglaucoma medications than those who underwent trabeculotomy with metal trabeculotomes, according to a study.
The 360° suture trabeculotomy procedure entailed using a 5-0 nylon suture, making a scleral flap to facilitate identification of Schlemm’s canal and creating a corneal side-port incision opposite the scleral flap to retrieve the suture.
The modified procedure was performed in 25 eyes with primary open-angle glaucoma (POAG) and 18 eyes with secondary open-angle glaucoma (SOAG). The results were compared retrospectively with standard trabeculotomy with metal trabeculotomes performed in 16 eyes with POAG and 19 eyes with SOAG.
Mean IOP values at 12 months postop were 13.1 mm Hg for the modified technique and 15.2 mm Hg for standard trabeculotomy. The mean number of antiglaucoma medications was 0.5 for the modified technique and 1.4 for standard trabeculotomy.
Surgical success was defined as 30% IOP reduction and IOP lower than 18 mm Hg at 3, 6, 9, 12 and 18 months postop while taking a similar number of medications.
In patients with POAG, a successful outcome was achieved in 84% treated with the modified procedure vs. 31% with the standard procedure. In SOAG patients, success was achieved in 89% with the modified procedure, compared to 50% with the standard procedure.
“Our results showing the efficacy and safety of the modified 360° suture trabeculotomy in both POAG and SOAG provide a feasible choice in some cases of adult open-angle glaucoma, although further long-term, prospective, randomized studies are necessary,” the study authors said.