Laser goniopuncture may enhance IOP lowering of previous surgery

Issue: September 10, 2016

Laser goniopuncture can contribute to IOP reduction after viscocanalostomy or phacoviscocanalostomy, according to a study.

Laser goniopuncture is a noninvasive, non-incisional technique performed with an Nd:YAG laser to create a break and open the trabeculo-Descemet’s window to maximize aqueous drainage and reduce IOP.

The study included 515 eyes that underwent viscocanalostomy or phacoviscocanalostomy; 136 eyes (26%) required subsequent goniopuncture a mean 15.11 months after the initial surgery.

The success of viscocanalostomy or phacoviscocanalostomy was defined as IOP of 18 mm Hg or less or a target set by the surgeon. Goniopuncture was the next IOP-lowering option before starting topical IOP-lowering medication when IOP was unsatisfactory.

Goniopuncture reduced mean IOP from 22.92 mm Hg to 17.08 mm Hg in all eyes; the 25% reduction was statistically significant (P < .0001). IOP was reduced a mean 7.6 mm Hg in the viscocanalostomy group and 4.85 mm Hg in the phacoviscocanalostomy group; the between-group difference was statistically significant (P = .0038).

Goniopuncture was required 11.35 months after viscocanalostomy and 14.57 months after phacoviscocanalostomy.

IOP-lowering medication was initiated in 69 eyes a mean 7.26 months after goniopuncture.

Complete success in IOP control was achieved in 35 eyes, and qualified success was achieved in 93 eyes. – by Matt Hasson

Disclosure: The authors report no relevant financial disclosures.

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Source:

Mathews D, et al. J Glaucoma. 2016;doi:10.1097/IJG.0000000000000333.