Comparison of 1-year effectiveness between phaco-microhook ab-interno trabeculotomy and phaco-iStent trabecular micro-bypass stent in primary open-angle glaucoma with low-teen intraocular pressure.
Matsuo Masato, Fukuda Hiroki, Buathong Jedsada, Omura Tetsuro, Tanito Masaki
AI Summary
This study compared phaco-µLOT and phaco-iStent for low-teen IOP glaucoma. Both reduced medications, but phaco-µLOT was more effective for IOP control, offering a promising option for these patients.
Abstract
Purpose
To investigate the surgical effectiveness of combined cataract surgery with microhook ab-interno trabeculotomy (phaco-µLOT) or iStent trabecular micro-bypass stent (phaco-iStent) in eyes with primary open-angle glaucoma (POAG) and preoperative intraocular pressure (IOP) controlled below 15 mmHg (low-teen IOP).
Methods
This retrospective cohort study included consecutive patients with POAG and low-teen IOP who underwent phaco-µLOT or phaco-iStent as their initial glaucoma surgery and were followed up for 1 year postoperatively. Surgical failure was defined as the inability to achieve the following criteria twice in a row: (A) IOP of 6-15 mmHg with over 20% IOP reduction; (B) IOP of 6-12 mmHg with over 20% IOP reduction.
Results
A total of 75 eyes from 75 subjects were included, with 48 in the phaco-µLOT group and 27 in the phaco-iStent group. The mean preoperative IOP and number of antiglaucoma medications were 13.1 ± 2.1 mmHg and 3.4 ± 0.9 in the phaco-µLOT group, and 12.6 ± 2.0 mmHg and 2.5 ± 1.2 in the phaco-iStent group, respectively. The number of antiglaucoma medications was significantly reduced to 2.5 ± 0.9 (phaco-µLOT) and 2.0 ± 1.1 (phaco-iStent) at 1-year postoperatively (all p < 0.05). For criteria A and B, the survival rates were significantly higher in the phaco-µLOT group than in the phaco-iStent group (all p < 0.01).
Conclusion
Both phaco-µLOT and phaco-iStent hold promise in reducing the need for antiglaucoma medications in POAG eyes with low-teen IOP. Phaco-µLOT may be more effective than phaco-iStent in controlling IOP.
Key messages: What is known Minimally invasive glaucoma surgeries (MIGS) procedures target the pressure gradient pathways in patients with higher preoperative intraocular pressure (IOP) levels, however, evidence on their effectiveness in normotensive glaucoma patients remains limited. What is new Combined cataract surgery with microhook ab-interno trabeculotomy (phaco-µLOT) or iStent trabecular micro-bypass stent (phaco-iStent) significantly reduced the number of antiglaucoma medications in primary open-angle glaucoma (POAG) eyes with preoperative IOP controlled below 15 mmHg (low-teen IOP). Phaco-µLOT may be more effective than phaco-iStent in controlling IOP. These procedures should be limited to reducing the number of antiglaucoma medications used, as they did not significantly reduce the postoperative IOP in POAG eyes with low-teen IOP.
MeSH Terms
Shields Classification
Key Concepts6
The number of antiglaucoma medications was significantly reduced to 2.5 0.9 in the phaco-microhook ab-interno trabeculotomy (phaco-LOT) group and 2.0 1.1 in the phaco-iStent trabecular micro-bypass stent (phaco-iStent) group at 1-year postoperatively (all p < 0.05) in eyes with primary open-angle glaucoma (POAG) and preoperative intraocular pressure (IOP) controlled below 15 mmHg (low-teen IOP).
For criteria A (IOP of 6-15 mmHg with over 20% IOP reduction) and B (IOP of 6-12 mmHg with over 20% IOP reduction), the survival rates were significantly higher in the phaco-microhook ab-interno trabeculotomy (phaco-LOT) group than in the phaco-iStent trabecular micro-bypass stent (phaco-iStent) group (all p < 0.01) in eyes with primary open-angle glaucoma (POAG) and low-teen IOP.
Both phaco-microhook ab-interno trabeculotomy (phaco-LOT) and phaco-iStent trabecular micro-bypass stent (phaco-iStent) hold promise in reducing the need for antiglaucoma medications in primary open-angle glaucoma (POAG) eyes with low-teen intraocular pressure (IOP).
Phaco-microhook ab-interno trabeculotomy (phaco-LOT) may be more effective than phaco-iStent trabecular micro-bypass stent (phaco-iStent) in controlling intraocular pressure (IOP) in primary open-angle glaucoma (POAG) eyes with low-teen IOP.
Combined cataract surgery with microhook ab-interno trabeculotomy (phaco-LOT) or iStent trabecular micro-bypass stent (phaco-iStent) significantly reduced the number of antiglaucoma medications in primary open-angle glaucoma (POAG) eyes with preoperative intraocular pressure (IOP) controlled below 15 mmHg (low-teen IOP).
Combined cataract surgery with microhook ab-interno trabeculotomy (phaco-LOT) or iStent trabecular micro-bypass stent (phaco-iStent) procedures should be limited to reducing the number of antiglaucoma medications used, as they did not significantly reduce the postoperative intraocular pressure (IOP) in primary open-angle glaucoma (POAG) eyes with low-teen IOP.
Related Articles5
Association Between Prior Selective Laser Trabeculoplasty and Phaco-iStent Inject Efficacy.
Observational StudyCombined Microinvasive Glaucoma Surgery With Phacoemulsification in Open-Angle Glaucoma: A Systematic Review and Meta-analysis.
Systematic ReviewAngle-based minimally invasive glaucoma surgery in normal tension glaucoma: A systematic review and meta-analysis.
Systematic ReviewTrabecular Procedures Combined with Cataract Surgery for Open-Angle Glaucoma: A Report by the American Academy of Ophthalmology.
Systematic ReviewMinimally invasive glaucoma surgery in angle closure.
ReviewIs this article assigned to the wrong chapter(s)? Let us know.