Ab Interno Trabeculotomy: Key Prognostic Factors.

UNLABELLED

PRéCIS:: The preoperative factors associated with a decreased survival rate of ab interno trabeculotomy (AbIT) perfomed using a Trabectome in open-angle glaucoma were selective laser trabeculoplasty (SLT) performed previously and axial length (AL) over 23.82 mm.

PURPOSE

The purpose of this study was to find preoperative factors that predict outcomes of AbIT by a Trabectome.

MATERIALS AND METHODS

This retrospective single-center cohort study involved consecutive patients with primary open-angle glaucoma and exfoliation glaucoma treated at Helsinki University Hospital with AbIT with preoperative intraocular pressure (IOP) ≥18 mm Hg and follow-up of at least 1 year. Success was defined as lowering of their IOP by at least 20% from baseline or reduction in glaucoma medications without any rise in IOP above baseline, and no subsequent glaucoma surgery.

RESULTS

Of the total 72 eyes of 67 patients, 51 eyes had exfoliation glaucoma and 21 had primary open-angle glaucoma. Mean preoperative IOP was 25.2±5.3 mm Hg, with a mean of 3.2±1.2 glaucoma medications. In the multivariable model, a history of preoperative SLT and higher preoperative AL had hazard ratios of 2.99 [95% confidence interval (CI): 1.26-7.10] and 1.53 (95%

CI

1.12-2.09) with statistical significance (P=0.013 and 0.007). The statistically significant cutoff point was 23.82 mm in AL in relation to the success rate, with success times taken into account (P<0.001). AL over 23.82 mm had hazard ratio of 5.75 (95%

CI

2.57-12.87, P<0.001).

CONCLUSION

Previous SLT and AL over 23.82 mm reduce survival after AbIT.