Modified 360-degree Suture Trabeculotomy for Pseudoexfoliation Glaucoma: 12-Month Results.
Hepşen İbrahim F, Güler Emre, Yalçin Nuriye G, Kumova Deniz, Aktaş Zeynep P
AI Summary
Modified 360-degree suture trabeculotomy effectively lowered IOP and medication dependence in pseudoexfoliation glaucoma patients over 12 months, offering a promising surgical option, even combined with cataract surgery.
Abstract
Purpose
We aimed to evaluate the 12-month results of a modified 360-degree suture trabeculotomy (ST) technique in patients with pseudoexfoliation glaucoma (XFG).
Patients and methods: The modified 360-degree ST was performed on 20 eyes of 20 consecutive patients with XFG resistant to maximal topical treatment. In 8 patients, ST was combined with phacoemulsification. The main outcome measures were the surgical success rate, the mean postoperative intraocular pressure (IOP), the number of antiglaucoma medications, and the operative complications.
Results
The baseline IOP (26.55 ± 8.91) and medications (3.15 ± 0.81) decreased significantly to 10.90 ± 2.73 mm Hg and 0.30 ± 0.80, respectively, at 12 months postoperatively (P<0.001). The magnitude of IOP reduction was 58.9%. Complete and qualified success rates were 68.4% and 94.7%, respectively. The entire circumference of Schlemm's canal was opened successfully in all cases. Hyphema, perforation of the trabeculodesmetic window, posterior synechia, peripheral anterior synechia, and a transient elevation of the IOP were noted. The results are comparable to our 6-month results and other previously published results for circumferential trabeculotomy.
Conclusions
The modified 360-degree ST provides a feasible choice in patients with XFG with a reasonable rate of complications. The 12-month success rates are promising. It can also be combined effectively with the current cataract surgery.
MeSH Terms
Shields Classification
Key Concepts6
The modified 360-degree suture trabeculotomy (ST) significantly decreased baseline intraocular pressure (IOP) from 26.55 ± 8.91 mm Hg to 10.90 ± 2.73 mm Hg at 12 months postoperatively (P<0.001) in 20 eyes of 20 consecutive patients with pseudoexfoliation glaucoma (XFG) resistant to maximal topical treatment.
The modified 360-degree suture trabeculotomy (ST) significantly reduced the number of antiglaucoma medications from 3.15 ± 0.81 to 0.30 ± 0.80 at 12 months postoperatively (P<0.001) in 20 eyes of 20 consecutive patients with pseudoexfoliation glaucoma (XFG) resistant to maximal topical treatment.
The magnitude of IOP reduction with modified 360-degree suture trabeculotomy (ST) was 58.9% at 12 months in 20 eyes of 20 consecutive patients with pseudoexfoliation glaucoma (XFG) resistant to maximal topical treatment.
The complete and qualified success rates for modified 360-degree suture trabeculotomy (ST) were 68.4% and 94.7%, respectively, at 12 months in 20 eyes of 20 consecutive patients with pseudoexfoliation glaucoma (XFG) resistant to maximal topical treatment.
The modified 360-degree suture trabeculotomy (ST) can be effectively combined with phacoemulsification, as demonstrated in 8 out of 20 patients with pseudoexfoliation glaucoma (XFG) resistant to maximal topical treatment.
Complications noted after modified 360-degree suture trabeculotomy (ST) in 20 eyes of 20 consecutive patients with pseudoexfoliation glaucoma (XFG) included hyphema, perforation of the trabeculodesmetic window, posterior synechia, peripheral anterior synechia, and a transient elevation of the IOP.
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