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Comparison of early versus late laser goniopuncture following deep sclerectomy for the management of open-angle glaucoma
  1. David Holmes1,
  2. Michelle Mei Pik Hui2,
  3. Colin Clement3
  1. 1 Faculty of Medicine, University of Sydey, Camperdown, New South Wales, Australia
  2. 2 Faculty of Medicine, School of Medical Science, Kensington, New South Wales, Australia
  3. 3 Glaucoma Unit, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Dr David Holmes, Eye Associates Orange, Orange, NSW 2800, Australia; holmesdp93{at}


Purpose To compare the outcome of early versus late Nd:YAG laser goniopuncture (LGP) after deep sclerectomy with mitomycin C (DSMMC) for open-angle glaucoma (OAG).

Methods A retrospective study of consecutive OAG eyes that underwent a LGP following DSMMC was recruited between June 2012 and November 2015. Success was defined as intraocular pressure (IOP) less than 21, 18 or 15 mm Hg with a reduction of more than 20% IOP from baseline without (complete success) or with medications (qualified success).

Results 99 eyes with OAG that underwent DSMMC were recruited into the study. Of these, 49 eyes (49.49%) had undergone LGP post-DSMMC. IOP was significantly reduced following LGP from 28.4 to 11.8 mm Hg. Comparison of Kaplan-Meier survival curves out to 60 months after LGP showed a trend towards better outcomes in the late LGP group with the only statistically significant difference noted for qualified success with IOP target <15 mm Hg. Complications were few with no difference noted between early and late LGP groups.

Conclusion There appears to be a trend towards late LGP being more effective after DSMMC when compared with early LGP; this however was not significant. This study corroborates previous published data confirming LGP is an effective and safe procedure for lowering IOP post-DSMMC procedure.

  • glaucoma
  • treatment lasers
  • treatment surgery
  • intraocular pressure
  • angle

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  • International Congress on Glaucoma Surgery, Montreal, 2018. RANZCO annual scientific meeting, Adelaide 2018.

  • Contributors DH was primarily responsible for drafting and amending the manuscript and data collection. MMPH was primarily responsible for data analysis. CC was the senior author responsible for planning the study, overseeing the drafting and data analysis.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The RANZCO Human Research Ethics Committee approved the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data are de-identified participant data collected during the course of standard clinical practice.