Ab-interno goniotrabeculotomy versus mitomycin C trabeculectomy for adult open-angle glaucoma: A 2-year randomized clinical trial
Section snippets
Patients and methods
From January 1993 to March 1994, 32 eyes of 32 consecutive white patients with medically uncontrolled POAG were enrolled for this study.
Patients were selected for glaucoma surgery on the basis of confirmed significant progression of anatomic and functional damage, in the presence of an inadequately controlled IOP on medical therapy.
All the patients were recruited from the Glaucoma Service, Clinica Oculistica, Brescia. Eligibility criteria were as follows: (1) no previous bulbar surgery; (2) IOP
Results
All patients completed the 24-month follow-up. In the MT group, 9 of the 16 eyes underwent uncomplicated argon laser suture lysis within 3 weeks after surgery (only one of the two sutures was released).
During the AIGT procedure, bleeding from the iridocorneal angle was evident in 6 cases (37.5%) at the time of the incision. In all cases, the bleeding was extremely modest and stopped spontaneously.
No major postoperative complications were recorded in the AIGT group during the follow-up, other
Discussion
Our results provide evidence that AIGT is able to induce a significant decrease in IOP in adult POAG, with fewer postoperative complications than MT. Moreover, no significant differences in IOP and a similar success rate (IOP ≤14 mmHg without any hypotensive therapy: AIGT = 87.5%, MT = 81.25%; Fisher’s exact test, P = 1) were found between the two groups at the end of follow-up.
In our series, MT was associated with early-onset and late-onset complications, similar to those reported in other
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The changing conceptual basis of trabeculectomy: A review of past and current surgical techniques
2012, Survey of OphthalmologyCitation Excerpt :There is limited data on goniotomy in adult glaucoma. In a randomized clinical trial on 32 eyes of 32 patients, 16 underwent goniotomy and 16 had MMC SK.201 At 24 months, 14 of 16 eyes (87.5%) of the goniotomy group and 13 of the 16 eyes (81.25%) of the SK group showed an IOP ≤ 14 mm Hg.
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2009, Canadian Journal of OphthalmologyCanaloplasty: Circumferential viscodilation and tensioning of Schlemm canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults. Two-year interim clinical study results
2009, Journal of Cataract and Refractive SurgeryCitation Excerpt :In general, the Collaborative Initial Glaucoma Treatment Study2 found IOP in the range of 14 to 15 mm Hg over the 4 to 5 years of follow-up. Other comparative studies of trabeculectomy6,26–31 report a mean IOP after 2 years in the range of 10.1 to 16.9 mm Hg and mean medication use in the range of 0.1 to 1.2 medications. The lowest IOP and medication results were usually associated with the use of adjunctive antimetabolites and careful postoperative management of the eye.6,11,14
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2009, American Journal of OphthalmologyCombined clear corneal phacoemulsification and ab interno trabeculectomy: Three-year case series
2005, Journal of Cataract and Refractive SurgeryCitation Excerpt :Experimental studies24,25 show that incising the trabecular meshwork and Schlemm's canal can increase outflow. Clinical studies18,26–29 confirmed that trabecular incision or trabecular removal can effectively reduce IOP. Incisional ab interno techniques have been modified over the years by several authors26–28 and have received renewed interest from ophthalmologists both for the treatment of juvenile glaucoma30,31 as well as for chronic open-angle glaucoma.29,32,33