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Takeshi Ono, Daisuke Shiba, Sayaka Adachi, Rihito Ui, Naoki Ozeki, Kenya Yuki, Kazuo Tsubota; Surgical effect of modified 360-degree suture trabeculotomy compared to trabeculotomy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2685.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the intraocular pressure (IOP) lowering effects and safety of modified 360-degree suture trabeculotomy (S-LOT) for glaucoma in comparison with trabeculotomy (LOT).
We included the eyes which underwent S-LOT or LOT as a sole procedure and followed for 2 or more months in this retrospective study. For cases of S-LOT which were unable to pass through 360 degree we incised the trabecular meshwork as possible by suture or metal trabeculotome. We investigated IOP, number of antiglaucoma medication (eye drops: 1 point, internal use: 2 points) and complications in the survey periods. Surgery was deemed to have failed when the IOP of the operated eye was 18 mmHg or more at any two consecutive follow-up examinations or when the patient required a trabeculectomy during the observation period.
111 eyes of 97 Japanese glaucoma patients were included in this study. S-LOT was performed on 79 eyes and LOT wad performed on 32 eyes. The mean preoperative IOP values (the mean number of antiglaucoma medications) were 31.6±8.8mmHg (4.0±1.4) in S-LOT group and 32.8±9.3mmHg (4.3±1.3) in LOT group, respectively. The mean postoperative IOP values (the mean numbers of antiglaucoma medications) at 12 months was 13.9±3.9mmHg (0.9±1.3) in the S-LOT group and 17.5±11.5mmHg (1.2±1.3) in the LOT group. Kaplan-Meier survival analysis showed that survival rates at 12 months were 71.4% in the S-LOT group and 54.8% in the LOT group, respectively. Log rank test showed there was a significant difference between two groups (P<0.05). 14 eyes (17.7%) in S-LOT group and 9 eyes (28.1%) in LOT group underwent additional trabeculectomies because of the inadequate IOP reductions. Transient IOP elevations above 30mmHg occurred more frequently in LOT group (20 eyes, 62.5%) than in S-LOT group (21 eyes, 26.6%) (P<0.001).Other complications included hyphema in 76 eyes(96.2%) and 24 eyes(75.0%), and Descemet's membrane detachment in4 eyes(5.1%) and 1eye(3.1%) and malignant glaucoma in 0 eye(0%) and 1 eye(3.1%) , respectively, after S-LOT and LOT.
S-LOT had a higher success rate compared to LOT.<br />
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