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Yuta Kitamura, Shuichi Yamamoto, Suguru Shirato; Outcomes of 360-degree suture trabeculotomy with deep sclerectomy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4934.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the surgical outcomes of 360-degree suturetrabeculotomy with deep sclerectomy (S-LOTDS) on eyes with different types of glaucoma.
This was a retrospective study of 20 eyes of 18 cases that underwent S-LOTDS at the Chiba University Hospital between July 2012 through October 2015. The postoperative follow-up period was 12 months. The outcome measures were the surgical success rate, the mean postoperative intraocular pressure (IOP), the mean number of anti-glaucoma medications, and the surgical complications. When the suture did not pass through the entire circumference, the trabecular meshwork was incised as much as possible by suture or metal trabeculotomy.
There were 14 men and 4 women whose mean age at the time of surgery was 66.4±16.7 years. The subtypes of glaucoma were; exfoliation glaucoma (12 eyes), primary open-angle glaucoma (5 eyes), and steroid-induced glaucoma (3 eyes). Nine eyes had cataract surgery during the S-LOTDS. The mean preoperative IOP was 26.4±5.9 mmHg, and the mean postoperative IOPs after 1, 3, 6, and 12 months were 16.4±9.5 mmHg, 12.2±2.9 mmHg, 13.3±2.8 mmHg, and 12.6±3.1 mmHg, respectively. The mean preoperative number of anti-glaucoma medications was 4.9±1.3, and the mean postoperative numbers of anti-glaucoma medications after 1, 3, 6, and 12 months were 1.7± 2.4, 1.1±1.9, 0.9±1.6, and 1.0± 1.5, respectively. The mean extent of the incision was 339 degrees. When the surgical success was defined as an IOP less than 15 mmHg or 18 mmHg at 12 months, the surgical success rate was 75% and 95%, respectively. The complications included hyphema in all eyes (100%) and a transient elevation of the IOP above 30 mmHg within one month after the surgery in 8 eyes (40%).
Although a transient elevation of the IOP occurred in 40% of the cases, S-LOTDS is an effective surgical option for lowering the IOP to under 15 mmHg.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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