Abstract
Purpose :
Postoperative peripheral anterior synechiae (PAS) formation after microhook ab-interno trabeculotomy (µLOT), a minimally invasive glaucoma surgery (MIGS) procedures is not well studied; however, it could potentially reduce the surgical effectiveness. Additionally, the investigation would contribute to a better understanding of outcomes of trabeculotomy-related surgeries. Therefore, the purpose of the current study was to investigate the characteristics of PAS formation after µLOT with a 360-degree gonio-camera, gonioscope GS-1 (NIDEK Co., Gamagori, Japan).
Methods :
Consecutive one hundred five eyes of 75 subjects with open-angle glaucoma were analyzed; the eyes had undergone µLOT or combined µLOT and cataract surgery as an initial glaucoma surgery. Postsurgical PAS formations were evaluated in 16 iridocorneal angle images with the best focus covering 360 degrees in each eye.
Results :
Compared to baseline, at 225±226 days postoperatively, the intraocular pressure and number of antiglaucoma medications decreased significantly (P<0.01, respectively). PAS formed in 86% of the eyes. The mean number of iridocorneal angle images in all eyes that exhibited PAS was 4.1 (26%) in the total circumference, 3.1 (39%) within the µLOT incision, and 1.0 (13%) outside of the µLOT incision; the rate was significantly higher within the incision than outside of the incision (P<0.01). Moreover, the higher PAS rate in total and that within the incision had the possible association with later postoperative days (P<0.01, respectively); that outside of the incision had the possible associations with µLOT alone rather than combined surgery, and with shallower preoperative central anterior chamber depth (P<0.05, respectively), which were calculated by the mixed-effect model.
Conclusions :
We could have performed the detailed observation of PAS formation after µLOT with 360-degree gonio-images, and the formation rate was significantly higher within the µLOT incision. The PAS within and outside of the incision would have different causes.
This is a 2021 ARVO Annual Meeting abstract.