Abstract
Purpose :
This study aims to compare the surgical efficacy and safety of the Tanito microhook trabeculotomy (TMH-CE) and iStent inject W (Inject-CE) when performed in combination with cataract surgery on the eyes of glaucoma patients
Methods :
A comprehensive retrospective analysis was conducted on a total of 78 eyes affected by glaucoma from 39 participants. Various parameters, including intraocular pressure (IOP), the count of antiglaucoma medications, best-corrected visual acuity (BCVA), anterior chamber flare (ACF), and corneal endothelial cell density (CECD), were assessed both before the surgery and at multiple time points following the procedure.The severity of each hyphema was estimated and given an R score according to the Shimane University Hyphema Scoring System (SU-R).This system, which is specifically designed to classify postoperative hyphema, categorizes the floating red blood cells (RBCs).
Results :
Before surgery, the intraocular pressure (IOP) was notably higher in the TMH-CE group (19.6 ± 6.7 mmHg) compared to the Inject-CE group (15.7 ± 3.8 mmHg) (p < 0.0001). At the 12-month follow-up, the TMH-CE group exhibited more substantial reductions in IOP and the number of medications (6.6 mmHg, 27.6%, and -1.1, respectively) compared to the Inject-CE group (2.7 mmHg, 12.4%, and -0.7, respectively) (p < 0.0001 and p = 0.0034). However, at this follow-up point, IOP and medication-number levels were statistically equivalent between the TMH-CE (13.0 ± 3.3 mmHg and 1.3 ± 0.9, respectively) and Inject-CE (12.9 ± 2.6 mmHg and 1.9 ± 0.9, respectively) groups (p = 0.88 and p > 0.99, respectively). The TMH-CE group exhibited a higher ACF, a higher frequency of layered hyphema, and a greater anterior chamber floating red blood cells score in the early postoperative periods. Despite these differences, the changes in BCVA, ACF, and CECD were equivalent between the two groups in later follow-up periods.
Conclusions :
The achieved IOP levels were identical between both procedures in the fellow-eye comparison. This study highlights the clinical efficacy of the TMH during cataract surgery for reducing IOP as well as early postoperative recovery of vision after the iStent inject W implantation during cataract surgery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.