Abstract
Purpose :
To evaluate the effectiveness and safety of 120-degree (nasal) versus 240-degree (bilateral) incisions in the context of Tanito Microhook Trabeculotomy (TMH) when combined with cataract surgery in treating patients with open-angle glaucoma.
Methods :
A retrospective selection of participants was conducted based on specific criteria: surgeries done by the same surgeon (M.T.) at Shimane University Hospital from April 2018 to August 2021, inclusion of patients who underwent both TMH and cataract surgeries, and diagnosis of primary open-angle glaucoma or exfoliation glaucoma without any previous intraocular or glaucoma surgeries, with a minimum of 12 months postoperative follow-up. From 185 eyes, 67 were chosen for each incision group, with propensity score matching for age, sex, type of glaucoma, and preoperative intraocular pressure (IOP). The Shimane University Postoperative Hyphema Scoring system was applied for hyphema severity assessment.
Results :
Initially, both groups had a preoperative IOP of 18.6 mmHg, which dropped to 13.2 mmHg in the nasal group and to 12.8 mmHg in the bilateral group after 12 months, a decrease of 29% and 31%, respectively. Medication scores also showed a reduction, from 3.4 to 2.7 in the nasal group and from 3.1 to 2.5 in the bilateral group. A notable observation was the significantly higher hyphema red blood cell score in the bilateral group as compared to the nasal group. Other factors like IOP, medication score, visual acuity, anterior chamber flare, corneal endothelial cell density, visual field mean deviation, and other surgical complication frequencies remained comparable between the groups throughout the study.
Conclusions :
TMH in conjunction with cataract surgery maintains similar levels of effectiveness and safety, irrespective of the incision size. However, the use of narrower incisions was associated with lesser early postoperative hyphema.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.