Abstract:AIM: To investigate the efficacy and safety of 90° inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).
METHODS: This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023, and 45 eyes underwent goniotomy combined with phacoemulsification, and 15 eyes underwent goniotomy as a stand-alone procedure. Postoperatively, intraocular pressure(IOP)and the number of medications were collected at 1, 3, 6, and 12 mo. The side effects of surgery were recorded 1 d, 1 wk, and 1, 3, 6, and 12 mo postoperatively. The primary outcomes were a reduction in IOP of at least 20% from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively. The secondary outcome was surgical success, defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.
RESULTS: At the end of 1 a, 78% of patients achieved both a >20% reduction in IOP and a reduction in the number of medications used. Overall success was achieved in 63% of patients. Microhyphaema was the most common complication, none of the patients experienced a complication requiring surgical intervention.
CONCLUSION: Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG, and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.
