Abstract:AIM: To evaluate the efficacy and safety of ab-externo microcatheter-guided 360° or 120° trabeculotomy combined with peripheral iridectomy in lowering intraocular pressure(IOP), reducing the need for antiglaucoma medications, and improving clinical outcomes in patients with open angle glaucoma(OAG).
METHODS:This retrospective study included 55 patients with OAG who underwent the procedure in the Enshi region between October 2019 and March 2024. Follow-up examinations were conducted at 1, 3, 6, and 12 mo postoperatively to record IOP, best-corrected visual acuity(BCVA), use of anti-glaucoma medications, and postoperative complications. The primary outcome measures were changes in IOP before and after surgery and surgical success rates(complete success: IOP ≤18 mmHg without medication; partial success: IOP ≤18 mmHg with medication).
RESULTS:The mean preoperative IOP was 26.7±4.4 mmHg. Postoperatively, the IOP showed a continuous decreasing trend at 1, 3, 6, and 12 mo, with all time points demonstrating a significant reduction compared with baseline(all P<0.001). At 12 mo postoperatively, the complete success rate was 62%, and the partial success rate was 38%. The use of anti-glaucoma medications was significantly reduced, with most patients maintaining target IOP without pharmacological assistance at 12 mo. No significant difference was observed in BCVA between preoperative and 12-month postoperative assessments(P=0.19). The most common postoperative complication was transient hyphema(20%), which resolved spontaneously within 1 wk, and no severe complications were observed.
CONCLUSION: Ab-externo microcatheter-guided 360° or 120° trabeculotomy combined with peripheral iridectomy significantly lowers IOP, reduces medication dependence, and demonstrates a high safety profile, making it an effective and reliable surgical option for patients with OAG.
