Department of Ophthalmology, Cumhuriyet University Medical School, Sivas.
Department of Ophthalmology, Erzurum Regional Training and Research Hospital, Erzurum.
J Glaucoma. 2020 Nov;29(11):1088-1094. doi: 10.1097/IJG.0000000000001627.
Ab interno (gonioscopy-assisted transluminal trabeculotomy) and ab externo 360-degree suture trabeculotomy (ST) achieved similar success rates for reducing intraocular pressure (IOP) without serious complications threatening visual acuity.
We aimed to compare the efficacy of ab externo and ab interno 360-degree ST in reducing IOP, decreasing the number of antiglaucoma medications required, and decreasing the rates of intraoperative/postoperative complications in adults with open-angle glaucoma (OAG).
This retrospective study included 33 eyes of 33 patients who underwent ab externo 360-degree ST (group 1) and 23 eyes of 23 patients who underwent ab interno 360-degree ST for OAG (group 2). We analyzed demographics as well as preoperative and postoperative (1, 3, 6, and 12 mo) data related to IOP, the number of antiglaucoma medications, complications, and surgical success rates.
In group 1, the mean IOP was 26.2±10.4 mm Hg, and the mean number of antiglaucoma medications was 3.2±1.0 preoperatively, decreasing to 11.2±3.0 mm Hg and 0.1±0.4 at 12 months, respectively (P<0.001, <0.001). In group 2, the mean IOP was 28.3±10.4 mm Hg, and the mean number of antiglaucoma medications was 3.5±0.9 preoperatively, decreasing to 13.3±6.5 mm Hg and 0.8±1.0 at 12 months, respectively (P<0.001, <0.001). Decreases in IOP at 6 and 12 months were similar in groups 1 and 2 (50% vs. 47%, P=0.6; and 51% vs. 49%, P=0.7, respectively). At 12 months, complete and qualified success rates were 88% and 97% for group 1 and 57% and 87% for group 2, respectively. The most common complications in both groups were hyphema and transient IOP spikes.
Ab interno 360-degree ST is similar to ab externo 360-degree ST in terms of safety and efficacy in patients with OAG.
内路（房角镜辅助经巩膜小梁切开术）和外路 360 度缝线小梁切开术（ST）在降低眼压（IOP）方面成功率相似，且没有严重威胁视力的并发症。
我们旨在比较外路和内路 360 度 ST 在降低开角型青光眼（OAG）成人的眼压、减少抗青光眼药物的使用数量以及降低术中/术后并发症发生率方面的疗效。
这项回顾性研究纳入了 33 只眼的 33 例接受外路 360 度 ST 治疗的患者（第 1 组）和 23 只眼的 23 例接受内路 360 度 ST 治疗的患者（第 2 组）。我们分析了人口统计学资料以及与眼压、抗青光眼药物使用数量、并发症和手术成功率相关的术前和术后（1、3、6 和 12 个月）数据。
第 1 组的平均眼压为 26.2±10.4mmHg，术前平均抗青光眼药物使用数量为 3.2±1.0 种，分别降至 12 个月时的 11.2±3.0mmHg 和 0.1±0.4 种（P<0.001，<0.001）。第 2 组的平均眼压为 28.3±10.4mmHg，术前平均抗青光眼药物使用数量为 3.5±0.9 种，分别降至 12 个月时的 13.3±6.5mmHg 和 0.8±1.0 种（P<0.001，<0.001）。第 1 组和第 2 组在 6 个月和 12 个月时的眼压下降率相似（50%比 47%，P=0.6；51%比 49%，P=0.7）。在 12 个月时，第 1 组的完全成功率和合格成功率分别为 88%和 97%，第 2 组分别为 57%和 87%。两组最常见的并发症均为前房积血和短暂性眼压升高。
内路 360 度 ST 在安全性和疗效方面与外路 360 度 ST 相似，适用于 OAG 患者。
