Kaushik Sushmita, Singh Ashok K, Thattaruthody Faisal, Chaudhary Sandeep, Sardana Manik, Raj Srishti, Pandav Surinder S
Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Ophthalmol. 2025 Aug 1;73(8):1190-1195. doi: 10.4103/IJO.IJO_2622_24. Epub 2025 Jul 28.
To study 1-year outcomes of bent ab-interno needle goniectomy (BANG) with phacoemulsification in patients across the glaucoma spectrum.
This Prospective, noncomparative interventional study enrolled primary glaucoma patients (open-angle and angle-closure) with medically controlled intraocular pressure (IOP) and visually significant cataracts who underwent clear corneal phacoemulsification with intraocular lens placement combined with BANG using a 25-gauge needle bent as a reverse cystitome. Patients completing a minimum 1-year post-surgical follow-up were analyzed. The primary outcome was the change in antiglaucoma medications (AGM) required after surgery. Complete and qualified success was defined as IOP between 6 and 21 mm Hg without and with up to two topical AGMs.
Thirty eyes of 30 patients with a mean age of 60.5 ± 10.3 years were analyzed. The mean baseline IOP was 15.3 ± 3.6 mmHg, and the mean number of topical AGM was 2.6 ± 1.3. Ten patients were on systemic acetazolamide. The topical AGM requirement decreased to 0.60 ± 0.99 (P < 0.0001) and 0.87 ± 1.02 (P < 0.0001) at 6 months and 1 year, respectively. The mean IOP decreased to 13.57 ± 2.79 (P = 0.028) and 14.43 ± 2.92 mmHg (P = 0.11) at 6 months and 1 year, respectively. No patient required oral acetazolamide at the 6-month and 1-year follow-up after surgery. At 1-year, complete and qualified success was seen in 14 eyes each. Six eyes (20%) had an episode of a transient IOP spike, which resolved in 2 weeks, and one eye had hyphema, which resolved by the fourth day. There were no serious complications.
Phacoemulsification with BANG is an effective and safe procedure for reducing the medication burden in patients with primary glaucoma.
研究不同类型青光眼患者行内翻式弯针房角切除术（BANG）联合白内障超声乳化吸除术的1年疗效。
这项前瞻性、非对照性干预研究纳入了原发性青光眼患者（开角型和闭角型），这些患者眼压经药物控制，且患有具有明显视觉影响的白内障，他们接受了透明角膜白内障超声乳化吸除联合人工晶状体植入术，并使用弯成反向囊膜切开刀的25G针头进行BANG手术。对完成至少1年术后随访的患者进行分析。主要结局指标为术后所需抗青光眼药物（AGM）的变化。完全成功和合格成功定义为眼压在6至21 mmHg之间，且无需使用局部AGM或最多使用两种局部AGM。
分析了30例患者的30只眼，平均年龄为60.5±10.3岁。平均基线眼压为15.3±3.6 mmHg，局部AGM平均使用数量为2.6±1.3种。10例患者使用全身乙酰唑胺。局部AGM的需求在6个月和1年时分别降至0.60±0.99（P<0.0001）和0.87±1.02（P<0.0001）。平均眼压在6个月和1年时分别降至13.57±2.79（P = 0.028）和14.43±2.92 mmHg（P = 0.11）。术后6个月和1年随访时，无患者需要口服乙酰唑胺。1年时，14只眼达到完全成功和合格成功。6只眼（20%）出现短暂眼压峰值，在2周内消退，1只眼出现前房积血，在第4天消退。无严重并发症。
BANG联合白内障超声乳化吸除术是减轻原发性青光眼患者药物负担的一种有效且安全的手术方法。
