Micro-invasive suture trabeculotomy after canaloplasty: preliminary results

• Published in: Clinical & experimental ophthalmology 2015-07, Vol.43 (5), p.409-414
• Main Authors: Voykov, Bogomil, Szurman, Peter, Dimopoulos, Spyridon, Ziemssen, Focke, Alnahrawy, Omar
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Female; Glaucoma; glaucoma incisional surgery; Glaucoma, Open-Angle - physiopathology; Glaucoma, Open-Angle - surgery; Humans; Intraocular Pressure - drug effects; Intraocular Pressure - physiology; Limbus Corneae - surgery; Male; Microsurgery; Middle Aged; new treatments; Postoperative Complications; Retrospective Studies; Suture Techniques; Trabeculectomy - methods; Visual Acuity - physiology
• ISSN: 1442-6404; 1442-9071
• DOI: 10.1111/ceo.12482

Background In this study, a conjunctival‐sparing ab interno approach for circumferential trabeculotomy, termed micro‐invasive suture trabeculotomy (MIST) and its preliminary results are presented. Design Retrospective case‐series in a university setting. Participants A total of 31 patients with open‐angle glaucoma with history of canaloplasty. Methods A conjunctival‐sparing ab interno approach for circumferential trabeculotomy, termed MIST. Main Outcome Measures Mean decrease of intraocular pressure (IOP) and number of pressure‐lowering medications. Results Mean decrease of IOP was 11.1 mmHg (standard deviation [SD], 9.9 mmHg) at 6 months, 12.1 mmHg (SD, 10.5 mmHg) at 12 months and 13.5 mmHg (SD, 11.4 mmHg) at 24 months. The average percent lowering of IOP was 36.7% (SD, 32.8%) at 6 months, 41.4% (SD, 35.9%) at 12 months and 44.6% (SD, 37.7%) at 24 months. The number of pressure‐lowering medications decreased by 1.1 (SD, 1.3) at month 6, by 1.2 (SD, 1.5) at month 12, and by 1.3 (SD, 1.6) at month 24. Conclusions MIST is a promising approach for the treatment of open‐angle glaucoma, which is insufficiently controlled with canaloplasty. The procedure achieved significant and sustained lowering of the intraocular pressure and demonstrated an excellent safety profile. The main advantages of the procedure are: easy to learn, fast to perform, and sparing of the conjunctiva for further filtration surgery, if necessary.