Circumferential (360°) trabeculotomy for steroid-induced glaucoma in adults

Purpose To evaluate the safety and efficacy of 360° circumferential trabeculotomy (TO) for steroid induced glaucoma (SIG) of short duration. Methods Retrospective analysis of surgical results of 46 eyes of 35 patients undergoing microcatheter-assisted TO. All eyes had high intraocular pressure for a...

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Published in:Graefe's archive for clinical and experimental ophthalmology 2023-07, Vol.261 (7), p.1987-1994
Main Authors: van Rijn, Laurentius J. (René), Eggink, Catharina A., Janssen, Sarah F.
Format: Article
Language:English
Subjects:
Eye
Glaucoma
Medicine
Medicine & Public Health
Ophthalmology
Steroid hormones
Steroids
Surgery
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container_end_page 1994
container_issue 7
container_start_page 1987
container_title Graefe's archive for clinical and experimental ophthalmology
container_volume 261
creator van Rijn, Laurentius J. (René)
Eggink, Catharina A.
Janssen, Sarah F.
description Purpose To evaluate the safety and efficacy of 360° circumferential trabeculotomy (TO) for steroid induced glaucoma (SIG) of short duration. Methods Retrospective analysis of surgical results of 46 eyes of 35 patients undergoing microcatheter-assisted TO. All eyes had high intraocular pressure for at most about 3 years due to steroid use. Follow-up was between 2.63 and 47.9 months (mean 23.9, median 25.6). Results Intraocular pressure (IOP) before surgery was 30.8 ± 8.3 mm Hg, with 3.8 ± 1.0 pressure-lowering medications. After 1 to 2 years, mean IOP was 11.2 ± 2.6 mm Hg ( n  = 28); mean number of IOP-lowering medications was 0.9 ± 1.3. At their last follow-up, 45 eyes had an IOP 
doi_str_mv 10.1007/s00417-023-06012-5
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(René) ; Eggink, Catharina A. ; Janssen, Sarah F.</creator><creatorcontrib>van Rijn, Laurentius J. (René) ; Eggink, Catharina A. ; Janssen, Sarah F.</creatorcontrib><description>Purpose To evaluate the safety and efficacy of 360° circumferential trabeculotomy (TO) for steroid induced glaucoma (SIG) of short duration. Methods Retrospective analysis of surgical results of 46 eyes of 35 patients undergoing microcatheter-assisted TO. All eyes had high intraocular pressure for at most about 3 years due to steroid use. Follow-up was between 2.63 and 47.9 months (mean 23.9, median 25.6). Results Intraocular pressure (IOP) before surgery was 30.8 ± 8.3 mm Hg, with 3.8 ± 1.0 pressure-lowering medications. After 1 to 2 years, mean IOP was 11.2 ± 2.6 mm Hg ( n  = 28); mean number of IOP-lowering medications was 0.9 ± 1.3. At their last follow-up, 45 eyes had an IOP &lt; 21 mm Hg, and 39 eyes had an IOP &lt; 18 mm Hg with or without medication. After 2 years, the estimated probability of having an IOP below 18 mm Hg (with or without medication) was 85 ± 6%, and the estimated probability of not using medication was 56 ± 7%. Steroid response was no longer present in all eyes receiving steroids after surgery. Minor complications consisted of hyphema, transient hypotony, or hypertony. One eye proceeded to receiving a glaucoma drainage implant. Conclusion TO is particularly effective in SIG with relative short duration. This concurs with the pathophysiology of the outflow system. This procedure seems particularly suited for eyes for which target pressures in the mid-teens are acceptable, particularly when chronic use of steroids is necessary .</description><identifier>ISSN: 0721-832X</identifier><identifier>EISSN: 1435-702X</identifier><identifier>DOI: 10.1007/s00417-023-06012-5</identifier><identifier>PMID: 36802230</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Eye ; Glaucoma ; Medicine ; Medicine &amp; Public Health ; Ophthalmology ; Steroid hormones ; Steroids ; Surgery</subject><ispartof>Graefe's archive for clinical and experimental ophthalmology, 2023-07, Vol.261 (7), p.1987-1994</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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(René)</creatorcontrib><creatorcontrib>Eggink, Catharina A.</creatorcontrib><creatorcontrib>Janssen, Sarah F.</creatorcontrib><title>Circumferential (360°) trabeculotomy for steroid-induced glaucoma in adults</title><title>Graefe's archive for clinical and experimental ophthalmology</title><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><description>Purpose To evaluate the safety and efficacy of 360° circumferential trabeculotomy (TO) for steroid induced glaucoma (SIG) of short duration. Methods Retrospective analysis of surgical results of 46 eyes of 35 patients undergoing microcatheter-assisted TO. All eyes had high intraocular pressure for at most about 3 years due to steroid use. Follow-up was between 2.63 and 47.9 months (mean 23.9, median 25.6). Results Intraocular pressure (IOP) before surgery was 30.8 ± 8.3 mm Hg, with 3.8 ± 1.0 pressure-lowering medications. After 1 to 2 years, mean IOP was 11.2 ± 2.6 mm Hg ( n  = 28); mean number of IOP-lowering medications was 0.9 ± 1.3. At their last follow-up, 45 eyes had an IOP &lt; 21 mm Hg, and 39 eyes had an IOP &lt; 18 mm Hg with or without medication. After 2 years, the estimated probability of having an IOP below 18 mm Hg (with or without medication) was 85 ± 6%, and the estimated probability of not using medication was 56 ± 7%. Steroid response was no longer present in all eyes receiving steroids after surgery. Minor complications consisted of hyphema, transient hypotony, or hypertony. One eye proceeded to receiving a glaucoma drainage implant. Conclusion TO is particularly effective in SIG with relative short duration. This concurs with the pathophysiology of the outflow system. 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(René)</au><au>Eggink, Catharina A.</au><au>Janssen, Sarah F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Circumferential (360°) trabeculotomy for steroid-induced glaucoma in adults</atitle><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle><stitle>Graefes Arch Clin Exp Ophthalmol</stitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>261</volume><issue>7</issue><spage>1987</spage><epage>1994</epage><pages>1987-1994</pages><issn>0721-832X</issn><eissn>1435-702X</eissn><abstract>Purpose To evaluate the safety and efficacy of 360° circumferential trabeculotomy (TO) for steroid induced glaucoma (SIG) of short duration. Methods Retrospective analysis of surgical results of 46 eyes of 35 patients undergoing microcatheter-assisted TO. All eyes had high intraocular pressure for at most about 3 years due to steroid use. Follow-up was between 2.63 and 47.9 months (mean 23.9, median 25.6). Results Intraocular pressure (IOP) before surgery was 30.8 ± 8.3 mm Hg, with 3.8 ± 1.0 pressure-lowering medications. After 1 to 2 years, mean IOP was 11.2 ± 2.6 mm Hg ( n  = 28); mean number of IOP-lowering medications was 0.9 ± 1.3. At their last follow-up, 45 eyes had an IOP &lt; 21 mm Hg, and 39 eyes had an IOP &lt; 18 mm Hg with or without medication. After 2 years, the estimated probability of having an IOP below 18 mm Hg (with or without medication) was 85 ± 6%, and the estimated probability of not using medication was 56 ± 7%. Steroid response was no longer present in all eyes receiving steroids after surgery. Minor complications consisted of hyphema, transient hypotony, or hypertony. One eye proceeded to receiving a glaucoma drainage implant. Conclusion TO is particularly effective in SIG with relative short duration. This concurs with the pathophysiology of the outflow system. 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subjects Eye
Glaucoma
Medicine
Medicine & Public Health
Ophthalmology
Steroid hormones
Steroids
Surgery
title Circumferential (360°) trabeculotomy for steroid-induced glaucoma in adults
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