Prospective, noncomparative, nonrandomized case study of short-term outcomes of 360° suture trabeculotomy ab interno in patients with open-angle glaucoma

Figures & data

Figure 1 The 360° suture trabeculotomy ab interno procedure.

Notes: (A) 1.7 mm temporal corneal incision, (B) nasal-side Schlemm’s canal incision using a Trabectome, (C) insertion of a 5-0 nylon suture into the exposed Schlemm’s canal, (D) clasp suture emerging on opposite side, and (E, F) removal of suture from same corneal opening, completing the 360° Schlemm’s canal incision.

Table 1 Preoperative characteristics of patients

Sex (male to female)	3:9
Age (years)	70.8±8.1 (60–89)
Subtype of glaucoma (POAG to XFG)	8:4
Mean preoperative IOP (mmHg)	19.4±2.5 (15.3–24.0)
Mean number of anti-glaucoma medications	3.2±0.8 (2–4)
Mean deviation (dB) in Humphrey	−8.5±4.9 (−1.05, −15.4)
Cup/disc ratio	0.78±0.15
Mean preoperative best-corrected visual acuity (logMAR)	0.06±0.16 (−0.08, −0.52)
History of cataract surgery (%)	3 (25.0%)
Follow-up period (months)	5.5±0.9 (3–6)

Note: Continuous data are expressed as the mean ± standard deviation (range).

Abbreviations: POAG, primary open-angle glaucoma; XFG, exfoliation glaucoma; IOP, intraocular pressure; logMAR, logarithm of the minimum angle of resolution.

Table 2 Course of IOP and reduction of IOP from baseline

Time after surgery	IOP (mmHg) reduction (from baseline, %)	P-value*	Eyes (n)
Preoperatively	19.4±2.5		12
1 D	14.4±6.3 (−27.0±24.6)	0.0041	12
1 W	21.5±13.3 (12.2±70.5)	0.5902	12
2 W	17.5±8.2 (−9.9±42.9)	0.4315	12
1 M	13.3±3.3 (−30.9±16.6)	<0.0001	12
2 M	13.3±2.5 (−30.9±11.5)	<0.0001	12
3 M	14.7±3.6 (−23.0±22.9)	0.0030	12
4 M	14.1±2.7 (−26.7±12.8)	<0.0001	11
5 M	14.0±2.8 (−26.9±15.4)	0.0002	11
6 M	13.8±2.7 (−30.5±12.3)	0.0004	8

Notes: Continuous data were expressed as mean ± standard deviation.

* P-value compared with preoperative IOP using the paired t-test.

Abbreviations: IOP, intraocular pressure; D, day; W, week; M, month.

Table 3 Number of anti-glaucoma medications

Time after surgery	Anti-glaucoma medications (n)	P-value*	Eyes (n)
Preoperatively	3.2±0.8		12
1 M	0.7±1.0	<0.0001	12
2 M	0.6±0.9	<0.0001	12
3 M	0.6±0.9	<0.0001	12
4 M	0.7±1.0	<0.0001	11
5 M	0.9±1.0	<0.0001	11
6 M	1.1±1.4	0.0002	8

Notes: Continuous data are expressed as the mean ± standard deviation.

* P-value compared with preoperative number of anti-glaucoma medications using Wilcoxon signed-rank test.

Abbreviation: M, month/months.

Table 4 Intraoperative and postoperative complications with the 360° suture trabeculotomy ab interno procedure

	Patients, n (%)
Intraoperative
Anterior chamber hemorrhage	12 (100)
Anterior chamber flattening	0 (0)
Descemet’s membrane detachment	0 (0)
Cyclodialysis	0 (0)
Iris injuries	0 (0)
Postoperative
Hyphema	8 (67)
IOP spike (≥30 mmHg)	3 (25)
Hypotony (<5 mmHg)	0 (0)
Peripheral anterior synechia	3 (25)
Endothelium cell loss ≥10%	0 (0)
Anterior chamber lavage	0 (0)
Infection	0 (0)
Wound leaks	0 (0)
BCVA decrease by 2 or more lines due to cataract	2 (17)
Procedure failure	1 (8)

Abbreviations: BCVA, best-corrected visual acuity; IOP, intraocular pressure.