Surgical effects of combined trabeculotomy and sinusotomy compared to trabeculotomy alone.
OBJECTIVE
To elucidate long-term surgical results and problems of combined trabeculotomy and sinusotomy in comparison with trabeculotomy alone.


METHODS
The study included 91 glaucomatous eyes in 57 patients with primary open angle glaucoma, who underwent either combined trabeculotomy and sinusotomy (40 eyes) or trabeculotomy alone (51 eyes). The mean follow-up period (+/-standard deviation) was 46.1+/-10.4 months (range: 30 to 60 months).


RESULTS
At the final examination, in 37 (93%) of the 40 eyes after combined trabeculotomy and sinusotomy and in 40 (78%) of the 51 eyes after trabeculotomy alone, intraocular pressures were well controlled. The mean intraocular pressures at the end of the first postoperative year were 15.6+/-3.0 mmHg in the 40 eyes after the combined procedure, and 17.8+/-3.1 mmHg in the 51 eyes after trabeculotomy alone (p=0.0001, unpaired t-test). Complications included Descemet's membrane detachment in 1 eye (3%) and 4 eyes (8%), and transient elevation of intraocular pressure to higher than 30 mmHg (IOP spike) in 6 eyes (15%) and 11 eyes (22%), respectively, after the combined procedure and trabeculotomy alone.


CONCLUSIONS
Combined trabeculotomy and sinusotomy is a useful surgical modality for the treatment of primary open angle glaucoma to obtain lower intraocular pressure levels than those after trabeculotomy alone.
Mizoguchi
T
T
Nagata Eye Clinic, Japan.
Nagata
M
M
Matsumura
M
M
Kuroda
S
S
Terauchi
H
H
Tanihara
H
H
D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013524:Surgical Flaps; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy; D014792:Visual Acuity