A novel technique of ab interno glaucoma surgery: follow-up results after 24 months.
OBJECTIVE
It was the aim of this study to investigate the efficacy, longevity, and safety of a new ab interno intervention for the treatment of primary open-angle glaucoma (POAG).


METHODS
The previously described method of radiofrequency-mediated "sclerothalamotomy ab interno" was applied in 53 eyes of consecutive patients with POAG between April 2002 and July 2002. Average preoperative intraocular pressure (IOP) was 25.6+/-2.3 mmHg (range 18-48 mmHg). Sclerothalamotomies were carried out with a custom-made high-frequency dissection 19 G probe (tip 0.3 x 1 mm) applying bipolar current with a frequency of 500 kHz (tip temperature 130 degrees C).


RESULTS
After a follow-up period of 24 months, the average IOP was 15.0+/-1.6 mmHg (range 11-20 mmHg) (p<0.005). The average number of topical agents was 2.6+/-1.0 (range 1-5) preoperatively. Twenty-four months after surgery such agents were used in only five (9.6%) eyes and the average was 0.21+/-0.53 (range 0-2). Transient IOP elevation was observed in 12 of 53 eyes (22.6%) postoperatively. In all cases elevated IOP could efficiently be controlled with topical medication. In general, IOP dropped continuously over the course of the 6 months following surgery and then remained constant.


CONCLUSIONS
This study indicates that sclerothalamotomy ab interno is a safe and efficient surgical method for the treatment of POAG. Long-term results clearly demonstrate the longevity of IOP reduction.
Pajic
Bojan
B
Department of Ophthalmology, Klinik Pallas, 4600 Olten, Switzerland. bpajic@datacomm.ch
Pallas
Grigoris
G
Gerding
Heinrich
H
Heinrich
Gerding
G
Böhnke
Matthias
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000867:Anterior Chamber / Q000601:surgery; D002648:Child; D003972:Diathermy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D012590:Sclera / Q000601:surgery; D013552:Swine; D016896:Treatment Outcome