title: [Long-term surgical results of initial trabeculotomy combined with sinusotomy performed inferiorly].
abstract: OBJECTIVE
  To evaluate retrospectively the long-term effects of initial trabeculotomy combined with sinusotomy performed inferiorly.
  
  
  METHODS
  Enrolled were 128 eyes of 100 patients who received initial glaucoma surgery. In 36 eyes, the removal of Schlemm's canal endothelium was also performed (removed group). The results were compared with the intact group
  
  
  RESULTS
  In the primary open angle glaucoma (POAG), mean intraocular pressure (IOP) at 3 years after surgery was 14.6 (intact) and 15.4 mmHg (removed). Kaplan-Meier life-table analysis showed that qualified success rates for the intact group at 8 years were 62.2% and for the removed group at 5 years 45.2% defined by 20 mmHg or lower. The results in developmental glaucoma (DG) were similar to those in POAG. No statistical differences in postoperative IOP between the intact and removed groups were seen in either POAG or DG. In exfoliation glaucoma (XFG), mean IOPs for the intact group at 3 years were 17.3 mmHg and for the removed group at 2 years 15.4 mmHg. The success rates for the intact group at 3.5 years were 25.2% and for the removed group at 4.5 years 64.3%. The results in the intact group were worse than in the POAG patients. Although visual disturbance was seen in 13% of the patients, the major cause was the progression of the cataracts.
  
  
  CONCLUSIONS
  The long-term results were the same as those of previous reports on surgery performed superiorly, including the frequency of visual disturbance. However the removal of Schlemm's canal endothelium is necessary in XFG for better IOP control.
authors.affiliation: Department of Ophthalmology, Kansai Medical University Hirakata Hospital, Japan. nambuh@hirakata.kmu.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nambu
authors.forename: Nobuo
authors.initials: N
authors.lastname: Jo
authors.forename: Maki
authors.initials: M
authors.lastname: Kuro
authors.forename: Keizo
authors.initials: K
authors.lastname: Minamino
authors.forename: Akira
authors.initials: A
authors.lastname: Ando
authors.forename: Rie
authors.initials: R
authors.lastname: Nambu
authors.forename: Miyo
authors.initials: M
authors.lastname: Matsumura
authors.forename: Kanji
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D004728:Endothelium, Corneal / Q000601:surgery; D005901:Glaucoma / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053208:Kaplan-Meier Estimate; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014130:Trabeculectomy; D016896:Treatment Outcome