Comparison of ab externo trabeculotomy in primary open-angle glaucoma and uveitic glaucoma: long-term outcomes.
BACKGROUND
The aim of this study was to compare the long-term outcomes of ab externo trabeculotomy in primary open-angle glaucoma (POAG) and uveitic glaucoma (UG).


METHODS
This was a retrospective single-center case series study.


METHODS
Twenty eyes of 17 patients with POAG and 22 eyes of 18 patients with UG were included in this study.


METHODS
The medical records of all consecutive patients with POAG and UG who underwent ab externo trabeculotomy since 2004 were reviewed.


METHODS
The main outcome measure was change in median intraocular pressure (IOP). Success was defined as IOP ≤21 mmHg (success 1) and IOP ≤21 mmHg and at least 25% reduction from baseline (success 2).


RESULTS
In the POAG group, the median IOP decreased significantly from 22 mmHg (95% CI 21-25 mmHg; n=20) at baseline to 14 mmHg (95% CI 12-16; n=13) after 4 years, P<0.001. In the UG group, the median IOP decreased significantly from 27 mmHg (95% CI 24.5-30.5 mmHg; n=22) at baseline to 12 mmHg (95% CI 9-15 mmHg; n=15) after 4 years, P<0.001. Seven eyes in the UG group failed within the first year after surgery compared to none in the POAG group. Of these, four eyes had Fuchs' uveitis syndrome and two had granulomatous uveitis. No sight-threatening complications occurred in both POAG and UG groups.


CONCLUSIONS
Ab externo trabeculotomy effectively reduced IOP in both UG and POAG groups. However, the success rates in the UG group were significantly lower due to the high failure rate in patients with Fuchs' uveitis syndrome and granulomatous uveitis. The procedure demonstrated a high safety profile in both UG and POAG patients.
Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany.
Antony
A
William
Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany.
Martin S
MS
Spitzer
Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany.
Deshka
D
Doycheva
Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany.
Spyridon
S
Dimopoulos
Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany.
Martin Alexander
MA
Leitritz
Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany.
Bogomil
B
Voykov
ab externo trabeculotomy; primary open-angle glaucoma; uveitic glaucoma