Short-term results of microhook ab interno trabeculotomy, a novel minimally invasive glaucoma surgery in Japanese eyes: initial case series.
OBJECTIVE
To report the first early postoperative results and safety profile after microhook ab interno trabeculotomy (μLOT).


METHODS
This initial retrospective observational case series included 24 consecutive glaucomatous eyes of 17 Japanese patients (7 men, 10 women; mean age ± standard deviation, 66.7 ± 17.9 years) who underwent μLOT. The trabeculotomy extent, surgical time, perioperative complications, interventions for complications and additional glaucoma surgeries during the follow-up for more than 3 months were collected by reviewing the medical and surgical records. The intraocular pressure (IOP), numbers of antiglaucoma medications, logarithm of the minimum angle of resolution visual acuity (VA), anterior chamber (AC) flare and corneal endothelial cell density (CECD) were compared preoperatively and postoperatively.


RESULTS
The trabecular meshwork was incised for a mean of 3.6 ± 0.5 clock hours temporally, 3.7 ± 0.5 clock hours nasally and total 7.3 ± 0.6 clock hours during the 6.2 ± 1.6-min surgery. The mean preoperative IOP of 25.9 ± 14.3 mmHg and number of antiglaucoma medication of 3.3 ± 1.0 decreased significantly (p = 0.0002 and p = 0.005, respectively) to 14.7 ± 3.6 mmHg and 2.8 ± 0.8 at the final visit at 188.6 ± 68.8 days postoperatively. Compared with preoperatively, the final VA, AC flare and CECD did not change significantly. Hyphema with niveau formation (nine eyes, 38%) and washout of hyphema (two eyes, 8%) were the most common postoperative complication and intervention, respectively. At the final visit, 19 eyes (79%) achieved successful IOP control of 18 mmHg or less and a 15% reduction or greater.


CONCLUSIONS
Microhook trabeculotomy normalizes the IOP during the early postoperative period in patients with glaucoma.
Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.
Masaki
M
Tanito
Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.
Ichiya
I
Sano
Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.
Yoshifumi
Y
Ikeda
Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.
Etsuko
E
Fujihara
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D012189:Retrospective Studies; D013997:Time Factors; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy / Q000295:instrumentation*; D016896:Treatment Outcome; D014792:Visual Acuity
intraocular pressure; microhook ab interno trabeculotomy; minimally invasive glaucoma surgery; surgical complication