title: Modified goniotomy as an alternative to trabectome in primary open angle glaucoma and pseudoexfoliation glaucoma: 1 year results.
abstract: OBJECTIVE
  To assess the outcome of modified goniotomy and trabeculotomy ab interno (Trabectome) surgery in adult primary open-angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma.
  
  
  METHODS
  Retrospective cohort outcome study.
  
  
  METHODS
  Two hundred and thirty-six eyes of 236 patients.
  
  
  METHODS
  This cohort outcome study included 68 POAG (mean age: 65.7 ± 16.0 years) and 22 PEX glaucoma patients (mean age: 78.3 ± 7.9 years) in the modified goniotomy cohort and 119 POAG (mean age: 73.9 ± 9.6 years) and 27 PEX glaucoma patients (mean age: 75.2 ± 8.0 years) in the Trabectome cohort. Modified goniotomy is defined as combined ab interno cyclodialysis and goniotomy. The patients were followed up for 12 months, and we analysed the data using SPSS v19.0.
  
  
  RESULTS
  In POAG, the intraocular pressure (IOP) was significantly reduced by 4.6 mm Hg in the Trabectome cohort (p < 0.001) and by 5.8 mm Hg (p < 0.001) in the goniotomy group at 1-year follow-up. In PEX glaucoma, the mean IOP was reduced by 9.7 mm Hg (p = 0.002) in the Trabectome surgery and by 6.7 mm Hg (p = 0.004) in the goniotomy cohort 1 year later. Comparing both surgery techniques in POAG, no significant correlation was found in terms of IOP at any of the follow-up visits (IOP at 1 year, p = 0.553). In PEX glaucoma, the IOP, visual acuity, and number of glaucoma medications did not differ significantly between the 2 surgery techniques 1 year later (IOP: p = 0.300; VA: p = 0.391; therapy: p = 0.908).
  
  
  CONCLUSIONS
  Modified goniotomy and Trabectome surgery are reliable and effective tools for the management of moderate POAG and PEX glaucoma. There was no significant difference in IOP between the 2 procedures over a follow-up period of 1 year.
authors.affiliation: University College London Institute of Ophthalmology, London, United Kingdom. Electronic address: milena.pahlitzsch@charite.de.
authors.forename: Milena
authors.initials: M
authors.lastname: Pahlitzsch
authors.affiliation: Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Gonnermann
authors.affiliation: Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany.
authors.forename: Anna-Karina B
authors.initials: AB
authors.lastname: Maier
authors.affiliation: Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany.
authors.forename: Eckart
authors.initials: E
authors.lastname: Bertelmann
authors.affiliation: Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany.
authors.forename: Matthias K J
authors.initials: MK
authors.lastname: Klamann
authors.affiliation: Eye Clinic Wittenbergplatz, Berlin, Germany.
authors.forename: Carl
authors.initials: C
authors.lastname: Erb
mesh_terms: D000368:Aged; D004867:Equipment Design; D017889:Exfoliation Syndrome / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy / Q000295:instrumentation*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*