Comparison of early versus late laser goniopuncture following deep sclerectomy for the management of open-angle glaucoma. Issue 10 (5th February 2020)

• Record Type: Journal Article
• Authors: Holmes, David; Hui, Michelle Mei Pik; Clement, Colin
• Is Part Of: British journal of ophthalmology. Volume 104:Issue 10(2020)
• Page Start: 1384
• Page End: 1389
• Publication Date: 2020-02-05
• Subjects: glaucoma -- treatment lasers -- treatment surgery -- intraocular pressure -- angle; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2019-315392
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Purpose: To compare the outcome of early versus late Nd:YAG laser goniopuncture (LGP) after deep sclerectomy with mitomycin C (DSMMC) for open-angle glaucoma (OAG). Methods: A retrospective study of consecutive OAG eyes that underwent a LGP following DSMMC was recruited between June 2012 and November 2015. Success was defined as intraocular pressure (IOP) less than 21, 18 or 15 mm Hg with a reduction of more than 20% IOP from baseline without (complete success) or with medications (qualified success). Results: 99 eyes with OAG that underwent DSMMC were recruited into the study. Of these, 49 eyes (49.49%) had undergone LGP post-DSMMC. IOP was significantly reduced following LGP from 28.4 to 11.8 mm Hg. Comparison of Kaplan-Meier survival curves out to 60 months after LGP showed a trend towards better outcomes in the late LGP group with the only statistically significant difference noted for qualified success with IOP target <15 mm Hg. Complications were few with no difference noted between early and late LGP groups. Conclusion: There appears to be a trend towards late LGP being more effective after DSMMC when compared with early LGP; this however was not significant. This study corroborates previous published data confirming LGP is an effective and safe procedure for lowering IOP post-DSMMC procedure.