Early Results of Irrigating Goniectomy With TrabEx+: A Novel Device for the Treatment of Open-angle Glaucoma. Issue 4 (4th April 2022)

• Record Type: Journal Article
• Authors: Gosling, Daniel; Wang, Haoyu; Auger, Graham
• Is Part Of: Journal of glaucoma. Volume 31:Issue 4(2022)
• Page Start: 268
• Page End: 273
• Publication Date: 2022-04-04
• Subjects: glaucoma -- minimally invasive glaucoma surgery -- TrabEx -- Ab interno trabeculectomy -- irrigating goniectomy; Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000001994
• Languages: English
• ISSNs: 1057-0829

Abstract

Abstract : Précis: Irrigating goniectomy with the TrabEx+ device can lower intraocular pressure (IOP) in patients with glaucoma, as a standalone procedure or combined with cataract surgery. Purpose: The aim was to describe the efficacy and safety of irrigating goniectomy performed using the TrabEx+ device, either as a standalone procedure or combined with cataract surgery, in eyes with medically treated open-angle glaucoma. Methods: A retrospective case series of eyes treated by a single surgeon at a single UK teaching hospital. Data was collected at follow-up visits at 1 week, 3, 6, 12, 18, and 24 months postoperatively. Primary outcomes included IOP and glaucoma medication reduction after surgery. Proportion of eyes achieving >20% IOP reduction, IOP <21 mm Hg, and no reoperation were classified as surgical success. Results: Seventy-three consecutive eyes of 64 patients (mean age 68.4±13.7 y) were enrolled. 62% were treated as combined procedures with cataract surgery. Overall, mean IOP decreased from 31.3±7.3 to 20.9±10.4 mm Hg at the latest follow-up (34% reduction) ( P <0.001) at the latest follow-up (16.1±10.3 mo) with mean preoperative medications decreased from 2.9±1.2 to 1.9±1.3 ( P <0.001). 73% met the definition of success at latest follow-up. Postoperative complications were recorded including hyphaema (17%), uveitis (3%), hypotony (1%), and persistent vitreous hemorrhage (1%). Eighteen percent required reoperation because of treatment failure. Conclusion: TrabEx+ appears to be effective in lowering IOP and medication with or without cataract surgery. However, long-term safety and efficacy will be better understood in a prospective study with longer follow-up.