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Graefe's Archive for Clinical and Experimental Ophthalmology

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Open Access 21-02-2023 | Glaucoma | Glaucoma

Circumferential (360°) trabeculotomy for steroid-induced glaucoma in adults

Authors: Laurentius J. (René) van Rijn, Catharina A. Eggink, Sarah F. Janssen

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 7/2023

Abstract

Purpose

To evaluate the safety and efficacy of 360° circumferential trabeculotomy (TO) for steroid induced glaucoma (SIG) of short duration.

Methods

Retrospective analysis of surgical results of 46 eyes of 35 patients undergoing microcatheter-assisted TO. All eyes had high intraocular pressure for at most about 3 years due to steroid use. Follow-up was between 2.63 and 47.9 months (mean 23.9, median 25.6).

Results

Intraocular pressure (IOP) before surgery was 30.8 ± 8.3 mm Hg, with 3.8 ± 1.0 pressure-lowering medications. After 1 to 2 years, mean IOP was 11.2 ± 2.6 mm Hg (n = 28); mean number of IOP-lowering medications was 0.9 ± 1.3. At their last follow-up, 45 eyes had an IOP < 21 mm Hg, and 39 eyes had an IOP < 18 mm Hg with or without medication. After 2 years, the estimated probability of having an IOP below 18 mm Hg (with or without medication) was 85 ± 6%, and the estimated probability of not using medication was 56 ± 7%. Steroid response was no longer present in all eyes receiving steroids after surgery. Minor complications consisted of hyphema, transient hypotony, or hypertony. One eye proceeded to receiving a glaucoma drainage implant.

Conclusion

TO is particularly effective in SIG with relative short duration. This concurs with the pathophysiology of the outflow system. This procedure seems particularly suited for eyes for which target pressures in the mid-teens are acceptable, particularly when chronic use of steroids is necessary .

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Title: Circumferential (360°) trabeculotomy for steroid-induced glaucoma in adults
Authors: Laurentius J. (René) van Rijn
Catharina A. Eggink
Sarah F. Janssen
Publication date: 21-02-2023
Publisher: Springer Berlin Heidelberg
Keywords: Glaucoma
Trabeculotomy
Trabeculectomy
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 7/2023
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-06012-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Circumferential (360°) trabeculotomy for steroid-induced glaucoma in adults

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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