Abstract / Summary
To evaluate the 2-year surgical outcomes of standalone ab interno trabeculotomy using a disposable 25-gauge needle under continuous irrigation in eyes with open-angle glaucoma and to investigate outcomes according to glaucoma type and lens status. This retrospective single-center study included 54 eyes of 46 patients with open-angle glaucoma who underwent standalone ab interno trabeculotomy between April 2016 and March 2020. Surgical failure was defined as intraocular pressure (IOP) ≥ 22 mmHg on two consecutive visits, additional glaucoma surgery, or persistent hypotony (< 6 mmHg for > 1 month). Kaplan–Meier survival analysis was used to estimate cumulative surgical success rates. Changes in IOP and antiglaucoma medication scores were also evaluated for up to 2 years postoperatively. Subgroup comparisons according to glaucoma type and lens status were performed using one eye per patient. The cumulative surgical success rates were 48.2% at 1 year and 39.5% at 2 years. Mean IOP decreased from 26.4 ± 9.9 mmHg preoperatively to 16.3 ± 5.4 mmHg at 2 years postoperatively, while the mean antiglaucoma medication score showed a modest reduction (4.8 ± 1.2 vs. 4.5 ± 0.7). The most common postoperative complication was transient hyphema, which resolved spontaneously within 1 week in all cases. Subgroup comparison showed a tendency toward better surgical survival in primary open-angle glaucoma than in secondary glaucoma ( P = 0.09), whereas no significant difference was observed between phakic and pseudophakic eyes ( P = 0.46). Standalone ab interno trabeculotomy using a disposable 25-gauge needle under continuous irrigation provided sustained IOP reduction over 2 years in eyes with open-angle glaucoma. These findings provide clinically relevant evidence supporting the feasibility of standalone ab interno trabeculotomy using a modified 25-gauge needle under continuous irrigation in eyes with open-angle glaucoma.