Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year Result
Objective: We aimed to evaluate the safety and clinical efficacy of ab externo microcatheter-assisted trabeculotomy combined with deep sclerectomy and trabeculectomy (MATT-DS-Trab) in the surgical management of advanced primary open-angle glaucoma (POAG).Methods: According to the inclusion criteria,...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-09-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.712332/full |
| _version_ | 1819118980264099840 |
|---|---|
| author | Hengli Zhang Xiaowei Yan Fan Li Lihua Ma Yulei Geng Kexin Jiao Guangxian Tang |
| author_facet | Hengli Zhang Xiaowei Yan Fan Li Lihua Ma Yulei Geng Kexin Jiao Guangxian Tang |
| author_sort | Hengli Zhang |
| collection | DOAJ |
| description | Objective: We aimed to evaluate the safety and clinical efficacy of ab externo microcatheter-assisted trabeculotomy combined with deep sclerectomy and trabeculectomy (MATT-DS-Trab) in the surgical management of advanced primary open-angle glaucoma (POAG).Methods: According to the inclusion criteria, we retrospectively collected and analyzed 37 POAG cases in advanced stage who received MATT-DS-Trab. The intraocular pressure (IOP), best corrected visual acuity (BCVA), use of anti-glaucoma drugs, shape of the filtering bleb, size of the scleral lake, complications, and the surgical success rate were recorded.Results: The mean IOP was 37.50 ± 8.11 mmHg before the operation, while it depleted to 10.08 ± 2.01 and 11.43 ± 2.07 mmHg at 1 week and 12 months after the operation, respectively (both P < 0.001 compared to preoperative IOP). From none to two kinds of anti-glaucoma drugs were used 12 months after surgery on the patients, which were significantly reduced compared with that preoperatively (P < 0.001). An L-type filtering bleb was the main form at all time points after the operation. At 12 months following surgery, an F-type filtering bleb accounted for 5.41% and no E-type filtering bleb was recorded. The length and height of the scleral lake shrunk with time, but there was no statistical significance (P > 0.05). Also, there was no correlation between the size of the scleral pool and the IOP (P > 0.05). At 12 months after the operation, the complete success rates were 94.59, 83.78, and 72.97% according to standards A (≤18 mmHg), B (≤15 mmHg), and C (≤12 mmHg), respectively. Intraoperative complications were mainly anterior chamber hemorrhage, and no complications related to the filtration bleb were observed after the operation.Conclusion: Based on multichannel mechanisms, MATT-DS-Trab is able to effectively reduce IOP in advanced POAG patients, with few serious complications and a high success rate. |
| first_indexed | 2024-12-22T05:57:29Z |
| format | Article |
| id | doaj.art-dac6436fe3734d348379ab7a70122a0a |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-22T05:57:29Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-dac6436fe3734d348379ab7a70122a0a2022-12-21T18:36:40ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-09-01810.3389/fmed.2021.712332712332Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year ResultHengli ZhangXiaowei YanFan LiLihua MaYulei GengKexin JiaoGuangxian TangObjective: We aimed to evaluate the safety and clinical efficacy of ab externo microcatheter-assisted trabeculotomy combined with deep sclerectomy and trabeculectomy (MATT-DS-Trab) in the surgical management of advanced primary open-angle glaucoma (POAG).Methods: According to the inclusion criteria, we retrospectively collected and analyzed 37 POAG cases in advanced stage who received MATT-DS-Trab. The intraocular pressure (IOP), best corrected visual acuity (BCVA), use of anti-glaucoma drugs, shape of the filtering bleb, size of the scleral lake, complications, and the surgical success rate were recorded.Results: The mean IOP was 37.50 ± 8.11 mmHg before the operation, while it depleted to 10.08 ± 2.01 and 11.43 ± 2.07 mmHg at 1 week and 12 months after the operation, respectively (both P < 0.001 compared to preoperative IOP). From none to two kinds of anti-glaucoma drugs were used 12 months after surgery on the patients, which were significantly reduced compared with that preoperatively (P < 0.001). An L-type filtering bleb was the main form at all time points after the operation. At 12 months following surgery, an F-type filtering bleb accounted for 5.41% and no E-type filtering bleb was recorded. The length and height of the scleral lake shrunk with time, but there was no statistical significance (P > 0.05). Also, there was no correlation between the size of the scleral pool and the IOP (P > 0.05). At 12 months after the operation, the complete success rates were 94.59, 83.78, and 72.97% according to standards A (≤18 mmHg), B (≤15 mmHg), and C (≤12 mmHg), respectively. Intraoperative complications were mainly anterior chamber hemorrhage, and no complications related to the filtration bleb were observed after the operation.Conclusion: Based on multichannel mechanisms, MATT-DS-Trab is able to effectively reduce IOP in advanced POAG patients, with few serious complications and a high success rate.https://www.frontiersin.org/articles/10.3389/fmed.2021.712332/fullprimary open angle glaucomamicrocathetertrabeculotomydeep sclerectomytrabeculectomy |
| spellingShingle | Hengli Zhang Xiaowei Yan Fan Li Lihua Ma Yulei Geng Kexin Jiao Guangxian Tang Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year Result Frontiers in Medicine primary open angle glaucoma microcatheter trabeculotomy deep sclerectomy trabeculectomy |
| title | Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year Result |
| title_full | Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year Result |
| title_fullStr | Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year Result |
| title_full_unstemmed | Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year Result |
| title_short | Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year Result |
| title_sort | microcatheter assisted trabeculotomy combined with deep sclerectomy and trabeculectomy in young to middle aged adults with advanced primary open angle glaucoma 1 year result |
| topic | primary open angle glaucoma microcatheter trabeculotomy deep sclerectomy trabeculectomy |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.712332/full |
| work_keys_str_mv | AT henglizhang microcatheterassistedtrabeculotomycombinedwithdeepsclerectomyandtrabeculectomyinyoungtomiddleagedadultswithadvancedprimaryopenangleglaucoma1yearresult AT xiaoweiyan microcatheterassistedtrabeculotomycombinedwithdeepsclerectomyandtrabeculectomyinyoungtomiddleagedadultswithadvancedprimaryopenangleglaucoma1yearresult AT fanli microcatheterassistedtrabeculotomycombinedwithdeepsclerectomyandtrabeculectomyinyoungtomiddleagedadultswithadvancedprimaryopenangleglaucoma1yearresult AT lihuama microcatheterassistedtrabeculotomycombinedwithdeepsclerectomyandtrabeculectomyinyoungtomiddleagedadultswithadvancedprimaryopenangleglaucoma1yearresult AT yuleigeng microcatheterassistedtrabeculotomycombinedwithdeepsclerectomyandtrabeculectomyinyoungtomiddleagedadultswithadvancedprimaryopenangleglaucoma1yearresult AT kexinjiao microcatheterassistedtrabeculotomycombinedwithdeepsclerectomyandtrabeculectomyinyoungtomiddleagedadultswithadvancedprimaryopenangleglaucoma1yearresult AT guangxiantang microcatheterassistedtrabeculotomycombinedwithdeepsclerectomyandtrabeculectomyinyoungtomiddleagedadultswithadvancedprimaryopenangleglaucoma1yearresult |