Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent

The aim of this study is to compare the surgical efficacy and safety between microhook ab-interno trabeculotomy (µLOT) and iStent trabecular micro-bypass stent implantation when both were combined with cataract surgery in both eyes of patients. Sixty-four glaucomatous eyes (32 participants; mean age...

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Main Authors: Yuji Takayanagi, Sho Ichioka, Akiko Ishida, Aika Tsutsui, Masaki Tanito
Format: Article
Language:English
Published: MDPI AG 2021-05-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/10/10/2129
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author Yuji Takayanagi
Sho Ichioka
Akiko Ishida
Aika Tsutsui
Masaki Tanito
author_facet Yuji Takayanagi
Sho Ichioka
Akiko Ishida
Aika Tsutsui
Masaki Tanito
author_sort Yuji Takayanagi
collection DOAJ
description The aim of this study is to compare the surgical efficacy and safety between microhook ab-interno trabeculotomy (µLOT) and iStent trabecular micro-bypass stent implantation when both were combined with cataract surgery in both eyes of patients. Sixty-four glaucomatous eyes (32 participants; mean age, 75.9 ± 7.6 years; 15 men, 17 women) were included retrospectively. Intraocular pressure (IOP), number of antiglaucoma medications, best-corrected visual acuity (BCVA), anterior chamber flare (ACF) and corneal endothelial cell density (CECD) were evaluated preoperatively, as well as 2, 3, 6, and 12 months postoperatively. Surgical complications and interventions were compared between the procedures. The preoperative IOP and medications with µLOT (18.8 ± 5.7 mmHg and 3.0 ± 1.2, respectively) were higher than with the iStent (15.5 ± 3.4 mmHg and 2.7 ± 1.2, respectively) (<i>p</i> = 0.0001 and <i>p</i> = 0.0437, respectively). At 12 months, the µLOT values (12.6 ± 2.3 mmHg and 2.3 ± 0.9, respectively) were identical to iStent (12.8 ± 2.5 mmHg and 2.3 ± 0.9, respectively) (<i>p</i> = 0.0934 and <i>p</i> = 0.3251, respectively). At 12 months, the IOP decreased more with µLOT (6.2 mmHg, 29.5%) than iStent (2.7 mmHg, 15.6%) (<i>p</i> = 0.0003). The decrease in medications was greater with µLOT (0.7) than iStent (0.4) (<i>p</i> = 0.0437). Survival rate of IOP control ≤15 mmHg and IOP reduction ≥20% was significantly higher after µLOT (40.6% at 12 months) than iStent (18.8%) (<i>p</i> = 0.0277). The frequency of layered hyphema was significantly greater with µLOT (8 eyes, 25%) than iStent (0 eyes, 0%) (<i>p</i> = 0.0048). The increase in the ACF at 2 weeks postoperatively was significantly greater with µLOT than iStent (<i>p</i> = 0.0156), while changes in the BCVA and CECD were identical between groups. The fellow-eye comparison showed that the IOP reduction was greater with µLOT than iStent when combined with cataract surgery.
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spelling doaj.art-e8399c14aca24007b64c956bc502921d2023-11-21T19:45:56ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-011010212910.3390/jcm10102129Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass StentYuji Takayanagi0Sho Ichioka1Akiko Ishida2Aika Tsutsui3Masaki Tanito4Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, JapanDepartment of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, JapanDepartment of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, JapanDepartment of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, JapanDepartment of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, JapanThe aim of this study is to compare the surgical efficacy and safety between microhook ab-interno trabeculotomy (µLOT) and iStent trabecular micro-bypass stent implantation when both were combined with cataract surgery in both eyes of patients. Sixty-four glaucomatous eyes (32 participants; mean age, 75.9 ± 7.6 years; 15 men, 17 women) were included retrospectively. Intraocular pressure (IOP), number of antiglaucoma medications, best-corrected visual acuity (BCVA), anterior chamber flare (ACF) and corneal endothelial cell density (CECD) were evaluated preoperatively, as well as 2, 3, 6, and 12 months postoperatively. Surgical complications and interventions were compared between the procedures. The preoperative IOP and medications with µLOT (18.8 ± 5.7 mmHg and 3.0 ± 1.2, respectively) were higher than with the iStent (15.5 ± 3.4 mmHg and 2.7 ± 1.2, respectively) (<i>p</i> = 0.0001 and <i>p</i> = 0.0437, respectively). At 12 months, the µLOT values (12.6 ± 2.3 mmHg and 2.3 ± 0.9, respectively) were identical to iStent (12.8 ± 2.5 mmHg and 2.3 ± 0.9, respectively) (<i>p</i> = 0.0934 and <i>p</i> = 0.3251, respectively). At 12 months, the IOP decreased more with µLOT (6.2 mmHg, 29.5%) than iStent (2.7 mmHg, 15.6%) (<i>p</i> = 0.0003). The decrease in medications was greater with µLOT (0.7) than iStent (0.4) (<i>p</i> = 0.0437). Survival rate of IOP control ≤15 mmHg and IOP reduction ≥20% was significantly higher after µLOT (40.6% at 12 months) than iStent (18.8%) (<i>p</i> = 0.0277). The frequency of layered hyphema was significantly greater with µLOT (8 eyes, 25%) than iStent (0 eyes, 0%) (<i>p</i> = 0.0048). The increase in the ACF at 2 weeks postoperatively was significantly greater with µLOT than iStent (<i>p</i> = 0.0156), while changes in the BCVA and CECD were identical between groups. The fellow-eye comparison showed that the IOP reduction was greater with µLOT than iStent when combined with cataract surgery.https://www.mdpi.com/2077-0383/10/10/2129microhook ab-interno trabeculotomyTanito microhook (TMH)iStent trabecular micro-bypass systemintraocular pressureminimally invasive glaucoma surgerycataract surgery
spellingShingle Yuji Takayanagi
Sho Ichioka
Akiko Ishida
Aika Tsutsui
Masaki Tanito
Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent
Journal of Clinical Medicine
microhook ab-interno trabeculotomy
Tanito microhook (TMH)
iStent trabecular micro-bypass system
intraocular pressure
minimally invasive glaucoma surgery
cataract surgery
title Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent
title_full Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent
title_fullStr Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent
title_full_unstemmed Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent
title_short Fellow-Eye Comparison between Phaco-Microhook Ab-Interno Trabeculotomy and Phaco-iStent Trabecular Micro-Bypass Stent
title_sort fellow eye comparison between phaco microhook ab interno trabeculotomy and phaco istent trabecular micro bypass stent
topic microhook ab-interno trabeculotomy
Tanito microhook (TMH)
iStent trabecular micro-bypass system
intraocular pressure
minimally invasive glaucoma surgery
cataract surgery
url https://www.mdpi.com/2077-0383/10/10/2129
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