Abstract
The purpose of this study was to compare the clinical outcomes of ab interno microhook trabeculotomy (µLOT) before and after cataract surgery for the combination of µLOT and cataract surgery. This retrospective case series included 40 eyes that underwent µLOT combined with cataract surgery at Kochi University Hospital. Groups 1 (20 eyes) and 2 (20 eyes) included eyes that underwent µLOT before and after cataract surgery, respectively. The patient characteristics and clinical outcomes were also analyzed. The mean preoperative intraocular pressure (IOP) in Groups 1 and 2 (26.1 ± 12.2 mmHg and 20.6 ± 8.8 mmHg) was reduced significantly to 14.1 ± 3.3 mmHg and 12.9 ± 3.2 mmHg, respectively, at 5–7 months postoperatively. The median preoperative number of antiglaucoma medications in Groups 1 and 2 (4.0 and 3.5) also decreased significantly, to 2.5 and 1.0, respectively, at 5–7 months postoperatively. Postoperative hyphema with niveau formation in Groups 1 and 2 was observed in one eye (5.0%) and six eyes (30.0%), respectively. For the combination of µLOT and cataract surgery, performing µLOT before cataract surgery may be less likely to result in postoperative hyphema with niveau formation.
Highlights
Trabeculotomy (LOT) is performed in patients with mild to moderate glaucoma other than angle-closure glaucoma to reduce the intraocular pressure (IOP) by reducing the resistance to aqueous flow by incising the trabecular meshwork and the inner wall of the Schlemm canal [1,2,3,4]
Among minimally invasive glaucoma surgery (MIGS), the microhook LOT reported by Tanito is especially easy and less time-consuming to perform because the tip of the hook is much smaller than that in the other gonio-surgery devices, and the intracameral manipulation of the hook is easier than in the other devices [10]
A study of combined cataract surgery and μLOT reported postoperative hyphema with niveau formation in 41% of cases [12], while another study of combined cataract surgery and Kahook dual blade categorized as MIGS reported no postoperative hyphema with niveau formation [13]
Summary
Trabeculotomy (LOT) is performed in patients with mild to moderate glaucoma other than angle-closure glaucoma to reduce the intraocular pressure (IOP) by reducing the resistance to aqueous flow by incising the trabecular meshwork and the inner wall of the Schlemm canal [1,2,3,4]. A recent study has revealed that μLOT is effective in reducing IOP especially in glaucoma patients with older age, steroid-induced glaucoma, or developmental glaucoma [11] Another advantage of μLOT is that it does not require expensive devices [10]. A study of combined cataract surgery and μLOT reported postoperative hyphema with niveau formation in 41% of cases [12], while another study of combined cataract surgery and Kahook dual blade categorized as MIGS reported no postoperative hyphema with niveau formation [13]. These studies utilized different surgical procedures and instruments. The present study compared μLOT before and after cataract surgery to determine if there were differences in clinical outcomes according to the timing of the cataract procedure
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