Abstract
BackgroundTo examine the use of ripasudil as a trabeculotomy outcome marker in patients with primary open-angle glaucoma (POAG).MethodsBetween May 2015 and December 2018, 35 eyes underwent trabeculotomy and were postoperatively followed for over 3 months. Ripasudil was defined as effective if drug administration resulted in a greater than 10% reduction in intraocular pressure (IOP). Patients were divided into effective (effective group) or non-effective (non-effective group) ripasudil administration groups. The need for additional glaucoma surgery or an IOP ≥ 21 mmHg indicated surgical failure. In both groups, a Kaplan-Meier survival-analysis was used to evaluate success probabilities related to postoperative IOP levels.ResultsEffective IOP reduction occurred in 14 of 35 eyes after ripasudil administration, which was shown by a decrease of more than 10%. Postoperatively, both groups exhibited significant reductions of IOP and antiglaucoma medication use for up to 24 months. At 12 and 24 months after trabeculotomy, probabilities of success in the effective vs. non-effective group were 100% vs. 94.7 and 100% vs. 75.4%, respectively (P = 0.14).ConclusionsTrabeculotomy is effective for achieving an IOP < 21 mmHg in ripasudil effective POAG eyes. Examination of ripasudil’s IOP-lowering effects may be useful in predicting surgical outcomes after trabeculotomy.
Highlights
To examine the use of ripasudil as a trabeculotomy outcome marker in patients with primary openangle glaucoma (POAG)
There was not a significantly higher cumulative probability of success after the trabeculotomy for the ripasudil effective eyes compared to the non-effective eyes, at 24 months after surgery the success rate was 100% for the effective group using criteria A
Dannheim reported that intraocular pressure (IOP) levels in 60% of 100 eyes with POAG were controlled below 24 mmHg without any administration of medication [9]
Summary
To examine the use of ripasudil as a trabeculotomy outcome marker in patients with primary openangle glaucoma (POAG). Increases in outflow resistance can cause elevated intraocular pressure (IOP). There are two aqueous humor outflow pathways, with the aqueous primarily flowing through the trabecular meshwork and Schlemm’s canal to the episcleral vein. There is an auxiliary uveoscleral pathway that passes through the iris root and ciliary muscle. Conventional pathways carry 80% of total aqueous humor out of the eye. In many types of glaucoma, an increased resistance to flow in these pathways is predominantly responsible for the elevated IOPs. Previous studies have examined Rho kinase inhibitors and reported finding
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