Abstract
ObjectivesTo investigate the effects of ciliochoroidal detachment (CCD) after 360-degree suture trabeculotomy ab interno (360S-LOT ab interno) on intraocular pressure (IOP) and postoperative complications during a 12-month follow-up.MethodsWe prospectively examined 44 eyes of 44 patients for 12 months after 360S-LOT ab interno surgery. Inclusion criteria were open-angle glaucoma including primary open-angle glaucoma, normal tension glaucoma, and exfoliation glaucoma without previous glaucoma surgeries. CCD was detected by swept-source anterior segment optical coherence tomography. Outcome measures were the course of IOP, the number of medications, and the postoperative complications of the CCD group compared with those of the non-CCD group.ResultsCCD appeared in 21 eyes (47.7%) within postoperative day 7 and disappeared within postoperative month 1 in 19 of 21 eyes. Although the IOP on postoperative day 1 in the CCD group (11.9 ± 7.7 mmHg) was significantly lower than that in the non-CCD group (19.2 ± 12.8 mmHg) (P = 0.020), the difference in the postoperative IOP between the groups decreased with time. No significant difference was seen in the number of medications and postoperative complications.ConclusionsCCD occurred in approximately half of patients after 360S-LOT ab interno and may have the transient effect of lowering the IOP immediately after surgery. Postoperative CCD had no effect on the later IOP, the number of medications and postoperative complications throughout 12-month of follow-up.
Highlights
The mechanism of action of a trabeculotomy involves a reduction in abnormal outflow resistance via removal of the inner wall of the Schlemm’s canal and the trabecular meshwork [1, 2]
Akagi et al demonstrated the presence of ciliochoroidal detachment (CCD) in 42% cases by using anterior segment optical coherence tomography (AS-OCT), and the CCD was associated with low intraocular pressure (IOP) immediately after Trabectome surgery during 3-month follow-up period [11]
We previously reported a reduction of the IOP value to approximately the middle-teen after 360-degree suture trabeculotomy ab interno (360S-LOT ab interno)
Summary
The mechanism of action of a trabeculotomy involves a reduction in abnormal outflow resistance via removal of the inner wall of the Schlemm’s canal and the trabecular meshwork [1, 2]. Akagi et al demonstrated the presence of ciliochoroidal detachment (CCD) in 42% cases by using anterior segment optical coherence tomography (AS-OCT), and the CCD was associated with low IOP immediately after Trabectome surgery during 3-month follow-up period [11]. These results suggested that CCD may result partly from the transient increase in uveoscleral aqueous outflow via the trabeculotomy site. Because the follow-up period was short in these studies, approximately
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