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Viscotrabeculotomy versus trabeculectomy in the surgical treatment of open angle glaucoma: a single center, randomised controlled trial

  • Clinical Investigation
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Abstract

Purpose

The aim of the study was to compare the effect of viscotrabeculotomy and the effect of trabeculectomy on the intraocular pressure (IOP) in cases of open angle glaucoma (OAG).

Study design

Prospective comparative study.

Patients and methods

The study was conducted on 148 eyes of 148 patients (87 men) presenting with and operated upon for OAG at Mansoura Ophthalmic center of Mansoura University in Mansoura, Egypt from 2012 to 2016. Patients were randomized into viscotrabeculotomy and trabeculectomy groups. Postoperative follow up visits were scheduled at weeks 1 and 2 then months 1, 2, 3, 6, 9, 12, 15, 18, 21 and 24. Complications were noted and managed according to needs. The primary outcome measure was IOP.

Results

The study was conducted on 148 eyes (74 right) of 148 patients (87 men). The mean ± SD (range, median) age of the study patients was 50.1 ± 11.5 (20–67, 53) and 51.1 ± 10.0 (27–65, 54.5) years respectively. The mean ± SD (range, median) IOP of the study eyes on maximal tolerated IOP lowering therapy was 23.15 ± 2.31 (19–30, 23.0) and 23.64 ± 1.87 (20–28, 23.0) mmHg respectively and at the end of the 24 months of follow up was 14.91 ± 2.4 (12–23, 14) and 16.64 ± 2.8 (14–25, 16) mmHg respectively (p =  < 0.0005). Notable complications included a mild hyphema in the viscotrabeculotomy group and an IOP spike in the trabeculectomy group.

Conclusions

Viscotrabeculotomy and trabeculectomy showed efficacy and safety in OAG patients. The former resulted in better IOP reduction.

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References

  1. Quigley HA. Glaucoma. Lancet. 2011;16(377):1367–77.

    Article  Google Scholar 

  2. Morrison JC, Pollack IP, editors. Glaucoma: science and practice. New York: Thieme; 2003. p. 154–5.

    Google Scholar 

  3. Chan KKW, Tang F, Tham CCY, Young AL, Cheung CY. Retinal vasculature in glaucoma: a review. BMJ Open Ophthalmol. 2017;1:e000032.

    Article  Google Scholar 

  4. Lee SH, Kim T-W, Lee EJ, Girard MJA, Mari JM, Ritch R. Ocular and clinical characteristics associated with the extent of posterior lamina cribrosa curve in normal tension glaucoma. Sci Rep. 2018;8:961.

    Article  Google Scholar 

  5. Evangelho K, Mogilevskaya M, Losada-Barragan M, Vargas-Sanchez JK. Pathophysiology of primary open-angle glaucoma from a neuroinflammatory and neurotoxicity perspective: a review of the literature. Int Ophthalmol. 2019;39:259–71.

    Article  Google Scholar 

  6. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M, Early Manifest Glaucoma Trial G. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. 2002;120:1268–79.

    Article  Google Scholar 

  7. Rajurkar K, Dubey S, Gupta PP, John D, Chauhan L. Compliance to topical anti-glaucoma medications among patients at a tertiary hospital in North India. J Curr Ophthalmol. 2018;30:125–9.

    Article  Google Scholar 

  8. Tanna AP, Johnson M. Rho kinase inhibitors as a novel treatment for glaucoma and ocular hypertension. Ophthalmology. 2018;125:1741–56.

    Article  Google Scholar 

  9. Jacob TF, Singh V, Dixit M, Ginsburg-Shmuel T, Fonseca B, Pintor J, et al. A promising drug candidate for the treatment of glaucoma based on a P2Y6-receptor agonist. Purinergic Signal. 2018;14:271–84.

    Article  CAS  Google Scholar 

  10. Liang YB, Wu HX, Liao N, Li M, Zhang Q, Wang PJ, et al. Trends of application of topical anti-glaucoma topical drugs in the Eye Hospital of Wenzhou Medical University for ten years. Zhonghua Yan Ke Za Zhi. 2018;54:520–5 ((in Chinese)).

    CAS  PubMed  Google Scholar 

  11. Dietlein TS, Moalem Y, Lappas A, Rosentreter A. Glaucoma filtering surgery in the elderly over eighty years old: an analysis of postoperative risks. Klin Monbl Augenheilkd. 2014;231:1224–9 ((in German)).

    Article  CAS  Google Scholar 

  12. Leleu I, Penaud B, Blumen-Ohana E, Rodallec T, Adam R, Laplace O, et al. Central 10-degree visual field change following non-penetrating deep sclerectomy in severe and end-stage glaucoma: preliminary results. Graefes Arch Clin Exp Ophthalmol. 2018;256:1489–98.

    Article  Google Scholar 

  13. Hohberger B, Welge-Lüßen UC, Lämmer R. MIGS: therapeutic success of combined Xen Gel Stent implantation with cataract surgery. Graefes Arch Clin Exp Ophthalmol. 2018;256:621–5.

    Article  Google Scholar 

  14. Arish M, Khallaghi H, Soltani ER. A comparative study of sutureless scleral tunnel trabeculectomy versus conventional trabeculectomy in the management of primary open-angle glaucoma. Int Ophthalmol. 2014;34:1055–9.

    Article  Google Scholar 

  15. Kinoshita-Nakano E, Nakanishi H, Ohashi-Ikeda H, Morooka S, Akagi T. Comparative outcomes of trabeculotomy ab externo versus trabecular ablation ab interno for open angle glaucoma. Jpn J Ophthalmol. 2018;62:201–8.

    Article  Google Scholar 

  16. Dang Y-L, Wang X, Dai W-W, Huang P, Loewen NA, Zhang C, et al. Two-year outcomes of ab interno trabeculectomy with the Trabectome for Chinese primary open angle glaucoma: a retrospective multicenter study. Int J Ophthalmol. 2018;11:945–50.

    PubMed  PubMed Central  Google Scholar 

  17. Otsu Y, Matsuoka M, Koshibu K, Miwa K, Kuro M, Minamino KT, et al. Reduction of intraocular pressure by additional trabeculotomy Ab Externo in eyes with primary open-angle glaucoma. J Glaucoma. 2018;27:914–9.

    Article  Google Scholar 

  18. ElSheikha OZ, Abdelhakim MA, Elhilali HM, Kassem RR. Is viscotrabeculotomy superior to conventional trabeculotomy in the management of Egyptian infants with congenital glaucoma? Acta Ophthalmol. 2015;93:e366–71.

    Article  Google Scholar 

  19. William A, Spitzer MS, Doycheva D, Dimopoulos S, Leitritz MA, Voykov B. Comparison of ab externo trabeculotomy in primary open-angle glaucoma and uveitic glaucoma: long-term outcomes. Clin Ophthalmol (Auckland, NZ). 2016;10:929–34.

    Google Scholar 

  20. De Moraes CG, Mansouri K, Liebmann JM, Ritch R. Triggerfish Consortium. Association Between 24-Hour Intraocular Pressure Monitored With Contact Lens Sensor and Visual Field Progression in Older Adults With Glaucoma. JAMA Ophthalmol. 2018;136:779–85.

    Article  Google Scholar 

  21. Salcedo H, Arciniega D, Mayorga M, Wu L. Role of the water-drinking test in medically treated primary open angle glaucoma patients. J Fr Ophtalmol. 2018;41:421–4.

    Article  CAS  Google Scholar 

  22. Newman-Casey PA, Robin AL, Blachley T, Farris K, Heisler M, Resnicow K, et al. The most common barriers to glaucoma medication adherence: a cross-sectional survey. Ophthalmology. 2015;122:1308–16.

    Article  Google Scholar 

  23. Frech S, Kreft D, Guthoff RF, Doblhammer G. Pharmacoepidemiological assessment of adherence and influencing co-factors among primary open-angle glaucoma patients—an observational cohort study (Bhattacharya S, ed). PLoS ONE. 2018;13:e0191185.

    Article  Google Scholar 

  24. Sihota R, Angmo D, Ramaswamy D, Dada T. Simplifying, “target” intraocular pressure for different stages of primary open-angle glaucoma and primary angle-closure glaucoma. Indian J Ophthalmol. 2018;66:495–505.

    Article  Google Scholar 

  25. Kazemian P, Lavieri MS, Van Oyen MP, Andrews C, Stein JD. Personalized prediction of glaucoma progression under different target intraocular pressure levels using filtered forecasting methods. Ophthalmology. 2018;1254:569–77.

    Article  Google Scholar 

  26. Hoang TKH, Kim YK, Jeoung JW, Park KH. Relationship between age and surgical success after trabeculectomy with adjunctive mitomycin C. Eye. 2018;32:1321–8.

    Article  CAS  Google Scholar 

  27. Jiang L, Eaves S, Dhillon N, Ranjit P. Postoperative outcomes following trabeculectomy and nonpenetrating surgical procedures: a 5-year longitudinal study. Clin Ophthalmol (Auckland, NZ). 2018;12:995–1002.

    Article  Google Scholar 

  28. Gilmour DF, Manners TD, Devonport H, Varga Z, Solebo AL, Miles J. Viscocanalostomy versus trabeculectomy for primary open angle glaucoma: 4-year prospective randomized clinical trial. Eye (Lond). 2009;23:1802–7.

    Article  CAS  Google Scholar 

  29. Kumaran A, Husain R, Htoon HM, Aung T. Longitudinal changes in bleb height, vascularity, and conjunctival microcysts after trabeculectomy. J Glaucoma. 2018;27:578–84.

    Article  Google Scholar 

  30. Güven Yılmaz S, Değirmenci C, Palamar M, Yağcı A. Evaluation of filtering bleb function after trabeculectomy with mitomycin C using biomicroscopy, anterior segment optical coherence tomography and in vivo confocal microscopy. Turk J Ophthalmol. 2015;45:132–7.

    Article  Google Scholar 

  31. Daher F, Almeida I, Ushida M, Soares B, Dorairaj S, Kanadani FN, et al. Intraocular pressure spikes within first postoperative hours following standard trabeculectomy: incidence and associated factors. Ophthalmic Res. 2018;59:142–7.

    Article  CAS  Google Scholar 

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Correspondence to Nader H. L. Bayoumi.

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Conflicts of interest

A. S. Elwehidy, None; T. H. Mokbel, None; N. H. L. Bayoumi, None; A. E. Badawi, None; S. M. Hagras, None.

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Corresponding Author: Nader Bayoumi

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Elwehidy, A.S., Mokbel, T.H., Bayoumi, N.H.L. et al. Viscotrabeculotomy versus trabeculectomy in the surgical treatment of open angle glaucoma: a single center, randomised controlled trial. Jpn J Ophthalmol 65, 395–401 (2021). https://doi.org/10.1007/s10384-020-00801-9

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  • DOI: https://doi.org/10.1007/s10384-020-00801-9

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