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Microhook ab interno trabeculotomy for secondary glaucoma in patients with hereditary transthyretin amyloidosis

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To report surgical outcomes of a Microhook ab interno trabeculotomy (µLOT) procedure for glaucoma secondary to hereditary transthyretin amyloidosis (ATTRv).

Study design

Retrospective case series.

Methods

Medical records of patients with glaucoma secondary to ATTRv with transthyretin Val30Met variant, who underwent µLOT, were retrospectively reviewed. Surgical success was categorized according to the postoperative intraocular pressures (IOPs, mmHg) as follows: (a) 6 ≤ IOP ≤ 21; (b) 6 ≤ IOP ≤ 18; and (c) 6 ≤ IOP ≤ 15, without light perception loss or additional glaucoma surgery. Secondary outcomes were glaucoma medication scores and postoperative complications.

Results

This study included 18 eyes (13 patients, 6 men). The mean follow-up period was 25.2±9.8 months (7–38 months). Kaplan–Meier analysis indicated success rates of (a) 1.00 at 6, 1.00 at 12, and 0.43 at 24 months; (b), 1.00 at 6, 0.93 at 12, and 0.43 at 24 months; (c) 0.94 at 6, 0.75 at 12, and 0.27 at 24 months after operation. Postoperative IOPs were significantly reduced from the baseline of 25.2±5.8 mmHg to 11.5±2.7 at 3, 12.3±4.1 at 6, and 13.8±3.9 at 12 months (Dunnett's test). Medication scores were also improved at 3 and 6 months but without a significant reduction at 12 months. There were no severe complications requiring surgical intervention except for additional glaucoma surgery.

Conclusion

µLOT for secondary glaucoma in ATTRv is safe and effective 1 year after surgery, but the effects diminish after 2 years.

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Data availability

The datasets analyzed during the current study are not publicly available because of the hospital’s policy to protect the personal information of the participants but are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank the Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine for introducing patients with ATTRv to our department and the paramedical staff members in our team for helping to make this study possible. We would like to thank Editage (www.editage.com) for their writing support.

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Authors and Affiliations

  1. Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan

    Junya Kitahara, Shinji Kakihara, Takao Hirano, Yoshiaki Takahashi, Akira Imai, Teruyoshi Miyahara & Toshinori Murata

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  1. Junya Kitahara
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  2. Shinji Kakihara
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  3. Takao Hirano
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  4. Yoshiaki Takahashi
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  6. Teruyoshi Miyahara
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  7. Toshinori Murata
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Corresponding author

Correspondence to Shinji Kakihara.

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Conflicts of interest

J. Kitahara, None; S. Kakihara, None; T. Hirano, None; Y. Takahashi, None; A. Imai, None; T. Miyahara, None; T. Murata, None.

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Corresponding Author: Shinji Kakihara

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Kitahara, J., Kakihara, S., Hirano, T. et al. Microhook ab interno trabeculotomy for secondary glaucoma in patients with hereditary transthyretin amyloidosis. Jpn J Ophthalmol 67, 84–90 (2023). https://doi.org/10.1007/s10384-022-00966-5

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  • DOI: https://doi.org/10.1007/s10384-022-00966-5

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