Safety and effectiveness of a new minimally invasive glaucoma surgery namely trabeculotome tunneling trabeculoplasty in primary open-angle glaucoma.

AIM: This study aimed to report the preliminary surgical outcomes of a new minimally invasive glaucoma surgery (MIGS), namely trabeculotome tunneling trabeculoplasty (3T) in primary open-angle glaucoma (POAG).

METHODS

This retrospective observational study with prospective follow-up included POAG patients who underwent 3T surgery at Chengdu First People's Hospital between December 2022 and June 2024. Postoperative follow-up was conducted at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months. Evaluations included intraocular pressure (IOP), number of medications, surgical success rate, and postoperative complications.

RESULTS

Baseline mean IOP was 23.06 ± 0.72 mmHg with a median of 3 (interquartile range, IQR: 2-3) medications. Postoperative IOP significantly decreased at all follow-up points except at 1 week (p < 0.05). At 12 months, the mean IOP was 16.22 ± 0.76 mmHg with a median of 0 (IQR: 0-1) medications. Complete surgical success rates were 80.0% at 6 months and 79.8% at 12 months. Early postoperative complications included IOP spikes in 34.9% and clinically significant hyphema in 6.3% (all grade 1). Cyclodialysis was rare (1.1%), and no severe adverse events were reported.

CONCLUSION

3T appears to be a safe and effective surgical option for POAG, providing sustained IOP reduction and medication burden relief with a low incidence of postoperative complications. Larger, controlled studies with longer follow-up are warranted to further validate these findings.