One-year outcomes of Bent ab-interno needle goniectomy with phacoemulsification in primary glaucoma.

PURPOSE: To study 1-year outcomes of bent ab-interno needle goniectomy (BANG) with phacoemulsification in patients across the glaucoma spectrum.

METHODS

This Prospective, noncomparative interventional study enrolled primary glaucoma patients (open-angle and angle-closure) with medically controlled intraocular pressure (IOP) and visually significant cataracts who underwent clear corneal phacoemulsification with intraocular lens placement combined with BANG using a 25-gauge needle bent as a reverse cystitome. Patients completing a minimum 1-year post-surgical follow-up were analyzed. The primary outcome was the change in antiglaucoma medications (AGM) required after surgery. Complete and qualified success was defined as IOP between 6 and 21 mm Hg without and with up to two topical AGMs.

RESULTS

Thirty eyes of 30 patients with a mean age of 60.5 ± 10.3 years were analyzed. The mean baseline IOP was 15.3 ± 3.6 mmHg, and the mean number of topical AGM was 2.6 ± 1.3. Ten patients were on systemic acetazolamide. The topical AGM requirement decreased to 0.60 ± 0.99 (P < 0.0001) and 0.87 ± 1.02 (P < 0.0001) at 6 months and 1 year, respectively. The mean IOP decreased to 13.57 ± 2.79 (P = 0.028) and 14.43 ± 2.92 mmHg (P = 0.11) at 6 months and 1 year, respectively. No patient required oral acetazolamide at the 6-month and 1-year follow-up after surgery. At 1-year, complete and qualified success was seen in 14 eyes each. Six eyes (20%) had an episode of a transient IOP spike, which resolved in 2 weeks, and one eye had hyphema, which resolved by the fourth day. There were no serious complications.

CONCLUSIONS

Phacoemulsification with BANG is an effective and safe procedure for reducing the medication burden in patients with primary glaucoma.