Results of a modified ab-external trabeculectomy surgical technique in patients with open angle glaucoma.

OBJECTIVE

Assess the safety and efficacy of a Modified Ab-externo Trabeculectomy surgical technique in controlling intraocular pressure (IOP) in open-angle glaucoma patients.

METHODS AND ANALYSIS: Patients diagnosed with primary or secondary open-angle glaucoma underwent this modified technique as the first filtering surgical treatment were included. The preoperative and final follow-up assessed IOP, hypotensive medications, the need for additional treatments, and early and late complications.

RESULTS

Forty-eight eyes of 38 patients were included. The mean age was 63.1 years (25-85 years), and the mean follow-up time was 35.3 months (range of 1147 months). The mean preoperative IOP was 25.21±3.48mmHg and 15.83±4.4mmHg by the follow-up end. Subsequent laser goniopuncture was performed on 14 eyes (29%) and needling in 4 eyes (8.4%). Complete success was achieved in 18 eyes (37.5%), qualified success in 17 (35.4%), and failed in 13 eyes (27.1%). Kaplan-Meier survival analysis shows a success rate of 81.7% at two years and 54.9% from year 4 to year 12. Multivariate analysis with generalized estimating equations (GEE) shows younger age as the main predictor for failure. Two eyes had choroidal detachment, three eyes progressed to cataracts that needed surgery, and five eyes had early bleb leaks.

CONCLUSIONS

This proposed technique is an effective surgical procedure for treating open-angle glaucoma with effective long-term IOP control and a low incidence of surgical complications and could be used in selected complex cases based on these results.