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Abstract #106022 Published in IGR 23-3
Reduction of Intraocular Pressure and Aqueous Outflow Resistance after Modified 360-degree Suture Trabeculotomy
Suzuki K; Shinmei Y; Hirooka K; Kanaya R; Shinkai A; Kijima R; Chin S; Ito YM; Ishida SJournal of Glaucoma 2023; 32: 204-209
PRCIS: Decreasing aqueous outflow resistance at trabecular meshwork is the main mechanism of modified 360-degree suture trabeculotomy, and the preoperative C-value, which shows aqueous outflow resistance, is likely to be useful for predicting IOP reduction. PURPOSE: To clarify the mechanism of intraocular pressure (IOP) reduction and the preoperative prognostic predictor of modified 360-degree suture trabeculotomy (ST). PATIENTS AND METHODS: Forty-three eyes of 32 patients with glaucoma who underwent ST at Hokkaido University Hospital between April 2017 and February 2020 were enrolled. The records of postoperative IOP and coefficient of aqueous outflow (C-value) after ST were reviewed from clinical charts retrospectively. Preoperative IOP and C-values were also reviewed and considered as the baseline. RESULTS: Although the differences were not significant, IOP decreased to 15.4±3.3 mmHg at 3 months (P=0.10) and 16.1±3.8 mmHg at 6 months (P=0.21). In addition, there were significant decreases in anti-glaucoma medication scores at both 3 and 6 months after surgery (P<0.01). The C-value increased significantly to 0.24±0.11 µl/min/mmHg at 3 months (P<0.01) and increased significantly to 0.27±0.14 µl/min/mmHg at 6 months (P<0.01). The rates of change in IOP were negatively correlated with that in the C-value at 3 months (r=-0.49 and P<0.01) and 6 months (r=-0.46 and P<0.01). The success rate (IOP<21 mmHg, IOP reduction>20%) was greater in the low baseline C-value group (≤0.17) than high baseline C-value group (>0.17) (P<0.05), and the baseline IOP and C-values were statistically significant in association with the success (P<0.05) at 6 months. CONCLUSIONS: Increased conventional outflow by elimination of the aqueous outflow resistance at the trabecular meshwork is the main mechanism of IOP reduction after ST. Preoperative examination of tonographic outflow facility may be useful for predicting the IOP reduction and outcome of ST.
Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
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