The efficacy and safety of 180° trabeculotomy for primary open-angle glaucoma combined with cataract_Chinese Journal of Evidence-Based Medicine

Authors：

XU Zhike ¹ , WANG Ling ² ,  WEI Xin ¹

1. West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
2. The People’s Hospital of Leshan, Leshan 6140000, P. R. China;

Corresponding author：

WEI Xin, Email: weixin_1982@163.com

Keywords：

Primary open-angle glaucoma; Cataract; Trabeculotomy; Trabeculectomy

DOI：

10.7507/1672-2531.202405171

Video：

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Objective To evaluate the efficacy and safety of phacoemulsification cataract extraction combined with 180° trabeculotomy assisted by gonioscopy (GT) and combined glaucoma filtration surgery (GFS) in the treatment of primary open angle glaucoma (POAG) with cataract. Methods The patients with POAG and cataract in the ophthalmology center of the People’s Hospital of Leshan from June 2021 to March 2022 were included. The patients were divided into GT group and GFS group according to surgical methods. Intraocular pressure (IOP), best corrected visual acuity (BCVA) logMAR, number of anti-glaucoma drugs used, success rate, and complications were compared between the two groups after 1-year followed-up. Results A total of 27 patients (43 eyes) in the GT group and 26 patients (34 eyes) in the GFS group were included. There was no significant difference in baseline between the two groups (P>0.05). BCVA logMAR in the GT group was lower than that in the GFS group at 1 year after surgery, the difference was statistically significant (P<0.01). The postoperative IOP in GT group was lower than that in GFS group, the difference was statistically significant (P<0.05). The difference in total effective rate, the number of anti-glaucoma drugs and the incidence of complications between the two groups were not statistically significant (P>0.05). Conclusion Phacoemulsification cataract extraction combined with GT is safe and effective in the treatment of POAG with cataract and has a good effect on reducing IOP.

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2.	Coleman AL, Miglior S. Risk factors for glaucoma onset and progression. Surv Ophthalmol, 2008, 53(Suppl 1): S3-S10.
3.	Sharpe RA, Kammerdiener LL, Williams DB, et al. Efficacy of selective laser trabeculoplasty following incisional glaucoma surgery. Int J Ophthalmol, 2018, 11(1): 71-76.
4.	Gedde SJ, Schiffman JC, Feuer WJ, et al. Treatment outcomes in the tube versus trabeculectomy (TVT) study after five years of follow-up. Am J Ophthalmol, 2012, 153(5): 789-803.
5.	Birnbaum FA, Neeson C, Solá-Del Valle D. Microinvasive glaucoma surgery: an evidence-based review. Semin Ophthalmol, 2021, 36(8): 772-786.
6.	Grover DS, Godfrey DG, Smith O, et al. Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: technique report and preliminary results. Ophthalmology, 2014, 121(4): 855-861.
7.	El Sayed YM, Mettias NM, Elghonemy HME, et al. Phacoemulsification with gonioscopy-assisted transluminal trabeculotomy versus phacoemulsification alone in primary angle closure glaucoma: a randomized controlled study. Acta Ophthalmol, 2024, 102(2): e195-e203.
8.	Faria BM, Costa VP, Melillo GHL, et al. Gonioscopy-assisted transluminal trabeculotomy for glaucoma: 1-year outcomes and success predictors. J Glaucoma, 2022, 31(6): 443-448.
9.	Liu WW, Petkovsek D, Shalaby WS, et al. Four-year surgical outcomes of gonioscopy-assisted transluminal trabeculotomy in patients with open-angle glaucoma. Ophthalmol Glaucoma, 2023, 6(4): 387-394.
10.	Salimi A, Nithianandan H, Al Farsi H, et al. Gonioscopy-assisted transluminal trabeculotomy in younger to middle-aged adults: one-year outcomes. Ophthalmol Glaucoma, 2021, 4(2): 162-172.
11.	Yoshida T, Nomura T, Yoshimoto S, et al. Outcomes of standalone ab interno trabeculotomy in the treatment of open-angle glaucoma in eyes with high myopia. BMC Ophthalmol, 2023, 23(1): 261.
12.	中华医学会眼科学分会青光眼学组. 我国原发性青光眼诊断和治疗专家共识(2014年). 中华眼科杂志, 2014, (5): 382-383.
13.	Loayza-Gamboa W, Martel-Ramirez V, Inga-Condezo V, et al. Outcomes of combined prolene gonioscopy assisted transluminal trabeculotomy with phacoemulsification in open-angle glaucoma. Clin Ophthalmol, 2020, 14: 3009-3016.
14.	Bozkurt E, Yenihayat F, Olgun A, et al. The efficacy of gonioscopy-assisted transluminal trabeculectomy combined with phacoemulsification. Int Ophthalmol, 2021, 41(1): 35-43.
15.	Aboalazayem F, Elhusseiny AM, El Sayed YM. Gonioscopy-assisted transluminal trabeculotomy: a review. Curr Eye Res, 2023, 48(4): 329-338.
16.	Velamala IP, Bharathi M. Gonioscopy assisted transluminal trabeculotomy: a boon to developing nations-a systematic review. Semin Ophthalmol, 2023, 38(2): 178-182.
17.	Song Y, Zhu X, Zhang Y, et al. Outcomes of partial versus complete goniotomy with or without phacoemulsification for primary open angle glaucoma: a multicenter study. J Glaucoma, 2023, 32(7): 563-568.
18.	Guo CY, Qi XH, Qi JM. Systematic review and meta-analysis of treating open angle glaucoma with gonioscopy-assisted transluminal trabeculotomy. Int J Ophthalmol, 2020, 13(2): 317-324.
19.	万月, 尹鹏, 石砚, 等. 内路小梁切开联合白内障超声乳化吸除术治疗原发性开角型青光眼的短期疗效. 眼科, 2019, 28(3): 169-175.
20.	Ahuja Y, Malihi M, Sit AJ. Delayed-onset symptomatic hyphema after ab interno trabeculotomy surgery. Am J Ophthalmol, 2012, 154(3): 476-480.
21.	周龙芳, 胡迭, 蓝婕, 等. 内路Schlemm管成型术治疗原发性青光眼的疗效及安全性观察. 眼科, 2020, 29(1): 20-25.
22.	Koch JM, Heiligenhaus A, Heinz C. Canaloplasty and transient anterior chamber haemorrhage: a prognostic factor. Klin Monbl Augenheilkd, 2011, 228(5): 465-467.
23.	Wan Y, Cao K, Wang J, et al. Gonioscopy-assisted transluminal trabeculotomy (GATT) combined phacoemulsification surgery: outcomes at a 2-year follow-up. Eye (Lond), 2023, 37(6): 1258-1263.
24.	Chen J, Wang YE, Quan A, et al. Risk factors for complications and failure after gonioscopy-assisted transluminal trabeculotomy in a young cohort. Ophthalmol Glaucoma, 2020, 3(3): 190-195.
25.	宋云, 张英哲, 林凤彬, 等. PEI联合房角分离术及房角切开术治疗中晚期PACG疗效及安全性评估. 中华实验眼科杂志, 2022, 40(4): 334-339.

1. Tham YC, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology, 2014, 121(11): 2081-2090.
2. Coleman AL, Miglior S. Risk factors for glaucoma onset and progression. Surv Ophthalmol, 2008, 53(Suppl 1): S3-S10.
3. Sharpe RA, Kammerdiener LL, Williams DB, et al. Efficacy of selective laser trabeculoplasty following incisional glaucoma surgery. Int J Ophthalmol, 2018, 11(1): 71-76.
4. Gedde SJ, Schiffman JC, Feuer WJ, et al. Treatment outcomes in the tube versus trabeculectomy (TVT) study after five years of follow-up. Am J Ophthalmol, 2012, 153(5): 789-803.
5. Birnbaum FA, Neeson C, Solá-Del Valle D. Microinvasive glaucoma surgery: an evidence-based review. Semin Ophthalmol, 2021, 36(8): 772-786.
6. Grover DS, Godfrey DG, Smith O, et al. Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: technique report and preliminary results. Ophthalmology, 2014, 121(4): 855-861.
7. El Sayed YM, Mettias NM, Elghonemy HME, et al. Phacoemulsification with gonioscopy-assisted transluminal trabeculotomy versus phacoemulsification alone in primary angle closure glaucoma: a randomized controlled study. Acta Ophthalmol, 2024, 102(2): e195-e203.
8. Faria BM, Costa VP, Melillo GHL, et al. Gonioscopy-assisted transluminal trabeculotomy for glaucoma: 1-year outcomes and success predictors. J Glaucoma, 2022, 31(6): 443-448.
9. Liu WW, Petkovsek D, Shalaby WS, et al. Four-year surgical outcomes of gonioscopy-assisted transluminal trabeculotomy in patients with open-angle glaucoma. Ophthalmol Glaucoma, 2023, 6(4): 387-394.
10. Salimi A, Nithianandan H, Al Farsi H, et al. Gonioscopy-assisted transluminal trabeculotomy in younger to middle-aged adults: one-year outcomes. Ophthalmol Glaucoma, 2021, 4(2): 162-172.
11. Yoshida T, Nomura T, Yoshimoto S, et al. Outcomes of standalone ab interno trabeculotomy in the treatment of open-angle glaucoma in eyes with high myopia. BMC Ophthalmol, 2023, 23(1): 261.
12. 中华医学会眼科学分会青光眼学组. 我国原发性青光眼诊断和治疗专家共识(2014年). 中华眼科杂志, 2014, (5): 382-383.
13. Loayza-Gamboa W, Martel-Ramirez V, Inga-Condezo V, et al. Outcomes of combined prolene gonioscopy assisted transluminal trabeculotomy with phacoemulsification in open-angle glaucoma. Clin Ophthalmol, 2020, 14: 3009-3016.
14. Bozkurt E, Yenihayat F, Olgun A, et al. The efficacy of gonioscopy-assisted transluminal trabeculectomy combined with phacoemulsification. Int Ophthalmol, 2021, 41(1): 35-43.
15. Aboalazayem F, Elhusseiny AM, El Sayed YM. Gonioscopy-assisted transluminal trabeculotomy: a review. Curr Eye Res, 2023, 48(4): 329-338.
16. Velamala IP, Bharathi M. Gonioscopy assisted transluminal trabeculotomy: a boon to developing nations-a systematic review. Semin Ophthalmol, 2023, 38(2): 178-182.
17. Song Y, Zhu X, Zhang Y, et al. Outcomes of partial versus complete goniotomy with or without phacoemulsification for primary open angle glaucoma: a multicenter study. J Glaucoma, 2023, 32(7): 563-568.
18. Guo CY, Qi XH, Qi JM. Systematic review and meta-analysis of treating open angle glaucoma with gonioscopy-assisted transluminal trabeculotomy. Int J Ophthalmol, 2020, 13(2): 317-324.
19. 万月, 尹鹏, 石砚, 等. 内路小梁切开联合白内障超声乳化吸除术治疗原发性开角型青光眼的短期疗效. 眼科, 2019, 28(3): 169-175.
20. Ahuja Y, Malihi M, Sit AJ. Delayed-onset symptomatic hyphema after ab interno trabeculotomy surgery. Am J Ophthalmol, 2012, 154(3): 476-480.
21. 周龙芳, 胡迭, 蓝婕, 等. 内路Schlemm管成型术治疗原发性青光眼的疗效及安全性观察. 眼科, 2020, 29(1): 20-25.
22. Koch JM, Heiligenhaus A, Heinz C. Canaloplasty and transient anterior chamber haemorrhage: a prognostic factor. Klin Monbl Augenheilkd, 2011, 228(5): 465-467.
23. Wan Y, Cao K, Wang J, et al. Gonioscopy-assisted transluminal trabeculotomy (GATT) combined phacoemulsification surgery: outcomes at a 2-year follow-up. Eye (Lond), 2023, 37(6): 1258-1263.
24. Chen J, Wang YE, Quan A, et al. Risk factors for complications and failure after gonioscopy-assisted transluminal trabeculotomy in a young cohort. Ophthalmol Glaucoma, 2020, 3(3): 190-195.
25. 宋云, 张英哲, 林凤彬, 等. PEI联合房角分离术及房角切开术治疗中晚期PACG疗效及安全性评估. 中华实验眼科杂志, 2022, 40(4): 334-339.

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