Juan Carlos Izquierdo
PARIS — In patients with uncontrolled open-angle glaucoma, better reduction of IOP was achieved when ab interno trabeculotomy was added to the combined treatment of phacoemulsification plus endocyclophotocoagulation than when it was not added, according to a study.
At the European Society of Cataract and Refractive Surgeons meeting, Juan Carlos Izquierdo, MD, presented initial outcomes of the retrospective comparison of the trimodal therapy, that is, phacoemulsification plus endocyclophotocoagulation plus ab interno trabeculotomy, vs. bimodal therapy, which did not include ab interno trabeculotomy.
“Both procedures were efficient and safe in the reduction of intraocular pressure in the 12 months of follow-up, but if you add ab interno trabeculotomy, you have a better reduction in the IOP and the difference between the interventions is clinically significant,” Izquierdo said.
Twenty-seven eyes of 21 patients were included in the trimodal group, and 22 eyes of 15 patients were in the bimodal group. No clinically significant differences were seen between the two groups with regard to age, baseline IOP or number of glaucoma medications. Baseline demographic characteristics were comparable as well.
At 12 months, mean IOP decreased from 16.96 mm Hg to 11.44 mm Hg in the trimodal group, a 32.5% IOP reduction. In the bimodal group, mean IOP decreased 20.3%, from 15.64 mm Hg to 12.45 mm Hg. The difference in decrease in IOP between the two groups, which was the primary endpoint, was statistically significant in favor of the trimodal group (P = .031).
In both groups, mean number of glaucoma medications decreased statistically significantly, from 2 to 0.8 (P < .001) in the trimodal group and from 1.5 to 1 (P = .011) in the bimodal group. – by Patricia Nale, ELS
Izquierdo JC. Initial outcomes of combined phacoemulsification with endocyclophotocoagulation with and without ab interno trabeculotomy in open-angle glaucoma. Presented at: European Society of Cataract and Refractive Surgeons meeting; Sept. 13-18, 2019; Paris.
Disclosure: Izquierdo reports no relevant financial disclosures.