Purpose: To compare postoperative outcomes between trabeculotomy (TLO) ab externo and TLO using the Kahook Dual Blade (TLO with KDB).
Subjects and methods: Of patients with preoperative intraocular pressure of 18 mmHg or higher who underwent TLO ab externo or TLO with KDB between December 2015 and October 2018, 64 patients (64 eyes) who underwent TLO ab externo (TLO ab externo group) and 73 patients (73 eyes) who underwent TLO with KDB (TLO with KDB group) were included. After performing propensity score matching in these patients, 31 eyes were selected for each group. The Kaplan-Meier survival plot was used to analyze postoperative outcomes. A successful outcome was defined as a postoperative intraocular pressure of 21 mmHg or below and an intraocular pressure decrease rate of 20% or greater.
Results: Intraocular pressure measured preoperatively and at 6 and 12 months postoperatively were 23.5±5.2, 15.7±4.0, and 15.4±4.6 mmHg, respectively, in the TLO ab externo group and 22.7±4.9, 14.7±3.6, and 15.1±4.6 mmHg, respectively, in the TLO with KDB group. Although intraocular pressure significantly decreased in both groups, no differences were noted between the surgical procedures. The survival rate at 12 months postoperatively was 79.9% in the TLO ab externo group and 62.6% in the TLO with KDB group (p=0.38). Hyphema and transient ocular hypertension were observed in 6 and 9 eyes, respectively, in the TLO ab externo group and in 5 and 8 eyes, respectively, in the TLO with KDB group.
Conclusions: No differences were noted in postoperative outcomes between the TLO ab externo and TLO with KDB groups. Moreover, no differences were noted in the frequency of postoperative complications such as hyphema and transient ocular hypertension between the two groups.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 753-758, 2020.