Ab interno microhook trabeculotomy lowers IOP, improves visual acuity patients with glaucoma

The combination of ab interno microhook trabeculotomy (microLOT) with cataract surgery in patients with open-angle glaucoma has shown to be highly effective in reducing intraocular pressure (IOP) and improving visual acuity, according to a study.

In the study, 114 patients with visually significant cataracts and mild to moderate open-angle glaucoma, were randomized to undergo microhook trabeculotomy with phacoemulsification (Group 1) or phacoemulsification alone (Group 2).

The baseline characteristics of the patients were largely similar between the groups, except for the number of antiglaucoma medications, which was higher in Group 2. The mean preoperative intraocular pressure (IOP) for Group 1 was 26.5 mmHg ±5.2 and for Group 2 was 25.3 mmHg ±3.1. These figures reduced significantly to 12.5 mmHg ±3.6 (P < 0.001) and 20.0 mmHg ± 2.7 (P < 0.001) at 12 months postoperatively, respectively.

Best-corrected visual acuity improved in both groups. In Group 1, visual acuity improved from 0.48 preoperatively to 0.00 postoperatively (P < 0.0001). In Group 2, the improvement was from 0.30 to 0.00 (P < 0.001).

The study also highlighted the significant reduction in antiglaucoma medication usage in both groups. In Group 1, the mean antiglaucoma medications reduced from 0.6 at baseline to 0.2 at 1 year postoperatively; in Group 2, the reduction was from 1.4 to 1.1.

Overall, 90.3% of eyes in Group 1 achieved complete success at the end of 1 year.

The most common complication observed was hyphema, noted in 4 patients, with 1 eye necessitating an anterior chamber washout.

Reference
Maheshwari D, Grover DS, Ramakrishnan R, et al. Early Outcomes of Combined Phacoemulsification and Ab Interno Tanito Microhook Trabeculotomy in Open Angle Glaucoma. Ophthalmol Glaucoma. 2023;S2589-4196(23)00194-1. doi: 10.1016/j.ogla.2023.10.007. Epub ahead of print. PMID: 37839794.