Relationship between Schlemm’s canal incision length and the results of ab interno gonioscopy-assisted transluminal suture trabeculotomy

• Published in: Scientific reports Vol. 15; no. 1; pp. 4664 - 10
• Main Authors: Tanabe, Hirotaka, Nakakura, Shunsuke, Nishimura, Kazuaki, Terao, Etsuko, Fujisawa, Yasuko, Nagata, Yuki, Oogi, Satomi, Adachi, Miku, Matsuya, Kanae
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 07.02.2025; Nature Publishing Group; Nature Portfolio
• Subjects: 692/699/3161; 692/699/3161/3169/3170; Ab interno gonioscopy-assisted transluminal suture trabeculotomy (GATST); Aged; Aged, 80 and over; Canals (anatomy); Cataract Extraction; Cataracts; Eye; Eye surgery; Female; Glaucoma; Glaucoma, Open-Angle - physiopathology; Glaucoma, Open-Angle - surgery; Gonioscopy - methods; Humanities and Social Sciences; Humans; Intraocular Pressure; Male; Middle Aged; Minimally invasive or microinvasive glaucoma surgery (MIGS); multidisciplinary; Open-angle glaucoma; Patients; Retrospective Studies; Schlemm's Canal; Schlemm’s canal incision length; Science; Science (multidisciplinary); Surgery; Surgical outcomes; Suture Techniques; Sutures; Trabeculectomy - methods; Minimally invasive or microinvasive glaucoma surgery (MIGS); Schlemm’s canal incision length; Ab interno gonioscopy-assisted transluminal suture trabeculotomy (GATST); Open-angle glaucoma
• DOI: 10.1038/s41598-025-88479-2
• ISSN: 2045-2322

We retrospectively investigated the relationship between Schlemm’s canal incision length and the results of ab interno gonioscopy-assisted transluminal suture trabeculotomy (GATST) with/without cataract surgery in open-angle glaucoma patients at Tsukazaki Hospital from 2018–2021. The study included 113 eyes from 76 patients (age: 70.0 ± 10.8 years; female/male: 43 [56.6%]/33 [43.4%]). GATST with and without cataract surgery was performed on 87 (phakia) [77.0%] and 26 eyes (pseudophakia) [23.0%], respectively; 102 [90.3%] eyes had primary open-angle glaucoma, and 11 [9.7%] had pseudoexfoliation glaucoma. Intraocular pressure (IOP) significantly decreased at 3/6/12 months, and the antiglaucoma eyedrop number significantly decreased at 6/12 months (all P values < 0.001). Linear mixed-effects models showed that incision length had significant positive associations with IOP spikes, hyphema grade, and IOP changes (amount/percentage) at 6 months; surgical success rate (IOP ≤ 15 mmHg, ≥ 20% reduction, no additional surgeries [criterion B]) at 6/12 months; and surgical success rate (IOP ≤ 21 mmHg, ≥ 20% reduction, no additional surgeries [criterion A]) at 12 months (Ps < 0.05). There were no significant associations with IOP changes at 12 months, surgical success rate (criterion A) at 6 months, or antiglaucoma eyedrop number at either timepoint (Ps > 0.05). Longer incisions were more likely to produce greater IOP reduction, requiring more attention to IOP spikes/hyphema.