Clinical Ophthalmology (Aug 2019)
Comparison of anterior chamber flare among different glaucoma surgeries
Abstract
Masaki Tanito,1,2 Kaoru Manabe,1 Mihoko Mochiji,1 Yasuyuki Takai,1 Yotaro Matsuoka21Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan; 2Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, JapanCorrespondence: Masaki TanitoDepartment of Ophthalmology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, JapanTel +81 85 320 2284Fax +81 85 320 2278Email [email protected]: To compare postsurgical anterior chamber flare (ACF) among conventional (trabeculectomy, LEC) and novel (EX-PRESS Shunt, EXP) filtration surgeries and microhook ab interno trabeculotomy (μLOT), a novel minimally invasive glaucoma surgery (MIGS).Subjects and methods: This retrospective study included 125 primary open angle glaucoma eyes (89 consecutive subjects) treated with μLOT (n=38), LEC (n=12), or EXP (n=75). The intraocular pressure (IOP), numbers of antiglaucoma medication, and ACF at preoperatively and 2 weeks; 1, 3, and 6 months postoperatively were compared among the surgical groups using a mixed-effects regression model.Results: The postoperative IOP (p<0.0001) and medication use were significantly (p<0.0001) lower in the LEC and EXP groups than with μLOT for up to 6 months postoperatively. The ACF differed significantly (p=0.0004) among groups; the ACF was significantly higher (p=0.0097, post-hoc Student’s t-test) with μLOT (33.6±52.8 pc/msec) than the EXP (15.7±19.9 pc/msec) at 2 weeks and was significantly (p=0.0111, post-hoc t-test) lower with μLOT (7.9±2.0 pc/msec) than LEC (12.0±6.1 pc/msec) at 6 months.Conclusion: Considering our observation, although its clinical significance is unclear, not all MIGS are minimally invasive regarding early postsurgical inflammation.Keywords: anterior chamber flare, trabeculectomy, EX-PRESS shunt, microhook ab interno trabeculotomy, minimally invasive glaucoma surgery, MIGS
