SO SÁNH AN TOÀN VÀ HIỆU QUẢ CỦA PHẪU THUẬT MỞ BÈ 360° ĐƯỜNG TRONG VÀ CẮT BÈ CỦNG MẠC Ở BỆNH NHÂN GLÔCÔM GÓC MỞ NGUYÊN PHÁT

Abstract

Purpose: To compare the 6-month efficacy and safety of 360° ab interno trabeculotomy using suture (GATT) versus trabeculectomy with adjunctive 5-fluorouracil (TRAB) in patients with primary open-angle glaucoma (POAG). Methods: This clinical trial analyzed 80 eyes with POAG undergoing either GATT (n=41) or TRAB (n=39). Primary outcomes included intraocular pressure (IOP), number of medications, surgical success (complete and qualified), and postoperative complications at 6 months. Results: Mean IOP significantly decreased in both groups at 6 months (GATT: 28.17 ± 9.11 to 14.20 ± 1.96 mmHg; TRAB: 28.39 ± 8.55 to 14.78 ± 2.01 mmHg; p=0.16). Medication use was lower in the TRAB group (0.62 ± 1.04 vs. 1.17 ± 1.20; p<0.05). Cumulative success rates were comparable (GATT: 95.1%, TRAB: 92.3%; p=0.586), but complete success was higher with TRAB (66.7% vs. 43.9%; p=0.01). Hyphema occurred in 54.8% of GATT eyes; hypotony was noted in 15.4% of TRAB eyes. Conclusions: Both GATT and TRAB effectively reduced IOP in POAG over 6 months. TRAB achieved higher complete success and medication reduction but posed a risk of early hypotony. GATT offers a less invasive option, potentially advantageous in cases requiring conjunctival preservation.