ĐÁNH GIÁ MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN KẾT QUẢ PHẪU THUẬT MỞ BÈ TỪ PHÍA TRONG TIỀN PHÒNG ĐIỀU TRỊ GLÔCÔM GÓC MỞ NGUYÊN PHÁT

Abstract

Objective: Evaluating the risk factors for ab interno trabeculotomy using iTrack microcatheter in treating primary open-angle glaucoma with prior failed incisional glaucoma surgery. Subjects and methods: This is a prospective clinical interventional study without control group. The studied subjects were 15 eyes (14 patients) diagnosed with open-angle glaucoma at the Glaucoma Department, Vietnam National Eye Hospital from March 2022 to December 2022. Selection criteria included: primary open-angle glaucoma eyes with prior failed incisional glaucoma surgery even using ≥ 2 different hypotensive drugs. All patients were older than ≥ 18 years old. Gender, age, past surgical history, preoperative visual acuity, preoperative intraocular pressure, axial length, complication, the extent of opned Schlemm canal during surgery and other factors were analysed using medical statistical algorithms. Results: The mean extent of the opened Schlemm’s canal during surgery in eyes with surgical success was higher than that in eyes with surgical failure (249,1°± 55,39° versus 147,5°±39,47°). The failure rate in eyes with postoperative hyphema greater than or equal to grade 1 after surgery was 75% while the failure rate in eyes with grade 0 hyphema was 9,1%. There was no correlation between factors such as age, gender, preoperative visual acuity, preoperative intraocular pressure, etc and the surgical outcomes. Conclusion: The extent of the opened Schlemm’s canal during ab interno trabeculotomy and the postoperative degree of hyphema were the 2 factors which affected significantly the surgical outcomes. Greater degree of Schlemm canal opened led to higher success rate and lower postoperative intraocular pressure. The grade of postoperative hyphema greater or equal to greater than grade 1 increased the probability of surgical failure.