Outcome of Goniotomy over 120°, 240°, and 360° in Juvenile Open-Angle Glaucoma: A Multicenter Study.

Abstract

Prcis: 240° and 360° goniotomy (GT) demonstrated similar efficacy in intraocular pressure reduction, both outperforming 120°GT in juvenile open-angle glaucoma (JOAG) patients at postoperative 6 months follow-up.

Purpose: To compare the surgical efficacy and safety of 120-, 240-, and 360-degree goniotomy (GT) for patients with juvenile open-angle glaucoma (JOAG).

Patients and methods: This multicenter retrospective study included 102 eyes of 102 JOAG patients, who underwent GT with a follow up of at least 6 months. Patients were categorized into three groups: (1) 120°GT, (2) 240°GT, and (3) 360°GT. Intraocular pressure (IOP), glaucoma medications, and complications were recorded at baseline and the final visit. Complete success and qualified success were defined as a postoperative IOP ≤21 mm Hg without and with medications, respectively.

Results: Mean age of the participants was 24.4±7.9 years. After a mean follow-up of 8.1±2.7 months, complete success rates were similar between the 240°GT (45.2%) and the 360°GT (63.2%) (P=0.135), and both were superior to 120°GT (18.2%) (P<0.05). Qualified success rates among patients in the 120°, 240°, and 360° GT groups were 93.9%, 96.8% and 100%, respectively, and showed no statistically significant difference (P=0.292). 360°GT required fewer medications than 240°GT and 120°GT (P<0.05), with no significant difference in medications between 120°GT and 240°GT (P>0.05). Hyphema was the most common postoperative complication, with a significantly higher incidence in the 360°GT (68.4%) compared to the 240°GT (41.9%) and 120°GT (33.3%) (P<0.05).

Conclusions: 240° and 360°GT showed similar efficacy in IOP reduction, and were superior to 120°GT. More extensive GT may provide better outcomes in JOAG.