Goniocurettage for removing trabecular mehwork: clinical reult of a new urgical technique in advanced chronic open-angle glaucoma Original Reearch Article

PURPOE: To elucidate the long-term outcome of goniocurettage a a new technique in trabecular microurgery for advanced open-angle glaucoma. METHOD: In a propective, nonrandomized clinical trial, 25 eye of 25 patient with a mean age ± D of 72.7 ± 10.1 year (range, 50 to 89 year) with uncontrolled chronic open-angle glaucoma that had undergone failed filtering procedure were treated by goniocurettage. Trabecular tiue wa craped away from the chamber angle by mean of an intrument imilar to a microchalazion curette (diameter, 300 μm). REULT: Before urgery, intraocular preure ranged from 29 to 48 mm Hg (mean ± D, 34.7 ± 7.1 mm Hg), and mean number of antiglaucoma medication wa 2.2 ± 0.56. Follow-up averaged (±D) 32.6 ± 8.1 month (range, 30 to 45 month). Overall ucce, defined a potoperative intraocular preure of 19 mm Hg or le with one preure-reducing agent, wa attained in 15 eye (60%), with five eye (20%) being controlled without medication. Conidering all uccefully treated patient, the mean intraocular preure wa 17.7 ± 3.1 mm Hg (range, 10 to 19 mm Hg) at the final viit. Mean intraocular preure reduction wa 17.1 ± 7.1 mm Hg in thee eye, repreenting a net decreae from baeline of 49%. Number of antiglaucoma medication dropped to 0.63 ± 0.29. Complication included localized Decemet membrane detachment in five eye (20%) and moderate anterior chamber bleeding in four eye (16%). CONCLUION: Thi new urgical technique can effectively control intraocular preure for long period of time in patient with open-angle glaucoma and a hitory of failed filtering procedure. Goniocurettage may be a uitable alternative to urgical treatment of glaucoma patient with exceive conjunctival carification.