{"title":"Influence of goniotomy incisional arc size on its efficacy and safety in juvenile open-angle glaucoma: a prospective multicentre study.","authors":"Zhixuan Wang, Zefeng Yang, Qingshu Ge, Peijie Lin, Yuhan Feng, Sujv Liu, Xiao Yang, Jinkun Liu, Yangfan Yang, Gong Chen, Xiaomin Zhu, Yadong Wang, Jing Ren, Aiguo Lv, Shumei Han, Heting Liu, Li Tan, Jiangang Xu, Yiting Zhang, Xiangxiang Ye, Yi Jiang, Kaiming Li, Fei Li, Yunhe Song, Fengbin Lin, Dilimulati Xiaokaiti, Zige Fang, Xiaoyi Liu, Ling Jin, Kai Zou, Yongjun Qi, Guihua Xu, Chukai Huang, Liming Tao, Pusheng Wang, Sujie Fan, Haijun Li, Peng Lu, Lin Xie, Jingming Shi, Yuhong Wang, Guangfu Dang, Liuzhi Zeng, Hongyang Zhang, Mingying Lai, Robert Weinreb, Xiaojing Pan, Xiulan Zhang","doi":"10.1136/bjo-2026-330493","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of goniotomy (GT) arc size on efficacy and safety in juvenile open-angle glaucoma (JOAG).</p><p><strong>Methods: </strong>This prospective, comparative, multicentre study enrolled 98 patients (126 eyes) with JOAG from 19 Chinese institutions. Patients who underwent GT were categorised into three groups based on the arc size of the incision: (1) 120° GT, (2) 240° GT and (3) 360° GT. Outcomes included intraocular pressure (IOP), surgical success rates, medication use and complications. Success was defined as postoperative IOP ≤21 mm Hg without (complete) or with (qualified) medications.</p><p><strong>Results: </strong>Mean patient age was 22.9±8.7 years. At 12 months postoperatively, complete success rates were comparable between the 240° GT (55.3%) and the 360° GT (64.7%) (p=0.447), and both were superior to the 120° GT (13.3%) (both p<0.001). Qualified success rates in the 120° GT, 240° GT and 360° GT groups were 80.0%, 93.6% and 91.2%, respectively, with no statistically significant difference (p=0.302). The 360° group required fewer medications than the other two groups at 6 months (both p<0.001), with no difference at 12 months (p=0.234). Hyphema was the most common complication, occurring more frequently in the 360° group (64.7%) than in the 240° (34.0%) and 120° (31.1%) groups (p=0.003).</p><p><strong>Conclusions: </strong>240° GT and 360° GT demonstrated comparable efficacy, both superior to 120° GT. 240° GT showed similar observed efficacy to 360° GT, along with procedural simplicity, fewer complications and no consumable use for JOAG; these findings warrant validation in randomised studies.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bjo-2026-330493","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To evaluate the effect of goniotomy (GT) arc size on efficacy and safety in juvenile open-angle glaucoma (JOAG).
Methods: This prospective, comparative, multicentre study enrolled 98 patients (126 eyes) with JOAG from 19 Chinese institutions. Patients who underwent GT were categorised into three groups based on the arc size of the incision: (1) 120° GT, (2) 240° GT and (3) 360° GT. Outcomes included intraocular pressure (IOP), surgical success rates, medication use and complications. Success was defined as postoperative IOP ≤21 mm Hg without (complete) or with (qualified) medications.
Results: Mean patient age was 22.9±8.7 years. At 12 months postoperatively, complete success rates were comparable between the 240° GT (55.3%) and the 360° GT (64.7%) (p=0.447), and both were superior to the 120° GT (13.3%) (both p<0.001). Qualified success rates in the 120° GT, 240° GT and 360° GT groups were 80.0%, 93.6% and 91.2%, respectively, with no statistically significant difference (p=0.302). The 360° group required fewer medications than the other two groups at 6 months (both p<0.001), with no difference at 12 months (p=0.234). Hyphema was the most common complication, occurring more frequently in the 360° group (64.7%) than in the 240° (34.0%) and 120° (31.1%) groups (p=0.003).
Conclusions: 240° GT and 360° GT demonstrated comparable efficacy, both superior to 120° GT. 240° GT showed similar observed efficacy to 360° GT, along with procedural simplicity, fewer complications and no consumable use for JOAG; these findings warrant validation in randomised studies.
目的：评价角部切开术弧度对青少年开角型青光眼（JOAG）疗效和安全性的影响。方法：这项前瞻性、比较性、多中心研究纳入了来自中国19家机构的98例JOAG患者（126只眼）。根据切口的弧度大小，将接受GT手术的患者分为三组：(1)120°GT,(2) 240°GT和(3)360°GT。结果包括眼压（IOP），手术成功率，药物使用和并发症。成功定义为术后IOP≤21 mm Hg，无需（完全）或使用（合格）药物。结果：患者平均年龄22.9±8.7岁。术后12个月，240°GT（55.3%）和360°GT（64.7%）的完全成功率相当（p=0.447），两者均优于120°GT（13.3%）。结论：240°GT和360°GT的疗效相当，均优于120°GT。240°GT的观察疗效与360°GT相似，同时操作简单，并发症少，无JOAG消耗性使用；这些发现值得在随机研究中验证。
期刊介绍：
The British Journal of Ophthalmology (BJO) is an international peer-reviewed journal for ophthalmologists and visual science specialists. BJO publishes clinical investigations, clinical observations, and clinically relevant laboratory investigations related to ophthalmology. It also provides major reviews and also publishes manuscripts covering regional issues in a global context.
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