Comparing the Effectiveness of Propensity Score-Matched Ab Interno Trabeculotomy Between Two Types of Trabecular Hooks.

Purpose: This retrospective study compares the surgical outcomes of ab interno trabeculotomy using the Kahook Dual Blade (KDB) and Tanito microhook (TMH) combined with cataract surgery.

Patients and methods: Twenty-four eyes from 19 and 17 patients with glaucoma in the KDB and TMH groups, respectively, were included. Background factors were matched for medication score and disease type using propensity scores.

Results: Preoperative age, sex, intraocular pressure (IOP), medication scores, and disease type were comparable between the groups. The intraoperative incision range was lower in the KDB than TMH group. The postoperative medication scores and IOPs were 2.7±1.6 mmHg and 14.5 ± 2.8 mmHg in the KDB group, and 2.0±1.8 and 13.8 ± 3.4 mmHg in the TMH group, respectively. There were no significant differences between the groups regarding changes in medication scores, IOP reduction rate, or survival 6 months postoperatively. Postoperative IOP changes were significantly associated with preoperative IOP in both groups, and trabeculotomy range in the KDB group. There were no significant between-group differences regarding the incidence of postoperative complications, excluding a higher incidence of hyphema in the TMH group.

Conclusion: Surgical outcomes for ab interno trabeculotomy using the KDB and TMH were not significantly different. There was no significant difference in the occurrence of postoperative complications, except hyphema, which may reflect the difference in the incision range of trabeculotomy between the hooks. Finally, in the KDB group, where narrow incisions range up to just over one quadrant, the trabeculotomy incision range correlated with IOP.