{"title":"弯曲Ab针间切口与腹腔镜辅助下经腔内小梁切开术治疗原发性开角型青光眼的随机临床试验","authors":"Gabriel Ayub, Vital Paulino Costa","doi":"10.1097/IJG.0000000000002629","DOIUrl":null,"url":null,"abstract":"<p><strong>Prcis: </strong>Gonioscopy-Assisted Transluminal Trabeculotomy achieved a higher success rate than Bent Ab interno Needle Goniotomy in pseudophakic primary open angle glaucoma eyes at 12-months.</p><p><strong>Purpose: </strong>To evaluate and compare efficacy and safety of standalone Bent Ab interno Needle Goniotomy (BANG) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in pseudophakic primary open angle glaucoma (POAG) eyes.</p><p><strong>Methods: </strong>Parallel, double-arm, 1:1 ratio, single masked, single surgeon, randomized clinical trial. Uncontrolled mild to moderate pseudophakic POAG eyes, defined by visual field mean deviation, were enrolled. Antiglaucoma medication was washed-out before surgery and at 11-months. Patients were followed by 12 months. Surgical success was defined as 6≤IOP≤18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) the use of medication.</p><p><strong>Results: </strong>Twenty-two eyes underwent BANG and 23 underwent GATT. At inclusion, mean IOPs were 21.18±2.87 mm Hg versus 19.87±2.34 mm Hg (P=0.1) under 2.41±0.9 versus 2.35±0.88 medications (P=0.71) in the BANG and GATT groups, respectively. Baseline washout IOPs were 25.55±4.9 mm Hg versus 25.43±4.98 mm Hg in the BANG and GATT groups, respectively (P=0.92). At POD330, IOPs in GATT and BANG groups were 15.62±3.29 mm Hg (-21.38%, P=0.04) and 16.95±2.82 mm Hg (-19.97%, P<0.01), respectively (P=0.16). At POD360, after washout, IOPs were 21.57±11.11 mm Hg (-15.17%, P=0.06) and 24.59±7.94 mm Hg (-3.75%, P=0.53) (P=0.31 between the groups). The mean number of medications used at POD330 was 1.1±1.55 in GATT (-53.19%, P<0.01) and 1.82±1.05 in BANG eyes (-24.48%, P=0.06) (P=0.08 between the groups). GATT eyes had higher complete (60.1% vs. 4.5%, P<0.01) and qualified success rates (64.7% vs. 22.7%, P=0.01) than BANG eyes. Transient hyphema was the most common complication following GATT (56.52%) and BANG (40.9%).</p><p><strong>Conclusion: </strong>GATT eyes achieved higher success rates, lower mean IOPs and required less antiglaucoma medication than BANG eyes after 11-months.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Bent Ab interno Needle Goniotomy versus Gonioscopy-Assisted Transluminal Trabeculotomy in Primary Open Angle Glaucoma: A Randomized Clinical Trial.\",\"authors\":\"Gabriel Ayub, Vital Paulino Costa\",\"doi\":\"10.1097/IJG.0000000000002629\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Prcis: </strong>Gonioscopy-Assisted Transluminal Trabeculotomy achieved a higher success rate than Bent Ab interno Needle Goniotomy in pseudophakic primary open angle glaucoma eyes at 12-months.</p><p><strong>Purpose: </strong>To evaluate and compare efficacy and safety of standalone Bent Ab interno Needle Goniotomy (BANG) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in pseudophakic primary open angle glaucoma (POAG) eyes.</p><p><strong>Methods: </strong>Parallel, double-arm, 1:1 ratio, single masked, single surgeon, randomized clinical trial. Uncontrolled mild to moderate pseudophakic POAG eyes, defined by visual field mean deviation, were enrolled. Antiglaucoma medication was washed-out before surgery and at 11-months. Patients were followed by 12 months. Surgical success was defined as 6≤IOP≤18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) the use of medication.</p><p><strong>Results: </strong>Twenty-two eyes underwent BANG and 23 underwent GATT. At inclusion, mean IOPs were 21.18±2.87 mm Hg versus 19.87±2.34 mm Hg (P=0.1) under 2.41±0.9 versus 2.35±0.88 medications (P=0.71) in the BANG and GATT groups, respectively. Baseline washout IOPs were 25.55±4.9 mm Hg versus 25.43±4.98 mm Hg in the BANG and GATT groups, respectively (P=0.92). At POD330, IOPs in GATT and BANG groups were 15.62±3.29 mm Hg (-21.38%, P=0.04) and 16.95±2.82 mm Hg (-19.97%, P<0.01), respectively (P=0.16). At POD360, after washout, IOPs were 21.57±11.11 mm Hg (-15.17%, P=0.06) and 24.59±7.94 mm Hg (-3.75%, P=0.53) (P=0.31 between the groups). The mean number of medications used at POD330 was 1.1±1.55 in GATT (-53.19%, P<0.01) and 1.82±1.05 in BANG eyes (-24.48%, P=0.06) (P=0.08 between the groups). GATT eyes had higher complete (60.1% vs. 4.5%, P<0.01) and qualified success rates (64.7% vs. 22.7%, P=0.01) than BANG eyes. Transient hyphema was the most common complication following GATT (56.52%) and BANG (40.9%).</p><p><strong>Conclusion: </strong>GATT eyes achieved higher success rates, lower mean IOPs and required less antiglaucoma medication than BANG eyes after 11-months.</p>\",\"PeriodicalId\":15938,\"journal\":{\"name\":\"Journal of Glaucoma\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Glaucoma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/IJG.0000000000002629\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Glaucoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IJG.0000000000002629","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
结论：腹腔镜下经腔内小梁切开术治疗12个月原发性开角型青光眼的成功率高于弯Ab针间切开术。目的：评价和比较单刀弯Ab针间切开术（BANG）和刀镜辅助下腔内小梁切开术（GATT）治疗原发性假性开角型青光眼（POAG）的疗效和安全性。方法：平行、双臂、1:1比例、单蒙面、单手术、随机临床试验。以视野平均偏差定义的未控制的轻度至中度假性POAG眼被纳入研究。抗青光眼药物在手术前和11个月时被清除。随访12个月。手术成功的定义是（合格）或（完全）使用药物后IOP较基线降低20%。结果：BANG 22眼，GATT 23眼。纳入时，BANG组和GATT组的平均IOPs分别为21.18±2.87 mm Hg和19.87±2.34 mm Hg (P=0.1)，分别为2.41±0.9和2.35±0.88 （P=0.71）。基线洗脱IOPs在BANG组和GATT组分别为25.55±4.9 mm Hg和25.43±4.98 mm Hg （P=0.92）。在POD330时，GATT组和BANG组的眼压分别为15.62±3.29 mm Hg （-21.38%， P=0.04）和16.95±2.82 mm Hg（-19.97%）。结论：GATT组在11个月后的青光眼成功率较高，平均眼压较BANG组低，所需抗青光眼药物较少。
Bent Ab interno Needle Goniotomy versus Gonioscopy-Assisted Transluminal Trabeculotomy in Primary Open Angle Glaucoma: A Randomized Clinical Trial.
Prcis: Gonioscopy-Assisted Transluminal Trabeculotomy achieved a higher success rate than Bent Ab interno Needle Goniotomy in pseudophakic primary open angle glaucoma eyes at 12-months.
Purpose: To evaluate and compare efficacy and safety of standalone Bent Ab interno Needle Goniotomy (BANG) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in pseudophakic primary open angle glaucoma (POAG) eyes.
Methods: Parallel, double-arm, 1:1 ratio, single masked, single surgeon, randomized clinical trial. Uncontrolled mild to moderate pseudophakic POAG eyes, defined by visual field mean deviation, were enrolled. Antiglaucoma medication was washed-out before surgery and at 11-months. Patients were followed by 12 months. Surgical success was defined as 6≤IOP≤18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) the use of medication.
Results: Twenty-two eyes underwent BANG and 23 underwent GATT. At inclusion, mean IOPs were 21.18±2.87 mm Hg versus 19.87±2.34 mm Hg (P=0.1) under 2.41±0.9 versus 2.35±0.88 medications (P=0.71) in the BANG and GATT groups, respectively. Baseline washout IOPs were 25.55±4.9 mm Hg versus 25.43±4.98 mm Hg in the BANG and GATT groups, respectively (P=0.92). At POD330, IOPs in GATT and BANG groups were 15.62±3.29 mm Hg (-21.38%, P=0.04) and 16.95±2.82 mm Hg (-19.97%, P<0.01), respectively (P=0.16). At POD360, after washout, IOPs were 21.57±11.11 mm Hg (-15.17%, P=0.06) and 24.59±7.94 mm Hg (-3.75%, P=0.53) (P=0.31 between the groups). The mean number of medications used at POD330 was 1.1±1.55 in GATT (-53.19%, P<0.01) and 1.82±1.05 in BANG eyes (-24.48%, P=0.06) (P=0.08 between the groups). GATT eyes had higher complete (60.1% vs. 4.5%, P<0.01) and qualified success rates (64.7% vs. 22.7%, P=0.01) than BANG eyes. Transient hyphema was the most common complication following GATT (56.52%) and BANG (40.9%).
Conclusion: GATT eyes achieved higher success rates, lower mean IOPs and required less antiglaucoma medication than BANG eyes after 11-months.
期刊介绍：
The Journal of Glaucoma is a peer reviewed journal addressing the spectrum of issues affecting definition, diagnosis, and management of glaucoma and providing a forum for lively and stimulating discussion of clinical, scientific, and socioeconomic factors affecting care of glaucoma patients.
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