Safety, Efficacy, and Timing of Nd:YAG Laser Goniopuncture After Nonpenetrating Deep Sclerectomy for Glaucoma: A Retrospective Cohort Study

Division

West Florida

Hospital

Regional Medical Center Bayonet Point

Document Type

Manuscript

Publication Date

11-15-2021

Keywords

trabeculo-Descemet membrane, Yttrium aluminum garnet laser goniopuncture;, iris incarceration, nonpenetrating deep sclerectomy

Disciplines

Eye Diseases | Ophthalmology

Abstract

BACKGROUND: Neodymium-doped yttrium aluminum garnet laser goniopuncture is an adjuvant procedure for nonpenetrating deep sclerectomy. We investigated optimal laser goniopuncture timing and the effect of laser iridoplasty on success rates.

METHODS: This single-center retrospective cohort study compared intraocular pressure control in patients with early versus late laser goniopuncture after nonpenetrating deep sclerectomy and evaluated the effects of laser iridoplasty pretreatment. A 3-month cut-off was used to define early versus late laser goniopuncture. The primary outcome was the proportion of patients maintaining intraocular pressure control according to definitions of complete (no medications) and qualified (with medications) success at 15, 18, and 21 mmHg thresholds. Data were analyzed using right-censored Kaplan-Meier estimation and log-rank testing.

RESULTS: A total of 124 eyes of 124 patients were analyzed. Complete success rates after 3 years were 9.2%, 14.6%, and 23.3% for early laser goniopuncture and 21.8%, 26.0%, and 55.4% for late laser goniopuncture for 15, 18, and 21 mmHg, respectively (all

CONCLUSION: Late laser goniopuncture (3-month cut-off) was associated with better intraocular pressure control and less adverse events than early laser goniopuncture.

Publisher or Conference

European Journal of Ophthalmology

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