The second one had iris incarceration following late goniopuncture. During postgoniopuncture follow-up visit, distortion of pupil and IOP increase was noticed and the eye did not respond to topical drops and was reoperated.
Nd:YAG laser goniopuncture was performed in 14 (36.6%) eyes, suture lysis in 13 (34%), and needling in 9 (24%) of the operated eyes.
(a) Complications Phacocanaloplasty Phaco-deep P value (N = 37) %/n sclerectomy (N = 38) %/n Hypotony < 7 d 35% (13) 34% (13) 0.933 Hypotony > 30 days 13% (5) 8% (3) 0.431 Flare in anterior 8% (3) 3% (1) 0.291 chamber (AC) Choroidal effusion 5% (2) 0 0.146 Bleb fibrosis 0 24% (9) 0.002 Hyphema 46% (17) 0 0.001 Erythrocytes in AC 27% (10) 0 0.001 (b) Additional procedures Phacocanaloplasty Phaco-deep P value %/(n) sclerectomy %/(n) 5-FU subconjunctival 0 95% (36) 0.001 injections 3.75/person Suture lysis 0 34% (13) 0.001 Goniopuncture 22% (8) 37% (14) 0.295 Needling 0 24% (9) 0.001 TABLE 5: NEI VFQ-25 scores; P value based on Mann-Whitney U test.
If the IOP remains high after three to four weeks, a YAG laser goniopuncture should be considered before the addition of topical medical treatment.
In these cases, if a YAG laser goniopuncture fails to lower IOP and medical therapy is not sufficient or is poorly tolerated, a trabeculectomy can be a reasonable choice.
No cases needed YAG laser goniopuncture or ab interno revision.
Total number of cases that required YAG laser goniopuncture along the 48 months follow-up was 5 cases.
When the postoperative IOP level was unsatisfactory (either >21 mmHg or there was a progression in the mean deviation of the visual field defect), an intervention in the form of YAG laser goniopuncture, needling, or ab interno revision was resorted to.
The authors preferred ab interno revision under vision and subconjunctival 5 fluorouracil injections over YAG laser goniopuncture because in many cases the trabeculo-Descemet's membrane could not be easily visualized besides the unfamiliarity of this technique to us.
There were three cases of goniopuncture
performed due to the IOP elevation above 25 mmHg.
in the treatment of short-term post-trabectome intraocular pressure elevation: a retrospective case series study," Journal of Glaucoma, 2012.