Outcomes Of Bent Needle Ab Interno Goniectomy In Moderate To Severe Open Angle Glaucoma Eyes
Published 2023 - 41st Congress of the ESCRS
Reference: FP16.08 | Type: Free paper | DOI: 10.82333/fq14-8p92
Authors: Anand Naik Bukke* 1 , Saurabh Verma 1 , Karthikeyan Mahalingam 1 , Tanuj Dada 1 , Namrata Sharma 1
1Dr Rajendra Prasad Centre for Ophthalmic Sciences,All India Institute of Medical Sciences,New Delhi,India
Purpose
To assess the safety and efficacy of bent ab interno needle goniectomy (BANG) in moderate to severe primary open angle glaucoma patients, who were undergoing phacoemulsification for visually significant cataract.
Setting
Prospective interventional study
Methods
This study was conducted at tertiary care hospital in primary open angle glaucoma eyes with medically uncontrolled IOP with visually significant cataract, treated by single surgeon between November 2021- December 2022. A 26gauge needle was used to excise 30° of Trabecular meshwork using intraoperative gonioscopy in all patients before performing capsulorhexis during cataract surgery. The pre and post operative IOP and number of antiglaucoma medications, intraoperative complications were documented. These patients were followed up at 1 day, 1 week, 3,6- and 12-months post operatively. The repeated ANOVA test was used to compare preoperative and 6 months and 12 months postoperative data. P value <0.05 was considered statistically significant.
Results
Forty-six eyes of 42 patients were operated for BANG with VCDR 0.85:1. Preoperative mean IOP and number of antiglaucoma medication (AGM) was 22.4 ±6.1 mm of Hg and 3.73 ±1.13 respectively. 40 of 46 (87%) eyes at 6-month postoperative period with mean IOP was significantly reduced to 12.5 ±2.4 mm of Hg(p =0.001) on 2.78 ±1.1(p =0.000) topical AGMs, while 24of 46 (52%)eyes at 12months postoperative follow up meanIOP was 12 ±1.3 mm of Hg (p < 0.0001) on 2.96 ±1.2 (p =0.001) topical AGMs. 27of 40 eyes(68%) at 6months and 20 of 24 eyes(83%) of eyes at 12months achieved ≤12 mm of Hg(Qualified success). Reduction in ≥1 AGMs postoperatively at 6 and 12months was 70%(28/40) and 66%(16/24) of eyes respectively. filtration surgery required in 2 eyes.
Conclusions
A 30-degree BANG using a 26 G Needle is a safe and cost effective MIGS for developing countries with favourable IOP outcomes Upto 1 year. However, majority of patients require medication to achieve low target IOP.