外路微导管引导小梁切开术联合虹膜周边切除术治疗开角型青光眼OA

·AIM:To evaluate the efficacy and safety of ab-externo microcatheter-guided 360° or 120° trabeculotomy combined with peripheral iridectomy in lowering intraocular pressure(IOP),reducing the need for antiglaucoma medications,and improving clinical outcomes in patients with open angle glaucoma(OAG). ·METHODS:This retrospective study included 55 patients with OAG who underwent the procedure in the Enshi region between October 2019 and March 2024.Follow-up examinations were conducted at 1,3,6,and 12 mo postoperatively to record IOP,best-corrected visual acuity(BCVA),use of anti-glaucoma medications,and postoperative complications.The primary outcome measures were changes in IOP before and after surgery and surgical success rates(complete success:IOP≤18 mmHg without medication;partial success:IOP≤18 mmHg with medication). ·RESULTS:The mean preoperative IOP was 26.7±4.4 mmHg.Postoperatively,the IOP showed a continuous decreasing trend at 1,3,6,and 12 mo,with all time points demonstrating a significant reduction compared with baseline(all P<0.001).At 12 mo postoperatively,the complete success rate was 62%,and the partial success rate was 38%.The use of anti-glaucoma medications was significantly reduced,with most patients maintaining target IOP without pharmacological assistance at 12 mo.No significant difference was observed in BCVA between preoperative and 12-month postoperative assessments(P=0.19).The most common postoperative complication was transient hyphema(20%),which resolved spontaneously within 1 wk,and no severe complications were observed. ·CONCLUSION:Ab-externo microcatheter-guided 360° or 120° trabeculotomy combined with peripheral iridectomy significantly lowers IOP,reduces medication dependence,and demonstrates a high safety profile,making it an effective and reliable surgical option for patients with OAG.