Goniocurettage as First Choice of Surgical Treatment in Chronic Open-Angle Glaucoma: Outcomes and Complications

Federal University of Minas Gerais32 enrolled

Overview

The study has the purpose to evaluate the effectiveness and safety of the goniocurettage as a first choice of surgical treatment for primary open-angle glaucoma (POAG) in patients with good vision.

A prospective study in 33 eyes (32 patients) with uncontrolled open angle glaucoma under clinical treatment. The trabecular tissue was scraped away from the angle (goniocurettage) in about 100 degrees by means of an instrument similar to a microchalazion curette. The goniocurettage was done under direct visualization of the angle through a gonioscopy lens (Swan-Jacob) and a surgical microscope. Using the 17.0 SPSS software the investigators compared the intraocular pressure, the numbers of antiglaucomatous medications, the best correct visual acuity, the development of cataract, the central corneal thickness,the impact on the visual field, the impact on the optic nerve head and the central corneal endothelial cell density before and after the goniocurettage, and the intra and post operative complications.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Open-Angle Glaucoma Surgery

Interventions

GoniocurettagePROCEDURE

Ab interno surgery consisting on scraped away the trabecular tissue from the angle (goniocurettage) removing segments of pathologically altered trabecular meshwork from the scleral sulcus

Eligibility

Sex: ALLMin age: 40 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Disc and/or visual field findings consistent with Primary Open Angle Glaucoma * Uncontrolled intraocular pressure (≥21 mm Hg) or progressive glaucomatous neuropathy despite maximum tolerated medical therapy * 40 years old or over * Visual acuity higher than 0.2 * Open angles (greater or equal to Shaffer grade II) Exclusion Criteria: * Previous ocular surgery * History of glaucoma laser treatment * History of ocular trauma * Cyclodestructive procedures * Corneal edema or opacities * Endothelial decompensation * History of uveitis * Secondary glaucoma * neovascularization of the iris or angle * Congenital anterior segment abnormalities * Anatomically confusing angles without clear definition of the scleral spur or meshwork and inability to maintain follow-up

Locations (1)

Federal University of Minas Gerais

Belo Horizonte, Minas Gerais, Brazil

Outcomes

Primary Outcomes

Intra Ocular Pressure

The mean of at least three measures at 8:00 am two weeks before surgery. After intervention, the Intra Ocular Pressure was measured on the day after, one week after, two weeks after and every month at the same time until the end of the study (an expected average of 20 months).

Time frame: Change from Baseline in Intra Ocular Pressure at 20 months

Secondary Outcomes

Central Corneal Thickness

Time frame: Two weeks before, six months after and one year after intervention

Central corneal endothelial cell density

Time frame: Two weeks before, six months after intervention and one year after intervention

Best correct visual acuity

Time frame: Two weeks before, six months after and one year after intervention

Data from ClinicalTrials.gov

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