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

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

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.

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