Aqueous Angiography-Guided Bent Ab Interno Needle Goniectomy in High Versus Low Aqueous Humor Outflow Regions in Primary Open Angle Glaucoma: A Pilot Randomized Controlled Trial
Abstract
Précis: Trabecular cutting minimally invasive glaucoma surgery like bent ab interno needle goniectomy (BANG) when performed in baseline aqueous angiography identified low aqueous humor outflow regions, results in greater success of intraocular pressure reduction.
Purpose: To study the efficacy of bent ab interno needle goniectomy (BANG) in high versus low aqueous humor outflow (AHO) regions as determined by aqueous angiography (AA) in patients with primary open angle glaucoma (POAG).
Methods: A prospective, single-centre, pilot, randomized control trial recruited 30 eyes of 30 patients of POAG and visually significant cataract (45-80 y) and were randomised into 2 groups ("A": BANG performed in the high-flow regions and "B": BANG performed in the low-flow regions) of 15 each. AA was performed using indocyanine green dye (0.1%) to identify baseline high-flow and low-flow regions of the AHO pathways followed by BANG in these respective regions as per randomisation. Preoperative and postoperative data on IOP, number of antiglaucoma medications (AGMs), and any complications were noted over 6 months. Overall success was defined as achieving an IOP ≤15 and ≥6 mm Hg at 6 months of follow-up with AGMs (qualified success) or without AGMs (complete success).
Results: AA revealed high-flow regions of AHO pathways in the nasal quadrant and low-flow regions of AHO pathways in the temporal quadrant in all 30 patients. Both groups had comparable demographic composition [group A age:…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 30 participants or records.
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