線維柱帯切開術ab interno法とTrabectome®の短期治療成績の比較

Comparison of short-term outcome of trabeculotomy ab interno and Trabectome®

要約　目的：線維柱帯切開術ab interno法（以下，iSLOT）とTrabectome^®（以下，TOM）の術後3か月までの短期成績の比較検討。

対象と方法：対象は，広義開放隅角緑内障に両手術を施行し，3か月以上経過観察した196眼（TOM 141眼，iSLOT 55眼）。評価項目は，術前因子（病型，年齢，投薬スコア，眼圧，角膜内皮細胞密度），術中術後因子（白内障同時手術，線維柱帯切開範囲，前房出血量，一過性高眼圧，角膜内皮細胞密度，眼圧）。

結果：平均年齢70.5±10.8歳。術前と術後3か月眼圧はTOMが24.9±7.8，15.0±3.7，iSLOTが30.2±9.6，13.8±4.4で，iSLOTのほうが術後3か月の眼圧は有意に低く，前房出血スコアは高く，一過性高眼圧は少なかった。

結論：iSLOTはTOMより術後3か月での眼圧下降効果は高い。

Abstract　Purpose: To report short-term clinical outcome of suture trabeculotomy ab interno（iSLOT）and Trabectome^®（TOM）for open angle glaucoma.

Patients and Methods: One hundred ninety six eyes with open angle glaucoma who underwent iSLOT or TOM were reviewed. The parameters investigated were glaucoma type, age, preoperative intraocular pressure（IOP）, glaucoma medications, corneal endothelial cell density, postoperative IOP at 1 and 3 months, hyphema score at 1 day, IOP spike elevation within 1 week, and corneal endothelial cell density at 3 months.

Results: The mean IOP was reduced from a baseline of 24.9±7.8 mmHg in TOM group and 30.2±9.6 mmHg in iSLOT group to 15.0±3.7 mmHg and 13.8±4.4 mmHg at 3 months postoperatively, respectively. There was a statistically significant difference in IOP at 3 months postoperatively between the groups. Hyphema score was significantly higher in iSLOT group, and an IOP spike occurred more frequently in TOM group than in iSLOT group.

Conclusion: Treatment of open angle glaucoma using iSLOT may yield better short-term outcome than TOM.