Surgical effects of combined trabeculotomy and sinusotomy compared to trabeculotomy alone

Purpose: To elucidate long-term surgical results and problems of combined t rabeculotomy and sinusotomy in comparison with trabeculotomy alone. Methods: The study included 91 glaucomatous eyes in 57 patients with primar y open angle glaucoma, who underwent either combined trabeculotomy and sinu sotomy (40 eyes) or trabeculotomy alone (51 eyes). The mean follow-up perio d (+/-standard deviation) was 46.1 +/- 10.4 months (range: 30 to 60 months) . Results: At the final examination, in 37 (93%) of the 40 eyes after combine d trabeculotomy and sinusotomy and in 40 (78%) of the 51 eyes after trabecu lotomy alone, intraocular pressures were well controlled. The mean intraocu lar pressures at the end of the first postoperative year were 15.6 +/- 3.0 mmHg in the 40 eyes after the combined procedure, and 17,8 +/- 3,1 mmHg in the 51 eyes after trabeculotomy alone (p = 0.0001, unpaired t-test), Compli cations included Descemet's membrane detachment in 1 eye (3%) and 4 eyes (8 %), and transient elevation of intraocular pressure to higher than 30 mmHg (IOP spike) in 6 eyes (15%) and 11 eyes (22%), respectively, after the comb ined procedure and trabeculotomy alone. Conclusion: Combined trabeculotomy and sinusotomy is a useful surgical moda lity for the treatment of primary open angle glaucoma to obtain lower intra ocular pressure levels than those after trabeculotomy alone.