Goniotomy for adult refractory glaucoma after failed anti-glaucoma surgery: a 24-month prospective observation study
Year: 2026
Type: preprint
Abstract: Purpose: To evaluate the 24-month efficacy and safety of goniotomy for adult refractory glaucoma after failed incisional surgery. Methods: A prospective study was conducted involving patients with refractory glaucoma who underwent goniotomy. Study outcomes included changes in IOP, the number of anti-glaucoma medications (AGMs) , and postoperative complications over an 24-month period. Logistic regression analysis was performed to identify potential risk factors for surgical failure. Results: A total of 81 eyes from 72 patients were included. All participants had undergone at least one prior incision surgery. Following goniotomy, mean IOP significantly decreased from 23.27±5.12mmHg preoperatively to 15.70±2.78mmHg at 24 months ( P <0.001), accompanied by a reduction in AGMs use from 2.79±1.02 to 1.43±1.37 ( P <0.001). Fifteen eyes (18.52%) were classified as surgical failures, and three patients required reoperations. Higher preoperative IOP was identified as a risk factor for surgical failure ( P <0.05). Postoperative complications included hyphema in 18 eyes (22.22%) and transient IOP spike in 8 eyes (9.88%). Conclusion: Goniotomy effectively reduced IOP and the need for AGMs in refractory glaucoma after failed surgery over 24 months, suggesting it may serve as a safe and viable therapeutic option in this challenging population.
Source: Research Square
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7160102535