Comparison of trabectome and microhook surgical outcomes

Background: Several methods can be applied for a trabeculotomy, including the uses of thread, a blade, cauterization, and a hook. We compared the outcomes of trabectome surgery and microhook surgery. Methods: We analyzed the cases of 133 eyes that underwent trabectome (72 eyes) or microhook (61 eyes) surgery and were followed for > 1 year. We defined failure as a < 20% reduction in the postoperative intraocular pressure (IOP) value or requiring additional glaucoma surgery. We used three surgical success definitions: ≤ 21, ≤ 18, and ≤ 15 mmHg IOP reduction. A Kaplan–Meier survival analysis was performed for the surgical outcomes. We compared the trabectome and microhook groups’ postoperative IOP values, number of glaucoma medications, and postoperative complications. Results: At 1 year postsurgery, the trabectome surgeries decreased the IOP significantly from 24.6 ± 7.3 to 13.3 ± 3.7 mmHg, and the microhook surgeries significantly decreased the IOP from 24.1 ± 9.2 to 12.5 ± 3.9 mmHg. The two groups’ 1-year postoperative IOP values were not significantly different (p = 0.310). The surgical outcomes of the trabectome surgeries were significantly better than those of the microhook surgeries (≤ 21 mmHg: p = 0.0049, ≤ 18 mmHg: p = 0.0029, and ≤ 15 mmHg: p = 0.0393). There were three patients with ciliary detachment in the microhook surgery group. Conclusions: Trabectome surgery provided significantly better surgical outcomes than microhook surgery. The risk of postoperative ciliary detachment should be considered in microhook surgery cases.