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Purpose <p>To evaluate the short-term effectiveness of laser goniopuncture (LGP) after deep sclerectomy (DS) in reducing intraocular pressure (IOP) in patients with open-angle glaucoma (OAG).</p> Patients and methods <p>This prospective pilot interventional case series included 16&#xa0;eyes of 16&#xa0;patients with primary OAG who had undergone DS but failed to achieve the target IOP. Laser goniopuncture was performed using an Nd: YAG laser. Patients were followed up for 3&#xa0;months with examinations at 1&#xa0;day, 1&#xa0;week, 1&#xa0;month, and 3&#xa0;months post-laser. Primary outcomes included the mean IOP, absolute and relative success rates, and failure rates, as well as the proportion of patients achieving a ≥ 30% IOP reduction. Secondary outcomes included the proportion of patients not requiring IOP-lowering medication, changes in visual acuity (VA, logMAR), and ultrasound biomicroscopy (UBM) of filtering bleb height. Pre- and posttreatment IOP was compared using paired <i>t</i>&#xa0;tests or Wilcoxon signed-rank tests as appropriate.</p> Results <p>Mean IOP decreased significantly from 26.69 mm Hg pre-laser to 12.31 mm Hg at 1&#xa0;day (<i>p</i> &lt; 0.001) and remained stable through 3&#xa0;months. The success rate remained high (85–95%), and 87.5% of eyes achieved an IOP reduction of 30% or more. The proportion of patients not requiring IOP-lowering medication increased from 0% before laser treatment to 93.8% at 1&#xa0;month and was maintained at 3&#xa0;months. Although a&#xa0;statistically significant change in VA (logMAR) was observed, this change represented an increase in logMAR values, indicating worsening of VA rather than functional improvement, and should therefore be interpreted with caution. The UBM showed a&#xa0;significant increase in filtering bleb height that correlated with IOP reduction. Only one patient (6.2%) developed mild hyphema, which resolved spontaneously.</p> Conclusion <p>Laser goniopuncture is an effective and safe adjunctive procedure after DS for achieving short-term IOP control in OAG, reducing the need for medication without serious complications. However, this pilot study is limited by its small sample size, lack of a&#xa0;control group, and short follow-up; longer-term studies are required to assess sustained efficacy.</p>

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Evaluation of laser goniopuncture after deep sclerectomy in open-angle glaucoma: a pilot case series with short-term results

  • 期刊论文

  • 发表日期：

    2026年2月27日

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  • Tran Ngoc Hung,
  • Nguyen Le Trung,
  • Vu Anh Tuan

摘要

Purpose

To evaluate the short-term effectiveness of laser goniopuncture (LGP) after deep sclerectomy (DS) in reducing intraocular pressure (IOP) in patients with open-angle glaucoma (OAG).

Patients and methods

This prospective pilot interventional case series included 16 eyes of 16 patients with primary OAG who had undergone DS but failed to achieve the target IOP. Laser goniopuncture was performed using an Nd: YAG laser. Patients were followed up for 3 months with examinations at 1 day, 1 week, 1 month, and 3 months post-laser. Primary outcomes included the mean IOP, absolute and relative success rates, and failure rates, as well as the proportion of patients achieving a ≥ 30% IOP reduction. Secondary outcomes included the proportion of patients not requiring IOP-lowering medication, changes in visual acuity (VA, logMAR), and ultrasound biomicroscopy (UBM) of filtering bleb height. Pre- and posttreatment IOP was compared using paired t tests or Wilcoxon signed-rank tests as appropriate.

Results

Mean IOP decreased significantly from 26.69 mm Hg pre-laser to 12.31 mm Hg at 1 day (p < 0.001) and remained stable through 3 months. The success rate remained high (85–95%), and 87.5% of eyes achieved an IOP reduction of 30% or more. The proportion of patients not requiring IOP-lowering medication increased from 0% before laser treatment to 93.8% at 1 month and was maintained at 3 months. Although a statistically significant change in VA (logMAR) was observed, this change represented an increase in logMAR values, indicating worsening of VA rather than functional improvement, and should therefore be interpreted with caution. The UBM showed a significant increase in filtering bleb height that correlated with IOP reduction. Only one patient (6.2%) developed mild hyphema, which resolved spontaneously.

Conclusion

Laser goniopuncture is an effective and safe adjunctive procedure after DS for achieving short-term IOP control in OAG, reducing the need for medication without serious complications. However, this pilot study is limited by its small sample size, lack of a control group, and short follow-up; longer-term studies are required to assess sustained efficacy.