Abstract
PURPOSE: To investigate the predictive factors for intraocular pressure (IOP) after microhook ab interno trabeculotomy (TLO). METHODS: We included 147 eyes of 97 glaucoma patients who underwent TLO. We recorded the following preoperative parameters: systemic parameters (age, height, body mass index, systolic blood pressure, diastolic blood pressure, and history of smoking), blood examination scores, ocular parameters (preoperative Goldmann applanation tonometry [GAT]-IOP, central corneal thickness, type of glaucoma, and preoperative use of anti-glaucoma eyedrops), and Ocular Response Analyzer (ORA) parameters (corneal resistance factor [CRF], corneal hysteresis, corneal-compensated intraocular pressure). We analyzed the preoperative parameters associated with postoperative GAT-IOP. Subsequently, similar analysis was performed using a corneal visualization Scheimpflug technology instrument (Corvis ST) parameters, instead of the ORA parameters. Postoperative GAT-IOP was measured after 12 months from TLO. RESULTS: When ORA parameters were used, preoperative high hemoglobin (Hb), high C-reactive protein (CRP), use of brimonidine tartrate, and high CRF were significant risk factors for postoperative high GAT-IOP, in addition to type of glaucoma. When Corvis ST parameters were used, preoperative high serum Hb, high serum CRP, usage of brimonidine tartrate, high biomechanical intraocular pressure, high stress-strain index, and low time to maximal displacement of whole eye movement were significant risk factors for postoperative high GAT-IOP. CONCLUSIONS: ORA and Corvis ST measurements suggested that stiff cornea was a risk factor for high postoperative GAT-IOP after TLO, in addition to preoperative high Hb, high CRP, and the use of brimonidine tartrate. TRANSLATIONAL RELEVANCE: Stiff cornea is a risk factor for high postoperative intraocular pressure after trabeculotomy.