Outcomes of bent ab interno needle goniectomy in a regional eye hospital in South Africa

Background: Bent ab interno needle goniectomy (BANG) is a novel technique for glaucoma surgery. Aim: This study aimed to evaluate the outcomes of the BANG technique. Setting: The study was conducted in Durban, South Africa. Methods: A retrospective chart review of 34 patients who underwent BANG with cataract extraction over two years was conducted. Data on demographics, preoperative antiglaucoma medications (AGMs), and intraocular pressures (IOP) were collected. Postoperative IOP and AGM counts were recorded at set intervals. Results: The IOP changes were significant only at 6 months, with a reduction from 19 mmHg to 14 mmHg (standard deviation [s.d.] 4; P = 0.024), representing a 27% decrease. A total of 93.8% of patients had IOPs of 21 mmHg or less, 87.5% had IOPs of 18 mmHg or less, and 43.8% had IOPs of 12 mmHg or less. Additionally, 43.8% of patients experienced an IOP reduction exceeding 20%. The mean AGM use dropped significantly at all visits: 0.4 at 1 week, 1.1 at 1 month, and 1.2 at 3 months (all P < 0.001). At 6 months, AGM use averaged 1.4 (s.d. 1.5; P = 0.002), a 55% reduction from the preoperative mean of 3.1. Over half (56.3%) of patients reduced AGM use by one or more, and 31.3% became drop-free. Conclusion: The BANG procedure combined with cataract extraction is an effective and cost-efficient option for managing glaucoma, particularly in resource-limited settings. Contribution: To our knowledge, this is the first study on BANG outcomes in Africa and among a majority of African patients.