Influence of goniotomy incisional arc size on its efficacy and safety in juvenile open-angle glaucoma: a prospective multicentre study

Purpose To evaluate the effect of goniotomy (GT) arc size on efficacy and safety in juvenile open-angle glaucoma (JOAG). Methods This prospective, comparative, multicentre study enrolled 98 patients (126 eyes) with JOAG from 19 Chinese institutions. Patients who underwent GT were categorised into three groups based on the arc size of the incision: (1) 120° GT, (2) 240° GT and (3) 360° GT. Outcomes included intraocular pressure (IOP), surgical success rates, medication use and complications. Success was defined as postoperative IOP ≤21 mm Hg without (complete) or with (qualified) medications. Results Mean patient age was 22.9±8.7 years. At 12 months postoperatively, complete success rates were comparable between the 240° GT (55.3%) and the 360° GT (64.7%) (p=0.447), and both were superior to the 120° GT (13.3%) (both p<0.001). Qualified success rates in the 120° GT, 240° GT and 360° GT groups were 80.0%, 93.6% and 91.2%, respectively, with no statistically significant difference (p=0.302). The 360° group required fewer medications than the other two groups at 6 months (both p<0.001), with no difference at 12 months (p=0.234). Hyphema was the most common complication, occurring more frequently in the 360° group (64.7%) than in the 240° (34.0%) and 120° (31.1%) groups (p=0.003). Conclusions 240° GT and 360° GT demonstrated comparable efficacy, both superior to 120° GT. 240° GT showed similar observed efficacy to 360° GT, along with procedural simplicity, fewer complications and no consumable use for JOAG; these findings warrant validation in randomised studies.

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Journal
British Journal of Ophthalmology
Published
2026-09-28
DOI
https://doi.org/10.1136/bjo-2026-330493
Primary Topic
Glaucoma and retinal disorders
Type
article
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article

Influence of goniotomy incisional arc size on its efficacy and safety in juvenile open-angle glaucoma: a prospective multicentre study

Xiaoyi Liu, Yihan Liu, Liming Tao, Lin Xie et al.
British Journal of Ophthalmology
Glaucoma and retinal disorders
article

Influence of goniotomy incisional arc size on its efficacy and safety in juvenile open-angle glaucoma: a prospective multicentre study

Xiaoyi Liu, Yihan Liu, Liming Tao, Lin Xie, Xiaojing Pan, Aiguo Lv, Yunhe Song, 党光福, Robert Weinreb, Xiulan Zhang, 韩树梅, Jinkun Liu, Kaiming LI, Fengbin Lin, Chukai Huang, Xiangxiang Ye, Liu Sujv, Yongjun Qi, Yiting Zhang, Zige Fang, Yan Wang, Hongyang Zhang, Yuhong Wang, Qingshu Ge, Yuhan Feng, Yangfan Yang, Peijie Lin, Peng Lü, Fei Li, Xiao Yang, Dilimulati Xiaokaiti, Jingming Shi, Gong Chen, Zhixuan Wang, Guihua Xu, Zefeng Yang, Li Tan, Jiangang Xu, Liuzhi Zeng, Kai Zou, Xiaomin Zhu, Mingying Lai, Jing Ren, Heting Liu, Sujie Fan, Yi Jiang, Ling Jin, Pusheng Wang
article en

Abstract

Purpose To evaluate the effect of goniotomy (GT) arc size on efficacy and safety in juvenile open-angle glaucoma (JOAG). Methods This prospective, comparative, multicentre study enrolled 98 patients (126 eyes) with JOAG from 19 Chinese institutions. Patients who underwent GT were categorised into three groups based on the arc size of the incision: (1) 120° GT, (2) 240° GT and (3) 360° GT. Outcomes included intraocular pressure (IOP), surgical success rates, medication use and complications. Success was defined as postoperative IOP ≤21 mm Hg without (complete) or with (qualified) medications. Results Mean patient age was 22.9±8.7 years. At 12 months postoperatively, complete success rates were comparable between the 240° GT (55.3%) and the 360° GT (64.7%) (p=0.447), and both were superior to the 120° GT (13.3%) (both p<0.001). Qualified success rates in the 120° GT, 240° GT and 360° GT groups were 80.0%, 93.6% and 91.2%, respectively, with no statistically significant difference (p=0.302). The 360° group required fewer medications than the other two groups at 6 months (both p<0.001), with no difference at 12 months (p=0.234). Hyphema was the most common complication, occurring more frequently in the 360° group (64.7%) than in the 240° (34.0%) and 120° (31.1%) groups (p=0.003). Conclusions 240° GT and 360° GT demonstrated comparable efficacy, both superior to 120° GT. 240° GT showed similar observed efficacy to 360° GT, along with procedural simplicity, fewer complications and no consumable use for JOAG; these findings warrant validation in randomised studies.

British Journal of Ophthalmology
Sun Yat-sen University (CN), Jinan University (CN), Chinese University of Hong Kong (HK), Xiamen University (CN), Grantham Hospital (CN), Shantou University (CN), Ya'an Polytechnic College (CN), Nanfang Hospital (CN), Ningxia Hui Autonomous Region Peoples Hospital (CN), Guangdong Provincial Hospital of Traditional Chinese Medicine (CN), Lanzhou University Second Hospital (CN), Han Dan City Eye Hospital - The Third Hospital of Handan (CN), Henan Provincial People's Hospital (CN), Huizhou Central People's Hospital (CN), Second Affiliated Hospital of Anhui Medical University (CN), Shandong Provincial QianFoShan Hospital (CN), Second Xiangya Hospital of Central South University (CN), Henan Provincial Eye Hospital (CN), Shandong Eye Hospital (CN), Shandong First Medical University (CN), State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Joint Shantou International Eye Center (CN), Southern Medical University (CN), Lanzhou University (CN), Chongqing Medical University (CN)
Openalex Percentile: Top 9%
Glaucoma and retinal disorders
DOISourceOpenAlex
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