Real-world efficacy of the intrascleral ciliary sulcus suprachoroidal microtube technique in Black and Afro-Latinx patients with glaucoma: a 1-year retrospective study

Abstract

Background: Suprachoroidal surgery can lower intraocular pressure and medication use. There is currently no commercial suprachoroidal product on the market. Here, we report our 1 year results of a novel ciliary sulcus suprachoroidal microtube technique. Purpose: To determine the real-world efficacy of intrascleral ciliary sulcus suprachoroidal microtube technique in Black and Afro-Latinx patients with glaucoma refractory to topical ocular hypertensive medications. Methods: A retrospective non-comparative single center study of 36 Black and Afro-Latinx patients with glaucoma and pseudophakia who underwent intrascleral ciliary sulcus suprachoroidal microtube surgery for glaucoma as a stand-alone procedure at a single practice. Investigated parameters were number of medications, visual acuity (VA), intraocular pressure (IOP), mean deviation on visual field (VF) test. Success was defined as (a) IOP ⩽ 15 mmHg and or ⩾ 20% reduction in IOP and (b) a reduction in number of medications. We used paired t-test to compare baseline and follow-up parameters. Results: We reviewed a total of 36 patients who had undergone the procedure. Twenty had success with 12-month follow-up in the study. The mean number of medications decreased significantly from 4.2 ± 1.0 preoperatively to 2.4 ± 1.7 in 12 months ( p = 0.021) with five patients being medication free. In addition, the IOP decreased significantly from 21 ± 8.2 to 13.5 ± 4.4 mmHg ( p = 0.032). In the 20 patients who had 12-month follow-up, the VA remained stable from Log Mar 0.62 ± 0.6–0.46 ± 0.6 ( p = 0.052). VF in patients with successful procedure (no further interventions) remained stable from baseline mean deviation of –16.53 ± 10.04 to –16.82 ± 9.80 dB at 6–12 months. Adverse effects were transient and included IOP spike, hypotony, hyphema, and cornea edema that were treated and resolved. Conclusions: This 12-month retrospective study demonstrated that intrascleral ciliary sulcus suprachoroidal microtube surgery can reduce IOP and medication burden in pseudophakic patients with glaucoma. However, despite several successes, surveillance should take place for IOP spikes, possible tube obstruction, and need for additional glaucoma surgery.