{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:50:17Z","timestamp":1790661017750,"version":"4.1.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>To evaluate structural alterations and healing responses in the trabecular meshwork region with optical coherence tomography (AS-OCT) following after gonioscopy assisted transluminal trabeculotomy (GATT) and microincisional trabeculectomy (MIT).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>73 eyes of 67 patients (M:F = 45:22) with \u22656 months of follow-up after MIT (n = 41) or GATT (n = 32) with or without combined cataract surgery were included for this prospective study. The angle as seen on AS-OCT at 1, 3, 6 months after surgery were evaluated for structural alterations like peripheral anterior synechiae (PAS), hyphema, and hyperreflective scarring responses. The scarring was graded according to the linear extent measured from the centre of the trabecular meshwork (TM) gutter to the sclera\/cornea as mild (&lt;250\u03bc), moderate (250\u2013500\u03bc), and severe(\u02c3500\u03bc), while the pattern of scarring was graded as open saucer\/gutter, closed gutter, and trench pattern. The association of the need for medication or surgical outcome and clinical variables and AS-OCT parameters including the pattern and severity of scarring were analysed using multivariate regression.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>All eyes achieved significant reduction of IOP and number of medications with a final IOP of 15\u00b13.2mm Hg at a mean follow-up of 8\u00b132. months. While mild scarring was seen more common in MIT, severe scarring was seen in &gt;65% of GATT eyes compared to 31% of MIT eye, p&lt;0.001. An open saucer was equally seen in MIT and GATT while the trench pattern was more commonly seen in GATT eyes (&gt;50%). Severe scarring in a trench pattern seemed to predict the need for medications for IOP control, though they independently did not seem to influence the final IOP or surgical outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>A severe form of scarring in a trench pattern on AS-OCT predicted the need for glaucoma medications after MIGS surgery. Regular monitoring of the scarring responses by AS-OCT and clinical examination are necessary to identify those at need for medications after MIGS.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0305740","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T18:41:10Z","timestamp":1719513670000},"page":"e0305740","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Healing responses at the angle after micro-invasive glaucoma surgery-an AS-OCT study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-8740","authenticated-orcid":true,"given":"Aparna","family":"Rao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujoy","family":"Mukherjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"pone.0305740.ref001","doi-asserted-by":"crossref","first-page":"e0183142","DOI":"10.1371\/journal.pone.0183142","article-title":"Minimally-invasive glaucoma surgeries (MIGS) for open angle glaucoma: A systematic review and meta-analysis.","volume":"12","author":"C Lavia","year":"2017","journal-title":"PLoS One"},{"key":"pone.0305740.ref002","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1001\/jamaophthalmol.2021.2351","article-title":"Minimally Invasive Glaucoma Surgical Techniques for Open-Angle Glaucoma","volume":"139","author":"AK Bicket","year":"2021","journal-title":"JAMA Ophthalmol"},{"key":"pone.0305740.ref003","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/IIO.0000000000000192","article-title":"Surgical Innovations in Glaucoma: The Transition From Trabeculectomy to MIGS.","volume":"57","author":"J Chou","year":"2017","journal-title":"Int Ophthalmol Clin."},{"key":"pone.0305740.ref004","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1080\/08820538.2021.1903513","article-title":"Microinvasive Glaucoma Surgery","volume":"36","author":"FA Birnbaum","year":"2021","journal-title":"An Evidence-Based Review. Semin Ophthalmol"},{"key":"pone.0305740.ref005","doi-asserted-by":"crossref","first-page":"e0286020","DOI":"10.1371\/journal.pone.0286020","article-title":"Microincisional trabeculectomy for glaucoma","volume":"18","author":"A Rao","year":"2023","journal-title":"PLoS One"},{"key":"pone.0305740.ref006","doi-asserted-by":"crossref","first-page":"e0293212","DOI":"10.1371\/journal.pone.0293212","article-title":"Intraoperative predictors for clinical outcomes after microinvasive glaucoma surgery","volume":"18","author":"A Rao","year":"2023","journal-title":"PLoS One"},{"key":"pone.0305740.ref007","doi-asserted-by":"crossref","first-page":"313","DOI":"10.2147\/OPTH.S397816","article-title":"Causes of Immediate and Early IOP Spikes After Circumferential Gonioscopy-Assisted Transluminal Trabeculotomy Using ASOCT.","volume":"17","author":"A Rao","year":"2023","journal-title":"Clinical Ophthalmology"},{"key":"pone.0305740.ref008","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/IJG.0000000000000564","article-title":"Outcomes of Gonioscopy-assisted Transluminal Trabeculotomy (GATT) in Eyes With Prior Incisional Glaucoma Surgery.","volume":"26","author":"DS Grover","year":"2017","journal-title":"J Glaucoma"},{"key":"pone.0305740.ref009","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/IJG.0000000000000956","article-title":"Gonioscopy-assisted Transluminal Trabeculotomy: An Ab Interno Circumferential Trabeculotomy: 24 Months Follow-up","volume":"27","author":"DS Grover","year":"2018","journal-title":"J Glaucoma"},{"key":"pone.0305740.ref010","first-page":"855","article-title":"Gonioscopy-Assisted Transluminal Trabeculotomy","volume":"121","author":"DS Grover","year":"2014","journal-title":"Ab Interno Trabeculotomy. 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