{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:00:32Z","timestamp":1753891232567,"version":"3.41.2"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T00:00:00Z","timestamp":1630627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> We aimed to evaluate the safety and clinical efficacy of <jats:italic>ab externo<\/jats:italic> microcatheter-assisted trabeculotomy combined with deep sclerectomy and trabeculectomy (MATT-DS-Trab) in the surgical management of advanced primary open-angle glaucoma (POAG).<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> According to the inclusion criteria, we retrospectively collected and analyzed 37 POAG cases in advanced stage who received MATT-DS-Trab. The intraocular pressure (IOP), best corrected visual acuity (BCVA), use of anti-glaucoma drugs, shape of the filtering bleb, size of the scleral lake, complications, and the surgical success rate were recorded.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The mean IOP was 37.50 \u00b1 8.11 mmHg before the operation, while it depleted to 10.08 \u00b1 2.01 and 11.43 \u00b1 2.07 mmHg at 1 week and 12 months after the operation, respectively (both <jats:italic>P<\/jats:italic> &amp;lt; 0.001 compared to preoperative IOP). From none to two kinds of anti-glaucoma drugs were used 12 months after surgery on the patients, which were significantly reduced compared with that preoperatively (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). An L-type filtering bleb was the main form at all time points after the operation. At 12 months following surgery, an F-type filtering bleb accounted for 5.41% and no E-type filtering bleb was recorded. The length and height of the scleral lake shrunk with time, but there was no statistical significance (<jats:italic>P<\/jats:italic> &amp;gt; 0.05). Also, there was no correlation between the size of the scleral pool and the IOP (<jats:italic>P<\/jats:italic> &amp;gt; 0.05). At 12 months after the operation, the complete success rates were 94.59, 83.78, and 72.97% according to standards A (\u226418 mmHg), B (\u226415 mmHg), and C (\u226412 mmHg), respectively. Intraoperative complications were mainly anterior chamber hemorrhage, and no complications related to the filtration bleb were observed after the operation.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Based on multichannel mechanisms, MATT-DS-Trab is able to effectively reduce IOP in advanced POAG patients, with few serious complications and a high success rate.<\/jats:p>","DOI":"10.3389\/fmed.2021.712332","type":"journal-article","created":{"date-parts":[[2021,9,4]],"date-time":"2021-09-04T08:04:00Z","timestamp":1630742640000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year 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