{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:55:24Z","timestamp":1778504124623,"version":"3.51.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"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>Background:<\/jats:bold> Circumferential trabeculotomy have evolved from ab externo to ab interno approach. Both procedures may lower IOP, but it is unclear which maybe a superior approach.<\/jats:p><jats:p><jats:bold>Purpose:<\/jats:bold> To compare the outcomes of ab interno and ab externo circumferential trabeculotomy in patients with primary open-angle glaucoma.<\/jats:p><jats:p><jats:bold>Design:<\/jats:bold> Retrospective, comparative case series.<\/jats:p><jats:p><jats:bold>Participants:<\/jats:bold> Primary open angle glaucoma patients undergoing ab interno (40 patients in Group 1) or ab externo (54 patients in Group 2) circumferential trabeculotomy, with about one half of them having prior incisional glaucoma surgery.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Outcomes including intraocular pressure (IOP), glaucoma medications and surgical complications were analyzed.<\/jats:p><jats:p><jats:bold>Main Outcome Measures:<\/jats:bold> IOP, medications and surgical success defined as an IOP of \u2264 21 mmHg and a reduction of IOP \u226520% from baseline (criterion A) or IOP \u2264 18 mmHg and a reduction of IOP 20% from baseline (criterion B) with (qualified success) or without (complete success) medications.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> At 1 year, IOP decreased by 37.1% (26.0\u201314.8 mmHg) in Group 1 and 39.5% (28.5\u201315.1 mmHg) in Group 2. Medications decreased from 3.5 in Group 1 and 3.6 in Group 2 pre-operatively to 0.6 \u00b1 1.0 and 0.3 \u00b1 0.6 post-operatively, respectively. Success rates did not differ significantly between groups based on criterion A (complete and qualified success: 68.7 and 81.9% in Group 1, and 75.3 and 90.4% in Group 2, respectively) or criterion B (complete and qualified success: 58.2 and 79.3%in Group 1, and 69.5 and 88.4% in Group 2, respectively). For eyes with prior filtration surgeries, the mean percent reduction of IOP (41.7 \u00b1 32.7% in Group 1, 39.7 \u00b1 27.8% in Group 2, <jats:italic>P<\/jats:italic> = 0.724) and the mean medication reduction (2.9 \u00b1 1.6 in Group 1, 3.4 \u00b1 1.0 in Group 2, <jats:italic>P<\/jats:italic> = 0.454) were not significantly different.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Ab interno circumferential trabeculotomy achieved comparable outcomes to ab externo trabeculotomy and may be an effective surgical option for patients with primary open-angle glaucoma.<\/jats:p>","DOI":"10.3389\/fmed.2021.795172","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T05:23:55Z","timestamp":1639977835000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Ab Interno vs. Ab Externo Microcatheter-Assisted Circumferential Trabeculotomy in Treating Patients With Primary Open-Angle Glaucoma"],"prefix":"10.3389","volume":"8","author":[{"given":"Weijia","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiwei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Xin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huaizhou","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ningli","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/j.exer.2005.10.011","article-title":"What controls aqueous humour outflow resistance?","volume":"82","author":"Johnson","year":"2006","journal-title":"Exp Eye Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1016\/j.exer.2008.11.033","article-title":"The changing paradigm of outflow resistance generation: towards synergistic models of the JCT and inner wall endothelium","volume":"88","author":"Overby","year":"2009","journal-title":"Exp Eye Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1016\/j.jcrs.2014.06.020","article-title":"Aqueous outflow: segmental and distal flow","volume":"40","author":"Swaminathan","year":"2014","journal-title":"J Cataract Refract Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1001\/archopht.1995.01100090126034","article-title":"360 degrees trabeculotomy for primary congenital glaucoma","volume":"113","author":"Beck","year":"1995","journal-title":"Arch Ophthalmol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.jaapos.2010.07.010","article-title":"An illuminated microcatheter for 360-degree trabeculectomy in congenital glaucoma: a retrospective case series","volume":"14","author":"Sarkisian","year":"2010","journal-title":"J AAPOS"},{"key":"B6","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1016\/j.ophtha.2013.11.001","article-title":"Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: technique report and preliminary results","volume":"121","author":"Grover","year":"2014","journal-title":"Ophthalmology."},{"key":"B7","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1136\/bjo.44.6.370","article-title":"A new technique for opening the canal of Schlemm. Preliminary report","volume":"44","author":"Smith","year":"1960","journal-title":"Br J Ophthalmol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/IJG.0b013e318218240c","article-title":"Reduction of intraocular pressure using a modified 360-degree suture trabeculotomy technique in primary and secondary open-angle glaucoma: a pilot study","volume":"21","author":"Chin","year":"2012","journal-title":"J Glaucoma"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1016\/j.jcrs.2016.08.016","article-title":"Modified 360-degree suture trabeculotomy combined with phacoemulsification and intraocular lens implantation for glaucoma and coexisting cataract","volume":"42","author":"Shinmei","year":"2016","journal-title":"J Cataract Refract Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1016\/j.ajo.2010.11.028","article-title":"Success rates of trabeculotomy for steroid-induced glaucoma: a comparative, multicenter, retrospective cohort study","volume":"151","author":"Iwao","year":"2011","journal-title":"Am J Ophthalmol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1097\/IJG.0b013e31829484df","article-title":"Illuminated microcatheter-facilitated 360-degree trabeculotomy for refractory aphakic and juvenile open-angle glaucoma","volume":"23","author":"Dao","year":"2014","journal-title":"J Glaucoma"},{"key":"B12","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.ajo.2017.06.004","article-title":"randomized trial on illuminated-microcatheter circumferential trabeculotomy versus conventional trabeculotomy in congenital glaucoma","volume":"180","author":"Shakrawal","year":"2017","journal-title":"Am J Ophthalmol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.jaapos.2012.05.013","article-title":"Goniotomy versus circumferential trabeculotomy with an illuminated microcatheter in congenital glaucoma","volume":"16","author":"Girkin","year":"2012","journal-title":"J AAPOS"},{"key":"B14","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.ajo.2014.12.001","article-title":"Illuminated microcatheter circumferential trabeculotomy versus combined trabeculotomy-trabeculectomy for primary congenital glaucoma: a randomized controlled trial","volume":"159","author":"Temkar","year":"2015","journal-title":"Am J Ophthalmol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1007\/s00417-015-2955-9","article-title":"Exit strategies in canaloplasty: intraoperative conversion into 180-degree trabeculotomy or 360-degree trabeculotomy in cases of unsuccessful catheterisation of Schlemm's canal: influence of degree of canal cleavage","volume":"253","author":"Alnahrawy","year":"2015","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"100733","DOI":"10.1016\/j.ajoc.2020.100733","article-title":"Gonioscopy-assisted transluminal trabeculotomy using an illuminated catheter for infantile primary congenital glaucoma. Case series","volume":"19","author":"Lehmann-Clarke","year":"2020","journal-title":"Am J Ophthalmol Case Rep"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1111\/ceo.13868","article-title":"Ab interno vs ab externo microcatheter-assisted trabeculotomy for primary congenital glaucoma with clear cornea","volume":"48","author":"Shi","year":"2020","journal-title":"Clin Exp Ophthalmol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1136\/bjophthalmol-2014-306269","article-title":"Gonioscopy assisted transluminal trabeculotomy: an ab interno circumferential trabeculotomy for the treatment of primary congenital glaucoma and juvenile open angle glaucoma","volume":"99","author":"Grover","year":"2015","journal-title":"Br J Ophthalmol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"63","DOI":"10.2147\/OPTH.S75739","article-title":"Prospective, noncomparative, nonrandomized case study of short-term outcomes of 360 degrees suture trabeculotomy ab interno in patients with open-angle glaucoma","volume":"9","author":"Sato","year":"2015","journal-title":"Clin Ophthalmol"},{"key":"B20","doi-asserted-by":"publisher","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":"Grover","year":"2017","journal-title":"J Glaucoma"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1097\/IJG.0000000000000802","article-title":"Surgical outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with open-angle glaucoma","volume":"26","author":"Rahmatnejad","year":"2017","journal-title":"J Glaucoma"},{"key":"B22","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1097\/IJG.0000000000001331","article-title":"Surgical outcomes of prolene gonioscopy-assisted transluminal trabeculotomy in patients with moderate to advanced open-angle glaucoma","volume":"28","author":"Aktas","year":"2019","journal-title":"J Glaucoma"},{"key":"B23","doi-asserted-by":"publisher","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":"Grover","year":"2018","journal-title":"J Glaucoma"},{"key":"B24","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1136\/bjophthalmol-2020-315954","article-title":"Outcomes of gonioscopy-assisted transluminal trabeculotomy in pseudoexfoliative glaucoma: 24-month follow-up","volume":"105","author":"Sharkawi","year":"2020","journal-title":"Br J Ophthalmol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1097\/IJG.0000000000001627","article-title":"Comparison of ab externo and ab interno 360-degree suture trabeculotomy in adult open-angle glaucoma","volume":"29","author":"Yalinbas","year":"2020","journal-title":"J Glaucoma"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1136\/bjophthalmol-2015-307880","article-title":"Microcatheter-assisted trabeculotomy versus rigid probe trabeculotomy in childhood glaucoma","volume":"100","author":"Shi","year":"2016","journal-title":"Br J Ophthalmol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e713","DOI":"10.1111\/aos.13414","article-title":"Two-year results of microcatheter-assisted trabeculotomy in paediatric glaucoma: a randomized controlled study","volume":"95","author":"El Sayed","year":"2017","journal-title":"Acta Ophthalmol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1001\/archopht.118.9.1251","article-title":"Schlemm's canal becomes smaller after successful filtration surgery","volume":"118","author":"Johnson","year":"2000","journal-title":"Arch Ophthalmol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.ogla.2020.02.002","article-title":"Risk factors for complications and failure after gonioscopy-assisted transluminal trabeculotomy in a young cohort","volume":"3","author":"Chen","year":"2020","journal-title":"Ophthalmol Glaucoma"},{"key":"B30","doi-asserted-by":"publisher","first-page":"00527","DOI":"10.1016\/j.ajo.2021.10.009","article-title":"A prospective study of intraocular pressure spike and failure after gonioscopy-assisted transluminal trabeculotomy in juvenile open angle glaucoma","author":"Shi","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1038\/s41433-019-0375-5","article-title":"Transient ciliochoroidal detachment after 360-degree suture trabeculotomy ab interno for open-angle glaucoma: 12-month follow-up","volume":"33","author":"Sato","year":"2019","journal-title":"Eye"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.795172\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T05:23:57Z","timestamp":1639977837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.795172\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,20]]},"references-count":31,"alternative-id":["10.3389\/fmed.2021.795172"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2021.795172","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,20]]},"article-number":"795172"}}