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

Authors

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

Published in

The British journal of ophthalmology. Sep 28, 2026. Epub Sep 28, 2026.

Abstract

To evaluate the effect of goniotomy (GT) arc size on efficacy and safety in juvenile open-angle glaucoma (JOAG).
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.
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).
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.

PMID:
42805775
Bibliographic data and abstract were imported from PubMed on 29 Sep 2026.

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