ArticleFrontiers in ophthalmology2026
Adjunctive ab-interno goniotomy in chronic angle-closure glaucoma: a retrospective proof-of-concept pilot study using doubly robust learning.
Article in Frontiers in ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: To assess whether an anterior segment optical coherence tomography (AS-OCT)-informed causal framework could estimate the added benefit of adjunctive ab-interno goniotomy during phacoemulsification with goniosynechialysis (Phaco-GSL) in chronic angle-closure glaucoma (CACG). Design: Retrospective single-center comparative cohort pilot study. Methods: In a single-center development cohort of 102 eyes, 54 underwent phacoemulsification with goniosynechialysis alone and 48 underwent adjunctive ab-interno goniotomy. Marginal treatment effects were estimated using stabilized inverse probability of treatment weighting (IPTW) and augmented inverse probability weighting (AIPW). Medication-free complete success was defined as intraocular pressure (IOP) 5-18 mmHg with at least 20% reduction from baseline without IOP-lowering medications or additional glaucoma surgery; qualified success used the same IOP criteria with or without medications. Qualified failure was defined as loss of qualified success or need for additional glaucoma surgery. Time to qualified failure through 24 months was analyzed using stabilized IPTW-weighted Kaplan-Meier curves and weighted Cox models. Predicted individualized benefit estimates for 24-month medication-free complete success were derived from baseline clinical and AS-OCT features using a doubly robust learner with ridge regularization and 5-fold cross-fitting. Results: Adjunctive goniotomy was associated with higher 24-month qualified-failure-free survival under stabilized IPTW adjustment (0.682 vs 0.425; weighted hazard ratio 0.475, 95% CI 0.257-0.880; p=0.018). Doubly robust estimates favored adjunctive goniotomy for 24-month medication-free complete success (risk difference 0.291; 95% CI 0.105-0.478) and qualified success (risk difference 0.233; 95% CI 0.064-0.403). Adjusted mean IOP differences were modest, whereas medication-free complete success and medication burden showed more apparent separation. Hyphema occurred numerically more often with adjunctive goniotomy. Predicted individualized benefit estimates (model-predicted absolute probability differences) were variable and were not interpreted as clinically actionable recommendations. Conclusions: Adjunctive goniotomy was associated with more favorable 24-month surgical control in this retrospective pilot cohort. Imaging-informed doubly robust learning may support future studies of treatment-effect heterogeneity, but the current predicted individualized benefit estimates require external validation before clinical use.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.