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26.09.2018 | Glaucoma | Ausgabe 2/2019

Graefe's Archive for Clinical and Experimental Ophthalmology 2/2019

Five-year clinical outcomes of combined phacoemulsification and trabectome surgery at a single glaucoma center

Zeitschrift:
Graefe's Archive for Clinical and Experimental Ophthalmology > Ausgabe 2/2019
Autoren:
Hamed Esfandiari, Priyal Shah, Pooya Torkian, Ian P. Conner, Joel S. Schuman, Kiana Hassanpour, Nils A. Loewen

Abstract

Purpose

To analyze the 5-year results of trabectome ab interno trabeculectomy of a single glaucoma center.

Method

In this retrospective interventional single-center case series, data of 93 patients undergoing ab interno trabeculotomy between September 2010, and December 2012 were included. Kaplan-Meier analysis was performed using success criteria defined as postoperative intraocular pressure (IOP) ≤ 21 mmHg, and > 20% reduction from preoperative IOP, and no need for further glaucoma surgery. Risk factors for failure were identified using Cox proportional hazards ratio (HR).

Results

The retention rate for 5-year follow-up was 66%. The cumulative probability of success at 1, 2, 3, 4, and 5 years was 82.6%, 76.7%, 73.9%, 72.3%, and 67.5%. Risk factors for failure were lower baseline IOP (HR = 0.27, P = 0.001), younger age (HR = 0.25, P = 0.02), and higher central corneal thickness (HR = 0.18, P = 0.01). Exfoliative glaucoma was associated with a higher success rate (HR = 0.39, P = 0.02). IOP was decreased significantly from 20.0 ± 5.6 mmHg at baseline to 15.6 ± 4.6 mmHg at 5-year follow-up (P = 0.001). The baseline number of glaucoma medications was 1.8 ± 1.2, which decreased to 1.0 ± 1.2 medications at 5 years.

Conclusion

Trabectome surgery was associated with a good long-term efficacy and safety profile in this single-center case series with a high retention rate.

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