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Graefe's Archive for Clinical and Experimental Ophthalmology

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28.08.2020 | Glaucoma

Long-term clinical results of trabectome surgery in patients with open-angle glaucoma

verfasst von: Yusuke Kono, Masayuki Kasahara, Kazunori Hirasawa, Tatsuhiko Tsujisawa, Shunsuke Kanayama, Kazuhiro Matsumura, Tetsuya Morita, Nobuyuki Shoji

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 11/2020

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Abstract

Purpose

To evaluate the 72-month clinical results of trabectome surgery (TOM) in patients with primary open-angle glaucoma (POAG), secondary OAG and childhood glaucoma.

Method

A total of 305 eyes from 249 glaucoma patients were analyzed in the current retrospective single-center study. Kaplan-Meier analysis was performed using three criteria: criterion A (postoperative intraocular pressure [IOP] ≤ 21 mmHg and ≥ 20% reduction from baseline IOP); criterion B (postoperative IOP ≤ 18 mmHg and ≥ 20% reduction from baseline IOP); and criterion C (postoperative IOP ≤ 16 mmHg and ≥ 20% reduction from baseline IOP). The changes in IOP, medication score, success probability, results of the multivariate analysis for success and failure risk factors, and complications were analyzed.

Results

The baseline IOP in all glaucoma patients decreased from 29.2 ± 9.8 mmHg with a 5.3 ± 1.7 medication score to 16.4 ± 5.8 mmHg (− 43.8%) with a 4.2 ± 1.5 medication score at 72 months (p < 0.01). The success probabilities in all cases for 72 months based on criterion A, B, and C were 44%, 35%, and 17%, respectively. For criterion A, no significant differences were found in the success probability according to the glaucoma subtype for 72 months. The combined surgical procedure significantly decreased the failure risk (hazard ratio [HR]: 0.59). On the other hand, the presence of POAG (HR: 1.6) and a history of past selective laser trabeculoplasty (HR: 2.2) significantly increased failure risk. One patient (0.3%) demonstrated endophthalmitis after TOM but recovered through appropriate treatment.

Conclusion

At the 72-month time point, approximately half of the glaucoma patients maintained an IOP ≤ 21 mmHg with ≥ 20% IOP reduction. TOM is a safe surgery but may not yield sufficient IOP reduction in patients who have received SLT or have POAG.

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Titel: Long-term clinical results of trabectome surgery in patients with open-angle glaucoma
verfasst von: Yusuke Kono
Masayuki Kasahara
Kazunori Hirasawa
Tatsuhiko Tsujisawa
Shunsuke Kanayama
Kazuhiro Matsumura
Tetsuya Morita
Nobuyuki Shoji
Publikationsdatum: 28.08.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 11/2020
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-020-04897-0

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Long-term clinical results of trabectome surgery in patients with open-angle glaucoma

Abstract

Purpose

Method

Results

Conclusion

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Springer Medizin

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Conclusion

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