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Abstract #112035 Published in IGR 24-3
Tube Versus Trabeculectomy IRIS Registry Study: 1-Year Secondary Treatment Outcomes
Sun CQ; McSoley MJ; Lum F; Chang TC; Gedde SJ; Vanner EAAmerican Journal of Ophthalmology 2023; 256: 97-107
PURPOSE: To describe 1-year secondary outcomes in the Tube Versus Trabeculectomy IRIS® (Intelligent Registry In Sight) Registry Study (TVT), and to compare to the TVT randomized controlled trial (TVT). DESIGN: TVT was a retrospective cohort study. METHODS: The 2013-2017 IRIS Registry was used to identify eyes that received a tube shunt (tube) or trabeculectomy after a previous trabeculectomy and/or cataract surgery and had 1 year of follow-up. The TVT compared a Baerveldt 350-mm glaucoma implant to trabeculectomy in similar eyes. RESULTS: In the TVT cohort, the tube (n = 236, 56.3%) and trabeculectomy (n = 183, 43.7%) groups had similar and significant reductions in intraocular pressure (IOP) from baseline to 1 year. In the tube group, IOP (mean ± SD) decreased from 26.6 ± 6.5 mm Hg at baseline to 14.3 ± 4.8 mm Hg at 1 year. In the trabeculectomy group, IOP decreased from 25.3 ± 6.4 mm Hg at baseline to 13.5 ± 5.2 mm Hg at 1 year. The trabeculectomy groups from both studies had similar 1-year IOP reduction (P = .18), although the TVT cohort used fewer medications at all time points (P < .01). There were more pronounced differences in the mean IOP and medications between the tube groups in the 2 studies, presumably due to the inclusion of valved tubes in TVT. More reoperations occurred in TVT. CONCLUSIONS: The TVT tube and trabeculectomy groups had comparable 1-year IOP reduction, although trabeculectomy eyes used fewer glaucoma medications. The trabeculectomy group in TVT and TVT had similar IOP and medication reduction at 1 year. Randomized controlled trials and electronic health record data both provide invaluable insight into surgical outcomes.
From the Bascom Palmer Eye Institute (C.Q.S., M.J.M., T.C.C., S.J.G., E.A.V.), Miami, Florida, USA; Department of Ophthalmology (C.Q.S.), University of California, San Francisco, California, USA; F.I. Proctor Foundation (C.Q.S.), University of California, San Francisco, California, USA. Electronic address: Catherine.sun@ucsf.edu.
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