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Abstract #47094 Published in IGR 13-3
A comparative study of trabeculectomy and the new clear-cornea filtering procedure, intrastromal diathermal keratostomy (IDK)
Bach-Holm D; Storr-Paulsen A; Norregaard JCActa Ophthalmologica 2011;
Purpose: For the first time to compare the 1-year success rates of trabeculectomy and the new clear-cornea filtering procedure, intrastromal diathermal keratostomy (IDK). Methods: Prospective clinical observational study including 99 consecutively operated eyes (69 patients) with well-established primary open-angle glaucoma referred for filtering operation. We compared the change in intraocular pressure (IOP), number of anti-glaucomatous medication, complications and reoperations after 1year. Seventy-four eyes were operated with trabeculectomy, and 25 with IDK. Complete success was defined as IOP (less-than or equal to)18mmHg, IOP lowered (greater-than or equal to)30%, no medication and no reoperation. Qualified success was defined as IOP (less-than or equal to)18mmHg, and IOP lowered (greater-than or equal to)30% with or without medication or reoperation. Results: Intraocular pressure pre- and postoperatively in the trabeculectomy group was 25.3 and 14.1mmHg versus 23.8 and 15.8mmHgin the IDK group. The number of medications pre- and postoperatively in the trabeculectomy group was 3.1 and 0.5 versus 3.2 and 1.3 in the IDK group. Forty-four (59%) of the eyes in the trabeculectomy group met the complete success criteria compared with 5 (20%) in the IDK group (p<0.01). Sixty-eight (92%) in the trabeculectomy group and 16 (64%) in the IDK fulfilled the qualified success criteria (p<0.01). Conclusion: Both the complete and qualified 1-year success rates of IDK are significantly lower compared with the success rates of trabeculectomy. The IDK does not reduce the IOP as much as the procedure of trabeculectomy, and it carries a higher frequency of reoperations and more medication postoperatively. Thus, our prospective data do not support the procedure of IDK as 'the gold standard' for filtering surgery in patients with open-angle glaucoma.
D. Bach-Holm. Department of Ophthalmology, University Hospital of Copenhagen, Nordre Fasanvej 57, 2000 Frederiksbe, .
Classification:
12.8.5 Other (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
13.2.1 IOP (Part of: 13 Therapeutic prognosis and outcome > 13.2 Outcome)
