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Abstract #5917 Published in IGR 2-1
Effect of trabecular aspiration on intraocular pressure in pigment dispersion syndrome and pigmentary glaucoma
Jacobi PC; Dietlein TS; Krieglstein GKOphthalmology 2000; 107:417-421
OBJECTIVES: Recently, the authors described a new form of nonfiltering glaucoma surgery-trabecular aspiration-designed to increase trabecular outflow in pseudoexfoliation glaucoma. This study was carried out to investigate whether trabecular aspiration is equally safe and effective in the treatment of pigment dispersion syndrome (PDS) and pigmentary glaucoma (PG). STUDY DESIGN: A prospective, nonrandomized comparative trial with historical control. PARTICIPANTS: Twenty eyes of 20 patients with medically uncontrolled intraocular pressure (IOP) caused by PDS or PG were treated by trabecular aspiration. INTERVENTION: Trabecular pigment particles were cleared with a pressure of 100-200 mmHg using a specially designed aspiration probe. MAIN OUTCOME MEASURES: The IOP and number of medications before and after surgery were measured. Intraoperative and postoperative complications were analyzed. Surgical success was defined as IOP < or = 21 mmHg with no more than one topical medication. Results were compared with those previously reported with similar treatment of pseudoexfoliative glaucoma. RESULTS: Mean pretreatment IOP averaged 27.0 (standard deviation (SD) 3.3) mmHg and was significantly reduced to 23.7 (SD 3.9) mmHg at the last follow-up (20.1±8.6 months). However, the cumulative life-table success rates were only 42% and 15% at three and 12 months, respectively. Considering both groups separately, the success rates in the PDS group were 63% and 18% at three and 12 months, compared to a success rate of 12% in the PG group as early as one month after surgery. CONCLUSIONS: Eyes with PDS responded better to trabecular aspiration than did those with PG, indicating that PDS and PG are two successive stages of the same disease process. Altogether, trabecular aspiration failed to achieve long-term pressure control in either of the two groups.
Dr. P.C. Jacobi, University of Cologne, Department of Ophthalmology, Cologne, Germany
Classification:
12.20 Other (Part of: 12 Surgical treatment)
