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Abstract #75639 Published in IGR 19-2
Three-year results of ab interno trabeculectomy (Trabectome): Berlin study group
Pahlitzsch M; Davids AM; Zorn M; Torun N; Winterhalter S; Maier AB; Klamann MK; Bertelmann EGraefe's Archive for Clinical and Experimental Ophthalmology 2018; 256: 611-619
PURPOSE: To assess the long-term outcome of Trabectome surgery in the treatment of primary open angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEX): 3-year results. METHODS: Trabectome surgery (NeoMedix, Tustin, CA, USA) was performed in 268 POAG patients (women 57.46%, men 42.54%, age 72.35 ± 9.63 years) and 98 PEX glaucoma patients (women 58.16%, men 41.84%, age 73.42 ± 8.54 years), and uncontrolled intraocular pressure (IOP). Parameters were examined preoperatively, 1 day, 6 weeks, 3, 6, 12, 24 and 36 months post surgery. Kaplan-Meier analysis was performed using Criteria A (IOP ≤ 21 mmHg or ≥20% reduction from preoperative IOP), Criteria B (IOP ≤ 18 mmHg or ≥20% IOP reduction), Criteria C (IOP ≤ 21 mmHg, with or without medication) and D (IOP ≤ 18 mmHg, with or without medication). Complete success was defined as IOP ≤ 21 mmHg (Criteria E) and IOP ≤ 18 mmHg without medication (Criteria F). RESULTS: IOP was reduced from 19.10 ± 4.11 mmHg to 14.27 ± 2.93 mmHg (p < 0.001) and glaucoma medication was decreased from 2.40±0.92 to 1.77±1.00 (p < 0.001) in POAG after 36 months. In PEX, IOP decreased from 22.49±9.40 mmHg to 14.57±5.05 mmHg after 36 months (p < 0.001). Medications dropped from 2.31±1.02 to 1.75±0.91 (p = 0.006). Kaplan-Meier analysis showed a success rate of 80.5% for POAG and 80.8% for PEX using criteria A (p = 0.933) and 62.4% for POAG and 73.7% for PEX using criteria B (p = 0.147) at 36 months postoperatively. Complete success showed a low survival rate (criteria E-13.5% in POAG and 7.9% in PEX, p = 0.070 and criteria F-12.8% in POAG and 5.9% in PEX, p = 0.083). CONCLUSIONS: Trabectome is a safe method to lower IOP in patients with POAG and PEX glaucoma in the long-term period. It is beneficial to inform patients prior to surgery about adjuvant glaucoma medication after the surgery.
Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, 13353, Berlin, Germany. milena.pahlitzsch@charite.de.
Full articleClassification:
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
