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Abstract #28101 Published in IGR 13-1
Effect of a failed trabectome on subsequent trabeculectomy
Jea SY; Mosaed S; Vold SD; Rhee DJJournal of Glaucoma 2011; Epub ahead of print
See also comment(s) by Brian Francis •
PURPOSE: To determine the effect of a failed trabectome on the outcomes of a subsequent trabeculectomy. PATIENTS AND METHODS: A cohort study of eyes that underwent trabeculectomy after a failed trabectome procedure (study) compared with eyes that underwent trabeculectomy as an initial surgical procedure (control). Inclusion criteria were open-angle glaucoma, age (greater-than or equal to)18 years, and uncontrolled glaucoma with maximally tolerated medical therapy. Exclusion criteria were concurrent surgery and follow-up less than 6 months. Outcome measures were intraocular pressure (IOP), success rate, and occurrence of complications. Failure was the occurrence of additional glaucoma surgery, loss of light perception vision, or IOP >21 mm Hg, (less-than or equal to)5 mm Hg, or <20% reduction below baseline on 2 consecutive follow-up visits after 1 month. RESULTS: Mean follow-up was 15.4 months and 18.6 months for study (n=34) and control (n=42) groups, respectively. IOP decreased from 27.6(plus or minus)11.8 mm Hg at baseline to 10.6(plus or minus)2.6 mm Hg at 2 years in study group, and 29.2(plus or minus)11.4 mm Hg to 11.0(plus or minus)5.4 mm Hg in the control group. The success rates at 2 years were 60.2% and 55.5% in the study and control groups, respectively (P=0.895). Systemic hypertension [P=0.009; adjusted hazard ratio, 4.03; 95% confidence interval, 1.41-11.53] and number of the preoperative antiglaucoma medications (P=0.005; 2.29; 1.28 to 4.11) were significant risk factors for failure in the multivariate analysis. Failed trabectome was not associated with trabeculectomy failure (P=0.899). Postoperative complications were similar. CONCLUSIONS: A failed trabectome did not affect the success rate of a subsequent trabeculectomy.
S. Y. Jea.
Classification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
