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International Ophthalmology
Published in: International Ophthalmology 11/2019

01-11-2019 | Glaucoma | Original Paper

Comparing the efficacy of trabeculectomy and diode laser cyclophotocoagulation in primary open-angle glaucoma

Authors: Somar Hasan, Theresa Theilig, Jan Darius Unterlauft

Published in: International Ophthalmology | Issue 11/2019

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Abstract

Purpose

The aim was to compare the postsurgical outcomes of trabeculectomy (TET) and transscleral cyclophotocoagulation (CPC) in a similar cohort of eyes diagnosed with primary open-angle glaucoma (POAG).

Materials and methods

For this monocentric non-randomized retrospective comparative trial, the records of eyes which underwent TET or CPC between 2013 and 2016 at our institution for the treatment of POAG were reviewed. Parameters analyzed before surgery as well as 1 and 2–3 years afterwards were visual acuity (VA), intraocular pressure (IOP), mean defect (MD) of the visual field, number of glaucoma medications and the objective refraction using which the surgically induced astigmatism (SIA) was calculated.

Results

In total, 51 eyes of 51 patients underwent TET and 45 eyes of 45 patients underwent CPC. Mean VA dropped in both groups on the last follow-up after surgery (TET-group: 0.17 ± 0.17 to 0.23 ± 0.28 logMAR, p = 0.01/CPC-group: 0.22 ± 0.22 to 0.26 ± 0.27 logMAR, p = 0.01). In the TET- and CPC-groups IOP decreased significantly (TET: 24.9 ± 6.4 to 14.9 ± 3.1 mmHg, p = 0.001/CPC: 23.0 ± 6.5 to 16.0 ± 4.1 mmHg, p = 0.001) although more pronounced and less depending on IOP-lowering medication in eyes after TET. MD remained stable after TET (7.4 ± 4.8 and 8.1 ± 4.9 dB, p = 0.1) but further deteriorated in eyes after CPC (9.0 ± 4.9 and 10.7 ± 4.6 dB, p < 0.001). SIA was comparable in both groups on the last follow-up (TET: 0.83 ± 0.69 D; CPC: 0.91 ± 0.65 D, p = 0.6).

Conclusion

The IOP reduction achieved without medication was more pronounced in the TET-group compared with the CPC-group. Visual field remained stable in the TET-group, while further deteriorating in the CPC-group during follow-up. Eyes undergoing CPC had a higher demand for additional medication to reach comparable success rates as TET. Due to this performing TET is favorable over CPC in POAG eyes.
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Metadata
Title
Comparing the efficacy of trabeculectomy and diode laser cyclophotocoagulation in primary open-angle glaucoma
Authors
Somar Hasan
Theresa Theilig
Jan Darius Unterlauft
Publication date
01-11-2019
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 11/2019
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-019-01093-w

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