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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-03-2018 | Glaucoma

Three-year results of ab interno trabeculectomy (Trabectome): Berlin study group

Authors: Milena Pahlitzsch, Anja M. Davids, Malte Zorn, Necip Torun, Sibylle Winterhalter, Anna-Karina B. Maier, Matthias K. Klamann, Eckart Bertelmann

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 3/2018

Abstract

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.

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Title: Three-year results of ab interno trabeculectomy (Trabectome): Berlin study group
Authors: Milena Pahlitzsch
Anja M. Davids
Malte Zorn
Necip Torun
Sibylle Winterhalter
Anna-Karina B. Maier
Matthias K. Klamann
Eckart Bertelmann
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 3/2018
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-017-3882-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Three-year results of ab interno trabeculectomy (Trabectome): Berlin study group

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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