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 ≥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, ≤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±11.8 mm Hg at baseline to 10.6±2.6 mm Hg at 2 years in study group, and 29.2±11.4 mm Hg to 11.0±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.
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 ≥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, ≤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±11.8 mm Hg at baseline to 10.6±2.6 mm Hg at 2 years in study group, and 29.2±11.4 mm Hg to 11.0±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.
Authors: Randolf A Widder; Sven Dinslage; André Rosentreter; Jens F Jordan; Pia Kühnrich; Claus Cursiefen; Klaus-Dieter Lemmen; Thomas S Dietlein Journal: Graefes Arch Clin Exp Ophthalmol Date: 2014-09-12 Impact factor: 3.117
Authors: Hamed Esfandiari; Priyal Shah; Pooya Torkian; Ian P Conner; Joel S Schuman; Kiana Hassanpour; Nils A Loewen Journal: Graefes Arch Clin Exp Ophthalmol Date: 2018-09-26 Impact factor: 3.117
Authors: Jens F Jordan; Thomas Wecker; Christian van Oterendorp; Alexandra Anton; Thomas Reinhard; Daniel Boehringer; Matthias Neuburger Journal: Graefes Arch Clin Exp Ophthalmol Date: 2013-10-26 Impact factor: 3.117