Review of results from the Tube Versus Trabeculectomy Study.
Gedde S, Anderson D, Budenz D, Del Calvo M, DePool I, Fantes F, Greenfield D, Hochberg J, Hodapp E, Lee R, Marcellino A, Palmberg P, Parrish R 2nd, Herndon L, Challa P, Santiago-Turla C, WuDunn D, Emerick G, Heuer D, Kent A, Bradham C, Langdale L, Barton K, Amalfitano F, Rai P, Sidoti P, Gedal A, Luayon J, Ovase R, Tai K, Nguyen Q, Miller N, Shields S, Anderson K, Moya F, Brandt J, Lim M, Sponzo M, Sherwood M, Burke R, Skuta G, Jobson J, Ogilbee L, Reynolds A, Sarkisian S, Varma R, Francis B, Walonker F, Feldman R, Baker L, Bell N, Carranza J, Espinoza A, Prum B, Beall J, Perkins T, Kaufman P, Perkins T, Soderling B, Feuer W, Londono L, Schiffman J, Shi W, Chen P, Feuer W, Schiffman J, Singh K, Spaeth G, Wright M, Barton K, Brandt J, Emerick G, Feldman R, Gedde S, Herndon L, Heuer D, Kent A, Nguyen Q, Parrish R 2nd, Perkins T, Prum B, Sherwood M, Shields S, Sidoti P, Skuta G, Varma R, WuDunn D, Gedde S, Heuer D, Parrish R 2nd.
Source
Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA. sgedde@med.miami.edu
Abstract
PURPOSE OF REVIEW:
The Tube Versus Trabeculectomy (TVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube-shunt surgery to trabeculectomy with mitomycin (MMC) in eyes with previous cataract and/or unsuccessful glaucoma surgery. This article reviews published results from the TVT Study.
RECENT FINDINGS:
Tube-shunt surgery had a higher success rate than trabeculectomy with MMC during the first 3 years of follow-up. Trabeculectomy with MMC produced greater intraocular pressure (IOP) reduction in the early postoperative period compared with tube-shunt placement, but similar IOPs were observed after 3 months. Tube-shunt surgery was associated with greater use of adjunctive-medical therapy than trabeculectomy with MMC during the first 2 years of the study, but no difference in medication use was seen at 3 years. The incidence of postoperative complications was higher after trabeculectomy with MMC compared with tube-shunt surgery, but serious complications associated with vision loss and/or reoperation developed with similar frequency after both surgical procedures. No difference in the rate of vision loss was present following trabeculectomy with MMC and tube-shunt surgery after 3 years of follow-up. Cataract progression was common, but occurred with similar frequency with both procedures.
SUMMARY:
Intermediate-term results of the TVT Study support the expanded use of tube shunts beyond refractory glaucomas. Tube-shunt surgery is an appropriate surgical option in patients who have undergone prior cataract and/or unsuccessful filtering surgery.
- PMID:
- 20040872
- [PubMed - indexed for MEDLINE]
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